Monday 29 February 2016

Lessons from Combat Trauma


     Shay, an experienced psychiatrist, writes (in italics) about his experiences treating many Vietnam vets with PTSD. 
     I suspect that a surprising proportion of us, though never having physically been in an actual war, have nevertheless accumulated, not the same, but similar trauma over a perfectly imperfect lifetime. And have probably never received any timely counseling.

     “The child’s inner sense of safety in the world emerges from the trustworthiness, reliability, and simple competence of the family.”
     Children who grow up feeling unwanted, know no safety - have definitely been traumatized: http://www.johnlovas.com/2013/11/attachment-to-people-memories-concepts.html

     “… moral injury is an essential part of any combat trauma that leads to lifelong psychological injury. Veterans can usually recover from horror, fear, and grief once they return to civilian life, so long as ‘what’s right’ has not also been violated.”
     Children expect unconditional love, but none of us receive it. The greater the gulf between what we ardently need and what we feel we receive, the greater the sense of betrayal - the 'moral injury': http://healthyhealers.blogspot.ca/2013/07/the-inner-child-unconditional-love-and.html

     “Another veteran in our program wrote: ‘In my wildest thoughts I never expected or wanted to return home alive, and emotionally never have.’ 
     The sense of being already dead may contribute to the berserker’s complete loss of fear … It may also be the prototype of the loss of all emotion that defines for combat post-traumatic stress disorder the prolonged states of numbness – the inability to feel love or happiness or to believe that anything matters.” 
     How does a child appear when the expected source of unconditional love repeatedly says wildly hurtful things to the child? S/he may not reveal any change in expression. But there's inner amazement & profound confusion - 'Is this a Martian pretending to be my mother?' Also internally, there are earthquakes & aftershocks, with new layers of concrete hastily lathered around the heart.

     “What I want to emphasize here is the rapid transformation of grief into rage. For many of the (Vietnam) veterans in our treatment program for combat post-traumatic stress disorder, replacement of grief by rage has lasted for years and become an entrenched way of being. Much therapeutic effort aims at reawakening the experience of grief, which we regard as a process of healing, painful as it is.” 
     “I believe that the emergence of rage out of intense grief is a biological universal and that long-term obstruction of grief and failure to communalize grief can lock a person into chronic rage.” 
     I suspect many 'angry young men', as well as women, express their grief through rage.

     “There is growing consensus among people who treat PTSD that any trauma, be it loss of family in a natural disaster, rape, exposure to the dead and mutilated in an industrial catastrophe, or combat itself, will have longer-lasting and more serious consequences if there has been no opportunity to talk about the traumatic event, to express to other people emotions about the traumatic event, to express to other people emotions about the event and those involved in it, or to experience the presence of socially connected other who will not let one go through it alone. This is what is meant by communalizing the trauma.”
     It may not be until the late teens, when children of dysfunctional parents move away from home, and finally have the courage & safe opportunity to explore, and perhaps vent their grief.

       Jonathan Shay. “Achilles in Vietnam. Combat Trauma and the Undoing of Character.” Scribner, NY, 1994.

 

Monday 15 February 2016

Ego, Morality, Character Development, Enlightenment & Psychosis


     "The notion of connectedness or union is present in some form in most cultures and all of the major religions. It has been given many names, including Brahman in Hinduism, the Buddha-mind, the Tao, and the Kingdom of God. This Spiritual Ground can be regarded as the source of one’s sense of union with self, other people, the environment, and the universe. In yoga philosophy, this Spiritual Ground is regarded as the true nature of reality and self, with all mental activity serving only to obscure this truth by creating a sense of separate existence. 
     This concept implies that the Spiritual Ground becomes more accessible as the cognitive activity that maintains one’s ego-identity diminishes. Whether one experiences contact with the Ground as edifying or destructive relates to the developmental health of one’s ego at the time this contact occurs, as well as the means by which one’s ego boundaries are transcended. Contact with the Ground is conceptualized as occurring through 'porosity' of the ego; this can occur either through spiritual development, which allows larger and larger fields of the Ground to be identified as Self, or through illness, trauma, drugs, or impaired development, which can permit premature contact with the Ground through defective maintenance of needed ego cohesion. This model, then, can account for the superficial similarity between psychotic and mystical states, and also for the significant differences between the sequelae of mystical experiences and psychosis. 


      In both psychosis and 'enlightenment,' individuals appear to have altered ego boundaries and to think and act in irrational ways. But in the case of a psychotic regression, this is a prerational, pre-egoic state, and in the case of healthy mystical experience, it is a transrational state built upon and extended beyond a normal, healthy ego. Wilber names this confusion between the two conditions the 'pre/trans fallacy,' and Freud’s criticisms of religion as a regressive defense may be partly understood in terms of this error. 
     The concept of the pre/trans fallacy underscores the necessity of healthy ego development as a prerequisite for constructive transpersonal experience: without it one is unable to integrate such experiences and is at risk of psychological fracture and regression into lower functioning states. Interestingly, character development is emphasized in many of the non-Western wisdom traditions that use various techniques to induce transpersonal states. Often the aspirant must go through extensive personal development and moral training prior to practicing the methods, as a safeguard to prevent subsequent spiritual difficulties. Also of interest are studies showing a positive correlation between mystical experiences and enhanced psychological functioning, further underscoring the substantial difference, in spite of superficial appearances, between psychotic regression and transpersonal states."

       Kasprow MC, Scotton BW. " A Review of Transpersonal Theory and Its Application to the Practice of Psychotherapy." The Journal of Psychotherapy Practice and Research 1999; 8:12–23.


 

Thursday 11 February 2016

Role of Transpersonal Approaches


     "All transpersonal approaches are concerned with accessing and integrating developmental stages beyond the adult ego and with fostering higher human development. Because of this concern, most transpersonal theories deal extensively with matters relating to human values and spiritual experience. 
     This focus sometimes leads people to confuse the interests of transpersonal psychiatry with the concerns of religion. Transpersonal psychiatry does not promote any particular belief system, but rather acknowledges that spiritual experiences & transcendent states characterized by altruism, creativity, & profound feelings of connectedness are universal human experiences widely reported across cultures, and therefore worthy of rigorous, scientific study
     Inattention to these experiences and the roles they play in both psychopathology and healing constitutes a common limitation in conventional psychotherapeutic practice and research."

       Kasprow MC, Scotton BW. " A Review of Transpersonal Theory and Its Application to the Practice of Psychotherapy." The Journal of Psychotherapy Practice and Research 1999; 8:12–23.
 
 
 

Monday 1 February 2016

The Best Medicine - Start Now!

     "People often say that laughter is the best medicine, but it's not. Really, I think it is more accurate to say that friendship is the best medicine."

       Patch Adams MD http://www.patchadams.org
       "Bringing fun, friendship and the joy of service back into health care."

     And friendship with oneself has to be present before we can extend friendship to others, be it patients, family or other loved ones. We ache to know ourselves at the most profound depth - who are we? For this we need to step into the 'laboratory of the mind' - meditation.
     As obsessive doers & fixers, we postpone & find every excuse to avoid meditation, but NOW is the optimal time to get into it: http://jglovas.wix.com/awarenessnow#!WHEN-is-it-a-Good-Time/c17jj/56ae724e0cf2062bd4107a0c