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.

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.

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...

Chronic Pain and TMS – the hidden cause

When, in my mid-thirties I became struck by a mystery illness which rendered me incapable of more than 3 hours work a day, I feared the worst. The symptoms were very varied but began with incredible fatigue. Then my joints swelled up so that walking became painful. I had unexplained rashes and itching, dizziness and headaches, it went on and on. I went back and forth from the GP and various hospital and blood tests. They could find nothing organically wrong with me and left me with a 6 months prescription for painkillers telling me it would probably get better of its own accord!

So, I determined I would find out more about chronic pain and fatigue and see if I could unlock whatever it was with alternative methods. I tried acupuncture (which was helpful), homeopathy (which was not – for me anyway). Then I tried massage and chiropractic and finally some Chinese herbs which were incredibly effective as they detoxified my body and enabled it to begin to heal. I started to see that health and wellbeing was more than curing myself of disease. It was about bringing my body back into balance.

Fast forward 15 years and I am now a fully qualified therapist specialising in Chronic pain, specifically TMS or Tension Myositis Syndrome (which is closely related to Chronic Fatigue syndrome although they may manifest differently). It is a stress-related illness – by which I don’t mean necessarily due to an obvious stressor but it can be accumulated, low-level stress like being in the wrong job, relationship for you, or by burying your emotions of loss, grief or anger. Men and women are different in this respect as their emotional landscapes are different which may explain the huge preponderance of women with CFS/ME as compared to men. Men on the other hand may get unexplained back pain, or auto-immune diseases. Modern medicine calls these conditions different illnesses, and attempts to treat them symptomatically. This doesn’t work as the central cause isn’t in the affected part but in the brain.

Now, here’s where this gets tricky as people in pain do not like being told ‘it’s all in the mind’. That isn’t what I’m saying at all. The pain is very real and there is real physical disturbance in the tissue causing that pain. However, the ultimate causation is in the imbalance in the nervous system which comes from undischarged emotion. It is a simple biological fact that we are hardwired for emotion – the two most primitive are fear and defensive anger (rage). In the animal kingdom (of which we are part from an evolutionary perspective) animals will display these emotions as a survival tactic. If we didn’t have fear we would be incautious and perhaps get eaten, if we didn’t have rage we couldn’t stand up to our attackers with the same result. The part of the nervous system that controls this is the autonomic nervous system and it is composed of two parts; the sympathetic and the para-sympathetic. They are like the accelerator and brakes respectively that modulate the body’s responses to outside stimulus. But they also response to internal stimuli – our feelings and emotions.

So, if we are afraid, our heart rate increases, our breathing is rapid, we are geared to the so-called  ‘fight or flight’ response which involves the brain and endocrine (hormone) system. If we have a situation where neither of these is possible we can exhibit a freeze response where our body is in perpetual slow motion – lacking energy and vitality. This is probably the basis for Chronic Fatigue syndromes – much more common in women whose nervous systems tend to freeze more than they fight. [i]That our mind can create this may seem nonsensical until you begin to understand our evolutionary heritage. As animals, our mind is incredibly complex and designed to deal with threat- it cannot differentiate between real threat and perceived threat – perception is everything! So, for instance we can get anxiety because our mind is interpreting a situation as threatening even when it is relatively innocuous. This is because the brain is a pattern recognition machine and it links certain events together by their associated senses or emotions. So, for instance a certain smell will evoke a memory as will feeling fearful – but the associations may be unconscious, so for instance your boss may remind you of someone you once feared so they trigger that response in you causing unconscious stress.

TMS is the physical response of the body to that cumulative, low-grade stress. It inhibits blood flow to the tissues casuing local ischaemia (or oxygen deprivation). The tissues become hypoxic, lactic acid builds up and pain and fatigue is the result – especially in muscles and tendons. There only needs to be a small amount of reduction too to have serious effects. If the nerves are affected then the pain may be accompanied/replaced by tingling or odd feeling sensations. But because the root cause – stress – is never addressed all physical approaches be they massage, physio, pain killers and surgery will never work. It has been noticed of instance that in people with Fibromyalgia most pain killers are ineffective.

There has been a lot of research into TMS but the main author who first coined the term was Dr john Sarno[ii]. He was in rehabilitation medicine for 30+ years and began to notice patterns of trauma in his patients that, if he encourage them to highlight and address their unprocessed emotions, they were able to reduce or remove their pain altogether. He hypothesised that the mind was creating pain as a diversion to these uncomfortable emotions – in the mind’s view physical pain is less damaging! He also noticed  that the pain could shift and move around when these feelings were addressed. Combined with his research into normal pathology of the spine and tissues with ageing, he came to the conclusion that the root cause was not physical but emotional.his work has since been furthered by clinicians such as Dr James Alexander[iii] who being a psychologist, was able to hypothersise how this mechanism might be mediated.

I have written extensively on this in other blogs and won’t repeat here, but mindbody medicine which acknowledges that we are both mind AND body is really the only logical way forward to solve the epidemic of mindbody disorders that we are currently seeing. These include in no particular order; CFS/ME, auto-immune disease, IBS, anxiety/panic disorders, headaches/migraines, insomnia, etc. In my practice I work with people on a mindbody level - we investigate the whole person not just the physical symptoms.  I use massage and Reiki to stimulate the body and rebalance the energy system, and then various psycho-somatic techniques such as EFT (tapping ) and EMDR within a hypnotherapeutic framework (which emphasises safety and self-empowerment).

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[i] Peter Levine:  ‘In unspoken voice- how the body releases trauma

[ii]Dr john Sarno: ‘The Mindbody Prescription’ and ‘Healing Back Pain’

[iii] Dr James Alexander; The hidden Psychology of Pain’

Medical contributions to psycho-genic pain

Further to my first blog on reading The Hidden Psychology of Pain by Dr James Alexander, I thought I'd add some more thoughts. I thoroughly agree with his contention that the medical establishment contributes in no small part to the perpetuation of the notion that pain can only have a physical cause. The idea that emotions can cause pain is dismissed in the main, especially since both physician and patient make the mistake of thinking that this means the pain is 'all in the mind' and therefore not real!. Psychogenic pain is completely real - it has a physical manifestation - which can be due to lack of oxygen supply to the tissues or over-contraction (spasm) but the over-riding cause is an emotional memory which has not been released and continues to replay the motor action that was in place at the time that the encoding traumatic event first occurred. So, in simple language the body holds the trauma in memory and, as this is never discharged, chronic pain ensues.. This may take the form of back pain, shoulder pain or in very severe cases, fibromyalgia and other chronic fatigue-related syndromes. There is usually complex childhood trauma at the heart of these syndromes.

The brain is able to create physical symptoms via the combination of limbic system (deep brain) which triggers the Hypothalamus, Pituitary, Adrenal (HPA) axis mediated by the autonomic nervous system; the body is flooded with stress chemicals (mostly cortisol from the adrenal glands) and the stress cycle begins. Cortisol will cause most of the symptoms seen, especially if it is released continuously.

Unfortunately, when a person is misdiagnosed with a physical cause of this (via increasingly sophisticated technological scans which reveal 'pathology' of the various tissues), the belief that there is indeed something physically 'wrong' is corroborated. What you are not told is that many people who are not in pain have the same 'pathology', but since they do not consult their doctors, this is rarely appreciated. However, there are many reliable studies that have confirmed this, it just does not fit the current model. If the pain was caused by the structural abnormalities then why doesn't everyone who has these abnormalities have pain? It just doesn't make sense.

With some chronic pain/fatigue syndromes like CFS/ME the symptoms are so varied that it is hard to see how they relate at all. They can range from cognitive disorders, digestive issues, cold hands and feet, postural hyptension (low blood pressure when standing up), etc, etc. The brain lies at the heart of all of these symptoms via, as we have said, the HPA axis and excess cortisol but for someone suffering it is hard to believe this.

I recently had  a client tell me that she has finally got a diagnosis of Menieres disease, a disorder of the inner ear that affects hearing and balance. It causes sudden attacks of vertigo (a spinning sensation), tinnitus (a loud ringing in the ears), and a temporary loss of hearing. She seemed relieved that at last there is an explanation for the very disabling symptoms she has been experiencing. However, I am not convinced that this 'disease' is not simply another manifestation of the autonomic nervous system imbalance. Sadly, it is hard to contradict the medical view as it is so supported in our culture, and, for someone in pain, they need to have an explanation or they fear that people will think they are making it up or 'swinging the lead' as it used to be called. Being told by a doctor that you have 'x disease' and then, worse, being told it is bad enough to merit investigation, usually by tests (in this case MRI), further traumatises the patient and ensures the symptoms will continue and usually get worse. For traumatisation to occur requires that the person be helpless. There is nothing like being subject to medical investigation with complex interventions by 'experts' to make a person feel helpless. They are totally disempowered from their bodies, their self-determination and become stuck in the anxiety loop.

Unless they are able to work with a trusted holistic/mindbody practitioner who can demonstrate the real meaning of these symptoms and give them tools to alleviate the stress, the likely prognosis is poor. We have seen people die from these chronic fatigue related diseases, and most live a thoroughly reduced quality of life. It takes a lot of courage to break free of the medical model, with its round of tests and specialists who each corroborate the view that this is lifelong and nothing much can be done. And the social care model, that only pays disability payments to those with defined conditions simply adds to the burden that these people feel. If they then get better does that mean they never had it in the first place?? how will they live while they are recovering but are still not well enough to work? This places such a pressure on people that they are unlikely to step outside the system, especially since this means losing the little certainty they had.

It is a very challenging field in which to work. But I have no doubt medical science and psychology will eventually unite and prove that this psycho-genic model is the correct one. We will in the future be able to understand our emotional fallibility without blame - and have a collaborative healthcare team to work with us to re-write the programme and release us from pain.