The scar that won't heal

Today is a very important day. It's the day after I uploaded my book to Kindle - a year's work and a very intense year it's been. Not only did it take a year's writing to get the 85K words, but then there's the proofing (thanks to the stalwart efforts of a friend), references and booklists to compile, getting someone to write the forward and so on. The book was actually written about 2 months ago but all the rest took a long time to complete.

During this time of writing and fretting, I've also been struggling with some personal issues which has entailed me getting quite anxious in a way that hasn't occurred since my last bout of depression 15 years ago. Initially all was going well but sometime around August my clinic (which is a conservatory at the back of my house) developed a leak. After heavy rain a stain would slowly make its way from the corner of the room and fill the air with the smell of damp plaster until it dried out again with the sun. Now, under normal conditions I would just call in the builder who erected it and demand reparations. But he is not to be found.. And I have no written guarantee despite months of requesting it. Beware a builder who can't/won't respond to your requests for things in writing!

So I called in another builder who has painstakingly worked backwards from the most likely cause to the least, repairing and making 'good' various badly done bits from flashing to the roof. After each repair comes the hope, then dashed after the next rainstorm. Finally this last weekend I admitted to myself my reaction has been so extreme, that I need therapy. I can't sleep when rain is due, my guts churn, my chest feels tight. I can't sit still, or eat for worry - and it feels like a personal attack when that stain comes back time after time..

So, of course it's no co-incidence then that my book is called The Scar the won't Heal; Stress Trauma and Unresolved Emotion in Chronic Disease'. Perhaps in the writing of it, I have touched upon some of my most painful memories, including the death of my father at 19. In EMDR (Eye movement desensitisation and reprocessing) therapy this week, it was this that came up. My feelings of abandonment when he died, and that I was somehow responsible. How strange! I know logically this isn't true but my emotional brain believes it, and the issue of fixing the leak has become a cipher for what I couldn't achieve 30 years ago. I had no control then and I have none now.  And both things seem to threaten my sense of self in a way that sounds ridiculous but nevertheless that's how my body is reading it.

So, it's really been a case of 'healer heal thyself' and I have tried to see this time as an important reminder of how illogical emotional memory formation is and how it affects us in later life if triggered. Which is exactly what my book is about - and how this can translate into anxiety, depression and chronic pain, IBS, TMJ, etc. So the universe has given me another swift kick up the backside to look at myself and deal with my stuff so I am in a better position to help others deal with theirs. Onwards people. Oh and please god I get the leak mended soon. Driving me crazy. Literally.

My Book nearly completed and musings on Virgina Woolf, Amy Winehouse and the nature of trauma.

As I near the completion of my soon-to-be-published book 'The scar that won't heal'; healing everyday trauma and unresolved emotion', I realise I have learnt to  notice the effects of trauma so well that I can spot it in the stories or lives of others. Yesterday watching the new BBC series 'Life in Squares' about the Bloomsbury Group, it suddenly occurred to me that the reason that the writer Virginia Woolf suffered from such debilitating depression was maybe due to a traumatic incident in childhood. Nothing in the series indicated that fact. It was purely from the evidence of her early struggles with mental illness, the triggering of severe relapses by the death of her parents (which I read about subsequently) and something about the strict Victorian upbringing which the series so clearly shows, which stultified the two women.

The Victorians were notorious for their sexually strict morals (outwardly) and the therefore unfortunate fact that many children were sexually abused in secret. What differs then of course was that no-one dare talk about it - Freud when he first declared that much of the neurosis he saw was due to sexual abuse of his clients as children scandalised Viennese society and he was forced to retract the idea and declare instead that these were children's fantasies (after all doesn't every child want to have sex with their parents??). Sadly these ideas were universally accepted as he was so influential no-one dared to disagree for many years. Even in the 1970's a standard psychiatric textbook declared incest to be so rare as to be unimportant and in any case had no significant effect on the child!* Today after the Jimmy Saville enquiry and the grooming of children in major UK cities we know differently..

Children are profoundly affected by such experiences, as well as lesser traumas such as being unloved or betrayed and the result, when their brains are still forming, is permanent dysfunction from subconsciously triggered traumatic memory. And, as my book makes clear this has very real physical results; dizziness (fainting), tinnitus, depression, migraines, panic attacks, irritable bowel syndrome and so on. These effects are real and they could be the basis of much mental and physical suffering including bipolar disorder which Virginia is believed to have suffered from.

I was incredibly saddened but also vindicated to read that she and her sister Vanessa, had indeed been abused by their half brothers, George and Gerald Duckworth, as she recalled in an essay ' A sketch of the Past' written in 1939. Could our current understanding of traumatic memory have saved her if she lived today?

Would Amy Winehouse be dead if she'd had trauma treatment rather than standard addiction detox therapy (the eponymous 'rehab' of her famous song). This relies on abstinence which deals with the effects of addiction but not the cause. As soon as the stress builds up again, the cravings return. Although she did not have abuse in her past, she most definitely had trauma - the divorce of her parents when she was 9, was, to a highly sensitive child, hugely significant. And then, in later life,  her father wasn't able to provide the boundaries she so needed. Add to that meeting a similar addictive, traumatised partner, and her death was assured. Trauma is no respecter of talent.

But would she and all the other people who have these hidden scars be healed now?  To be honest it's unclear whether this information has filtered down to mental health professionals, or certainly primary care where most people first report mental health issues. There is still much work to be done. I hope in writing my book, which details much of the science behind the stress response and how it relates to traumatic memory, will help elucidate this information to a sceptical public and other professionals. The science is there. It just hasn't been joined up sufficiently yet to be understandable within a specialised, fragmented medical model. I hope to redress that balance.

* Bessel van der Kolk, one of the worlds' leading figures in the study of trauma, read us an extract from the manual as part of my trauma training. It was mind-blowing.

Talking hypnotherapy

What a week this has been. Started with my hypnotherapy training (Module 3 now) in Bournemouth. 2 long days of theory and practice culminating in an assessed treatment using the Milton model of deliberate permissive language (e.g 'you may feel that...', 'I wonder if, now or in a moment, you will begin to feel x...'), This opens up the possibility for people to experience hypnosis however they want to. It takes the power away from the hypnotherapist (not like Derren Brown then!) and back to the client. Hypnosis, it seems is not magic, but simply an applied skill which uses the knowledge of how the mind creates and stores memories, emotions (which can be attached to those memories) and replays them for us whenever we encounter something familiar. This is why our subconscious emotions (many of which were learned in childhood) can be so destructive. We have no control over them and we do not even know what we are operating from..

And I was reminded of this personally too as my cat Sidney, my little companion, fell ill this week and I was struggling to cope with the notion of losing him (he stopped eating and drinking and there was a possibility he wasn't going to survive). My fear and sense of loss was so huge - even though the worst hadn't happened yet I was operating as if it was. The term 'as if' is used a lot in hypnosis communication. We ask someone to imagine something 'as if' it were happening. The subconscious mind doesn't know the difference between reality and imagination - the response will be the same. So, if I ask you, to imagine that your hand is stuck to your knee as if it was stuck with superglue, if I really get you to engage your imagination it becomes impossible to move! This is called the hand-stick routine and it is fascinating!

Hypnotherapy is more therapy than hypnosis in my opinion. It elicits information from the client, devises a strategy to help them and then uses hypnosis to deliver the intervention. But you need all the skills of an empathetic counsellor and more to be effective. Rapport is essential in hypnosis or the client will be not willing to follow your suggestions. So, we are learning so much more than how to induce hypnosis. We are doing a full session of therapy too. Using tools such as Socratic questions e.g 'what would happen if you did?' to get the client to analyse their own thinking critically. So much of this is used in self-help books eg check out Byron Katie's 4 questions which ask you 'turn it around' but with hypnotherapy there is more evidence based guidance and a full training.