Our Weird Addictions

 

People have infinite ways of providing themselves comfort as an answer to emotional pain. Cutting, burning, picking or scratching the skin; pulling out hair, chewing nails down to the quick. Actually almost anything done excessively in an altered state can do the trick: shopping, spending, hoarding, exercising, sex, masturbating, gambling, and, of course, eating or restricting eating. Almost anything that can be put in the mouth, inhaled, touch the skin, or impact the nervous system in a dramatic way that releases endorphins is of great use to those suffering emotional pain. Many  modalities share the common advantages of being individually controlled, can be done in private and kept secret, pose no resistance of themselves, break no laws, and create a very efficient, alternate hedonic loop in the brain that gets the relief to where it needs to be in a hurry. An alternate route of satiety and relief that is much faster and effective than other routes. Actually, to understand how these methods alter the nervous system to relieve pain is to understand they are a rather brilliant idea.

 

But how can I, as a therapist, say that? Well, Jon Conolly, the creator of Rapid Resolution Therapy has reminded us that the human predicament is quite unlike any other animal’s  walking the face of the earth. When a dog or a monkey has to deal with having to run or fight for it’s life, the brain’s emotional mechanism floods them with negative feeling and motivates them to profoundly pay attention and take action to get their situation to stop happening.  It is turned on and off quite efficiently. They are not in pain while it’s on. A rabbit running for its life is motivated, alert, and made unusually strong and fast.  It all  lasts no more than seconds,  at most, a couple minutes. The animal, if it survives,  shivers a bit, shakes out its coat, and resets emotionally back to normal. It goes about nursing whatever physical wounds it has suffered matter-of-factly, without anything like emotional pain. If it is caught and its brain understands there is no chance for escape or successful counterattack, a kind of peacefulness settles over it and its mind exits the scene. There is no emotional pain there either.

 

But not so with us. For us,  the flush of anger, grief, fear, betrayal, outrage, etc., can turn on and stay on for years. Think about the predicament of some people having to cope with the flood of something meant to meet survival challenge with all its original intensity every hour of their life. Unremitting jacked up anger, horror, terror, disgust. You get up with it, you spend your day with it,  go to bed with it, and it is there in the night.  A switch that had it turned off,  would have been tolerable, but now stuck in the “on” position, spells excruciating pain. And then because humans can stick on meanings afterward, shame, guilt, or hate may also appear. Still another layer of pain. This guy is sitting on a bench and sees a pretty lady chatting happily with a man. He remembers his wife’s infidelity. That gal is riding on a subway and she smells a certain body odor. She remembers her rape. All you have to do is lightly push on the sore spot and even though it’s twenty years later the person is beside themselves. It no longer has anything to do with survival but the old brain doesn’t know that. It keeps sending the signal to get it to stop.

Take cutting. Imagine how sick of  that pain you’d have to be to be willing to localize and control it by cutting on the tender tissues of the breasts or inner thighs or even genitals. Connolly points out that now at least you have it in one place and you know who’s doing it and how long the worst part will last.

 

From this perspective, it is not hard to figure how something damaging that also offers relief, containment,  and instant comfort could be recategorized by the primitive part of our mind as an old friend, a reliable one at that. But that is not how the parents  who bring in their 14 year-old daughter to therapy see her cutting, or how the culture sees the 22 year old’s bulimia or the sex addict’s repeated immersions in pornography.  The culture to protect itself sees the behavior and wants us to put it outside the limits of acceptable with a label.  Instead,  this attitude glues pathology onto the person’s identity even firmer as they are seen as weird, abnormal, and aberrant because people are more likely to go along with a consensual meaning instead of taking a longer look at a phenomenon for themselves.  And this is what is happening even if we give it a fancy diagnostic name.

And what if counselors buy into all this distancing and labeling? To me it’s like going up to a very lonely and desperate person and insulting them for choosing to hang with the one friend they’d found in the world. “Hey, Why do you keep hanging around with that jack**s?”, is not a question I want to lead with or imply. I want them to get that I get how much pain they’ve been in. Are there better ways to handle it? Without a doubt. But I won’t get there, wont get a connection with that person in order to shift them into something better until they get that I get them.

It’s on me to convey that I understand how desperate they got and how frightening it would be to let go of that old friend. And that I have something better in view, like an end to the obsolete messages themselves; the start of a whole new life.

 

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Codependency

Codependency is a term that was given birth in the addiction recovery community. It originally gave clinicians a way to get a handle on the remarkable similarity they often saw in the troubled family members of addicts. Over time another and perhaps better term was coined by P. Melody, developmental immaturity. She provided us a frame on which to arrange the deficits we saw in self-esteem, boundaries, reality, interdependence, and affect regulation. Others noticed associated problems, such as resentment, manipulative control, being “enmeshed” with another, and trying to find one’s worth through satisfying the needs of others.

But the above thinking was missing the more recent insights from adult attachment theory that sees some dependency as an inevitable and natural part of bonding in close relationships. The attachment luminaries made a distinction between a functional dependency which comes by way of secure attachment and gives us the safe haven and secure base we need to develop ourselves and explore life versus an unhealthy dependency that allows neither. Codependents had no working models of self and other that were in balance, no secure attachments, and scarce little comfort or support. Indeed, as we got to know them, their orientation to the world made sense as we learned of their shaky start, the shocking amounts of abandonment or neglect they’d suffered; childhoods clipped short because of overwhelming family circumstances. It is through that lens that I see them and will describe them further.

Real participants are not textbook examples, but persons of complex mixtures, with tinctures of various traits. There is a lostness and an inability to think for oneself. A woman might be running a company by day, making all sorts of crucial judgments, but in the context of her intimate relationships she loses her way as she submerges herself in someone else’s reality. She wants to be taken care of in a total way even as she tries to totally steer someone else’s life; she can cite chapter and verse on another but may lose the ability to express any sort of preference of her own and, at the extreme, seems to vanish as a person in her own right. A guy might back away from any confrontation, take all sorts of continuing abuse, and dutifully go on mopping up after an out-of-control person in his life out of the belief that it is up to him to hold all things together.

Both may look to others to literally decide the steps to take in their life or for “the answers” about what they should do next. It is as if thinking or planning for oneself is an exhausting and noxious chore. These folks tolerate aloneness poorly, and often go into a deep funk upon the ending of a relationship. But then they don’t waste much time before jumping right into the next one. They have an uncanny blindness for signs of obvious danger and keep picking wounded partners, the worst candidates to return the intimacy they crave. Unable to see their own part in creating an unlivable environment of gullt and unending obligation, they are often angry or sad, befuddled as to why their relationships fall apart while those of others seem to work. He or she may complain of having done everything for family, made every kind of sacrifice, only to go unappreciated, and hold a deep resentment for being cheated on the deal. There is the sadness of unrequited love, but an even deeper sadness for having given up on their own becoming, for having abandoned their own unfolding potential, a kind of perpetual mourning for a self that has not yet lived.

For these lost boys and girls of the world, the experience of being seen, or more accurately, being found, is life-changing. We want to reverse the experience of invisibility and not mattering. In Rapid Resolution Therapy we know how to do this. Jon Connelly, the method’s creator, emphasizes that traumatized individuals need to have powerful, impactful new experiences in the present and that therapists can create these sensory-specific experiences through enhanced connection throughout the therapeutic process. By demonstrating a lively interest in the participant’s experience, we create an impact whereby they feel felt and seen. By creatively using metaphor, we create a new experience in the present moment that can shift mind into more adaptive functioning.

One process we have is called changing perceived identity and internal geography, a process that bridges into a profound new apprehension of the self. The participant learns self, or essence, is not the many false things they’ve believed, and it is certainly not defined by others’ behavior. Essence is still intact, and no matter what has been lived through, she is still on her own journey to express her perfection in everything she does. This comes as exceedingly good news.

We introduce her to the precursors of stuckness, such as thinking from the negative or disappearing the present. She begins to learn how to first orient toward what is desired instead of what she doesn’t want, and how to get present with what is actually happening right now. As we go along we clear the ghosts of any major abuse/neglect episodes. We teach how to think as a scientist would rather than getting bogged down in moralisms or bemoaning how life should’ve somehow turned out differently. From there she naturally moves into being a more causative, active agent in her own life. She gets that if even bees can do this, that is, move adaptively toward new fields and flowers that give nectar, she certainly can do this in her own time and way.

We know how to wake up identity through expression of preferences and choices. We know how to build a model with each participant which includes taking the long view, i.e., taking no action that wouldn’t have a long term beneficial effect on self. She learns to aggressively seek out things that nurture her, casting a wider net, as opposed to pouring herself into one person. She learns, perhaps for the first time in her life, to balance giving with getting and that respect is foundational to any relationship. She is often in the middle of the latest crisis, so we anchor a movie to take care of any emergent situations or especially upsetting people. It’s a big tool box with many tools.

I’ve learned that the mind can generalize to a thousand other instances from a few well-framed specifics. So much that looks lost can suddenly shift, with an awesome efficiency and precision, into a newfound certainty and direction. It is the experience of being found that makes the difference. It is, indeed, an amazing inrush of grace. And I am so blessed to be part of it.

“I once was lost, but now am found
Was blind, but now I see.”
–John Newton

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Depression

 

Rapid Resolution Therapy takes a rather unique view of Depression. Unique, I think, because it actually leads the therapist into unique and innovative ways of seeing the effect we want to have and using language to help our clients up and out of the bogs they get in.

Jon Connelly teaches that emotion is really effort. Nature has arranged it so that any negative emotion is the primitive brain’s tool to get the animal to take an action to get something in the world to stop. Think of a mother bear defending her young or a rabbit fleeing from a wolf. Mind is using emotion to activate their whole system to take an action to affect a situation, in rabbit’s case to run and in mother bear’s case, to attack. This is a radically different way to see it than attributing the cause of emotion to the external thing. Mind is not pushing  big negative buttons just out of boredom or to put the animal in a bad mood. Pushing the button always has a practical and survival-oriented purpose–to make the animal act to change a situation because that’s good for its bloodline.

But with humans, this older part of the brain has to constantly cope with a data flow about stuff that isn’t in existence. Past things that are no longer happening and future things that we can forecast or imagine. So with us a threatening picture can come up on the screen and the older part of our brain doesn’t take into account it really isn’t in existence. Mind starts pushing the negative emotion button in a rather indiscriminate and inaccurate way. Our negative emotions in these cases are all about effort to change that out-of-existence situation, no matter how off-target to what is actually going on.

But here’s where it gets interesting. When you put effort into something that doesn’t respond to your effort, you have done what is  ideal to prepare the ground for depression. Jon explains this in terms of the old isometric exercises that TV workout shows used to feature. Nobody does these anymore. Why? Because they are depressing! Imagine going to a gym five days a week and trying to heave a bar bolted to the floor. The intellectual part of our mind wouldn’t keep this up more than a minute or two. But the older part of the brain, with it’s eternal now orientation, keeps trying and trying. Pouring effort into something that won’t respond to your effort breeds the sense of powerlessness and hopelessness that is the perfect witches’ brew for a depression. If someone really puts their all into this, their whole heart, telling themselves it is now a need like air and food and that their life’s happiness rides on producing an outcome, even though it’s patently impossible, you have amplified the possibility of creating a real whopper of a depression at least tenfold. Think about people you know who’ve spent a substantial part of their lives trying to get someone or something else to change, despite ample evidence to the contrary. They are not brimming over with vim and verve.  I’ll tell you it’s not the intellectual part of the brain that’s at the wheel, but the older part, attempting to pour effort and then more effort into something or someone who doesn’t respond.

Some of Connolly’s newest thinking on this incorporates rage. Suppose someone got violated and her brain is flashing the threat signal to do something to take an action about a situation that’s no longer in existence.  Her mind is using negative emotion to get her to stop a situation. Could be anger, could be fear, or any other negative emotion.  So far you have the first part of the problem. Now add to that the human propensity to react with anger when something is perceived as wrong.  Then secondarily something else happens– anger kicks in because it shouldn’t have happened in the first place. The moment humans tell themselves something “shouldn’t have happened”, anger flashes as if to an actual threat happening here and now. Her mind is screaming at her to go ahead and do something about it–get it to stop and to correct the injustice,  only she can’t do anything about any of it, it happened 15 years ago. She gets the feedback signal that she hasn’t yet got it stopped so she tries harder. Both vectors are working on her. Or to say it differently, with emotion added to the scene about shouldn’t have, we have a second vector of threat. Anger in nature implies a threat, so the secondary anger from “shouldn’t have” piggybacks on the original threat. As she gets angrier she gets more threatened which gets her angrier, which begets more threat, and so on and so on. This loop has her pouring in emotional effort from deep reserves to get something to stop or turn out differently, and it’s impossibility always leads her back to the same place. This is a desperate place to be and the only word for it is rage.

What happens next is profound. All that rage is hot,  like steam in a pipe. Think about a pipe with superheated steam running through it, so hot the pipe itself is glowing red.  Now the participant has to be shielded from an element of her own system. It’s just too hot to be tolerated. She can’t get her hands on it to do anything with it and she cannot stay in close contact with it for very long.  So her mind wraps the pipe in a thick asbestos batting. That batting is depression. Thicker and deeper than usual to keep it all under wraps.  From outside, the rage can now appear quite cool, disguised, hidden far below the surface. But from inside, the batting is poisoning her with the accumulating crud of threat– a muffled protest, an abiding bitterness, hatred, jadedness, giving way to a detachment or numbness that spiders out through more and more of the personality. There can be a near total withdrawal from life and things that might bump into or wake up all the rage. We’ve all known people wrapped tight like this.

Just putting these concepts out there is part of Connolly’s genius. His seemingly limitless fund of metaphors and perspectives gives us more and more ways to language things.  We see more clearly what to clear and how to work with people to have the effect we intend for them. I am now thinking and seeing in terms of annihilating life’s should or shouldn’t have’s or any other distorted meaning that has her trapped. There’s plenty in life we could think of as “wrong” but how much rage do we want to swallow?  I’m thinking life’s knocks are tough enough without all the distortion. I want to blow away rage by shifting mind into done and finished with that and the realization that whatever tough thing happened, it couldn’t not have happened or been done any other way.  I’m seeing her free from her thick casing, graceful, content, at peace, totally in touch with what is beneficial and possible for her now.


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Intimidation

Beginning this month I switch things a bit, taking a look at some common life problems from a Rapid Resolution Therapy perspective. The topic this month is Intimidation, a theme that seems to show up in a lot of people’s lives.

We know in these times of economic challenge,  some may be in jobs that are not to their liking.  Others may have returned home or to a relationship of situational dependency.  In both situations, leaving may have a steep downside, and may be perceived as not an option. Intimidation seems to take root in these soils, causing great anxiety and pain. As one person put it, “I seem to just freeze when he (she) acts that way. I should know better and usually hate myself afterwards, but at the time, I just take it. It’s like I can’t think of anything else to do.”

This deer-in-the-headlights effect is commonplace around an intimidator and should not be taken as a sign of personal weakness. We’ve all heard of the fight/flight response, but freezing around a predator is also one of nature’s built-in options that takes place in the oldest part of the brain. When a cat catches a mouse, and its brain understands that both running and fighting are no longer possible, the mouse goes totally limp, its mind and body cooperating to feign death. The almost instant down-regulation of the nervous system and mental numbing  is meant to keep us and all other animals still until the predator loses interest and danger passes, or at least keep us anesthetized if we are going to be eaten alive.

People often try to reason with an intimidator or express their hurt, hoping to wake up empathy and understanding. They may persist despite evidence to the contrary, especially if caught up in their own expectation that people should always be reasonable, responsible, and kind. The problem with this approach, I believe, lies in not recognizing that the intimidator’s prefrontal cortex is off-line. This is the part of the brain in charge of self-awareness, empathy and good judgment, where normally a person could look at the whole picture, and back-off for the good of all concerned.

But intimidators are dealing mainly from the older brain, where perceived powerlessness and threat to survival register and have to be acted upon.   That part of the brain doesn’t have what Dan Siegel has called mindsight, the ability to read the inner world of someone else, and may not compute the valuable social information coming in from others.  For intimidators, the threat is immediate and must be acted upon. Displays of anger, aggression, and control become appealing because they work–temporarily.  They intimidate others in order to go one-up,  to climb up and out of the victim position, which is where they see themselves. They learn powerlessness and emotional pain don’t have to be felt; they can be short-circuited and transferred to another. But this loops back on them. Control and aggression carry within them the seeds of heightened insecurity. Fear, rigidity and loss of mindsight amount to a massive inability to adapt, which sets intimidators up for even more vulnerability in each new situation. 

From the view of this as a relational system, this is a powerful cue that pulls for a symmetrical (complimentary) response from others.  They simultaneously hate and are drawn to the vulnerability which they create in others or others carry for them.  And vulnerability seems to activate them when they come across it in others. They don’t see the outstretched olive branch their victim may be holding. They see a red flag, a reminder they could be weakened and hurt again.

So here’s a story that might help. Long ago in old Mexico, on a remote hacienda, young Pedro was watching his father and the other men handle the cattle at branding time. Pedro wanted to take part, and be more like the men. His father said, “Pedro, my son, to be a man you must first deal with El Malo, the bull.” El Malo stood about ten hands high at the shoulder, was solid muscle, and known for his nasty and unpredictable temperament. More than one of the ranch hands had a long scar along the ribcage from getting careless around El Malo’s great horns. His father continued. “My son, you must go into the corral and face El Malo. And you must find a way to get him into the barn. Then you can take part in the branding.”

The boy was very scared, and didn’t know how he was going to do it, but he climbed into the corral. The bull was at the other end nosing in the dirt, his huge withers and flank shining in the sun. Pedro advanced slowly, one tentative step at a time, until he was within arm’s reach of the bull’s nose. He was still very frightened, but he observed: the bull, looking back at him, had a mixture of emotion in his eyes. There was anger, but there was also fear, sadness, and confusion. Mostly confusion. Pedro leaned way forward and dared to touch the great muzzle and for just an instant, the bull let him. But then becoming wary again, El Malo snorted and backed up, waving his horns. Even more of that confused look was in his eyes. Suddenly, Pedro turned around and with his back to the bull, walked even steps across the corral back to the barn door, counting to himself as he went. When he got to the barn, he made sure to lean his back right against it so his hands found the crossbar that locked the doors. Then he started yelling and dancing, shouting “Toro, Toro”, making quite a fuss. The bull hooved the ground one, twice, and then charged. Pedro watched him come, counting the bull’s strides and at just the right moment, lifted the crossbar, spun out of the way, opening the barn door, as El Malo’s massive head and trunk whisked by. His momentum carried him all the way into the barn, with his backside facing out, whereupon Pedro quickly shoved the doors closed and dropped the crossbar. The men cheered and clapped his father on the back, as his father smiled broadly and nodded at his son. Pedro had figured out how to get El Malo the bull into the barn.

(Disclaimer: The reader should not to take this as literal, specific advice. It would, for instance, be a very bad idea to purposefully incite a more powerful person who is in a position to harm you. The point of the story is get us to realize we may have more of our brain on-line,  as it were, than an intimidator usually does, and hence, more creativity ready at our disposal)

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When Something is Split Off

“Man, I just can’t get myself going.” I know the lawn needs cutting, and I even bought a $900 riding mower, but when I go out there and go to get on it and turn that key, I just hate it. I find myself saying, “The hell with it. I don’t care if it grows two feet, I’m not cutting it.”

In my work with hoarders I’m finding what lies beneath procrastination is often frozen or split off hurtful experiences. We isolate these and banish them to the nether regions of our minds where they continue to cast a shadow and have an effect. In Rapid Resolution Therapy we learn that after laying a strong foundation of connection and clearing major abusive incidents, there are sometimes “minor” incidents that still rise to the front to be taken care of and likewise cleared up. With mind already shifting and looking forward toward the new life we’ve intended together with the client, mind can now safely scan back and pick out just the right incident or string of incidents that still casts a shadow.

The fellow above had actually gotten his home about 90% cleaned up but found that certain “chores” still brought up the old resistance and the urge to give up in disgust. I asked him to stay with the picture of the ongoing success that we both knew about and, while staying with that, let mind scan back and pick out something that needed clearing. Without hesitation he went to age 12 when his dad would make him cut the front yard with an old rotary push mower and cut it again and again until it was just right. He then made him transplant all the tulips, weed the entire flower bed, basically expecting the performance of a professional landscaper out of his son. If anything was amiss, he would dismiss him, sending him away,  to do some lesser task inside the house. In other words, at age 12, if he couldn’t function like a professional, he would get demoted on the spot, treated as a rather useless day laborer and dismissed from his father’s favor. He continued, “I remember getting so frustrated with the whole thing, I’d just kick the shovels, kick the mower, and throw bags of dirt around.” He hadn’t thought about any of this consciously in years and years, and yet here it was still casting a shadow.

So I had him join me in looking back on the boy.  I told him we or no one else would look at that kid as reacting differently or worse than any other kid on the block. He was in the middle of a tough situation and he was surviving, just getting through it in the best way he knew how. Nothing happening there said anything about him. Certainly no impartial bystander would expect a kid in that situation to handle it better and most would wonder what was going on for the dad to put all that on the kid. From a more enlightened spot in the present,  where we both realized he was now in terms of being an adult with 90% of his home cleared, I had him look back and watch as the boy watched us with what we realized, and slowly start to get what we knew. I asked him to watch for the change in the boy’s eyes, watch for a certain light coming into the eyes, the sign that he was getting it. He saw it, opened his eyes, and nodded his head, breathing a big sigh.

The next time we met he greeted me with a wry grin. “You know for the last couple weeks, I’ve been making a game of mowing the lawn.” “What do you mean?” I asked. “Well, there’s a couple little boys that live next door. They watch me out of their window. So I went and asked their mom if it’d be okay if I let them ride on the mower with me. She said, ‘Sure’. So I bring them up in the seat and just for a moment let them take the wheel and try keeping it in a straight line. I keep my hand on the wheel, give it a bump if they lose their line, but just let them give it a try. The mom came up to me the other day telling me how they came in that night and couldn’t stop talking about riding on the mower. What a big kick they’d gotten out of that. And that helps me, ’cause I see what fun they’re having.”

When things that have been split off are reunited, the part of the self stuck in that experience is reabsorbed. As the experience is made part of the self again in a way that’s okay, mind frees all sorts of energy.  It takes all that inspiration, and puts pen to paper in new ways–ways that are unpredictable, poetic,  and amazing to behold. The energy freed up from things in the past joins the energy that comes together with the combined intention of therapist and client, and as Jon Connolly so often states, it has to expand, it can’t go anywhere else but to source. It fuels the total transformation of the client stepping into his or her new life now, fully present, clear,  flexible, with mind bringing into awareness all sorts of new benefits and possibilities. I couldn’t have planned a more elegant application of the use of this energy. His mind did it perfectly.

(Note: All stories are shared here with client’s permission. Names are omitted to protect confidentiality.)

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Guerilla Connection

There is a famous story that Milton Erickson used to tell about the studies of Margaret Mead, Jane Belo, and Gregory Bateson when they went to Bali in the 1930′s. They found the Balinese people can go into a deep trance at a blink and in fact can do things like go to the market, accomplish their shopping, even visit a neighbor–all while in a trance. Autohypnosis is part of their daily life. The three famous researchers actually brought back movies of this occurring for Erickson to examine. Of course it didn’t surprise him; he recognized this is not a culturally specific phenomenon, but pointed out that for all peoples, trance is a rather ordinary everyday experience (My Voice Will Go With You: The Teaching Tales of Milton Erickson, edited and commentary by Sidney Rosen, p.74). Erickson himself was legendary for recognizing hypnotherapeutic opportunities and making lightening-fast use of them.

Rapid Resolution therapists are keenly interested in making rapid connections with our clients and making best use of these naturally occurring states.  We could, in the best sense of the term, call this Guerilla Connection. We want the world to drop away for the client,  to grab their complete attention, and to create a special kind of joining experience,  because it sets up a profound receptivity to our healing interventions. There are subtle changes that indicate a client’s “response attentiveness”. They will vary a bit from person to person but could include a flattening of facial expressions, staring, absence of blinking, and almost complete immobility.

This can be created in multiple ways: as we demonstrate interest and understanding in their situation; as we use appropriate humor and become interesting, even intriguing, to the client; as we provide uplift, separating identity from illness language and using tense changes to locate trouble in the past; as we use voice to create pauses, tonal emphases, or duplicate word choice, rate and volume of speech; as we use our own body to mirror posture and rate of breathing; as we listen to stories from their personal lives and catch certain signs of trance, particularly rich, sensory-laden words that are anchoring an experience that is pivotal for them. I’m remembering one lady who started telling me about being able to smell her deceased mother’s perfume sometimes. In retrospect, I missed that one.  I only needed to tell her “That’s it. Stay with that” and she would have slipped into an immediate connection, a connection she had previously been blocked from.

A person’s language can tell a lot about their preferred channel for forming connection. Someone sharing with you something from “the way they see it” or from their “point of view” is likely to favor visual input. But not everyone is visual or adept at creating images in their mind’s eye.  Another person may emphasize the verbs “hear” or “say” in their reports of experience, or what something “sounded like” to them; they may automatically assume they must recite large fragments of conversation for you to get what they experienced. Such a person favors auditory input. And, of course, others will “lean toward” being “in touch with” something,  or the “feel” of an experience. They will even demonstrate with their bodies through shudders, shrugs, and shifts of posture whether they were “comfortable” or not with something. These are the kinesthetic folk.

Of course,  Guerilla Connection works both ways.  The other day as I was checking out of a restaurant and paying for the meal at the counter, a sudden sneeze came on me. One of those that tickles for awhile and works its way up, that you try your hardest not to have. As my hand went up instinctively to protect others from the spray I thought sure was coming, the cashier mirrored my hand and raised hers suddenly to her own nose while her eyes riveted me. The raising of the hand to cover the mouth and nose is a universal gesture that she recognized and used to join me. While shaking her head “No” she ordered me to say  ”Watermelon, Watermelon, Watermelon” three times!  I looked at her in amazement because it sounded urgent and ridiculous, like the words “Ab-ra Ca-da-bra” before the climactic moment of a magic trick. I obeyed like a schoolboy and said the magic word “Watermelon” three times. And you know what,  it worked! Not only no sneeze but the tickle completely vanished. In about 2.5 seconds she had created a “purposeful communication utilizing connection, credibility, and effective language to get the desired response from the subconscious.” She had done a Guerilla Connection on me and performed a mini piece of good samaritan therapy.

I’m just amazed by language and all the other ways we communicate and how,  as a species, we connect in the everyday to help each other. As you sit down with someone, or even as they walk into your office, keep all channels open and you may find a way to do a Guerilla Connection and make something very powerful happen fast.

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Post-Traumatic Growth

Recently on National Public Radio three trauma experts discussed what we have learned in the ten years  since 9/11. Two of them, professors,  remarked on developing a  fascination with Post-Traumatic Growth. The term refers to the fact that some people who go through a trauma of seismic proportions, move out of their grief rather quickly, take stock of their priorities, and redirect their effort and commitment in an all-encompassing way. They do so in a way that clarifies identity and direction, stabilizes emotion, and makes them stronger for the future.

 

It rather amazed me that this was considered a new concept. The Chinese character for crisis is a combination of the words for “danger” and “opportunity”, the possibility of two roads leading out of trauma.  Now, China has been around a long time. Who could argue that civilizations have experienced, from the earliest times,  traumatic blows that challenge their very existence,  and advance,  or not,  depending on how well they are able manage the opportunity side of the equation?  Post-Traumatic Growth is no new thing either for a person or society.

 

So what is PTG? To put a human face on it, I saw an interview leading up to the ten year mark with former mayor of NYC, Rudy Giuliani, who walked New Yorkers and much of the country through the hell of those days. The reporter asked him how 9/11 changed him. He paused a long minute. You could tell he didn’t have a prepared response.  And then he said 9/11 had changed him in just about every way a person could be changed. Spiritually, as he learned to pray at his time of greatest need and got the answers he sought, enlarging his faith forever.   Awareness of his mortality, as he realized we all, sooner or later, will face a situation that dwarfs the resources, skill, or strength we can bring to it. Or, as jazz great Wynton Marsalis once put it, “Life has a paddle for every behind.” And it stretched Rudy Giuliani into a greater grasp of his life’s work and the call the hour had placed upon him.  It was as if history itself had put a hand on the middle of his back and pushed him onto the stage to lead the people of New York through their darkest hour. He discerned that his message on behalf of all New Yorkers had to be this:  that though buildings may come down, New Yorkers would not be cowered by terrorist acts. That their answer had to be they would not live in fear, scared into a despair that would make them relinquish the freedoms we live by.  Being the voice of that message and getting it out in those days following the attacks took him into territory he never knew he could travel.  The look on his face told me this was no mere flag-waving by a veteran politician. He meant every word. He really had been stretched. He had experienced Post-Traumatic Growth.

 

What to notice is this:  PTG turns on getting a sudden glimpse of the direction life wants you to go. It is not about being brazenly over-confident or well-prepared. No one is.  You may wonder, “Wow, am I strong enough for this?”  People interviewed after a disaster usually admit to such thoughts.  But they also say they just did what they had to do, they couldn’t have done it any other way.

 

As one moves into PTG,  mind is shifting into HD mode and getting a picture,  a vivid model of how to function optimally,  for that moment and future moments. There is no division in the mind, but a rapid winnowing out of what no longer matters, and sudden clarity about what matters most and what one needs to do next. The mind seems to  zero in and sees the bigger picture all at once; it brings to awareness what is most beneficial and possible, so there is an economy of thought and of action for that particular context. It is a transcendent moment that may be over in a flash, like the passengers who rushed the cockpit of United 93 to save the lives of people they would never meet. Or it may reshuffle things for a lifetime, like the  widow of a fireman killed in the line of duty, who started a national foundation to benefit the kids of all fallen firemen everywhere.

 

One gets a vivid model of the self they are meant to be. The mind accelerates toward it, getting on all levels how most of the rules, roles, and messages that pertained to one’s former life are no longer relevant. One sluffs off a skin that no longer fits and moves ahead with a unified identity and mission. The energy that is thrown off in this metamorphosis is palpable to those around,  the difference in strength,  unmistakeable.  As it expands, this energy can connect with others and take them in. On the anvil of humanity falls the hammering blows of trauma that life deals out. Some metal shatters and breaks off as slag. But some metal is tempered, made stronger as its atoms rearrange, and are fashioned into a whole new instrument, capable of more.

 

 

 

 

 

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Healing Relational Trauma Part 3 of 3 part series


We live in the shelter of each other    – a Celtic saying

Susan Johnson, arguably our era’s most prominent researcher and developer of today’s most coherent, research-based system of couples therapy, Emotion Focused Therapy, says emotional starvation is real. She echoes what John Bowlby said 40 years earlier. He and Mary Ainsworth in their now famous attachment studies documented that humans monitor the emotional and physical availability of our caregivers, that we reach out to this person when we are upset, that we miss this person when apart, and that we count on this person when we go out into the world to explore (Johnson, 2007). Harry Harlow, a colleague of Bowlby’s , found monkeys depend on what he termed “contact comfort” and preferred it even to food, when given the choice. On the flip side, isolation from a caregiver revealed the accumulating mental toxicity and crippling that results when there is emotional starvation.  “Effective dependency”, heretical in Bowlby’s day, when separation and individuation ruled developmental theory, still runs  counter to our culture’s norms. But it is now recognized as central to healthy social development and later satisfaction in adult love relationships. It turns out  that a sense of secure attachment not only makes close relationships work, but also is one of the keys to recovery from trauma.

 

The pain resulting from lack of secure attachment in adult love relationships is, I believe, one of the most underestimated forces affecting our health. When attachment bonds are strained or eroded, not just our mental life, but the delicate balance of our stress hormones, our immune systems, our cardiac function,  our overall resilience, aging process, and even longevity are often thrown into a downward spiral. It follows that when a person lacks a secure base and safe haven in relationships the effects of trauma are amplified and become even more pernicious.

 

Perhaps one of the most striking historical examples of this was the relationship between Abraham and Mary Todd Lincoln. After the death of their son Willy in 1862, the second son who had died,  Mary, who already suffered from mood problems, lapsed into a deeper and more complicated depression.  Kentucky born, she had also lost several brothers by that time who served on the Confederate side, as well as brother-in-laws, her sisters’ husbands, taking each successive loss worse than the last. She alternated between distracted and prolonged bouts of crying on the one hand, and frenzied outreach on the other,  at times writing Lincoln disorganized letters pleading for his support, even though they lived under the same roof.   But she could not access her husband and witnesses from that time testify she could not be consoled. He was already working up to eighteen hours a day as he took the troubled course of The American Civil War increasingly onto his own shoulders, but also used work to distance himself from her intensity.  Her descent into compulsive shopping was legendary, as she would buy up to 300 pairs of gloves at a time, or spent thousands on lavish furnishings for the White House to soothe herself. She could be rattled by the most benign of events. Once, when the President rode out to survey a nearby battlefield, a general’s wife happened to ride up beside him. Mary,  further back in in her carriage spotted this, and suspected an affair was underway. She fumed , accused, and tried to gather support for her point of view all through the day and into a reception dinner that night, embarrassing both Lincoln and his guests.  Without any internal or external anchor, she collapsed, and had to spend the next two days in bed. Her notorious tirades and flights into paranoia became more frequent,  and all but her own servants learned to stand clear. By the time of Lincoln’s assassination in April of 1865, she had little left with which to fight, and with that final blow, she never really recovered. She deteriorated over the next two years and was pronounced “insane” by her doctors, spending much of her remaining days in her darkened room in her family’s home in Illinois.

 

In Hold Me Tight, Susan Johnson cites numerous ingenious studies of couples under stress,  ranging from real life emergency room situations to experiments set up in laboratories.  These show that love bonds are literally our buffer, a mediating force in our perception of shock, stress, and pain. She has re-mapped the whole territory of couples counseling by seeing clearly that:  1) the intense emotions and life and death meanings that couples attribute to disconnection are not melodrama, but real. They make sense from a survival perspective and the ancient wiring of the limbic brain. 2) That deeper attachment needs and fears are the real plot beneath the surface drama of repeated conflicts. One partner feels an urgent need for closeness and to repair the gap and so goes on the attack. The other feels immobilized, like a failure, wary of emotional display,  and so withdraws in order to calm things down and preserve the status quo. Both miss the crux of the matter, and these strategies create further misunderstandings that just bring on more cycles of disconnection.  3) Moments of accurate emotional engagement that redress these underlying fears and needs are  key to restoring safety and jump-starting growth in both partners. The smallest moments or gestures of emotional engagement and responsiveness have inordinate power to redefine a couple’s map for the better, and therefore set them back on the right path.

 

The relationship between trauma and relational distress is a complex one, and much more has been written than can be summed here. But one point must be made relevant for those who work with survivors of trauma.  The partner who survives the kind of trauma caused willfully by another person  experiences what Judith Hermann called a “violation of connection”.  This kind of “attachment injury” involves a sense of betrayal or abandonment at one’s point of greatest need. It is especially potent to create distortion and poison the stability of a survivor’s current relationship.  There emerges a  reciprocal loop in which the after effects of trauma continue to erode the relationship, and, ongoing relationship distress can, in turn, exacerbate lingering symptoms of trauma. After awhile, the couples’ hair trigger reactivity, fiery clashes, cold withdrawals, and tense surveillance of one another can resemble a shared version of  PTSD.  This requires a skilled therapist who manifests genuineness, compassion, and patience, and who understands how to handle the inevitable impasses, working at a much slower pace.

 

Rapid Resolution Therapy has evolved as an individual method for healing trauma. It has different tools and approaches than those that work primarily in the context of the survivor’s relationship with their intimate partner. Our focus is on getting the individual’s mind to update and the recruitment of unconscious strength. Couple-based methods focus on accessing the strength nature has programmed into the “we”, as two stand together to face life’s troubles. Couples approaches claim that working models of the self and the relationship become stronger at the same time, and that may well be an advantage.  There is one important difference, however. Most models of couples therapy assume trauma’s effects will always be there in one form or another. RRT doesn’t  assume traumatic reactions have to be a permanent part of anyone’s life or that the dragon can only be “pushed further to the periphery” as the couple reconnects and muddles through together.  We know trauma can be cleared entirely and with lasting results.

But aside from these differences, RRT shares many commonalities, particularly with EFT. One is that when new information breaks through rigid constructs, it takes place in the deepest part of the mind.  RRT can look on with appreciation at a sister technology that understands how things can shift suddenly, how healing our need for  safe connection takes place below the level of negotiating, teaching communication skills,  ironing out cognitive errors, or learning new sexual positions. Second, we are pulling with the same pair of oars when we position clients to look at relationships scientifically. In the case of EFT, there is the the effort to make behavior understandable as mishandled attachment needs and primal fears that, when triggered, follow a predictable course for all humanity. We agree on the  therapist’s use of self to create a strong countervaling positive experience within the session. We concur with keeping participants emotionally connected to the present. And while we don’t “respect” feelings per se,  we respect the primordial wiring of the human mind,  and how its responses,  often confusing especially in relationships, are understandably oriented toward survival, and ultimately make sense.  Finally, we look forward together eagerly to the next few years and what new knowledge research will surely bring to us, about how to heal trauma’s ravages, whether individually or within a committed relationship.

I hope you, the reader, have enjoyed this three part series as much as I enjoyed writing it. I welcome your comments and wish you continued success and peace.

 

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Reconstructing Meaning Part 2 of 3

Last month we discussed the role affect regulation plays in recovery from trauma. Affect is driven by thoughts and thoughts, in turn, are informed by meanings. It is useful to note at the outset many of these meanings lie outside conscious mind’s power and scope. Deeper mind, with its vast storehouse of implicit memories and ability to condense meanings and code them in various ways, makes meaning much more than just a conscious construct or a unidimensional belief. Trauma in general, and relational trauma, in particular, ( that rises to the level of an attachment injury) has the power to smash into awareness and leave an indelible imprint, blowing to bits our basic assumptions about relationships, human nature, justice, self-efficacy, and the availability of support or safety in the world. Think of someone who has witnessed torture or been abused or abandoned with no hope of letup. He or she may reshuffle meanings in a way that refutes any belief in self-efficacy, justice, goodness, support, or safety and hold this refutation on a very deep level. This is the extreme. Others can simply develop a “sore spot” (Johnson, 2007) for the two primal wounds of deprivation or desertion that makes a relationship suddenly seem unsafe, when cued by current negative interactions.  It is this disordered meaning, then, that settles into place after the trauma and causes the survivor additional suffering. We see a range of  difficulties with trust, a dread of vulnerability, an existential wariness, or at the extreme, a conviction of living on borrowed time and inevitable doom.

Meanings are densely layered and complex. Think of a guy stuck in a traffic jam. No one is having much fun, but this guy is getting in and out of his car in an agitated way, shouts out expletives to no one in particular, and finally beats his fists on his steering wheel until his knuckles bleed. Whatever is going on with this guy, is about a lot more than just the traffic. Think of a tuning fork suspended over other tuning forks. An outer event or an inner one hits a note and they all start to vibrate. Events may “pull up” feelings, emotional tones, bodily sensations, sensory traces, interpersonal vignettes, memory fragments, etc., from across a lifetime that are all congealed in a flash into a composite meaning.

Rapid Resolution Therapy recognizes distorted meaning aggravates trauma in several subtle ways. And these may come from the culture or prior learning. First, there is the equation of troublesome feelings, thoughts, or behaviors with identity. This amounts to defining the self with passing states, or worse, labels. Second, there is the attempt to articulate desires or needs through negation. When someone rattles off how/what they don’t want to be or do, they haven’t yet accessed what they do want, making forward movement almost impossible. Third, the vanishing present. You may hear someone go on about the past, what they or others should’ve done, then jump to predicting the future, equally devoid of new possibility or different outcome. What happened to the present? It just disappeared, and with it, the awareness of corrective action that right now might turn things around. Fourth, introspection and self-analysis. Intelligent people use these to an obsessive degree, albeit with brilliant insightfulness, only to keep themselves stuck. With the headlights turned in, or the driver looking continually in the rear-view mirror at himself, the car cannot be effectively driven down the road. Lastly, one cannot grow up in this culture and escape the explanation of all mishaps by a moralistic outlook. The roots of this go back to Puritan times and even before. Success and doing well was equated with moral rectitude; its opposite was equated with falling from grace or being outside the predestined benefits reserved for the elect. If something bad happened, it’s because someone was somehow not right with God. This person was therefore to blame for opposing God’s will, and their suffering makes sense as a consequence. People should be doing well, prospering, feeling good, controlling things, overcoming, avoiding mistakes, etc. If they didn’t, it’s because they got themselves mixed up with the bad thing, didn’t apply themselves, or got on God’s bad side. In other words, it’s due to their sin. The conclusion that they brought this on themselves and are only getting what is coming to them is the final reductionistic step in a single cause view of the world, thus relieving us of the anxiety of living in a world with multiple causalities. It’s amazing how frequently this disturbed thinking still shows up even in intelligent people. It completely misses the scientific fact that things exist because they were caused; and causes, more often than not, are multi-dimensional and complex, a weaving together of genetics and the environment. Science knows that it is almost never one monolithic factor that explains something, but many factors, which are sorted out over time with painstaking construction of hypotheses and careful research.

When attachment goes poorly early in life, or secure initial attachment is later injured causing what is termed an “attachment wound”, the person is traumatized, and again we have an imprint to which attaches distorted meanings about self and others. When new injuries come about or one moves into a vulnerable state, these meanings emerge and are amplified. Again, think of the tuning fork. Especially in the context of abuse or neglect by those who should’ve protected or nurtured, meanings fall across the self: self is unloveable, defective, the cause of the bad behavior of others, deserving of abuse or abandonment. Or self is adrift in a dangerous world, unendingly and intolerably vulnerable to the betrayal and deceit of others, so self must be vigorously defended at all costs.

A movie that powerfully depicted all these was Good Will Hunting. Will, the hero, was brutalized as an orphan and learned to live on his own, fiercely anti-dependent with even his closest friends. But now as a young man he falls in love with a girl enrolled at the Ivy League college where he is a janitor. It has been a fairy tale of a romance and their love has blossomed into physical intimacy. But it is when she offers her whole-hearted commitment to him and invites him to share her life, he explodes. Putting her love on the line,  her needs in his hands,  and exposing herself to total rejection rings a big alarm in Will. His deep conviction of unlovability and certainty of inevitable betrayal by others, which have been pushed down into deeper mind for years, explode across the screen. We see his cycle: explode, push others away, numb out, retreat into familiar isolation, live to see another day. If you can call this living. Point is, the strong affect and behavior are driven by distorted meanings that lie far below conscious awareness.

Rapid Resolution Therapy seeks to neutralize destructive meanings: through exposing childlike moralisms and egocentricity, by inducing a more scientific view that because things were caused, they couldn’t, on final analysis, have happened any other way; by educating clients that our sophisticated brains, while capable of so much, are also prone to many errors and the attachment of deficient meanings at the point of injury is one of them. Our ability to attach catastrophic meanings and embellish them is a normal response to trauma, but if left unchecked, can lead us astray into a world of intense hurt. For survivors of trauma it is often the case, but interestingly enough, with a strong enough connection, they are eager to transition to a more neutral meaning or even to no particular meaning at all. People find real comfort as dysfunctional meanings are emptied out and events are seen as the result of a vast interplay of genetics and environment, including the brokenness in others, so it is finally ludicrous to place oneself at the center of it all. One assumes a more humble, grateful stance and even the ability to laugh at oneself, knowing the world is not going to unfold according to our preferences any time soon. In this profound transformation, the meanings attached to trauma disintegrate and are emptied of their existential sting.

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Treating Trauma: Affect Regulation (Part I of 3)

How does a person recover from trauma? The literature over the last decade or so has advocated that people improve if three key goals are met. These three goals emerge again and again across the writings of many of the recognized leaders in the field. In this three part series, I want discuss these and then reflect on them from a Rapid Resolution Therapy perspective. I’ll share some thoughts about the first today, leaving the other two for future blogs.

The first goal is affect regulation. This is the king of all goals because it is the most prominent symptom found in all populations, whether we’re talking war veterans or rape survivors, or people dealing with life threatening illness, or of course, survivors of early childhood abuse. The loss of the ability to regulate emotions, particularly anxiety and anger, is perhaps the most significant general effect of the trauma experience (van der Kolk, 1996). Why is this such a big deal? Well, aside from the misery it creates for the individual and his or her primary relationships, it constitutes the loss of a foundational skill, a skill so basic for living that it is developed in the first two years of life.

While the brain is going through its first major growth spurt, from the last trimester of pregnancy through the second birthday, a child is learning at a body-mind level from the primary caregiver how to tolerate intense affect and live with interpersonal stress. Through thousands of episodes of attunement (to the child’s needs), then mis-attunement (because no caregiver is perfect), then re-attunement and reconnection with the caregiver, a child is literally building the infrastructure of circuitry on the right side of the brain the necessary circuitry to allow for temporary lapses in important relationships and the emotional pain that attends them. How well he does this will tell the story of how he handles future trauma and forms relationships with those around him.

The child’s self learns to shift flexibly with the context as he goes from distress over an unmet need, to watching the caregiver sometimes miss the target, intensifying his distress, to then watching the caregiver pick up on the need correctly, and finally moving to meet the need. This is showing him that neither he nor the world are coming to an end and things will eventually become safe and stable once again; that distress doesn’t last and people, who are imperfect responders, can nevertheless be counted upon over the long haul. The next time you see a baby coming to the end of a crying jag as caregiver soothes, watch as the bottom lip shivers as the child quiets from the outside in. Maybe he lays his head against a shoulder one minute, rearing back to stare into the caring face the next, finally sticking his thumb in his mouth to suck on. You are witnessing in real time the building of new neural connections and the learning of affect regulation.

Unhealed trauma somehow disrupts this early circuitry and an adult who knows cognitively that life will go on will nevertheless react to stress, especially interpersonal stress, in a dysregulated way, swinging between extremes of rage or anxiety at one end and numbing and shut down of all affect at the other. They seem incapable of taking comfort , and affect will be prolonged and intense over seemingly minor issues. They describe themselves as thin-skinned, raw, like some buffer between them and life’s stress has been lost. So many clients have told me over the years about someone they were in some kind of close relationship with who was abused in their youth but never dealt with it. They describe when they’d fight,  the change that comes over the friend or relative, as if they were battling with a two year-old. They are more on the mark than they know.

Now the interesting thing about affect regulation is that it comes about in two ways. First comes the development of interactive regulation, as illustrated above, where we learn to reach for another. But then we develop auto-regulation, the ability to regulate stress autonomously. The thinking is, people who have had secure attachments will be able to use both modes. Those with organized insecure attachments will have difficulty shifting between one or the other, and those with disorganized insecure attachments will be able to access neither (Schore teleconference, 2011).

The trauma field has approached problematic affect regulation from multiple theoretical vistas, from cognitive restructuring to rapid eye movement desensitization, to exposure based therapies to body workers, to finding new meanings through post modern experiential, narrative and constructiontivist therapies to hypnosis and neuro-linguistic programming. Some say we are in the midst of a big paradigm shift, from primarily cognitively based approaches to recognizing the primacy of unconscious emotional processes and in the future we will train all therapists of whatever persuasion to work with affect in more (yes, I’ll say it) attuned ways.

From what I can tell, Rapid Resolution Therapy seems to be on the leading edge of this paradigm shift and has already tuned in to its possibilities. But we go about it differently than anyone else. From an RRT perspective, affect remains dysregulated because the deeper part of the brain hasn’t gotten the message that the dangerous event is over–isn’t even in existence. Therefore, it keeps sending obsolete messages to do something about the threat. One difference with RRT is that we actually tell the client this. It is amazing how many have gone for therapy for years and have never heard an explanation of how mind really works to relieve them of the misconception that the problem is due to some sort of personal defect or the result of not having “worked” on it hard enough.

From here it seems to me RRT combines the two natural forms of affect regulation. We essentially integrate and utilize both learning processes throughout the session. For instance, from the first moments, we pace the participant into a state of safety and hope, an altered state called connection, wherein they resonate to being deeply understood, held, and given the promise of forward movement. Then we hold up a model of a restored self and hold it up with absolute conviction. Through a variety of deepening techniques we use the energy of connection to move mind toward that model. We are actually retraining them, in a very rapid fashion, first how to use another to regulate the distress and then focusing attention on the deep resources they have within to do this for themselves. What makes us different is this: it is not a matter of discussion or processing in the classical sense, it is mainly a matter of updating and a recruitment of unconscious strength, a much quicker shift than many realize is possible. As mind absorbs this, what authors call the self-state shifts. Clients learn, like a child does, to shift the self with the context, to plug back into now, where one has survived the trauma and completed it, and to know this on all levels, throughout the body and mind. Clients focus their attention on what has changed–the present experience of stability, security, and reconnection, believing it will last and be there for them in the future, as well. In effect, we re-instate in them the ability to auto-regulate.

Attachment theorists remind us that attunement is not just between two minds but is communication between two bodies as well. As mind updates itself, this is confirmed on a bodily level. One of the keys to this, incredibly enough, is missed by many of the other therapies. And that is the importance of remaining emotionally connected in the present to the therapist. Approaching traumatic material this way enables them to reach a point of being able to tell these events as mere historical fact, as just one chapter in their lives. The therapist listens to all the horror of abuse with a calm body, staying emotionally present. Resonating to this and matching it, the client sees his or her body reacts less strongly, less strongly still, and eventually body does not react at all even though they are verbalizing what have been the most disturbing events of their lives. This is a new experience. Instead of the usual abreaction confirming entrapment in a past more real than the present, the felt equanimity confirms a present more real than the past. The trauma is really over, the past in fact does not exist except as a matter of record. Survival equals victory. On the way to this realization, I believe what we witness is the rapid transition from interactive regulation of affect to auto-regulation, as they take it over for themselves. The self has shifted with the context and confirmed on a deep body-mind level that one is here, now. They have the experience that mind can no longer recreate the pain, therefore safety and security exists, so one can move on to better things.

My hope is all readers will have found of something of value here. It is hard to capture in language the beauty and power of the total transformation we see daily. We take our inspiration from those who have struggled courageously for years against unpredictable affect and from the joy that comes in witnessing their sudden freedom. I particularly hope my colleagues will find some benchmarks and points of reference with the best thinking emerging from the field of trauma care and be inspired, as I have, to weave these new insights into their work.

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