To fight or not to fight?

How many times have you heard the expressions ‘fight cancer’ or ‘battle depression’? It’s like society gives us a medal if we fight. If you don’t ‘put up a fight’ it’s like you’re giving in or giving up. (Read a previous post that explains more about our societal judgements about supposedly not ‘putting up a fight’).

Mainstream medicine perpetuates the approach of fighting and attacking a dis-ease, as if it were something disgusting inside us that we need to get rid of as soon as possible before we’re contaminated by it. Inherent in this approach is that the dis-ease needs to be battled externally, usually with medication and/or surgery. An integrative approach on the other hand, looks at the entire person, not just at localised symptoms. It seeks to understand dis-ease at a deeper level, thereby empowering the person to be healthier from the inside out. This is not a passive approach, a lot can be done to become healthier without having to fight what is making us unhealthy. And the closer we learn to listen to our body, the more subtle the cues we are able to pick up before things get worse.

As I wrote in last weeks post, we can view symptoms as sign posts from our body to change direction, or we can beat ourselves up for having a disease/disorder. We can also try to beat the disease out of us. We get to choose our response. That’s not to say that we’re always going to be happy about something, it’s crucial to be emotionally honest. Being honest about how we truly feel is also a brilliant stress reliever. We naturally feel better and lighter when we’re not pretending or forcing our feelings.

I’m not saying that we can prevent everything, especially things like environmental toxins, but we can do a lot more than we think we can to get and stay as healthy as possible.

The root cause

How many times are symptoms treated as the underlying disease? Take for example high blood pressure. Is it a disease or a symptom of something else? What happens when you take medication for blood pressure? Does it make it go away? No, it doesn't, it masks the symptoms that could lead you to the cause or causes of your high blood pressure. If you go down that route, you'll have to take the medication for life and it'll have side, or as I like to call them, direct effects. I would never suggest to anyone to stop taking medication, but I think long term, medication just doesn't work and often, if not always, it causes more problems than it solves.

That's what symptoms are good for. They are a bread crumb trail that lead us to the true cause, if we're listening. But what often happens is that we, along with conventional medicine, get bogged down in the symptoms. The obsession with symptoms eventually becomes a maze, out of which there is no exit. And there is nothing as frustrating or more expensive as not getting better, or indeed getting worse.

Symptoms are a sign for us to change direction; to exercise, eat well, reduce our stress, heal our relationships ... They are symbolic and metaphoric of what is going on in our lives. If we heed their messages, they won't have to shout so much. But if we ignore them or try and medicate them into oblivion, they will get worse. Listen to your symptoms, take them seriously but zoom out and see the bigger picture they're painting for you.

The stigma around mental health

There is still a lot of stigma around mental illness. The word stigma is often bandied about like as if it’s not really that damaging and it doesn't ruin people's lives. It reminds me of the old saying “Sticks and stones may break my bones but names will never hurt me”. But names do hurt, a lot. They might not break our bones but they can break our psychological well being which has a direct and negative impact on our physical health too.

I can totally understand why people want to keep the fact that they have a mental health issue private and that is their prerogative.  But the reason why we keep it private is important.  There are places where you can reach out for help safely and confidentially*. Shame is too often the reason why people feel they can’t tell anyone and when you see how society in general reacts to mental illness, can we blame people for not opening up? Having nowhere to turn is a desperately lonely position to be in.

I have a family member with schizophrenia, and not only does she suffer from stigma, my immediate family does too. I’ve seen how people react when I tell them or they find out. Very few people behave in the same way when you tell them a family member has cancer, nor do they think cancer might be contagious. There is often little to no compassion when people hear that others are suffering from mental illness. Instead, too often there is fear, gossip and plenty of ignorant judgements.

My experience is that every single one of us has been affected by mental illness. Whether it’s because we have been diagnosed with a mental health issue or a friend or loved one has, or maybe we haven’t been diagnosed with anything but we know that our mental health could be better.

The husband of Carolyn Spring, who is a counsellor, says she is the one of the sanest people he knows. Carolyn has dissociative identity disorder after suffering the most horrific ritual abuse in her childhood. In my experience the sanest people don’t pretend they have it all together, they’re not perfect and they also know that reaching out for help, to the right people, is one of the most courageous things they can do.

*The caveat to total confidentiality is if you are in danger of hurting others, everyone is obliged to report this. If you are in danger of hurting yourself, an immediate action plan should be put in place to keep you safe.

Towards a comprehensive model of trauma

This article, Towards a comprehensive model of trauma is a synthesis of my MA thesis, hope you enjoy it. Here is an excerpt:

Currently, a posttraumatic stress disorder (PTSD) diagnosis is the closest thing there is to a trauma diagnosis. However, PTSD criteria do not cover the entire range of trauma-based symptoms and conditions (Dansie et al., 2012; Hall, 2000). The reality is that many people suffering with trauma do not qualify for a PTSD diagnosis, and are instead diagnosed with different disorders based on the symptoms they display, not on their etiology (D’Andrea, Ford, Stolbach, Spinazzola, & van der Kolk, 2012; Haven, 2009; Herman, 1992; McFarlane, 2010; Sledjeski, Speisman, & Dierker, 2008; van der Kolk, 1994). Reducing or containing various symptoms, without first locating and addressing their cause, often results in inaccurate and multiple diagnoses. This prolongs unnecessary suffering, usually leads to retraumatisation, is time consuming and wasteful of scarce resources. Therefore improved classification of disorders according to etiology is very much warranted. Read on 

Normalising innate behaviours

All of us use expressions such as “I was scared stiff” or “I froze”. But how many of us know that the response that these expressions refer to is tonic immobility? (More commonly known as the freeze response). We’re all aware of the famous ‘fight or flight’ term, but few of us have heard of tonic immobility, a response to any threat that we perceive as dangerous, that can overwhelm our coping mechanisms. We can even find experiencing tonic immobility itself overwhelming because it can render us, involuntarily, physically immobile and unable to speak, which leaves us feeling helpless. And on top of that, we often judge ourselves harshly when we respond in a supposedly ‘weak’ or ‘passive’ way. We feel ashamed of not ‘fighting back’ and these appraisals can also overwhelm us and prevent us from resolving any trauma.

Tonic immobility is evolution’s gift to us in order to keep us alive. Sometimes, in the face of threat and danger, it is safer to remain immobile or ‘play dead’, rather than fight or run. Sometimes fleeing or fighting are not even viable options, especially when we’re very young. We don’t make the choice not to move or not to call out for help voluntarily, this innate behavior and instinct is hardwired in us in order to ensure our survival.

As Peter Levine writes in his book In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness:

As traumatised individuals begin to reown their sense of agency and power, they gradually come to a place of self-forgiveness and self-acceptance. They achieve the compassionate realisation that both their immobility and their rage are a biologically driven, instinctual imperative and not something to be ashamed of as if it were a character defect. They own their rage as undifferentiated power and agency, a vital life-preserving force to be harnessed and used to benefit oneself. Because of its profound importance to the resolution of trauma, I’ll repeat myself: the fear that fuels immobility can be categorized, broadly, as two separate fears: the fear of entering immobility, which is the fear of paralysis, entrapment, helplessness and death; and the fear of exiting immobility, of the intense energy of the “rage-based” sensations of counterattack. Caught in this two-sided clamp (of entering and exiting), immobility repels its antidote implacably so that it seems impossible to break through it. However, when the skillful therapist assists clients in uncoupling the fear from immobility by restoring “self paced termination of immobility”, the rich reward is the client’s capability to move forward in time. This “forward experiencing” dispels fear, entrapment and helplessness by breaking the endless feedback loop of terror and paralysis.

Using EFT for asthma

Chronic inflammation is the root cause of many physical diseases. What causes the inflammation? Chronic stress, poor eating habits, poor gut health/flora, food allergies and intolerances, not enough good quality sleep, not enough exercise. Chronic inflammation plays a huge role in chronic conditions such as asthma.

We are going to address the emotional contributors (i.e. emotional stress) to chronic asthma in this article by using EFT. Keeping your stress levels to a minimum will really help your body to deal with excess inflammation and hopefully you will see big improvements in your overall health. We often make poor health choices because of emotional stress, so dealing with it first can help us eat better and exercise more. Have a go at answering the following questions. Write them down, you might be pleasantly surprised at the insights that you come up with.

In traditional chinese medicine, lungs are the seat of grief, so any unresolved sadness and grief you have will be worth taking a look at. The lung point is at the side of the thumb, try tapping this point continuously whenever you feel sad, and see if it helps you release the sadness/grief from your body.

What was happening in your life around the time, or just before, you developed asthma?

Have you had asthma since birth? What was your birth like? Were you wanted?

How does having asthma make you feel? For example, smothered, panicky etc?

How does it affect your breathing?

What does it stop you from doing in your life?

Are there any advantages to not having to do certain things because of your asthma?

How easy/comfortable is it for you to receive? This might seem like a strange question, but one of the most basic things we receive from life is the breath. How easy is it for you to take in a deep breath and feel nourished by it? 

Do you feel you deserve to be here? Again, just go with these questions and see what answers come up. You might be surprised and the answers might be well worth tapping on.

Do you want to be here?

The intimate link between trauma and dissociation

I believe that traumatic experience is different from trauma, it does not necessarily lead to what we call trauma. Browne (1990) defines trauma as “unexperienced experience” and I agree with this definition. For an experience to remain unexperienced, or for trauma to occur, dissociation has to be present, as it is the mechanism by which an experience remains unexperienced. This is why chronic or persistent dissociation always results in trauma.

Why does an experience remain unexperienced? Because it has overwhelmed our coping mechanisms, we can’t process or feel it, so, as Browne says “instead of a way of avoiding external danger, it [dissociation] is now utilised to deal with the threat of internal destabilisation; whenever we are faced with an overwhelming experience that we sense as potentially disintegrating, we have the ability to suspend it and “freeze” it in an unassimilated, inchoate form and maintain it in that state indefinitely, or for as long as necessary”.

An overwhelming experience can be an external (any type of abuse for example) or internal (the way we perceive or appraise an experience) threat. Therefore there is no such thing as an objective stressor, if the symptoms of trauma are present, and there are many, not just the obvious ones like PTSD, we can say that someone is traumatised.

Some have asked whether peritraumatic dissociation can lead to trauma. While it does not necessarily lead to trauma because it is usually a temporary response, the exception seems to be the involuntary tonic immobility response (more commonly known as the freeze response). Tonic immobility is a somatic dissociative response that protects against overwhelming threat that could result in death. If not discharged, this usually temporary response can also become persistent and chronic leading to trauma.

Some researchers have argued that tonic immobility is inherently traumatic (Bovin, 2011), however Levine (2010) disagrees. He believes that it is the coupling of tonic immobility with intense emotions such as fear that renders the response traumatic. In fact, this forms the basis for Levine’s theory of trauma. That said, some trauma sufferers report that the experience of tonic immobility has been very overwhelming for them.

For example not being able to call out for help or being rendered physically immobile can feel very helpless. Then there are the appraisals of these same behaviors, such as “I should have fought back” or “I am so ashamed I just lay there”, which can also be extremely traumatising. Some of the reasons for these responses may be that tonic immobility is not as widely known or understood as the flight or fight responses. So many may be confused and/or shocked when they become immobile and can’t do or say anything. We also seem to have lost or shunned our connection with our evolutionary past and instincts. Therefore, it can be difficult to understand and accept survival behaviours such as tonic immobility.

Culturally, many of us are taught to fight when faced with threat, so there is a lot of criticism for rape survivors for example if they haven’t fought back. In fact, many times the perpetrator might not even be prosecuted because evidence of a struggle was not found. It is any wonder then that this response is so misunderstood? Tonic immobility is also referred to as “passive resistance or avoidance” many times in the psychological literature which I think is a derogatory and superficial evaluation and could in fact give impetus to appraisals such as “I should have fought back” or “I’m weak and to blame”.

Have we simply lost the ability to experience and discharge tonic immobility because of the cultural cage we live in that disowns many, if not all, of our survival instincts, particularly those pertaining to the body? Animals in the wild freely discharge the enormous survival energy that the response generates without feeling fear, helplessness or shame, which also ensures their survival. Maybe we should (re)learn something from them?

References

Bovin, M.J., & Marx, B.P. (2011). The importance of the peritraumatic experience in defining traumatic stress. Psychological Bulletin, 137(1), 47–67.

Browne, I. (1990). Psychological trauma, or unexperienced experience. ReVision, 12(4), 21–34.

Levine, P.A. (2010). In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. Berkeley, CA: North Atlantic Books.

Give up all the other worlds, except the one to which you belong