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.

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.

Book writing news

Started my book-writing course  (today) and although the title isn't fixed yet (something to do with Healing past trauma; how unresolved emotions undermine your health).. I've written some chapter headings and nearly 10,000 words. Of course since the first part of the book is my story (illustrating how even a 'normal' childhood can impact the adult experience of life), it's been reasonably easy to write (who can't write about themselves!). The next few chapters will use case studies to detail the myriad ways in which blocked emotions or trauma (even mild events can be traumatic to a sensitised person) can cause many chronic illnesses such as chronic fatigue, anxiety, and numbing. Finally I'll be looking at ways in which you can release these to live a more healthy, satisfying life.

Writing is always self-exposing but particularly when you are writing about your own experience and it has caused me some trepidation as many of the people I am writing about are still alive (my mother for instance). However, it's not a blame-game'. I'm very careful not to get into that with either my clients or myself. The point is; your experience is your experience - it's no-one's fault and the point of healing it is not to divert responsibility to someone else i.e 'it's their fault I ended up this way'. This is, instead, an honest account of how childhood events impact upon the adult by virtue of imprinting in the emotional brain (limbic system and brainstem). I think it's a fascinating area and explains why so many people have intractable pain and distress which does not respond to talk therapies (the origin of these emotions are pre-verbal memories which don't have a narrative).  For instance when I had my tonsils out at age 7 or 8, the idea then was that parents did not stay with you overnight. They just left you there. The experience was extremely frightening for me as my parents in their wisdom didn't tell me till the day they dropped me off, AND, it was the first time I had ever been away from home without them. Hospitals have never been my favourite places (I get a weird anxious feeling in them) and now I know why.

I am boosted in my understanding by a new book hot off the press by Bessel Van der Kolk; 'The Body Keeps the Score'. What a great title. Honestly, it's almost the book I wanted to write although based on his clinical experience which is far greater than mine (he is a trauma specialist in NY). I can't recommend it highly enough if you are interested in this field as I am. it was released in 2014 so bang up to date.

Anyhow, the writing process is ongoing, the main thing is how to publish and in what format - digital or print? lots to learn so an exciting time. Of course I'm not sure anyone will want to read it, but hey, I am determine to be positive. You don't know til you try. Happy 2015 everyone.

Dental troubles

What a few weeks it's been.
What should have been a simple dental  restoration (a crown on a back molar) has turned into a major trauma...

After having my last upper molar on the left (UL6 for those geeks who really want to know) crowned a few weeks ago my life has been absolutely altered by excruciating muscle spasms in my neck and head, my sleep disrupted with tinnitus, buzzing and a horrible taste in my mouth ever present.

This first appeared after the temporary crown was fitted (plastic) but got much worse when the permanent (porcelain/metal) crown was put on.I thought at first I was rejecting the metal (I am highly metal sensitive - I can't wear earrings for instance). But after subsequent investigations by an osteopath, and 2 trips back to the dentist it appears to be more about misalignment of the teeth. If the bite is not meeting properly (malocclusion) then this appear to set all the bones of the cranium and jaw off. Then the muscles strain to bring everything back into alignment and if they can't do it they are in permanent strain which makes them spasm.

It seems this is all much worse if you grind your teeth at night (which apparently I do) - I have TMJ (temporomandibular joint) syndrome. I never realised this until now but waking up 2-3 times in the night with my mouth open and pain in my neck I realise that is what is happening. It appears that the jaw is grinding to try to realign the bite (which with natural teeth would happen as you would grind down any that are high). With a porcelain crown it is so hard that no amount of grinding will do that so it's a never ending cycle of pain and grinding. So you get pain transferring down the neck to the shoulders and up to the top of the head. I've had sinus infections, headaches and terrible neck pain and clunking. I can't believe such a tiny thing can cause so much pain.

I am about to go and get it readjusted again (the dentist gets you to bite and sees where it is not meeting properly then he grinds it down with a drill). This will be my second time. It's not fun, and it's been an absolute nightmare overall.. I would say to anyone considering a crown - check first if you have problems with TMJ syndrome) as you may need extra work before and after the treatment from an osteopath or craniosacral practitioner. I finally found some mention of why this might be on a great website that talks about the link between the teeth and the body.  It helped explain to me why everything felt so 'off' and I felt so ill.

oddly though it has been an incredible learning experience - particularly as it brought back memories of being young and having so much dental surgery where I was anaethetised and had my tonsils and adenoids taken out. I swear I had one night where I relieved this surgery - like a waking dream. I think my mind was trying to exorcise the trauma of that event.. I had visions of people leaning over me - just shadows really and a dread fear. I know night-time is the worst for fear and worry but this was a different experience altogether. Quite out of body.

I will update when I have had another adjustment. I hope it is better..

Polyvagal theory and Trauma formation. How unresolved emotion can cause the freeze response

Am currently finalising my presentation for the Chrysalis Effect Practitioner Forum on Monday evening; my presentation is on Trauma formation and the Freeze Response (based on the work of Peter Levine) which I see as key to why people get stuck with conditions such as chronic pain and fatigue, CFS, ME, etc. I will be outlining:

*Role of the subconscious (limbic system) in dictating behaviour. The evolutionary triune brain.

*Trauma and unresolved emotion as 'landscapers' of the brain via the limbic system

*Beyond fight and flight; Polyvagal theory and the freeze response*

*Solutions to unlocking the freeze response; the psychosensory therapies; EFT, EMDR and havening

*POTS – Postural Tachycardia Syndrome - a red herring?

The event will be recorded so will be available on my website www.alchemytherapies.co.uk as soon as I have it. I will be sending out a newsletter with the link to my mailing list - subscribe now for my free e-book while you wait!
And if you want to know what you can do about this then see my other blogs on EMDR http://patriciaworby.blogspot.com/2013/11/emdr.html
and EFT.

A letter to Jenni Murray (BBC presenter of Woman's Hour)

Dear Jenni

I read in the Daily Mail that you have decided to have a gastric band fitted to combat the weight gain you have incurred over many years and which now threatens your health. Notwithstanding all the vitriol that you have received for this decision (motivated in part by fear of other women that if you can't manage it without surgery what hope for them?) But I was just saddened. That you have been forced down this road by well-meaning doctors and surgeons who claim it will cut your risk of diabetes, heart disease and the like. Well, in the short term that maybe true but no-one knows the long term risks of these procedures.. The surgery is going to have major implications for your health as you will no longer be able to absorb nutrients like you used to. This could increase your risk for cancer and other immune problems.

But the point of my letter is not to pour scorn on your decision but to tell you that there is another way that you haven't considered (at least not from your article anyway). You talked about having tried all the diets out there and they haven't worked. Of course not. Very few people manage to keep the weight off that way and in any case it requires constant vigilance and willpower. Wouldn't it be great if you could 'eat normally' and still lose weight? Well if you approach the psychological drivers of weight gain and treat them, you would be able to. Most people don't appreciate the huge part that subconscious processes play in our behaviour as they are, well, so unconscious. We eat to assuage a deep longing/need - for comfort, for protection, for freedom from boredom or because it's a quick fix that makes us feel temporarily better.  Our psyche tell us we are 'not right/good enough/loveable and we eat to contain that uncomfortable feeling. What I am talking about here is the role of emotions in unconscious eating. We all suffer from this to some degree but, depending on your background, and experiences when growing up, some of us have a more faulty self-image which no amount of diets or surgery is ever going to cure.

So, if the problem isn't 'physical' then why should the solution be? You need to look at using one of the new techniques that are just being developed under the term 'energy psychology'. In fact what they are is using electrical stimulation to change the neural programming in the emotional brain (limbic system). The one I would particularly recommend for eating problems is EFT or Emotional Freedom Technique. A book I would suggest to get you started would be 'Tapping for Weight loss' by Jessica Ortner who has used the technique herself to rid over 3 stone - without diets or restriction. and the benefits go beyond weight loss - they affect every part of your self-image so increasing your self-esteem and healing many old wounds and erroneous beliefs about yourself.

I don't know your story Jenni, but I know most of us have childhood trauma of one sort or another. Although we think we have 'dealt with it' we find that in fact it exists as a deeply embedded memory and belief structure that continues to affect us today. With a skilled therapist to augment the book you may be able to uncover these and deal with them but even without paying more than the cost of the book you can get great results. And it will certainly be cheaper and less dangerous than the surgery you are contemplating. I know that this is the best method I've ever come across - second only to hypnotherapy which also deals with subconscious process -  check out the hypno gastric band - that's another potential solution where you make your body self-limit it's own intake with feelings of fullness but without the surgery.. This is a subconscious problem and it needs a subconscious solution.

One day medicine will be unified- it will stop seeing things in terms of physical vs. mental and realise we are mind and body and one affects the other in profound ways. We will stop looking for the magic bullet of chemical medicine and look to supporting the body's innate healing powers instead. I hope that this new medicine will use some of the advances in modern medicine but doing so in a more intelligent, integrated way with knowledge from psychology and spirituality. These aren't flaky ideas. They are being proven  time and time again in myriad ways in labs and therapy clinics across the world. Don't be persuaded to give up your body to the knife until you've explored this. If I could intervene for you I would, but perhaps that's best left to you. I have learnt through hard experience that trying to persuade someone before they are ready is pointless. I just hope I'm not too late.

Best wishes
Patricia Worby

p.s orginal Daily Mail article is here http://www.dailymail.co.uk/femail/article-2736130/Why-I-m-getting-gastric-band-JENNI-MURRAY-years-battling-weight-s-taken-momentous-decision.html

POTS (postural orthostatic tachycardia syndrome).

I see the Daily Mail ran a story recently saying that POTS could be the 'cause' for 1 in 3 people with CFS. Having heard the woman who heads the research team at Newcastle university talk a couple of years ago I remember thinking at the time she is never going to work out the neurology of this because she's too narrow in her focus. She spent the first 20 mins of the talk (to University Researchers) justifying that CFS is a real disease and not just malingering (presumably the medics that she normally lectures to have that belief). Then when she got to the heart of her presentation and described how they put people on a 'tilt' table to measure their responses (this apparently is how they diagnose it). sounded barbaric and very unpleasant! However, my main bone of contention and one that has been repeated by the Daily Mail is that this is somehow the 'cause' of CFS when clearly it is just another result of autonomic dysregulation (mediated by the limbic system). A client of mine has pointed me to a training programme called DNRS (Dynamic Neural Retraining System) which she uses - I noted they had an article on POTS too. http://www.dnrsystem.com/POTS.html. They say;

Symptoms can include but are not limited to:

• Increase in heart rate, dizziness, fainting, headache, sweating, shakiness, nausea -  mostly worse with standing
• Poor concentration and memory
• Discoloured hands and feet
• Sense of anxiety
• Chest pains
• Nerve pain
• Hyperacusis (sensitivity to noise)
• Photophobia (pain/relapse on exposure to light)
• Changes in taste and smell

I can remember having most of these symptoms when I was ill 15 years ago - however, no-one seemed to be able to link all of these symptoms - they were all treated separately. The first thing I was given was tablets for the dizziness which made no difference at all. However, had I been diagnosed with CFS or POTS for that matter it wouldn't have helped as it is still a descriptive diagnosis of exclusion (i.e we don't know what it is but it's not something neurological/structural, it's characterised by these things so we'll call it CFS/POTS, etc). So, given a diagnosis like that people are left to manage the symptoms with no idea that the limbic system controls all of these things and that ongoing subconscious stress is triggering the limbic system into sympathetic dominance or vagal freeze. Without understanding what is behind it all people are left powerless and controlled by a medical system that then feeds them expensive drugs and surgery as the answer. It would be quite criminal if it wasn't legal...