Friday, 20 February 2015

Dissociation as a response to trauma

Whether one has suffered the trauma of abuse or the more cumulative low key trauma of rejection or poor parental attachment, dissociation is often the result. If the dissociation is very severe it may interfere with the person being able to inhabit their body and 'depersonalistion' is the term used. Whatever the diagnosis (and there are many in the latest psychiatrists' diagnostic manual the DSM-V), I aim to look at it as a survival technique rather than an illness. In therapy I am keen to help clients understand it as a clever way that the mind has devised of keeping them safe. This approach rather than being locked into inhabiting your diagnosis (I am dissociated, I have dissociative identity disorder DID) has the benefit of empowering the person rather than allowing them the sink into passivity..

People with this condition may well have always struggled with being social in larger groups and found that they retreated into their own quiet world to survive. Of course social anxiety is common, even among those of us who consider ourselves mentally well it is quite a stressful thing - it's just that most of us are clever at hiding it! For trauma sufferers it is completely intolerable. They cannot even work up the courage to walk into a room where there are large numbers of people...

The sad things is that with this degree of dissociation, the sufferer does not feel real in their body, and their interactions with others are superficial. One client told me the only reason she could come and see me is that I look like a 'cardboard cut-out' to her so she doesn't really believe I'm real either. I felt inclined to show her I have three dimensions and am as real as the chair she is sitting on but she doesn't believe that is real either so you can see that the perception of reality is altered and makes functioning extremely difficult.

However, it is important to feed back to these clients that the problem is in their perception, not the reality.. the reality is that their body still notices everything that happens to them, and responds to it. But they are simply not aware, the disconnection is between the sensation (and the feelings that these engender - usually fear) and the interpretation by the brain (meaning - e.g I am in danger). I always stress that the disconnection they feel is ultimately a safety valve for the feelings that have simply become intolerable. Particularly when the feelings are ones of rejection and humiliation (shame) from those who are meant to love you, those feelings are simply unacceptable and are disconnected from the mindbody completely.

So, when you understand the dissociation as a symptom of your experience (usually sensitised early in childhood to rejection and shame) and how then you have interpreted things, the labels no longer matter so much. They are just defences your mindbody has erected. They can be dismantled but very, very gently. This degree of spiritual disconnection from your own body cannot be solved easily.

The usual approaches to trauma, like EFT and EMDR are difficult to apply as the person is asked to concentrate on their feelings as a precursor to both techniques which is almost impossible for them. So, although I do use these, I have to allow the person to gain confidence in trusting their own body not to betray them first by
  • psychoeducation
  • bodywork
  • pendulation
One of the techqniques I have found especially useful in the beginning is applied kinesiology - it has a huge following in chiropractic circles where it is used as a sort of communication system with your subconscious. I find that very interesting but, more appropriate for dissociation disorders is learning to use it psychologically. Check out these two videos; in order they are Bruce Lipton;
and Rob Williams.. They are a 2-lecture series on 'The biology and psychology of perception'. I hope you find they inspire you as they did me. Both men are respected in their individual fields, Bruce in particular is a cell biologist so nothing flaky there.. his book The Biology of Belief is required reading for anyone interested in the mindbody link.

Finally, its worth noting the more naturopathic interpretation of this is that you have a deficiency of spleen energy - apparently there is a link between the spleen and rejection. See
It may be a little too 'woo-woo' for some who reject the notion of meridians, but its written by Alison Adams who is a highly qualified UK dentist and now naturopath. Her website is full of nuggets of information. I am constantly amazed by how many conventionally trained doctors and other clinicians are finding truth and answers in the more esoteric fields of 'alternative' health.

Monday, 2 February 2015

The ups and the downs of ageing and selfhood

Having had a strange few days of highs and lows I have been pondering the nature of ageing and what it means to inhabit our bodies. My mother had some sort of heart arrhythmia a couple of weeks ago and has had a pacemaker fitted. I went to visit her for the first time yesterday (having not been well enough really to visit at the risk of passing on whatever flu bug I had).  My mum is 81 and has previously been a healthy and active person, working one day a week in the local PDSA charity shop and visiting my brother every Saturday on the bus. I fear that may have come to an end.

She collapsed while having her hair done at the hairdressers, she doesn't remember passing out, she only knows she woke up in an ambulance. She was out for approximately 10 mins and they were worried they wouldn't be able to rouse her. She was then taken to hospital for assessment and endured what sounds like a typical A&E experience in this country, where she was left hooked up to a ECG machine on a trolley for 8 hours while they waited for a bed. She says all she had with her was her handbag and they had put her in a gown but not given her a blanket or drink until she begged the nurses saying how cold and thirsty she was. She says they looked annoyed when she asked (which mirrors my experience - they are all under such tremendous pressure with not enough staff that the basic kindnesses go out the window).

She had her pacemaker fitted the next day in what seems like a miracle procedure - local anaesthetic and inserted through the artery under her arm. She was discharged after 2 days and now has care from 2 lovely ladies who come morning and evening to help her dress. She seemed well enough when I saw her but she shows signs of having lost a lot of weight, she has lost the use of her left arm (which is her dominant hand) so is severely restricted in cooking and dressing. I was a little surprised by how quickly she has become 'old' and passive. She is scared of using the microwave in case it interferes with the device; the booklet she was given says she is not to get within 6 inches of microwaves or hairdryers so, my Mum being ever cautious, she goes out the room completely when the microwave is on and hasn't washed or dried her hair yet, preferring to use dry shampoo. She seems convinced that she can't use her arm, even though the advice was just to not to lift it above her head for a few weeks.

Nothing I say can convince her, she waits for the consultant appointment this week to tell her whether she can have her hair washed, risk walking, etc. Women of my mother's generation (and class I guess) are in awe of their doctors and their word is God. Anyway it was a mixture of relief (that she has survived with her humour intact) and exasperation that I attempted to help and be a good daughter. I did her hair for her. It was a strange but oddly healing experience. We've never had the greatest relationship but I am slowly building it, as she ages and I find more compassion in my heart for her strengths (famously dotty, genial and good natured) and try hard to ignore her weaknesses (lack of empathy for those closest to her, judgemental at times).

And in that reflection of course is the fact that, as I approach 51 (this week!!), I feel, well, surprisingly young in comparison! I had gone to visit feeling quite down about my approaching birthday but seeing her passivity and helplessness, I realise I am not there yet and still have a lot of living to do. We are all ageing and we are quite terrified if we're honest but as I continue to work with my clients and learn so much through the work we do together I realise that our fears are universal and very, very human.

I had a dispiriting Saturday exhibiting at a Wellbeing day where I sat, ignored for the most part, as people who read cards or palms, sold crystals or even, gasp, make-up were well attended. Working on your emotional health just isn't that high up the agenda for most people. They'd much rather have a foot-rub! Can't say I don't understand that but I kept feeling that wellness is so one-dimensional if all it means is attending to the physical needs of the body.. I mean I love massage, (and I do it for goodness sake) so I'm not denying the importance but I SO believe in this stuff that I do and I get such great results when people are able to release their subconscious fears and beliefs that I can't understand why everyone doesn't get this excited. :)

I did have one 'client' on the day - she was another therapist who was interested in trying a taster session of EFT as she'd heard of it but she couldn't think what we could work on as she'd 'sorted everything previously with other therapies'. I asked her 'is there anything troubling you?'. She said 'well only this nagging back pain' so we decided to work on that. Now, I use Faster EFT with a few extra touches of my own from my training in trauma and hypnotherapy, and it's quite a quick and incisive tool. In fact within minutes I had my poor lady in tears as she reconciled the fact of not loving or forgiving herself for stuff that happened to her in childhood. I had not expected to go so deep so quickly but then I am not in control of what comes up. All I can do is take the person into their own resourcefulness to counteract the pain and move them in and out of that experience very gently - what we call 'pendulation'.  I hold the space and trust that their brain/mind will allow them to move through it. A feeling of safety is paramount and must be created beforehand.

I watched her face all the way throughout - the facial muscles and expressions are intimately connected with our emotions - via the vagal nerve - and are very instructive. Her face suddenly looked very scared and childlike. as we worked through what had come up and gradually defused the emotional charge, the adult began to creep back in. At the end of what had been perhaps 20 mins she asked me what I saw and I told her. She said it was very odd because that day she had grabbed a crystal to take with her (I don't know much about them myself but she was obviously convinced that their energy helps her); the one she had grabbed was for 'the inner child' apparently.

As we drew to a close and I asked her how she felt she said 'my back pain is gone' and looked astonished. This is no longer a surprise to me as it used to be. I now know that emotional stuckness can be expressed in bodily pain and it seems clear from the work I've done that the pain will often shift, or move or change its character in response to clearance of these old emotional memories. She walked away feeling and looking quite different. I don't know if she'll venture to come back and see me for a longer session - I can't control that but I know I did good work with her and I felt that my purpose for going that day had been realised. I then wondered as I looked at the young women handing out free lipstick whether they could say the same.