So how does all of this fit together?
You will be delighted to learn that we can put it all onto a nice two dimensional diagram and here it is again.
At one end, there are Psychotic imbalances, where Unconscious Processing and high Flight and Fight arousal overrides the capacity to be present in the real world and take useful Conscious Processing (or action). At the other end, access to Unconscious Processing is limited; resulting in ineffective and distorted Caetextic behaviours which generate high anxiety and practical dysfunction and a badly malfunctioning Conscious Processing capacity.
In the middle, we find the balance where there is access to both Unconscious Processing and Conscious Executing and this is either done healthily (and so there will be no serious mental distress) or it is difficult to do because arousal is high as the Flight & Fight is at least firing partly out of control and the life led is not working very well. And it is in this centre ground that most depressions, anxieties and addictive behaviours are to be found. The x axis of the spectrum diagram measures the degree to which mental problems are hard to deal with as brain function is less efficient. These are at the extremes and there, though harder to deal with, healing is not impossible for many. And interestingly, the principles of how to heal are no different at the extremes from those that apply to the centre ground.
Healing from mental problems – it’s all about the emotion
Having given what I hope is a comprehensible explanation for what causes mental problems; it is no surprise to discover that how to heal or be healed can also be made comprehensible. And just as our explanation deconstructs what is typically believed to be complex into something far simpler, the same is true for healing or treatment. This far simpler Human Givens understanding of mental problems has the distinct advantage that from such an understanding, one can begin to comprehend and indeed facilitate helpful change. The secret is not to begin with a diagnosis or to pathologise, but instead to ask the question: “What can be done to reduce arousal and to assist in action that will get a life that is working better?
It is axiomatic that for those in mental distress, emotional arousal will be high (periodically or continually) and that it is the reaction to this Whirlpool that is an integral part of mental distress. Or to put it another way, high emotional arousal makes us all stupid and so unable to act and think well. The corollary is also true – that a productive use of subtle emotional clues and hence useful learning and action will only take place when calm and then we are emotionally healthy.
Human Givens argues that for all of us, emotions will precede and drive the thought and action. It follows that therapies which focus on challenging the thought (such as Cognitive Behavioural Therapy or CBT) will always be flawed or at best hard work – like digging a garden with a kitchen spoon. Finally if the shifting of and the working with emotions is the essence of effective therapy, then the use of trance tools and methods would seem pretty important – as this is the well understood route into the REM state which is where emotions can be accessed and moderated. Is it too obvious to remark that for therapies that do not use trance (such as CBT), it is perhaps like asking GPs to treat bacterial infection without antibiotics or plumbers to mend central heating systems without screwdrivers?
So, if the core of mental distress is the failure of emotional resources to be working well; it will be with emotions that healing begins. “What are the emotions saying and how well or badly are they being used in support of the necessary action that will cause essential emotional needs to be better met?” And for the healer/therapist there is the subsidiary question – “what can I that allows emotional resources to be working more effectively and so to facilitate action and change that get needs better met?”
Healing through emotions involves three distinct processes – reading emotions, healing emotions and using emotions. All three processes are intimately bound up with psychological healing and though rarely clear cut and separate in practice, it makes a lot of sense in logic to distinguish between them.
We know that the brain understands and communicates by patterns (metaphors) and seeks to complete these in the environment and that the emotions that arise are the primers for action. Moreover, the experience of many therapists and certainly those trained in the Human Givens is that trauma is at the root of many of the mental problems that are given labels by the psychiatric profession – from psychoses, schizophrenias and personality disorders. And this is for the simple reason that the trauma reaction is, by definition outside one’s conscious control and so the failed attempts to deal with this then becomes the mental illness label.
It is clear therefore that a good place to begin treating a mentally distressed individual is to identify whether there is trauma or trauma like symptoms operating? The source of trauma or threshold trauma can be obvious and well remembered in a past experience. Or it can be more obscure in that the event is remembered but the association with the current uncontrolled emotions is not obvious to the sufferer. And yes finally, there are memories that are locked deep away and cannot be easily identified or retrieved.
These traumas and near traumas and the consequential arousals do need to be identified and if possible cleared (see the use of Rewind in healing emotion below). But what is typically the case is that those who have active trauma like emotional arousal will have well developed imaginative resources and will therefore be good trance subjects – that they will have easy access to their Unconscious Processing. So their susceptibility to mental problems can embrace the means for recovery.
If we follow the emotionally sensitive pattern matching continuum (yes I know another continuum) away from the extreme of trauma to subtler and less obviously destructive but still potentially damaging emotions, then we are still looking at a well embedded emotional pattern match. This will be activated in response to certain (normally environmental) triggers and be supporting action that is not helpful in getting needs better met and so is adding to a vicious circle decline towards the risk of ever more serious mental problems.
Generally these patterns can be neutralised and eased by using trance methods. But there is another possibility that needs to be considered. And that is that the dominant causal linkage goes not from the emotional pattern match in the direction of a life that is in consequence not working, but from a life that is not working to the apparently destructive emotional pattern match. Since these linkages will always in fact be going in both directions, the best approach is to be pragmatic. Do you delve into the past to clear the damage or do you stay in the present to activate the goal setting problem solving capacity, which is in all of us? To activate problem solving might then indeed require that a pattern matching is cleared but this would be on the basis of practical goal directed problem solving rather than from the starting point more akin to a fishing expedition. The former may be better in many cases as one can focus on what is happening to that person right now. One further reason why this focus on the present can be important and even sufficient is that self confidence and self esteem are invariably under threat as a lack of emotional control will feed a vicious circle. A loss of self confidence is a rational response to this failure, yet it may make matters worse to focus directly on this eroding self confidence. It will be better to concentrate on change now and as this has its beneficial effect, so self confidence will also improve and a virtuous circle can be established.
What of diagnosis? The answer is not to pretend that it is ever much more than a description of symptoms or behaviours but instead to consider the spectrum question. Where on the continuum of mental distress is the client – in the centre ground or toward the psychosis or caetextic extreme? Is there too easy emotional expression or too little – towards emotional diarrhoea or emotional constipation?
Finally for the centre part of the spectrum where most distressed individuals will be found, how is the reaction manifesting? Is it in worry and hence depression, in fears and avoidance and so to anxieties or in attempts to protect and self medicate and so moving toward addictive behaviours?
In terms of making this distinction, the classic indication of depression is exhaustion in the mornings even after a long period of sleep and a state of constant or near constant destructive and purposeless ruminations. Depression is often explained by sufferers as being trapped in ones brain and thoughts –asking the same useless questions all the time and not coming up with any useful answers. From this exhaustion come anxieties and fears mainly but can also embrace many others emotions from guilt, shame and an overwhelming sadness and hopelessness. My own view, based on my work with depression is that for most who are depressed, there is also a terror borne of incomprehension which then leads to a terrible passivity. In terms of the continuum (or spectrum) of mental distress, depression, though mostly at the centre is more likely to be found edging towards the psychotic end – simply because the dream trance state or unconscious processing is being overwhelmed in a depression state.
And what of anxieties, which will truly occupy the centre ground of the spectrum? Anxieties are much more diverse in their manifestation than depressions in the sense that they tend to be focussed in specific areas and have apparently quite different characteristics. Over vigilance, catastrophic projections and a fear response that drives toward highly protective and avoidant behaviours are the typical anxiety indications. But these then manifest in many ways – to social and performance anxieties, to phobic responses that then extends into agoraphobia. Panic is often lurking somewhere, the experience of which can become a trauma reaction n its own right. Finally, the anxiety can spread like a virus into more than one area of life and become quite generalised and ever-present. Perhaps the main point is that a trauma memory is virtually always present and will be feeding anxieties and hence resulting in some combination of over vigilance, avoidance, catastrophic projections and an over sensitivity to body feelings.
Finally there is the addictive or protection response, which because it is rooted in action, however inappropriate rather than rumination. This maybe thought of as residing toward the caetextic end of our spectrum’s centre ground. Addictions, which I have always found to have similarities to obsessive behaviours, are at their core a desperate holding on against the fear of the vacuum if they were to let go. In addictive states, lives become increasingly unbalanced such that needs are not being met and stress and low self esteem are spiralling out of control. This in turn feeds the addiction. There is also an important distinction between dependencies that are shameful and/or illegal (drugs, such as heroin, cocaine and cannabis, gambling, sex) and those that are socially acceptable (alcohol and smoking). Eating and diet based addictions are also somewhat different, if only because we must all eat.
At the beginning, the addiction is fairly small and a quite natural movement toward a pleasure. But as the addiction grows (if it does), then it begins to take over – and this can reach the stage that a large part of one’s time is spent thinking about it, preparing for it and indulging it. And of course if the addictive activity is illegal and/or expensive and/or shameful, then some of that time is spent in concealment. This hints at why dependence can take over? Concealment separates you from people who can meet your essential needs appropriately for connection and intimacy and shared experiences. And so the addiction begins to take over and pushes away parts of a life that is actually much more important. And then when this happens it can become really scary of course, even to contemplate letting the lifestyle dependence go – because what else will you have?
I have identified four distinct areas that drive much of the emotion healing that I do and which I respectfully suggest can drive emotion healing generally. These four are all based on my Human Givens training (obvious to all who have been similarly trained). However, there is a slightly different emphasis, as an adaption to my experience as a therapist. These four are Communication to influence emotions unconsciously, Preparation of the ground on which the therapy will take place, Clearing of past clutter and finally the Future Focus. So first Communication, two Preparation, three Clearing and four Future Focus. In the next session, as I elaborate on these please note that I am not offering a mini manual of how to be a counsellor. The fouc is on principles and not practice detail.
No 1 Unconscious Communication
The main tool of a counsellor/psychotherapist, including one trained in Human Givens is the words and language they use together with its tone, rhythm and expression and the natural complementary extension to body language. So, what is the guiding principle that drives the therapeutic purpose for this communication? It is to shift the focus of the unconscious processing. We know emotions and emotional responses are formed and reformed here and are continuously formed and reformed to drive better action. So you could say that the purpose of communication is to redirect the attention of unconscious processing.
There are well understood ways in which this can be done. Many have developed from the work of Milton Erickson and his disciples and followers. They concern the careful use of indirect or soft and permissive language in support of what are self evident psychological principles of influence.
Thus this hypnotic language should not be too directive and suggestions cannot be too specific as this might create resistance and prompt unhelpful pattern matching. Instead indirect language focuses attention to find meaning for each subject – in the way that will make sense to that subject. Such language will be suggestive and indirect, permissive rather than directive. Thus an Ericksonian equivalent of “you are feeling sleepy” would be something like “and perhaps as you sit there, listening to me here, you might begin to notice a pleasant feeling of drowsiness.” Nobody can argue with a statement like that and neither will teh subject’s unconscious – but the unconscious will be opening up. In supporting this, there are a number of “tools of the trade”.– using truisms and presuppositions that can be expected to be accepted without question and the linking of suggestions to truisms – “and because you already know how to relax, you can relax even deeper here today as you listen to the sound of my voice.”
The offering of illusory choice, called double binds is another powerful tool to reduce resistance and direct attention to achieve desired outcomes. We in fact use double binds all the time –“will you have tea or coffee” presupposes that you will have a drink and so a statement “will you relax now or in a minute” is similarly set up. Nominalisations are powerful too. These are nouns which are not fixed or real and so cannot be carried in a wheelbarrow – words such as holiness, serenity, goodness, progress, safe, peaceful and so on. To have meaning, we each have to go on a search within.
All of these words are directing the subject to the trance state, which makes the unconscious mind more ready to find new interpretations and emotional pattern matching. This language, which the unconscious mind is more likely to accept will occur when resistance is overcome. And then important suggestions can be embedded – behind the accepting trance state aided by deliberate confusion, misdirection and ambiguity. Metaphors and stories are an additional and powerful tool of influence as metaphor is the “language” of the unconscious and when well used, metaphors and stories can gently direct attention in the desired direction.
Gabrielle Roth hit the nail on the head, saying “If you just set people in motion they’ll heal themselves”.
In summary, the purpose of communication with the unconscious is to close off some of the doors that lead to emotions that are not helpful because they are driven by dominating fear, worry, anger, guilt, shame and so on and to open other doors that invite entry to confident action at arousal low enough that these emotions can be read and acted upon appropriately. And typically, this is best done using trance and permissive and indirect trance language.
One also needs to use language that makes sense and can be appreciated by the client and to a degree at least will accord with his/her experience, her moral values and her understanding of how change is possible. We are talking here of what is called utilisation – clearly related to how indirect language is used both in and out of obvious trance situations. It is hard to overestimate the importance and scope of utilisation.
Thus we are concerned with language and influence in the most complete sense, knowing that it is essential to work with what the client uses, what the client brings and what the client seems to be, everyday and in the present. Together with awareness of the opportunities from utilisation, a complementary task of most good therapy is to engineer an early experience of ratification. Ratification may be understood as any early therapeutic experience which will challenge or calm or open the client to something a little different and even unexpected, including the experience of trance – such that they are opening themselves to the possibility of change.
Ratification is part of the process of the cultivation of positive expectancy – the expectation that change and recovery can be expected. If this is achieved then the patient will begin to share with the therapist, the unconscious searching out to find what is needed to heal – an aspect of the placebo, which all healers probably seek to make use of.
The Placebo: It is noteworthy that conventional medicine is certainly aware of the placebo but goes to great lengths to take out the placebo effect when testing for new drugs and procedures. The ambivalence of conventional medicine to the existence of the placebo effect is surely a clue as to why conventional medicine is so rarely about healing, as opposed to body fixing and why it can be so unsatisfactory, particularly for the treatment of mental illness. This is what the United Kingdom Parliamentary Committee on Science and Technology has to say: : “…prescribing placebos… usually relies on some degree of patient deception” and “prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS.” The use of the verb “prescribing” gives the game away. Medical doctors may be happy to reject our natural healing capacity as bad medicine, but no good counsellor would dream of doing the same.
Let’s return to how to cultivation of positive expectancy and the understanding that expectancy triggers our in built capacity to heal. There must be expectancy that healing is possible – for only then will the mind/body’s own healing resources be activated. And to the extent that a client believes he/she will get better and has faith in the skills and experience of the counsellor to help, then he/she is already at first base.
Rapport building or the establishment of a working alliance has long been understood as an essential pre-requisite for good counselling (and indeed any healing) – that the client or patient feels comfortable with and has trust in the motives, competence and humility of their therapist. But this is best done by establishing a belief and expectation of improvement and recovery. Expectancy is pretty well equivalent to and in my experience is the essential element to rapport building.
Of course, this expectation has to be credible. Clients can rarely be fooled as we are talking about subtle body language, an unconscious tone of voice as much as anything else. Again Human Givens training will help to establish this as the HG knowledge of what is mental illness is so accessible and easily identifiable by the patient’s own experience. The fact of evidence of therapeutic success can merely add to this. And by so doing, one is accessing the clients own natural unconscious expectation of beneficial change – or the placebo.
And then, after some improvement (or ratification), both the patient and therapist can relax and feel a naturally growing confident expectation. On the other hand, if there is no improvement within a few sessions or it is not sustained, then it is absolutely critical that the therapist remains calm and positive. This is to keep pressure off and so to be open to whatever might be needed to be changed. And if confidence is lost then so does positive expectancy and then the therapy is over.
After establishing the expectation of change, the requirement then widens to the most general of all – which is to the shifting of attention towards supporting a better emotional response. This is what the door opening is all about. And there are so many doors that can open.
Attention can be directed to the useful resources and strengths the patient may have and their most useful memories and away from those that are doing so much damage. And further, to focus on new interpretations (stories) of the past – that attend on real or newly constructed experiences of success and achievement and more balanced explanation, with more shades of grey and less black and white. Motivations may be tweaked towards better action or away from action that damages. And so on.
The indirect language of Milton Erickson is designed just for this – presupposing the desired outcome, embedding a suggestion within other words, linking desired change to truisms (and so implying a causal link) and concentrating on positive and congratulatory language and focus.
Reframing is at the heart of what the redirection of attention is about and is perhaps the best way to summarise the purpose of all of the heavyweight therapeutic attention shifting. What is needed is a shift or reframe that will facilitate an understanding and interpretation to events that prompts an emotional response that assists better action. And as we have seen, this normally revolves around the skilful and appropriate use of indirect language, metaphors and stories and so on that makes the best use of healed emotional resources, aided by the placebo effect. The therapist may be gently leading the patient but the patient is following willingly and with curiosity and openness. You can see that Roth was on the right lines.
Two – Preparation
Normalisation is at the heart of preparation and simply means the offering of a credible explanation of why the client is feeling so bad. It can be understood as the bridge between communicating with the unconscious (the first) and the clearing out of the clutter (the third). Thus, if normalisation does its job it will begin to take away the pressure of feeling culpable, guilty and ignorant, which is the typical condition of the mentally distressed. A recovery mindset then can take root – makes sense and so be owned by the patient.
Normalisation becomes a liberating reframe by providing an accessible and apparently sufficiently complete explanation for the endured mental problems – that not only makes sense but will accord with the experience of the sufferer. So the explanation, suitably tailored to the nature of the problem and the client experience will be a major exercise in utilisation also. That it is normal and you are not going mad – that the terrible way you are feeling and the lack of emotional control that is being endured has a simple explanation that is rooted in the common psychology of us all.
The positive effect of this is that hope is built and pressure relieved – because so much of the anguish and pain of mental problems (notably for depression, addictions and extending to psychosis and diagnoses of say schizophrenia) arises because there is so much ignorance. Moreover, this ignorance extends well beyond the sufferer to include the common media explanations and up to and including most of the medical “experts” and “expertise”. The consequence of such widespread ignorance is to feed the fear and arousal that is causing the distress in the first place. Humans are programmed to be always asking the question “why” when they are feeling bad and then, depending how desperate they are, to alight on all manner of explanations, however unreasonable, improbable and unhelpful they may be.
Recovery mindsets, as hope returns generate pathways around action and change and an openness to tasking as a complementary therapy too.
Three Clearing out the clutter
De-traumatisation is the clearing away of the unconscious pattern matching that has damaging, crude and uncontrollable emotional responses from the living of lives today. These emotions arise in our current experiences but can be identified from experiences in the past.
At one extreme there is trauma or threshold (i.e. near) trauma pattern matching, as we have discussed. In these cases, de-traumatising is about facilitating exposure to an original memory in such a relaxed and dissociated way that the memory is shifted away from the primitive limbic system and so becomes calmed. From a Human Givens therapy perspective it is inconceivable to be unable to de-traumatise such memories when required (the favoured tool of Human Givens is the Rewind trance technique) as it is an essential capacity of the therapist to begin to quieten emotions and so provide an experience of a new control over emotions. This basic de-traumatising capacity is though, not only helpful for specific memories of trauma but also to clear emotional memories of extended periods of high stress, even those that have extended over many years and even for catastrophic and hence terrifying projections.
There are however many other less crude but still unhelpful emotional pattern matching that inhibits the living of a life that works and so impact adversely on emotional health. How could it not be as metaphorical pattern matching is the essential means by which we all make sense of and thereby live our lives? Thus, what we may still call trauma can exist in relation to childhood experiences of family breakdown or school bullying, to exposure to embarrassment or loneliness and of separation. This list is endless. In terms of dealing with such less powerful but still damaging patterning, it is about being pragmatic and proportionate. What does the patient believe is required or might be helpful, how might such pattern clearing help to get needs better met and what might be the consequential second order of unhelpful pattern matching as individuals look to find a way to cope with the original unwelcome patterning?
Virtually all people who are on the spectrum of disorders, between the psychotic extreme and the centre will be living with active trauma of some kind, while those at or towards the psychotic end will, by virtue of an active imagination be suffering disproportionately. Indeed their lives can easily descend into what might be understood as serial traumatic experiences that then escalate further. If this is the case, then the Rewind may be needed on many occasions or a more expanded trance work – to clear much of the historical memory and create new stories. This is not far removed from time line work (see below) and is often particularly appropriate for those diagnosed with a wide range of mental illness by the experts – such as Personality Disorders, addictive behaviours and the like.
In practice, there is no clear dividing line between de-cluttering that is strong or specific enough to be based around the use of Rewind and other instances sourced by emotional pattern matching from the past. The language of unconscious communication (see above) used in trance situations is typically the best way to clear these pattern matches. My experience is that in many circumstances, the use and development of an appropriate metaphor can be helpful – such as slowing down the speed of a train so that the scenery can be enjoyed, or seeing a broad wide and deep river to represent the richness of the world out there or of a mountain peak where all is laid below, clear and serene and so on. And then, there are a host of good stories that can connect and make sense unconsciously and which will seed change.
I have also found that the Chasing Rainbows ideas of Rita Leaman can be a very useful and often easily applied way to clear unconscious patterning – that the habitual emotions that are still active as an adult remain those of that scared, lonely and unhappy child. The way to clear it is to give permission for that small child to relinquish its responsibility and to find some peace and for the adult to then take over.
Undertaking action (or doing) and specifically, the setting of tasks is another way that emotional responses can be modified and cleared. Milton Erickson was the master of using tasks to facilitate change. They were often strange or onerous and difficult or even paradoxical and a such many have become part of the folklore of therapy. For example, Erickson asked a elderly depressed lady, an active church goer to grow an African violet for each wedding and christening or another, that a journalist who was drinking far too much should visit the cactus section of his local botanical gardens, or that a woman desperate for a boyfriend should use the space in her front teeth to squish water through it at her work water fountain and so on. The art is to open the unconscious via an active experience to a different realisation or interpretation or experience that demands a new response and hence understanding. And these tasks are often just set, without any hint of what to expect other than to open to something different.
Four – future focus
Future focus is about getting a life to work well now – knowing that this is the sure fire way to protect against mental problems arising again. The focus is on small steps which get essentials emotional needs better met, and on where there are gaps and deficiencies and finding ways to make the best use of the client’s emotional resources to drive the necessary action and hence control. The assumption is that most trauma and negative emotional pattern matching have been cleared and that this final phase can naturally develop the resources that have been identified.
This is about setting practical goals to be met – mainly around community and relationships and satisfying work, but also around control of emotions. This might be where the focus is on learning skills and cultivating empathy and when the time is right to work on addictive behaviours. Self evidently, rehearsal and visualisations in trance are often important.
The effective use of emotional resources remains the key. So imagination is used to enhance motivation and then visualisation and rehearsal will follow quite naturally. We are of course back to the REM or trance state of unconscious processing. We will be looking to develop a strong motivation or dominant emotion, preferably around a positive vision of the future, so moving towards but if necessary a negative future, that will repel us away.
In doing this woe may have to try more than one motivation, visualisation, metaphor and short-term goal, as long as we remember that it is the first step change that can set the new direction – the principle of the first domino.
Human beings are problem solving creatures of course and if we are successfully accomplishing this, then we will b calm. We never stop trying to reframe all the time and to do use what we know of how the REM state operates – by embedding or slipping in powerful suggestions (dominating by the verb – STOP smoking, NOTICE change, VISIT friends and so on. And be doing this by reminding of all of our automatically operating resources that work without our thinking of it (balance, digestion, empathy) – the law of Reversed Effect.
And so to finish, I want to introduce the idea of our time line – which can be understood as the progression and story of our lives that we hold within our unconscious processing REM state, much of which we can resurrect into consciousness So we all have such a story and the first mistake is to believe that it is fixed by history of what we “know” actually happened. This is not so as our history is just a story that is fixed by the emotions around the events and the interpretation that we make. And the story can be changed – toward one that gives us power and even where events are more as they “could have been” rather than as we hitherto believed that they were. This powerful time line metaphor is concerned with clearing out the past – in other words rehearsing and playing out a new but credible history with more empowering interpretations, that can then flow into a cleaner future.
At the extremes
At the psychotic end of the spectrum, communication is easy, almost too easy and so becomes dangerous as there is be great sensitivity to metaphor and indirect trance communication, both in and out of trance. Practically, effort is needed to use language and questioning to narrow the field of attention of an extreme end spectrum individual – in order to connect to reality.
At the caetextic end, trance states and indeed stories and complex metaphors are difficult if not impossible to use simply because access to Unconscious Processing is so hard. This means a natural attention to specifics, albeit very differently formulated for left and right brain caetextics, including tasks and instruction e.g. learning relaxation techniques to tame chaotic emotions. Use of logic and universal reasoning and review can also direct attention differently. This is a slow process and a caetextic’s sense of self is always vulnerability. This lack reflects fundamental feelings of insecurity in a world where everything is constantly changing.