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PowerTips October 2001
This month we have the following: Treating Trauma. A review of Gary Craig's "story" technique, including Ericksonian applications and the choice set-up which I developed early this year. Choose Your Life. This new chat list for depression self-treaters is now active. Neuro-somatic Treatment for Depression: Join our International Research Project. Share in this groundbreaking research effort and help change the face of mental health care world wide.
Electronic Journal for the New
Psychotherapies - V19/10/01
Welcome all readers, old and new, to the October 2001 edition of Power Tips, the first electronic journal in the world for the new psychotherapies.
What a terrible month indeed was September. In the aftermath we see the best and the worst of humankind and everything in between. As we move forward on the journey to recovery, attending to political, social, economic, philosophical, physical, emotional and spiritual issues, let us remember to attend to our own needs for healing and wholeness as committedly and as lovingly as we do to our clients' needs.
One of the sequelae of trauma is, of course, depression and this month we remind you that a chat list for people who are treating or self-treating depression has been set up, and after some early reticence, is now active.
Also this month, I provide information for interested therapists to take part in our international research project for the energy therapies. A brief description of the project, together with documentation required, is included.
As always, I encourage anyone who has completed a research project or who has come across an interesting research paper relating to innovative approaches to mental health to contact me on Christine@lifeworks-group.com.au so that it may be considered for inclusion in Power Tips, and also for listing on the GoE web site.
This month we have the following:
Gary Craig, developer of Emotional Freedom Techniques, first explained the story technique as a way of safely contacting and eliminating the overwhelming painful emotions experienced as a result of trauma.
A Brief Background to Treating Trauma
Traumatic stress may be caused not only by experiencing trauma first hand, but by observing others undergo a traumatic event. A traumatic event need not be horrendous in order to have great impact -- it is of course the sufferer's perception which defines the meaning of the trauma.
We also suspect that many people may be "primed" for traumatic response by earlier (childhood) experiences. This may explain why not everyone who experiences trauma develops traumatic stress.
Trauma is known to have many sequelae: depression, addiction, anger/irritability, hyper-vigilance, mood-swings, eating and sleeping disorders, and others. In wishing to avoid these, we should take the precaution of treating traumatic stress as early as possible and certainly as thoroughly as possible.
In the old days, where, incidentally, most conventional therapists are well and truly stuck, talk therapy and pharmacotherapy were the most common approaches to the treatment of trauma. We are so fortunate now in having a number of evidence-based treatment choices for trauma: EFT, BSFF, and NLP in particular. This article discusses trauma treatment with EFT.
Regardless of which approach we use, it is incumbent upon the therapist to treat in an environment of safety, such that we ensure to the best of our ability the comfort and wellbeing of the client at all times. Trauma treatment should be totally out of bounds for the inexperienced or unsupervised therapist! The reason I say this is that in order for the therapist to keep a safe environment, one of the many abilities which the therapist must have is the ability to catch the emotional response beginning to build in the body before the client's own conscious cognition and in this way "back off" to a safer place from which to attend to the disturbance. Even then, it may well be impossible to stop painful emotions and one then must have the ability to stay in close rapport, maintain intense focus on the process, while guiding the client to a safer space -- I am speaking of a tiny window of time, perhaps as little as 0.5 seconds, in which to respond..
Keep in mind that the following is absolutely not a prescription for treating trauma. At best it is a general guide only, as the experienced therapist will readily recognise. There are many "what ifs" to consider.
The First Step
If the client is already in a distressed state, our first step is to relieve the immediate feelings of distress so that we can find a safe place to proceed from. Here we are not concerned with causal material, but only with actual sensory representations here and now.
Once the client is in a relatively stable internal state, we ask the client the question "If someone were to make a movie about the whole event, what might they call it?" We then tap on "Even though 'name of movie' I ........", with the reminder phrase being 'name of movie'. We treat this until the person feels comfortable to begin treating the technique. EFT practitioners will be aware that there are a number of styles of setup statements which are very effective. Early this year we developed a setup which declared a choice, decision or made a statement of belief. Eg:
Even though ...... I choose to feel powerful and
I'd now like to add to this a setup statement inspired by Tapas Fleming:
Even though ...... it did happen, it's over, and I am safe.
Get a starting SUDS on the traumatic event by asking the client to "guess" at what the score might be if they were to vividly imagine the whole thing as if reliving it. Ensure the client does not vividly recall. We actually say "Do not vividly imagine it, merely guess what it would be if you did." In fact, at some level the client must probably vividly imagine the event in order to answer the question, but will do so unconsciously. We can say this fairly confidently because in order to make sense of the statement "without vividly recalling" the mind must have a representation of "vividly recalling".
Explain the story method of EFT, so that the client understands that he/she may begin telling the story only when he/she feels 100% comfortable, that the story must start prior to any feeling of discomfort or even knowledge of the traumatic event, and that the client must absolutely stop as soon as they feel any emotional response beginning to occur. In practice, you will mostly see the response in the body well before they become aware of it and will call halt yourself in order to catch and treat what came up.
Treat any and everything that comes up and causes an emotional response of any kind, use the client's words, and ensure the client has 100% comfort about the material before proceeding with the story. The end result of this work should be that the client is able to tell the whole of the story in total comfort.
Tricks of the Trade
During this process the client may be in trance, offering enormous potential for metaphor, Grovian language, pre-suppositions, embedded commands, meta model interventions, conversational timeline therapy and much more.
For this reason it is often not even necessary for the client to talk. If the client does become distressed, we may decide the fastest way out is through, and take over the tapping and the talking. Supreme calibration skills are required for this step in order to respond accurately to what the client is experiencing.
Sending the Client Home Safely
We never presume that we have eliminated every single aspect of the traumatic response. The client needs to be equipped with the tools and the environment to quickly and safely treat any remaining aspects.
Treatment of any issue can trigger awareness of other issues. The client needs to be aware of the possibility that other issues may come up for them and will also require treatment.
Warning -- Treating Clients who are in a Dissociative State
This has been a recent thread on chat lists and deserves repetition here. It is totally inappropriate for any but the most highly skilled therapists to take on clients in a dissociative state. Warning signs may be numbness to emotions or seeming amnesia. The dangers of working with such clients are many and varied and enormous harm may be done.
My own belief is that it is generally unsafe to work with such people using techniques such as EFT because EFT does not provide a way of communicating or negotiating between aspects of the personality. One may be fooled into believing one is making progress, only to trigger the appearance of a highly emotional and outraged "part". I believe that BSFF, provided it is used slowly and methodically in a way appropriate to the client's particular psychological landscape (ie, in respect of all "parts") is possibly the safest intervention available.
Choose Your Life.
Recently we set up a chat list for people wanting to learn to self-treat their own depression. We set up the list for one reason only: we realised that many people with depression also have the inability to pay for appropriate treatment and the new therapies were simply inaccessible to them.
Initially the group was silent but as it has grown, the mail has started to flow and we now "have contact".
The list will not suit everyone. On-line chat groups have very few of the safety structures of physical therapy groups and therefore are not appropriate for people who are in a state of overwhelm. The purpose of the group is to promote self-learning of the energy therapies, not to attempt to treat one another, and no member is responsible for the emotional wellbeing of another.
Initially, The Lifeworks Group is committed to an active role in the group in order to set the tone, maintain safety, and build the skills of core people in the group. Eventually, we hope to withdraw entirely as the group becomes highly skilled and self-sufficient. That is the dream.
Therapists may find the group a useful adjunct for their clients, assisting them to follow through with homework and providing a network of fellow travellers in the healing journey.
To subscribe to the group, simply send a blank mail to ChooseYourLifeemail@example.com.
International Research Project - "Neuro-somatic Treatment for Depression"
We are ready to roll on this groundbreaking international project. Some therapists have already indicated their interest, and we need more!
These are the steps you need to follow to take part in the project:
1) Re-read August Power Tips for overview and conditions of project.
2) Contact me on Christine@lifeworks-group.com.au to register your interest, giving details of qualifications and experience, stating the intervention/s to be employed.
3) Gather participants for your trial. The number of participants is not of great importance, but ideally should be around 30. Very often newspapers and other media are happy to help publicise clinical trials -- this should not cost you money. Have each participant collect a physician's referral to the trial. A press release, a participant intake sheet, as well as pro forma letter and referral slip for physicians, will be sent to you on receipt of your registration of interest. Have an objective third party delegate individuals either to the treatment group or the control group. As far as possible, the characteristics of each group should match; ie, gender, age, severity of symptoms, duration of symptoms. All individuals will self-evaluate their depression by completing both the Montgomery Asberg Depression Rating Scale, and the Lifeworks Joy Inventory.
4) Gather the treatment group for a 2-day period in group format, treating depression with any intervention which could be described as neuro-somatic or neuro-linguistic. This may include EFT, BSFF, TAT, TFT, or NLP, or any variations of those. The accent should be on training for self treatment.
5) On the day following the 2-day training/treatment period, all trial members (including the control group) again self-evaluate using the MADRS and LJI. At this point mail all paperwork to: Christine Sutherland, The Lifeworks Group Pty Ltd, PO Box 2018, WARWICK 6024, Western Australia.
6) On the sixth month following the 2-day training/treatment period, all trial members (including the control group) again self-evaluate using the MADRS and LJI.
7) On the twelfth month following the 2-day training/treatment period, all trial members (including the control group) again self-evaluate using the MADRS and LJI.
Statistics will be compiled in conjunction with staff at Curtin University of Technology, The Lifeworks Group Pty Ltd, and the Centre for Mental Health Services Research, and a full paper written up. Participating therapists will be nominated in the paper. Publication will be sought in reputable medical/scientific journals around the world. Copies will be available electronically on the Lifeworks web site as well as the AMT web site.
I urge all qualified counsellors and therapists to get behind this effort to demonstrate the broad efficacy of the interventions we are using. It is my mission to change the face of mental health care all over the world, and by working together on this worthwhile and groundbreaking project, we are together taking a stand for the humane and effective treatment of people in pain.
If you are not subscribed to the Meridiantherapy chat list, the most active list in our field, please do so today by sending a blank email to Meridiantherapyfirstname.lastname@example.org.
If you are not already subscribed to Power Tips and would like to do so, please just send a blank email to PowerTipsemail@example.com. We welcome your comments and suggestions to Editor@lifeworks-group.com.au.