Working with dissociation; some surprising symptoms and their resolution

In the course of my work some things still manage to surprise me. Today I was working with a lovely client who has endured years of chronic fatigue as a result of traumatic dissociation (but who was unaware exactly what was the issue - she just knew she failed to connect with her life somehow). This lady is a delight to work with (as are all my clients really), but she has a very particular way of releasing the pent up energy that has been spent keeping her emotions locked in.

In one of our first sessions as we went through the process of trauma transformation (using a mixture of EFT, EMDR and havening) we got to the point of discharge of an old belief system and its stored energy and she said she felt like shaking. I have come across this discharge response before, both in clinic and in my research (particularly the work of Peter Levine*) and luckily was not perturbed by this comment. I suggested she get up and indeed 'shake it all off' which she proceeded to do. The next few days were remarkable for this lady; previously unable to concentrate on things she succeeded in playing the piano for the first time in years and spent an hour making something in needlework. It was a remarkably quick turnaround. But more was to come...

In another session we were discussing the myriad symptoms of traumatic dissociation including tinnitus, vertigo and ear wax build up and pain. I told her a story of my own problems with my ears, and we got around to discussing how she might move forward. I explained about using Levine's shower techniques where you direct the spray to parts of your body whilst saying 'this is my arm, this is my chest, etc.' Sounds wacky if you don't understand dissociation, but effectively the brain refuses to acknowledge parts of your body if they were involved in some traumatic event in your past. This can be mild like tinnitus where blood supply to the nerve is restricted, or it can be severe as in depersonalisation. My client at this point had an 'ah-ha' moment and told me the story of how, until she had a number of sessions of massage in her thirties, she had never been able to draw anything on the middle of a piece of paper, they always ended up on the left only. This is a classic example of dissociating the right side of your body (represented here by the visual field in the brain). This was her brain's response to an overwhelming trauma at some point in her childhood where she effectively 'cut off' the right side of her sensory perception. The right side of the brain also happens to be the side of creativity and play so I suggested this might be the reason why she had given up all the things she loved to do.

I do massage as part of treatment with some clients, others have a mixture of EMDR, EFT and havening. I chose the appropriate technique for different people. I have noticed that connection with the body is the most important precursor to recovery. But whatever way you do it, the results of release are phenomenal; you gain joyful appreciation, connection to yourself and others, a deep peace that you haven't felt since you were tiny (hopefully). I have witnessed this time and time again with clients- and because I am a HSP - Highly Sensitive Person (see the work of Elaine Aron) I can feel the change in that person that I am working with. Another lady I worked with recently seemed to visibly 'drop' into herself at one point; I swear I felt it happen. I commented - 'you just seemed to arrive back into your body' and she opened her eyes and said that is what she felt had happened also. She has been so much better since then.

The one thing that enables me to do this important work of trauma recovery is to witness people making progress - usually bit by bit (too quick and the change is overwhelming and the threat response is activated)- but sometimes as I've described above it can be remarkably quick. And, when, as today I have 2 clients who are able to sit with me and describe feeling real joy in their lives for the first time since childhood, more energy, and a sense of purpose I know that my work is done. We are all 'work in progress' but with the right tools and person it becomes SO much easier.

Frozen shoulder - the double burden

Frozen shoulder is something that I come across often in my practice. In my initial training as a massage therapist we were taught it was an unexplainable condition that came on suddenly, mostly in women of middle years and would last 1 - 2 years and disappear as suddenly. This intrigued me. How could a condition just disappear?

It is characterised by an inability to move the arm out from the body more than a few inches before intense pain is felt. usually when it first comes on it is noticed in the act of difficulty moving behind the body (as in doing up the bra in women). As it progresses movement will become increasingly limited and painful. What lies behind this symptomology? Is it a trapped nerve, or fascia - and if so how does it spontaneously resolve? What can a physical therapist do to help alleviate? These are some of the questions that have been troubling me.

In my subsequent study and practice of mindbody medicine, there appears to be a more logical explanation. If any of you have come across the work of Peter Levine, author of 'Waking the Tiger' (1) you will know that the mind and body work to keep the organism safe in times of danger or trauma. But, unlike the rest of the animal kingdom, we often do not discharge this energy after a brush with danger. The instinct to shake is often suppressed as we are told to 'pull ourselves together' or have a stiff drink. But in fact this normal body movement is necessary to remove the energy of the stress response from out of the muscles and if we don't do it, or can't do it we can get 'stuck' in an unresolved mobilisation to stress.

Now it is a fact that muscles move in concert with one another. Any movement needs the controlled response of two sets of muscles- the agonist and the antagonist. It is also true that emotions play a part in mobilising this response. Say for instance you are involved in a car crash and you go to move your hands up to protect yourself but they are held by the seatbelt. your instinct is thwarted. your life or the threat of injury has undoubtedly been saved but there may be a lingering response in your brain which is not discharged. It appears that this may be what lies behind such conditions as frozen shoulder. As Peter Levine himself states "the motor expression of two intense instinctual responses creates a conflict and results in frozen states... the energy bound in inhibited (thwarted) responses  is so powerful that it can cause an extreme bracing that often has profound effects" (2, P196).

But it's not only extreme trauma like accidents or shell-shock under war conditions that create stress in the body. I have already written extensively about 'everyday trauma' of common events like poor parenting, bullying, surgery, etc in my recent book (3). These stimulate our stress responses too. And it may be that when this is not cleared from the mind body of the person that conditions like frozen shoulder, or sciatica represent those undischarged muscular and nervous responses to threat.

What can we do then as therapists - or sufferers ourselves to help discharge and heal? Well, there are many ways but all of them involved becoming more aware of the body and helping to tune in (interoception) to the movements our body is trying to make. With frozen shoulder it is suggested to make the small movement you can make without pain extremely slowly while concentrating on what your body is telling you. with gentle encouragement you are often able to increase the range of movement when you discover what messages are being sent to the muscles which are stimulating both the agonist and the antagonist at the same time to lock the range of motion. Go even slower and do it again. The answers will often come spontaneously as a wave of shaking, crying or sweating relief - the is I sympathetic activation and shows you that your body is releasing. obviously for some people this happens spontaneously within 1 - 2 years. but to be able to do this yourself means you don't have to suffer so long.

Peter describes these techniques in much more detail in his books - but for now I leave you with one thought. As an example of how this ant/agonistic muscle stimulation happens - people who jump from burning building often break their legs before they hit the ground (or the net) due to the simultaneous in tense contraction of the leg muscles putting intolerable strain on the leg ,bones!  (2, p198). Food for thought how smaller but perhaps more chronic stresses, especially in a helpless situation may change the brain to lock the body in a protective response cycle. This, I believe explains frozen shoulder than any other explanation I know of. And it may explain too, why women suffer far more from this than men. helplessness is a state characterised by childhood but also by some women (and men of course) in their adult lives. A bullying boss, husband or just the intense suffering caused by living in a world that does not support or encourage you can be enough. Food for thought indeed.

Copyright Patrica Worby 2016. www.patriciaworby.co.uk and www.alchemytherapies.co.uk

1. Levine, Peter (1997). Waking the Tiger. North Atlantic Books.

1. Levine, Peter (2010). In an Unspoken Voice; How the Body releases Trauma and Restores Goodness. North Atlantic Books

1. Worby, Patricia (2015). The Scar that Won't Heal; Stress, Trauma and Emotion in Chronic Disease. CreateSpace.

The Neuroscience of Being 'Us' - Part 2 How threat and unresolved emotion changes the brain

Interactions between the cortex (frontal lobe) and limbic system; the anterior cingulate and insula

(Part 2 of a 2 part series see here for part 1)
There is another important part of the mid-brain (adjacent to the amygdala) that has a function in registering threat and helping to lay the foundations of trauma. It’s called the Anterior cingulate cortex (ACC) and is important as a filtering system. It is another part of the brain that is functionally degraded as a result of trauma. It possesses structures called spindle cells which wrap around the nerve bundle of fibres linking the left to the right sides of the brain. These connections between left and right may be very important for how emotions are integrated and the meaning made of the emotional events in our lives– and it may be key to why techniques such as EMDR which stimulate better integration allow re-wiring to occur .

The Anterior Cingulate Cortex ACC is primarily involved in fear conditioning as it normally inhibits the amygdala, which as we know is the primary area for threat encoding. However, it also appears to play a role in emotionality, selective attention, and certain social functions, including emotional attachments and parenting, as well as generation of the concept of the self in relation to society. It is my contention that this is the part of the brain that fails in attachment disorder, and other more chronic relational trauma disorders. I have particularly noticed that the sense of self is often highly distorted, even in very outwardly functional people. They operate despite their own self-loathing to become very respected/hard-working/ achieving people but when questioned they cannot see that anything they have done has any worth. If you press them they will acknowledge grudgingly that it might have value but they do not feel that emotionally, it is more of an intellectual awareness. The ACC might be the part of the brain that we bring ‘online’ in trauma treatment, as when we do EMDR. We rewire the responses by a process of extinguishing the conditioned response of self-hating or limiting. I will discuss this within the tools section.

The insula (another part of the cortex just behind the PFC) is an area that helps interpret incoming sensation, rating it dangerous or not. It is highly involved in our subjective experience of pain, for example, and can become active just by imagining pain as well as in more pleasant experiences like music appreciation. It monitors incoming signals from the body (particularly the physiological experience of emotions like sadness, fear, anger, etc) and combines this information with the limbic system and brainstem to generate appropriate responses. As we will see later, when the signals get scrambled by unresolved emotional memory, stress is able to overwrite any inhibitory stimulus and most incoming signals are interpreted as painful, dangerous or life-threatening, causing all sorts of chronic pain and stress-related diseases.

Left and right sides; the Corpus callosum connection

Despite the fact that the cortical structures are split into left and right hemispheres, the brain remains undivided at the level of the lower reptilian brain structures - sometimes referred to as the ‘subcortical bridge’ In treatment, the client and therapist may also be able to capitalise on this. Nonverbal information, including “unconscious or preconscious codes, nuances we can never attach a name to,” cross most readily (Austin, 1999) . Using somatic experience as an entry point in therapy and maintaining mindful awareness of the body may facilitate information processing by enhancing information transfer between the hemispheres. This is what is aimed for in clinical hypnotherapy intervention by engaging the imaginative right hemisphere. However, there is controversy in hypnotherapy as to the nature of hypnosis as we have already shown with regard to whether it is a state separate from normal everyday experience or not. This was developed further by the great hypnotherapist and psychologist Pierre Janet.

We have already intimated that in subjects with PTSD and other lesser traumatically encoded states, the amygdala may become hyperactive towards “a generalisation of the fear response” or conversely underactive which “may allow continued functioning in situations characterized by ongoing threat” such as that experienced by a child who is under threat from their caregiver. That this may be in part to do with the alteration in function of the left and right hemispheres and specifically their inter-communication is an ongoing debate with psychotherapy.

This is an extract from my book The Scar the Won't Heal - available now on amazon. In the next instalment I look at Interactions between the cortex and the limbic system.

More on trauma, attunement and attachment

Trauma changes the way we are wired. And its effects can be lifelong.  Particularly attachment trauma from our earliest experience of attachment to our parents.

 

As recent research has discovered, the brain is “hard-wired to connect to other minds, to create

images of others’ intentional states, affective (emotional) expressions, and bodily states of

arousal” via a set of specialised neurons in the brain called mirror neurons. They are the basis of empathy and emotional resonance with others. These neurons allow us to interpret the world

around us by anticipating the actions of others by studying their facial expressions and bodily

movement. Young children will instinctively make eye contact with their mother to communicate,

well before they have verbal language. The mother’s attunement to this mutual dance of eye and

facial expression is absolutely vital in landscaping the infant brain to regulate arousal (i.e. calming

the child in the face of distressing stimuli) and thus ensuring empathy between them. If a child is not

soothed, and therefore doesn’t learn to self-sooth in the childhood years, they are likely to switch

between states of hyper- and hypo-arousal at the least stimulus without warning.

 

Imagine then if the mother is distracted, conflicted, in pain, or depressed. This fine-tuning, which

directly drives the neural development of her infant’s brain is distorted, fractured and sometimes

destroyed. In fact, as infant brain maturation is based on this “emotional interaction between mother and child, a negative maternal response will elicit a state of shame/withdrawal, characterized by a shift from sympathetic to parasympathetic arousal” producing a typical dissociation or freeze response which many never be recovered. This pattern of shame will result in inadequate development of coping strategies by the child, and contribute to problems with character expression and brain development. Normal development may actually be inhibited by excessive elicitation of shame, rendering these infants more vulnerable” to further trauma by relatively innocuous events.
Shame becomes the default position for children with this experience.
 

The future implications for that child, especially if not remediated by the mother or another

caregiver later, are lifelong. The child is sensitised to emotional stimuli, finds it difficult to find

emotional resonance with others and may withdraw or act out its distress in ways that the parents

find hard to deal with. As the child then grows and interacts with other children and adults their

inability to self-soothe will create more trauma as their actions are misinterpreted by others and they

become further subject to painful experiences of rejection. Many of my clients describe this process

of having been misunderstood at home and then bullied at school – a double whammy of emotional

pain which keeps them locked into a stress response, their brain failing to break its cycle of fight,

flight and freeze.

 

It’s not that most parents are deliberately abusive (although some are); it is often more a

systematic failure to connect with their child and create a harmonious living situation (as my

experience clearly demonstrates). The child grows up knowing this, but it is a wordless knowing,

doubly baffling as no-one talks about it, and in some cases you are given the opposite message

‘you don’t know how lucky you are’, etc. Unbelievably, some very cruel parents do

tell their children of their disappointment ‘I wish I’d never had you’, ‘you ruined my life’, etc but in the main it is an unspoken message of failure. A child is unable to make sense of this duality, and, being a magical thinker, believes they are the cause.

The child then develops strategies to overcome this by desperately trying to please the parent,

such as being the ‘good one’, burying their feelings and sometimes even becoming the parent

themselves. They develop certain habitual behavioural patterns that become fixed responses to

emotionally charged situations. Thus, if, as an adult they are similarly threatened (e.g. by a bully at

work for example), their responses are conditioned by this early experience to those of a child. They

will have no idea of this of course, because their thinking brain has constructed a very reasonable,

logical argument for why they feel the way they do (rationalisation) that does not see the response as a conditioned memory - it feels like the current situation that is the problem.. For example, the boss is just ‘a monster’ or the partner in the relationship is ‘impossible’ - 'they made me feel that way'. It’s the other person’s fault because you cannot conceive that you are triggering automatic conditioned responses to similar experiences in your past.

.

Thus, without your conscious awareness, you have contributed to the situation, as you have acted

in ways that conform to your map of the world governed by your emotional landscape and it is

difficult to perceive otherwise. In subtle ways even your choice of partner may even be dictated by

this; often you are attracted to people who have the same experience of trauma but the opposite

coping strategy6. For instance a couple I worked with both had difficult relationships with their

mothers which left them feeling worthless, but for the man this made him angry and volatile when

confronted, and for his partner her approach was to be the ‘good one’ and acquiesce her needs to

please others. They often struggled to be understood within the relationship as each would trigger

the other into these stereotyped behaviours. By being able to witness these behaviours rather than

get caught up in them, they had a chance to break the old habits and reveal their true selves to

each other.

 

This is an extract from my book The Scar the Won't Heal - available now on amazon. In the next instalment I will look at how this results in different attachment strategies in the child and later the adult..

 

1

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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.

Mental health in the news

2 main stories in the news this morning highlight the huge differences in the way mental health is treated compared to physical health in the Western Medical model.
The first concerns the German co-pilot Andreas Lubitz who deliberately crashed a plane with 150 people on board. He apparently saw over 40 doctors in the two years leading to the crash, with clearly no-one able to help him. It is a sad testament to medicine that we fail someone who so clearly was crying out for help. We may have saved so many lives if he had been...

The second story is about how the NHS treats  mental health with the story that  A&E staff are failing to treat and condemning people who harm themselves. I can understand this as in the past I would have been the same. But after training in trauma therapy extensively I now recognise the drivers of cutting and self-harming acts - and why people are driven to do them. They are calming for people whose nervous systems are so geared to threat that cutting actually down-regulates (reduces) that threat by changing the hormone system balance. Most 'normal' people find that hard to understand (though we regularly engage in similar but less violent acts of numbing like shopping, drinking, TV watching, perfectionism and over-work). It just seems that our ignorance is costing lives as when the people who should know about this i.e professional health care workers, do not and treat people as time-wasters and malingerers.
http://www.theguardian.com/society/2015/jun/12/ae-staff-attitudes-to-patients-in-mental-health-crisis-often-shocking

Mental health is woefully underfunded and ignored. Where provision is provided it is patchy and far too often relies on inadequate pseudo-diagnostic criteria like ADHD and now a whole raft of new disorders based on certain displayed character traits (see the latest psychiatrists' manual the DSM-V for the full horror of these unproven, poorly researched 'diseases'). These categories tell us nothing about what is going on for the person with these symptoms - they are based on a system that rewards a diagnosis with insurance payout. They have nothing to do with what is really behind themMost of the problems we see in Western society are a result of spiritual disconnection, nutritional depletion and a poor understanding of how memory and trauma are encoded and treated.

As I meet more and more ordinary people who exhibit signs of mental distress - and these are the functioning ones, I begin to see this is the tip of the iceberg. We are so far from living health, joyful lives and our culture encourages disconnection via envy, money grabbing, celebrity culture, etc. We need to recognise we all need love and connection, and that includes self-love as well as that from others. We need to be recognised above all, for who we are as individuals and have loving, supporting relationships. This cannot be prescribed unfortunately, but when someone falls out of their ability to cope as many do, they need a caring and understanding health service that offers more than crisis support. The model of trauma resolution that I use allows people to recognise that their symptoms are a desperate attempt by the mindbody to keep them safe, even though it has become untenable in their adult lives it needs to be acknowledges where they have been, and how strong they are to have survived. We need to promote understanding of the inherent goodness and healing ability of people, not treat them as abhorrent weaklings whose problems need to be dismissed, medicated and covered up. There are answers out there, there are amazing new treatments not yet available on the NHS but they all require a totally new approach to health and healing which is self-acknowledging and driven. I look forward to the day when suffering such as this is a thing of the past.

Perpetual student of wellbeing

Well I said 2014 would be the year of consolidation in my life: i.e.I would do no more courses for a while and concentrate on building my business. This has happened but  I must be honest and say I haven't given up studying completely. I have been doing a trauma treatment course by Dr Janina Fisher which looks at various models of trauma and how to overcome it. It's monthly by webinar and has been very instructive as the other students seem to be mostly psychologists and have a particular language and terminology that I don't always follow (not having studied psychology formally at university). But I have begun to pick up some useful tips about operating within the 'window of tolerance' with neither hyper or hypoarousal and thus being able to function well in the world which is the goal of every person but sometimes goes awry in children subject to relational (and other) trauma

 

I am also looking at Shame and Vulnerability by doing a self-study course with my favourite shame researcher (are there others??) Brene Brown. She runs a video based course here I am, as you see, a perpetual student.

 

But finally 2015 has come around and I wish to increase my credibility with my clients by obtaining a PhD. This isn't an easy task as you might guess as the area I am working in is not that common and my approach is not strictly psychological or medical. I am instead in the 'no-man's land' of being in a holistic field which rigidly defends its position as being research-based and yet if the research does no fit the current paradigm it is not accepted. So, I am having to go a bit 'off-piste' and do my research privately via a PhD registered in India. my study is going to be looking a the common trauma of everyday childhood experiences which, in some sensitive children, causes them to develop symptoms akin to PTSD. We don't have a name for this yet although common PTSD has been mooted by psychiatrists. I believe I am a someone who has this in my history, and it would explain a lot about my reactions to events in my life and my physical symptoms of Chronic Fatigue and depression. I would like to investigate this link by creating a questionnaire to be given to volunteers who suffer from  any of the CFS style conditions including any sort of Chronic Pain (which has lasted for more than 3 months). I am developing the questionnaire at the moment. I am hoping to be ready to send this out to groups and individual by the end of May. I have set up a page on my website devoted to it to give potential respondents more information, If you know anyone who might be interested in taking part in the study please direct them to this page for more information.

So, at the end of the study I should have more information on what the common factors in the personal history of sufferers is. I will keep you updated as I develop this further.

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.

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..

August musings on mindbody medicine and trauma

August the month of holidays... someone said on the radio today that August is the 'Sunday' of the months and I agree. It feels like a last-ditch effort to enjoy the sun and note how the nights are drawing in. And yet it's just part of the cycle of life really.

Interesting how in having 'down-time' the mind will remember other times you had that response. I had a client in recently who was about to go on holiday but was having very mixed feelings as she has lost her father recently and she was about to return to his former home in Italy. This manifested though as odd sensations and aches in her back and down her legs. Now, you will know if you have read anything I've written before that I am very much a believer in the mindbody connection. I told her it was very likely that these odd pains were linked to her imminent departure but that she should get checked at the doctors just in case. The doctor gave her a clean bill of health so we were left to work on the symptoms from a mindbody perspective.

According to my experience and the work of Dr. John Sarno, it seems that the mind will create aches and pains to distract you from the more painful and serious emotional pain that you are trying to avoid confronting. I know if you haven't come across this idea before it may sound strange but time and time again I have proved this. Anyhow, it seemed a classic case to me as these pains had come on suddenly a few days before her intended departure.. In our therapy session we started with EFT (emotional freedom technique or tapping) which allows you to both own the symptom but also release it. As we worked together I saw a wave of emotion appear to come from her stomach (where she had located the current pain) and wash over her face - tears soon followed. There was a tremendous amount of grief pent up in this person, which she hadn't really dealt with.

Leaving to go away was both pleasurable (it was a holiday after all) and painful as it was the place she had last seen her father AND in order to go she had to leave her elderly cat who was also very dear to her and who is on borrowed time already. This is a classic case of internal conflict; you both want to do something and you don't want to. The guilt and conflicted feelings come out with back-ache or sciatica or whatever. How can you tell if what you have is a true pathology (i.e structural problem) or a mind-body issue? Chase the pain. What I mean by this is use the EFT protocol (detailed and described in detail on my website www.alchemytherapies.co.uk/eft.htm) to apply the tapping protocol and see if the pain moves. it usually changes in some fundamental way pretty quickly.

For my client, I had instructed her to do this the night before she came to see me as it would give me a strong clue as to whether to treat the pain with physical or mindbody therapy. She reported that it went from her legs to her stomach. So, I had a pretty good idea we were dealing with a mindbody problem. In the therapy we did together the pain moved again from a tightness in the stomach to a constriction in the throat (interesting as this often reflects something unspoken). As we continued this developed into a full blown panic attack so I asked her to move to the table and we worked on calming the autonomic nervous system with belly breathing (which helps to break the shallow breathing- oxygen deprivation cycle triggering panic in the brain) and then I helped her speak her pain and then we shook her limbs to release the pent up emotion  (this last approach has been detailed in Peter Levine's work - Waking the Tiger and Healing Trauma). I find it helps people to experience their emotion through their body which is where it resides. There is much theory around how the mind and subconscious process interact. Again, see the information on my website.

Suffice to say I was successful in this treatment and my client left -shaken obviously but no longer having the trauma in her body. Her pain disappeared immediately and she has recently sent me a text from holiday saying how much she is enjoying herself. (though it's worth noting for accuracy that she did experience another panic attack at a subsequent time - one session is not going to undo 40/50 years of trauma!).

If any of this sounds interesting or you have anything to add please contact me through my website or facebook pages.

Clinical Hypnotherapist at last!

2 weeks ago I graduated in Clinical hypnotherapy, clutching my certificate and thinking 'now what?'. I have focussed on this moment for the last year so if feels odd to suddenly be free to practise but not know how to start. I have a website www.alchemytherapies.co.uk which has my hypnotherapy page. I try to update regularly and there are some free downloads on that website including some explaining hypnotherapy and the particular use I make of it for chronic conditions. as a tool for re-arranging the mindbody link (where certain memories/traumas are encoded in the body) I find it unsurpassed.

I am aiming to  use it to help clients overcome any limitation whether that be physical, emotional or mental. There is so much trauma out there - and most of it not obvious. A lot of disease has its roots in childhood trauma; it may be something obvious like abuse but often it is something more indistinct - an unloving parent, lack of stability, etc. We may think we have 'got over it' because we have made lives for ourselves as adults but in fact there are lingering beliefs and values that trip us up. Feelings of unworthiness for instance, dog us at every step (particularly women I find though it's not exclusive to them). Ultimately we believe that we ought not to give up security to live the life we want - we ought to work harder, strive for the love that's missing in our lives, do more, be more, and so on. This is exhausting and the longer we 'try' the more we focus on not being true to ourselves. This is how we slowly but surely succumb to dis-ease and depression.

It's not easy to become aware of these subconscious beliefs - it's not simply a case of 'deciding' to let go. This is a process and it needs

1. awareness - becoming mindful of what you tell yourself - the negative self-talk e.g  'I'm useless'
2. challenge - here's where we ask the all important question - is that true? 'what at everything?'
3. substitution - CBT therapists like myself use the term 'restructuring'. 'I'm good at other things'

Hypnosis makes this process infinitely more powerful as it talks to a deeper part of you that is holding on to these beliefs by switching off the analytical mind. You can't make these changes by willpower alone. You have to have access to that deeper part of you - and there are many techniques for doing this of which hypnosis, meditation, breath-work and bodywork (massage, Reiki) are some.

My reading and practice makes it clear that no one size fits all in this respect. Some people respond more to touch, others to a mindful exploration. That is why, in the end I have chosen to call myself a 'holistic therapist' and not one or the other. I treat the person not the disease/condition. This means I have to choose from a range of approaches and, working with the client, design a treatment plan. Nutrition is always a part because you can't work on a body that is struggling with toxins and expect it to work optimally. But ultimately, I use intuition and consultation with the client to work together to heal whatever they have come in with. This is true (w)holism. Interestingly the words whole, and heal come from the same root which signifies to me that for true healing we must become whole again. I'll leave with that profound thought...