Friday, June 23, 2017

Islands of safety

Peter Levine calls the places we can go to in our body when processing trauma; islands of safety. In the stormy waters of trauma, it is easy to feel like you’re drowning in awful and frightening sensations when you start reconnecting with your body, which is why you need these islands of safety. Not only do they give you some respite from feeling dreadful, they also help you to discharge any trauma as they enable you to stay with it, bit by bit (called titration) so you can release it. See my previous post explaining the steps of pendulation in more detail.


In other words, these islands are your internal resources and this feels very empowering as they will continue to grow the more you learn to locate them and, as any traumas release, these islands will become larger and join up so your body will feel like a safer place to inhabit. If you can’t locate a place of relaxation, calmness or neutrality inside your body, use your external resources instead. This could be the presence of a kind friend, the warmth of a hand on your arm (or your own hand), music, a pet, a sunset, whatever allows you to pendulate between your pain and that resource. This will enable you to connect internally as you begin to feel stronger.

Sometimes when we’re tapping, we can tap with the intention of wanting to get rid of something. Now there’s nothing wrong with that and before you tap on any issue itself, you’re better off tapping on wanting to get rid of it first. Being totally and utterly honest always works better with EFT and you will see results much faster. Using exercises like pendulation along with tapping through any difficulties/frustrations you experience can work wonders in my experience.

Monday, June 05, 2017

Breaking things down into small chunks

When we’re feeling overwhelmed it’s really useful to be able to break the overwhelm down into small chunks. The smaller chunks are more manageable and allow us to approach our pain with less fear that it will completely swamp us.

The natural response to pain is to avoid and move away from it. But if we keep doing this, we end up with mountains of pain that can flood us just thinking about them. As the old saying goes, feeling is healing, so that’s what we need to do in small manageable doses.


An exercise that I have found really helpful for this is pendulation, which is taken from Peter Levine’s book, In an Unspoken Voice. Any exercise works better when you’re really tuned in or triggered, but first you need to have had some practice with any exercise to even think of doing it when you’re feeling upset.

Pendulation exercise:

1. Locate a sensation or emotion in your body that doesn’t feel good. 
2. Locate another place in your body that feels good, relaxed or neutral. This can be an elbow, a little toe etc.
3. Put your attention on the sensation/emotion that feels upsetting.
4. When it starts to get too much, switch your attention to the relaxed/neutral place and stay there for as long as you need to.
5. Go back to the difficult sensation/feeling when you’re ready and see how it feels.
6. Keep swinging your attention back and forth like this between the two places in your body.
7. Notice any signs of nervous system release like yawns, sighs, burps, stomach gurgling, slower breathing and so on.
8. Do this exercise for as long as feels comfortable, don’t push through it and if you find yourself feeling urgent or desperate, tap on it.

Peter Levine calls breaking things down into small chunks, titration. Smaller doses of pain are more manageable to process than big mountains that have accumulated throughout our lifetime.

Saturday, May 27, 2017

The world of personality disorders

There’s an area where very few want to go in mental health and that’s the world of personality disorders.  As with everything in this life, there’s a spectrum and we’re all on it in some shape or form. Stress can be defined in many ways, but one of my favourites is that stress is caused by unmet needs. And one of our most important needs is for our caregiver(s) to be present with us. This translates to someone being attuned to us and our needs, we then conclude that our needs and therefore we, matter.

There’s some research that shows that some people who have personality disorders were born that way. They didn’t suffer any childhood trauma that would explain why they are the way they are. But that’s assuming that any trauma was measured properly, based on experience not just events. Besides the more obvious physical and sexual abuse, more insidious and hidden forms of trauma often go undetected or minimised, like neglect. And let’s not forget about accidents and medical procedures. There is also the often overlooked area of trauma in utero which research has shown explains a lot of subsequent “unexplained” behaviour. We’d like to believe that all babies are born a blank slate but that is not the case at all, unfortunately.  And then there is the field of epigenetics which helps to explain the phenomenon of intergenerational trauma which is hypothesised to last for at least 7 generations. So even if we haven’t suffered any trauma in this life, which is extremely rare, our life in the womb and the life of our ancestors can explain a lot about our current behaviours.

In his book, Born for Love, Bruce Perry writes about interviewing a teenage boy called Ryan who had raped a 15 year old developmentally disabled girl and showed no remorse, in fact he said “I don’t know what the problem is really, she never would have gotten laid by anyone as good as us”. Perry said he was as cold, perhaps even colder, than any sociopath he had ever interviewed, including some killers. It turned out that by the time Ryan had turned 3, he had had 18 nannies. He would scream if his mother (who spent at most one hour a day with him) picked him up but at age 3, this had stopped. Perry says this is consistent with children who have disrupted attachments, they stop crying and give up trying to get their emotional needs met. He believed that Ryan had attached to 18 different “moms” and each one abandoned him in his eyes, in fact it was his mother who thought the nannies were getting too close to her son who then fired them. Before he started school, the relational part of his brain had become stunted and functioned abnormally according to Perry.

In a course on family trauma I did by Robert Rhoton, he lists a series of behaviours of sympathetic (angry, aggressive, reactive, hostile, self-centred, coercive, bossy, tantrums, impulsive) and parasympathetic (reactive, emotional and psychological distancing, self-centred) dominance (branches of the nervous system), that are consistent with many of the behaviours that we see in personality disorders. When a person is healthy, these two branches are switched on as needed, neither one is permanently on. A dysregulated nervous system is the basis for a lot of our ills, both mental and physical. One of the most defining and despised characteristics of anyone with a personality disorder is that of being self-centred, the extreme end being a complete lack of empathy for others. It’s like their mantra is “what about me?” and I say that as an observation, not a criticism.


I remember hearing Sebern Fisher saying of people with Borderline Personality Disorder that “they don’t have much sense of themselves beyond those feeling states”. Just imagine how that might feel? You’re stuck in sympathetic or parasympathetic dominance, or alternating between the two, and that’s basically your only sense of self. It must be hell on earth. We hear all the time that we should separate the behaviour from the person, especially when it comes to children. But we have very little compassion for that same child who, as an adult, has a mental health problem for whatever reason. How do we ever hope to help anyone rehabilitate if we don’t show them some compassion and understanding for what’s really going on with them?

There are many strong opinions on people with personality disorders, some believing that they are essentially unhelpable. I don’t believe that they are unhelpable or unreachable, maybe some are unreachable because they just can’t, or won’t, open themselves up to any outside input, it’s just too dangerous and risky. I can’t remember who said that children who have suffered developmental trauma usually become either overly responsible or under responsible and in my experience that is very true. I think many who fit into the category of personality disorders are usually under responsible. Very little is their responsibility, it’s like as if they feel they will be annihilated if they own up to anything. As adults, we need to take responsibility for the direction our life is taking, particularly if we don’t like where it’s going. Not taking responsibility is the bane of most people’s lives and the lives of those they touch.

We can’t make others be willing to take responsibility. Our responsibility to ourself is to take care of us first. We do no one any favours by rewarding bad behaviour, least of all ourself. We have a choice as adults to stay or go if we are being abused, though it’s not always an easy choice, but children don’t have any choice. That’s why developmental trauma at the hands of caregivers in particular, is so detrimental. The betrayal and wounds run deep and it takes time and care to repair them, but they can be repaired. As Peter Levine says, trauma is a fact of life but it doesn’t have to be a life sentence.

Monday, May 22, 2017

Learned helplessness

Trauma often leaves us helpless and powerless and while our response comes from the autonomic nervous system, as in we have no voluntary control over it, there is such a thing as ‘learned helplessness’. We then learn to default to this conditioned state when we perceive threat, even though actual danger/threat might not be present.

Because of learned helplessness, we can cede our power over to people, particularly those that society calls experts, or those we feel have more authority than us. But there are no experts, there are only people with expertise*, the difference between the two in my opinion, is that experts think they know everything there is to know and in that arrogance, try to set everyone straight. People with expertise on the other hand realise that just like everyone, they’re always learning. With an expert you’ll feel less than, with a person who has expertise, you’ll feel equal to. We need guidance, but what we don’t need is to be told what to do or what it is we need, we know that already on some level and a good practitioner will guide us back to that knowing, if we’ve lost trust in it.

St Declan's cliff walk, Ardmore, Co. Waterford, Ireland
Trauma informed care is important. What it means in reality is that someone has been trained to work with trauma or someone has been trained to recognise the signs of trauma and refer on. Many things help us on our journeys through trauma, if it has helped you, it counts, whether it’s yoga, walking, meditation, painting, swimming, reading etc. By utilising whatever it is, you are not saying it is the panacea, you are saying that it is making your life that bit easier and more pleasant. It really can be the ‘small’ things that can add up to the big things in life.

Maybe we’d like aha/breakthrough moments more often, or even just once ;-) and maybe even a magic wand wouldn’t hurt once in a while. Or maybe we do have aha moments and go forward 10 steps only to take 3 steps back. None of our journeys are linear, they look more like the back of a tapestry; a bit of a mess. But we forget that on the front of our tapestry, we’re creating our own unique picture.

We need to remember to count the good in our lives so we get to actually view the real picture every now and then, this will help us through the difficult times by inspiring us and giving us much needed hope and a bit of a break from trying to fix ourselves all the time. This is not a false or forced positivity but a genuine acknowledgement of the good in us and our lives. I think without this balance, we can easily despair and feel hopeless.

* I first heard of the distinction between expertise and experts from a lecturer I had in university.

Monday, May 15, 2017

The bladder meridian

Inflammation, the language of stress, can show up in lots of different ways and in different organs and in this week’s blog post, I’m going to discuss the bladder meridian (bladder 2), the eyebrow point in EFT. The bladder meridian is paired with the kidney meridian, which governs fear. The bladder meridian is the guardian of peace and the longest and most complex meridian in the body.


We can get quite overwhelmed when we think of everything that can go wrong, or that has gone wrong, with our health, but if we keep it simple and think in terms of relieving our stress whenever we can, we can really make some big improvements.

Where dis-ease shows up in our body and mind can be symbolic and tapping on the symptoms can be a doorway in to the root cause (which is nearly always a dysregulated nervous system due to undischarged traumatic stress). For example, imbalances in the bladder meridian can show up as excessive urination, interstitial cystitis, pain in the eyes, colds, blurred vision, nasal congestion, abdominal distension and so on. The key is to listen and follow the golden thread that leads us to resolution.

Monday, May 08, 2017

I am worthy just for existing

So many of us value ourselves and are valued by others for what we do, not who we are. This drives us to push, force and struggle but we never feel we’re enough or have done enough.

Try saying “I’m enough” out loud, how true does it feel on scale of 0 to 10? 10 being true and 0 being not true at all. Or if you find it difficult to rate how you feel by numbers, what does it feel like in your body when you say these words? How do you know it’s true, not true, or half true etc?


Or try saying it the opposite way “I’m not enough”. Do you have “evidence” to back this belief up? Try tapping on the following and change it to suit you and how you feel. You can download the EFT shortcut in the menu on the right hand side of this page.

Even though I feel that my worth is what I do, not who I am, I accept myself anyway

Even though I don’t feel enough because … I completely accept how I feel

Even though I don’t feel worthy (of …) I am open to that changing

TH: I’m not enough
Eyebrow: Because … (what memories/people pop up?)
Side of eye: Who I am isn’t enough
Under eye: And that feels …
Under nose: So I have to keep doing …
Under chin: To feel worthy
Collar bone: But it’s never enough
Under arm: I never get “there”

TH: Where is there?
Eyebrow: Love from others?
Side of eye: Love for myself?
Under eye: Acceptance?
Under nose: Validation?
Under chin: How would that feel?
Collar bone: That I’m enough?
Under arm: It would feel …

TH: When did I first feel I wasn’t enough? (Guess, if you don’t know)
Eyebrow: Just as I am
Side of eye: How would it feel
Under eye: Not to have to do anything
Under nose:  To be worthy (of …)
Under chin: I could do it because I wanted to
Collar bone: Not because I feel I have to
Under arm: And that would feel …

Saturday, April 29, 2017

Dissociation as a root cause

As Karla Mc Laren says in her book, Language of Emotions, emotions nearly always arise in clusters. It’s rare that neat well-behaved emotions come up one at a time, patiently waiting their turn to be felt. No, life is messier than that and of course when emotions such as anger, fear and sadness come up together, we can easily become flooded, especially the younger we are, and so we leave the premises as Tara Brach says. The premises being our body and mind.

Leaving the premises is another way of saying dissociation. Currently, there are distinctions between psychic and somatic dissociation which reflects the current mind/body split. But where does psychological dissociation begin and where does somatic dissociation end? I think it’s impossible to say this person has 48% psychic dissociation and is 52% somatically dissociated, that is, if anyone is ever 100% dissociated. All we can really look at is how dissociation, in any form, adversely impacts the life of someone and help them accordingly.

Paul Dell, for example, calls psychological dissociation, ‘clinical' dissociation and somatic dissociation, ‘animal defenses’, at least from my understandings of his writings. Dell argues that clinical/psychological dissociation is 'abnormal' whereas animal defenses are 'normal' and part of our evolution. I think both phenomena mirror the evolutionary development of our brains, bodies and minds and are normal and adaptive when we are faced with threat. Issues arise when dissociation, both psychological and somatic, becomes chronic and persistent. The mind, brain and body are linked in an interconnected system, when they are treated separately, disaster can result, especially for the person suffering.

Humans are animals the last I checked. These distinctions illustrate just how far removed we’ve become from our animal nature, body and instincts, which has done our nervous systems no favours whatsoever. If a wild animal does not discharge the freeze response (tonic immobility), if they survive being eaten by a predator, they remain in a startled and hypervigilant state which makes their chance of survival very poor. Remaining hypervigilant, they perceive threat where there is none and become less sensitised to real and present threat. This hyperaroused state also creates exhaustion, so when they do need to act, they don’t have the energy or stamina to outrun the predator. The exact same thing happens to what we call ‘civilised’ humans who have been traumatised. Too many of us have lost our knowledge and ability to shake vigorously after receiving a shock, to howl, cry and scream when we’ve lost a loved one and so on. Many of us have had to learn to keep it all in to survive and not rock the boat.

This mind/body split is also mirrored in current measurement scales for psychic and somatic dissociation. There is the well known Dissociative Experiences Scale (DES) which measures psychological dissociation. Out of 28 questions, there is one nod to the body, question 13. Then there is the Tonic Immobility Scale* and the Somatoform Dissociation Questionnaire (SDQ20), which both measure somatic dissociation. There have been some steps forward in the field, a recent paper by Nijenhuis (2017) recommended that conversion disorders be recategorised as dissociative sensorimotor disorders in DSM-5. (He uses the terms cognitive-emotional and sensorimotor dissociation in this paper in place of psychic or somatic dissociation).

*Click on image to see larger view of Tonic Immobility Scale

I know there is debate over whether dissociation is a process or a state, I think it can be both. I haven’t yet heard a term that better describes leaving our bodies and minds and the resulting split, or splits, that can result (what Nijenhuis and van der Hart (2011) refer to as structural dissociation of the personality). I believe that anxiety arises when we’re overwhelmed by years worth of stuff, it’s a compounded state consisting of unfelt emotions (and physical sensations etc), that we’ve dissociated from, consciously and unconsciously.

Download this excellent app for free here

So many ‘disorders’ stem from dissociation and trauma, which is why I believe it is so important to normalise the terms themselves and the experience of them. They are the root cause for so many so-called different ‘disorders’. All of us are somewhere on the dissociation continuum, as we are on any continuum. Who among us hasn’t been hurt (traumatised) or wanted/needed to avoid (dissociate from) pain?  Isn’t it about time that we started looking for and healing the root cause instead of being blinded by symptoms? Isn’t that what science is supposed to do? Concepts like dissociation can really frighten people, but with education and normalisation they don’t have to.

So, where do you start on your healing journey, wherever you find yourself? You start slowly, taking one step at a time. As Martin Luther King Jnr says: A journey of a thousand miles, begins with one step. You start by being as kind as possible to yourself as you go inside to reconnect with what remains unexperienced so you can experience it as slowly and as gently as you need to. Don’t forget to resource and support yourself wherever and whenever you can. This isn’t about pushing through and going fast, in fact the more urgent you feel, I think the more slowly you should take things or you risk being overwhelmed and even retraumatising yourself.

References
Bernstein, E. M. and Putnam, F. W. (1986). Development, reliability, and validity of a dissociation scale, Journal of Nervous and Mental Disease 174(12): 727-735.
Fuse, T., Forsyth, J. P., Marx, B., Gallup, G. G. and Weaver, S. (2007). Factor structure of the Tonic Immobility Scale in female sexual assault survivors: An exploratory and confirmatory factor analysis, Journal of Anxiety Disorders 21(3): 265-283.
Nijenhuis, E.R.S., Spinhoven, P., Van Dyck, R., Van der Hart, O., & Vanderlinden, J. (1996). The development and the psychometric characteristics of the Somatoform Dissociation Questionnaire (SDQ-20), Journal of Nervous and Mental Disease, 184, 688-694.
Nijenhuis, E. R. S. and van der Hart, O. (2011). Dissociation in trauma: A new definition and comparison with previous formulations, Journal of Trauma & Dissociation 12(4): 416-445.
Nijenhuis, E. R. S. (2017). Ten reasons for conceiving and classifying posttraumatic stress disorder as a dissociative disorder, European Journal of Trauma & Dissociation 1: 47-61.

Monday, April 24, 2017

Let me count the names

Can you think of any physical disease where people might have insults hurled at them just because they had the physical disease? I certainly can’t. People would think it cruel and unkind, yet it’s okay for people with mental illness to be insulted and derided. It’s even called ‘joking’ by some. The sheer amount of insults hurled at anyone who has a mental illness speaks for itself, this is a short list and it’s only in English. The name calling and consequent shaming, illustrates the fear and ignorance of mental illness (or indeed any condition related to mind and brain health such as intellectual disabilities) is still alive and kicking. Ask anyone how the stigma affects their day to day life and unfortunately, they and their families will have plenty of stories.

In the case of schizophrenia and bipolar disorder (formerly known as manic depression), people are/were called schizophrenic and manic depressive, which I think is absolutely appalling. I can think of only one physical disease in which that happens which is diabetes, people who have this condition are often referred to as diabetics. Are people their illness now, is there nothing else to them except the illness?


Many so-called mental disorders are actually caused by trauma. Just imagine stigmatising someone because they’ve been through tough times? Hard to believe that that could happen isn’t it? But maybe that’s because many people haven’t made the link between adverse experiences and poor mental health. They might still believe the outdated claim that it’s a “chemical imbalance”. So where does the chemical imbalance originate from then? You’ll get very few satisfactory answers to that simple question in mainstream medicine. Or maybe it’s because the shame of mental illness goes so deep that we prefer to deflect and project our fears that it could be us onto others. Name calling, it’s sad to say, is only part of the stigma, discrimination in all its different forms can really inflict untold suffering.

Another major cause of mental illness is inflammation, especially in our gut which is intimately tied to our brain, the health of our gut affects our brain’s health and vice versa. And what is one of the biggest sources of inflammation? Stress; biological, emotional, environmental etc. So traumatised people are especially vulnerable to any chronic disease, both mental and physical, because their stress levels are usually high, as the ACE study and many other studies have showed.

I have never heard someone with schizophrenia say “I am schizophrenic”, instead they usually say “I have schizophrenia”, it’s others who usually refer to them as schizophrenics, and surprisingly a lot of them are mental health professionals. Leaving space for who you are beyond any diagnosis or label is crucial. This isn’t about being politically correct, as that terrain is always changing, it’s about how we see people who are suffering with mental health issues and how they feel as a result. And more importantly, how they feel as a result of how they see themselves.

When I’m tapping, I often use ‘I am’ and ‘I feel’ sentences which I find really useful. Take the statements, I am bad or I feel bad, for example. Feeling bad is (hopefully) temporary, whereas I am bad, is permanent. It’s a belief, a “truth”, but not “the” truth. It’s always good to differentiate between ‘I feel’ and ‘I am’.