Contact and Mindfulness by Dr Elizabeth McCardell, M. Couns., PhD

Dec 2009

     A few years ago I spontaneously devised a game where a friend and I, with fingers extended, reach across to touch the other’s finger, reminiscent of God and Adam in Michaelangelo’s famous painting found in the Vatican. An electric contact is made with an accompanying zzzzzzz.  We then break into much laughter.
 

     I like this game greatly (known among my friends as “doing a God and Adam”). To me it sums up the exciting quality of contact, and not just human contact. There is electricity in the contact between humans and other animals and humans and plants and the rest of the earth, when excitement and interest is there.  

      Recently friends and I swam with seals off Carnac Island in Cockburn Sound off Rockingham in Western Australia – an incredibly beautiful place with pristine waters and white sands. Though there we did not actual touch the seals in a physical sense, we were wonderfully energized in meeting the other.

       I also met a shell as I dived down through surging water, my fingers not quite close enough at first, but with an extra kick, I touched, grasped, and plucked it from the sea floor. This was a gift for a friend.  The shell’s sharp salty smell a sweet reminder of her days on the West Coast’s beaches.

It is likewise wonderful dropping down the streets of cities, like Sydney, meeting a surge of people as they come up the other way; of making contact with a smile with people I don’t know; of chance meetings with the like minded in book shops or cafés.

     Or the contact of meeting eye to eye with a green tree frog found under a tarpaulin in my backyard, or hearing a bird reiterating my laughter, or the deep swish of the wind in the trees as I, too, realize something new. Or the touching of an ancient melody caught for a moment on my lips.

     Contact is extraordinary.  Here we are, entities apparently separate, coming together in maybe a short time, and meeting and sharing and parting. It is this rich encounter that excites me when I greet each client. Indeed, it is the promise of such rich encounter that I look forward to when I wake up each day. 

      In contact, though, there is something even more powerful than the delight of connecting. In contact we can move into new levels of consciousness with ourselves, one  another and the deep ecology of the environment. This requires mindfully being  present and watching without attachment to what arises for us in our bodies, our breath, and the passing parade of our thoughts.  When we are  profoundly present for another person our presence  shifts the other’s conscious experience from their pain-body (as Eckhart Tolle describes it) to a gentler state of being.

     Staying in contact within ourselves is much harder. When we are afraid we want to escape from it; when we are angry we want to lash out; when we are embarrassed we want to end our embarrassment, and so on.  These inner feelings generally have deleterious effects on our ways with others and our world. Dumping onto others what we experience as   suffering within ourselves is no solution (wars are made of this). We do need to acknowledge and   make full contact with it within ourselves: to know its edges, the stories that arise and the habitual responses that surround it, as well as all those grumbly reactions and irritations that we feel in response to it. In staying in contact with the feelings we normally try to dispel we actually have new capacities, new insights, and new ways of responding. The intensity lifts. It doesn’t generally happen quickly, though.  I have found that this method of mindful contact with the suffering I’ve known throughout my life is often intensely uncomfortable, interesting in a curious way, but difficult nonetheless. I also know, at least for myself, it is necessary in order that I be truly who I am. It is a method of mindfulness I encourage my clients to explore.

     Contact is electric and when combined with mindfulness practice fundamental shifts in awareness and new insights and ways of engaging with others becomes real and alive. We become alive, playful and ready to engage  wholly with those about us, even the small green tree frog in our garden and the swish of the wind in the trees. 

Copyright @ 2013 Dr Elizabeth McCardell

Evocations. Hypnosis as Everyday Trance by Dr Elizabeth McCardell, M. Couns., PhD

Aug 2012

      Not so long ago a friend came to visit for the first time and commented on the near absence of photographs in my house and wondered aloud whether perhaps I had something to hide. I replied that for sure, I had few photos, but that did not mean my house is empty of presences. I am surrounded by gifts from friends and family and all the gifts are rich with stories. Indeed, I live in a multi-storied house.
 

     There are the ornamental teapots chosen by an old friend and her daughter, each painted differently. There is the carapace of a large black beetle and a bronze dove feather given by another lovely friend who knows my delight in the natural world. A small orange glass bottle from a woman with whom I had a like me one moment, dislike me the next type of friendship, sits among the exuberances from others. An exquisite red Norwegian porcelain vase stands wonderfully next to a miniature snow covered pine tree. The little tree is actually a Christmas decoration that I never put away, because I like the evocation of a northern hemisphere winter scene. There is a shell given to me by a mentor who encouraged me into my current profession. Those who have seen my business card know I use the image of the whirls of a shell. It is my mentor’s shell gift that inspired me to use the image to speak of what I am connected to (sea pictures are always close to my heart), and secretly, whom I am connected to, for there is a lineage here, a Tao of relationships. 

     I have bought very few things in my life and, apart from the treasures of musical instruments, mountains of books, and necessary household items, the rest are gifts from those who have cared for the me-ness of me.  No photo gives me this, for photos, in the main, are studied little numbers that hardly ever capture vivacious life as it happens.

      A multi-storied house is, as the name suggests, a multi-narratived dwelling. A multi-narrative is a story told from many perspectives. The gifts that surround me are rich in story. My red vase is not just a vase. It speaks of Norwegian birch trees in winter, it hearkens silence and close listening, of strength and fragility. The giver of the vase is a very talented counsellor who works with the bereaved parents of sudden infant death syndrome children, listening closely to their fragility and profound loss.

       The black beetle and feather came to me from a dear friend for whom the connection with the natural world is a deeply spiritual one, something we share. Together we have worked on polishing her first novel, a book in which the voices of people and wolves intermingle with the deep voice of rock, water, air and twig.

      We are all multi-storied beings. There is nothing within us nor around us that has a single strand of meaning and thus no single line of interpretation and misinterpretation (for we do not always get it right). No single story means we have a complexity of possible ways to respond to the same thing. A glass bottle evokes in me memories of hours spent in the back shed at home (I was about 15 at the time) working over a Bunsen burner with pieces of glass, melting and twisting them into fabulous shapes. The wizardry of moulten glass – at once liquid and solid, a substance that could be shaped but felt under pressure as hard – mesmerized me. The orange glass bottle given by a former university colleague contains for me these two contradictory motions of emotion: of hardness and softness, of resistance and fluidity, of dislike and like. The coloured glass parallels the red/orange of my colleague’s hair, and so on.

      Our capacity for evocation means that everything we bring into the therapeutic space sings to a multiplicity of songs upon the breathe of pain, according to our feelings and memories and ancient and not so ancient embodied experiences. The fluidity and resistance to what is brought can be shaped into new ways of seeing. There is always that possibility. Sometimes the old way of seeing ourselves and our relation with others dominates and dominates and dominates and seems resistant to change, but with support and challenge (and this is what I offer my clients, as a glass worker provides the alchemical substance of glass), shifts in awareness and understanding can begin. 

     I saw a client recently who had resumed the alchemical work that is counseling several months ago, following on from earlier work she had undertaken in Sydney. I knew as soon as she came into my room that she was different; she was self assured, she was fluid in her movement, her face was relaxed and rested (she’d suffered years of insomnia), and when she said she thought this would be her last session I felt the two contrary-flow emotions of  “I’ll miss you,” and “Yes, it is right, this is the ripe time to complete this work, at least for now.”

Passionate Sadness and Liquid Love. by Dr Elizabeth McCardell, M. of Counselling, PhD

Nov 2012

     "Becoming upset is actually a sign you are going uphill – and it's a very difficult haul. But you can make it. Tears are a healthy display of passion. They are liquid love," so says the well respected grief counsellor, Mal McKissock. I am moved by these words and my own recent loss to write about grief.

     A few weeks ago my beloved and very beautiful cat, Paschie, passed away after a week of terrible convulsions. It was not toxicity, nor epilepsy, nor an illness that brought it on, but an insidious space occupying lesion in her brain. Paschie was something of a therapy cat for my patients preparing to climb down the stairs to my consulting room. She sat on the bins near the top of the stairs and offered her sweet softness to them. Now she is no more.

     I miss her, mostly at night when we used to sit together breast on breast, sometimes sharing our breath, as animals do. Now she shares the mango tree where my father’s ashes lie.

     I have given sacred space to her where she used to eat. A small ceramic tri-coloured cat (Paschie was a grey-white-ginger calico cat) bought on a journey to Heidelberg, Germany, sits there with a little Buddha, and soft grey china dove (for I called her “little bird” sometimes) and some flowers. I change the items placed there as I’m moved to do so. This is not a shrine with things and memories stuck in space, but a celebration of her life. One day I shall sweep the space clear.

      My friends welcomed the posting of her pictures and her stories, and I have felt wonderfully supported by them. With this generous love, I know my own feelings of passionate sadness, that admixture of tears and laughter, and feel in my tears my intense liquid love; a liquid love that melds my love for cat and father and all those others I have known who have passed on. 

     Elisabeth Kübler-Ross’s five stage model of grieving  (denial, anger, bargaining, depression, and acceptance) is not something I relate to, and I am not alone. The journal Scientific American (22/10/2008) reports that there is no scientific basis of this grief model. The linear quality of the five stage model is rejected by other grief counsellors, most notably Mal and Dianne McKissock who run a centre called the Bereavement Care Centre in Sydney, who instead see the rising, the falling, the interrelatedness, the fluidity, the intensity and lightness of grief in the same way as meteorologists consider the weather: using the model of chaos theory. Here there are no first things, no endings, either; what arises is created from  a range of unpredictable dependent variables (time, relationships, context, lie of the land, day of the week, etc). The key point is the unpredictable dependent variables that do not follow any stage theory.

     Of course, the idea of a stage theory seems to offer a linearity and predictableness that  affords a sort of short circuiting appreciated by the medical model of health, but which doesn’t take account of the rich complex of stories, of tears and laughter, of sensing the presence of a person or animal in memory, footprints, fur on chairs, photo and ceramic artifacts, of the sharing of love between friends and family, nor even the playfulness of dreams. Death is final, but only in a single sense. As life is interconnected, so a passing is more than a physical absence. We are “more than” and it is in this “more than” that we grieve and celebrate and tell our stories. It is in this “more than” that healing takes place.

     Our society has an anxiety regarding grief such that some wont even look into the eyes of the grieving person and some will even cross the road to avoid encounter. Some will say, in the case of death of loved one (whether cat, child, friend, or even partner), and very cruelly, “Oh well you’ll have another one,” thus diminishing terribly the nature of love, for love is not merely having, but sharing. It is a shocking thing that the discomfort around grief means that many have to conceal their passionate sadness and in concealing it seek medical help and medication for the pain that then gets called “depression”.

      We, nevertheless, celebrate Anzac Day, and allow grieving. We do not say of this day that all those who do grieve haven’t worked through their grief. We allow the grieving to tell their stories, and in their stories, relive their experiences. This is an important process, which should be welcomed into the rest of the year and the rest of us our lives.

     I encourage sharing through stories, art, sacred space, and conversation the ongoing presence of departed loved ones for whenever a person desires it. I encourage the expression of  liquid love, for being upset is not a sign you’re going downhill; in fact is a sign you’re healing. Know that you’ll not get stuck nor paralysed in your grief, but instead move through – back and forth – maybe throughout all life, feeling sad, feeling happy, and knowing this is the quality of love, and your unique capacity for relationships.

Patient, Client, Collaborator, Journeyman

Patient, Client, Collaborator, Journeyman  By Dr Elizabeth McCardell, M. Couns., PhD
Jan 2012 

     Last night I was bouncing around my tongue the words, patient and client, wondering which more accurately describes the persons who come to see me. Wondering, too, how they viewed themselves, and wondering which I like when I consult a colleague. 

     The two words feel different in the mouth. Pay-shent  is soft and rather nice to say, while kli-ent has a much more mechanical, clipped quality to it. The Latin derivation of patient is patiens , meaning  “to suffer or bear,“ while the word client is derived  from cliens, which means, rather scarily, “one who is obliged to make supplications to a powerful figure for material assistance”.  I don’t think I like the implications of either, but I need a word, a recognizable word.

     My profession of counsellor/psychotherapist customarily uses the word client, while medical professionals (GPs, specialists, physiotherapists, etc) and most of the alternative health professionals (acupuncturists, naturopaths, herbalists, etc) use patient. Does this mean, when a person comes for physical healing they are automatically seen as someone who suffers and is fixed by an expert, in a passive sort of way, but when they come for mental and emotional work, they must actively bow down to the so-called expert, or as one commentator says, be responsible for their solutions because an expert says so. A modern interpretation of client is one who is engaged in business with an operator. Urk! The power play implicit in both words of patient and client irks me.

     Two studies I’ve read on what people who go to health professionals prefer to be called got contradictory results. One claimed the majority of customers (there’s another word) prefer to be thought of as “patients,” while the other asserted that they like to be called “clients”.  So there you go. Perhaps both studies were biased in the way their questions were designed and got the results they expected, perhaps the two samples were too radically different to bear comparison; who knows.

As I see it, coming for therapy, whether for physical, emotional, or mental pain/dis-ease is collaborative work.  There must be a willingness on both sides to find and enhance the best course of action for greater whole self health, to facilitate a person feeling well in themselves. So, maybe I could call the other person my collaborator.  I rather like that – even with its dual meanings of double espionage, as well as those who work together on a joint project (we’ll forget about the spy bit, though).

     Words, words, words. Instead of choosing one word over another perhaps I could use whatever word suits the quality of relationship. A health forum I visited in preparation for writing this article queried why we need a word at all, but this is a cop out because we still refer to those who come to us as either “patient” or “client” (and each word comes with a portmanteau of meanings and assumptions, and the word we choose betrays our bias). Also, those like me, who write about our cases, albeit disguised,  need a good word.  Parts of me lean towards “patient,” for its soft tone; parts of me has been conditioned by my professional training and the idea of the person actively participating in their healing, likes “client”.  I best prefer, though, “collaborator” for its sense of  partnership in a joint endeavour, of fellowship on a journey where the process of discovery (of choices, awareness, insights, etc) is the destination, not the destination as an end, and I am a guide, for I have journeyed with many over the years. At the heart, I am a fellow journeyman. We journey together.

Post-traumatic Stress Disorder

Post-traumatic Stress Disorder   by  Dr Elizabeth McCardell, M. Couns., PhD, Dip Clin Hypnotherapy
July 2013

     He flew helicopters during the Vietnam War, picking up very damaged bodies. He flew home from the war and got a job with an airline as an aircraft mechanic. Thirty years later the airline collapsed and he no longer had a job. Fortunately, he was close to retirement anyway, so he took the opportunity to stop work. The very next day, he found himself standing on the rails of a local bridge about to jump in. Instead he rang me.

     He had been perfectly alright during his years as a mechanic – apparently. Maybe he worked too hard, for he never had time to form  intimate relationships with anyone, never had children, lived a quiet life in a small somewhat isolated house on the edge of town near the airport. He went to work, came home, cooked dinner, ate, watched a little television, didn’t drink alcohol, didn’t smoke, went to bed, got up, went to work …

     Now memories deluged in: blood, entrails, faces half blown off, burnt flesh; the chaos of piles of bodies staining the forest floor; chopper noises and wind, endless wind and that tacktacktacktacktack. Nightmares all night, every time he closed his eyes; nightmares every time he blinked and nightmares with his eyes open.

     He hadn’t thought much about the war, he didn’t dare too, all those  years since he returned home from Vietnam, and now that’s all there was.

     The onslaught of memories, dramatic though they  were, were not the only signs of what we now call Post-traumatic Stress Disorder (PTSD), the fact that this man felt numb and sort of distant from others was a sign things were not right. I found out, too, that he had suffered insomnia for many years, and he was jumpy, and easily irritated.  He also didn’t really think he had a future.

     This man lived  in a very orderly manner, mechanically almost. He avoided situations that reminded him of the extreme stressfulness of the war. He attended no Anzac Days, belonged to no veteran clubs. He effectively held anxiety at arms length which allowed him to get on with life, more or less.

     When I saw him a dozen or so years ago, I worked entirely from a talking therapy model, with some relaxation techniques thrown in. I’m not sure I achieved much, but then I didn’t practice clinical hypnotherapy.  I’ve since learned that hypnotherapy increases the likelihood of recovery by about 93% for people with PTSD. Medication can be helpful, but only superficially.

      Clinical hypnotherapy is a wonderful tool. It doesn’t resemble stage hypnosis, and there is nothing wooo wooo about it.  A state of oblivion nor mental unresponsiveness is not induced. Clinical hypnotherapy  is a state where ordinary day-to-day awareness is reduced and a person’s attention is directed toward a specific mental idea, problem, physical stimulus, fantasy or insight and through this medium, new insights and new ways of being become possible, and part of the continuous reality of now.  In this way the therapeutic trance state is not dissimilar to watching television, reading a novel,  painting a picture, or playing golf. What is different about it is that positive changes to your life actually happen.

      Clinical hypnotherapy can be very effective in the treatment of PTSD, depression, anxiety, pain management, habits you want to break like smoking, binge drinking and eating, sleep problems, and so on. Why clinical hypnotherapy works so well with these problems is that these conditions already have elements of a trance state within them. By working within this dynamic, the therapist can alter how things are perceived and thus remove the cycling effect of these problems.

      Why some people develop PTSD and others don’t is still poorly understood. Trauma is felt as such when a person is met with appalling circumstances that arise when we are unprepared for it. The feelings we have are of shock, powerlessness and horror. This sudden interruption to our normal functioning can persist for years, indeed a lifetime, after the trauma is over.

      At a physiological level, cortisol levels rise in response to physical and psychological stress. The body produces the hormone cortisol to regulate energy levels, by converting protein into energy by the release of glycogen (sugar) into the blood stream. We need energy to deal with stress. We need to be able to run away from terrible situations, if we can. If we can’t run, our bodies can hold itself in a state of chronic stress, and in the case of my Vietnam veteran client, a chronic state of held-in terror. There’s certain evidence to suggest that high cortisol levels can be transferred from mother to child. My client’s parents may  well have experienced their own trauma during the Second World War, thus giving him a predisposition to PTSD. War is horrific, and the people suffering PTSD are numbering among the thousands. It’s believed that 40% of soldiers fighting in Iraq will suffer PTSD. The effect reverberates down the generations.

      To be clear, Post-traumatic Stress Disorder can arise from a range of traumatic events, including: interpersonal violence (eg being mugged, or unexpectedly attacked, or robbed at gun point), combat violence, sexual assault, irregular sexual abuse,  torture (random torture is the worst), sudden and unexpected death of a close family member or dear friend, earthquakes, and volcanic eruptions, tsunamis, mining accidents, and so on. The most binding characteristic of these events is that of their unexpectedness. It is no wonder that when we have experienced such fundamental disruptions and we have no immediate means of discharging that energy, our physiological and psychological responses of hyper vigilance, sleeplessness, irritability, panic attacks, depression, and worst of all, our sense of powerlessness take over our lives. Trauma, however, can be healed.

      Meditation, relaxation techniques, physical exercise, and emotional and psychological support, are all very useful approaches in the effective treatment of this most disturbing problem, but talking with someone and getting assistance through clinical hypnotherapy and psychotherapy provides actual means for recovery.

Using what is already there

Using what is already there   by Dr Elizabeth McCardell, M. of Couns., PhD, Dip Clinical Hypnotherapy

June 2013

     I was doing the initial assessment before a hypnotherapy session with a client recently, for work on his difficulty sleeping. Among other things, I wanted to know if he had had any prior experience with hypnotherapy. He said he had, but what he described was creative visualization, which is only one technique of hypnotherapy. He said it was kind of useful, but it didn’t have an enduring effect. He also said he had a relaxation cd that sort of worked, but he found it difficult to stay focussed.

     Creative visualization can be very effective, but only if the imagery is sufficiently pertinent to the person using or receiving it. This point is one I wish to develop here. It follows the principles I use, and have described previously, of using what is already within the ordinary experience of a client in therapy, for it is this unique and personal resource that aids in the process of recovery.

      There is an elegance in doing this that is very Taoist. The word “Tao” is difficult to translate and is usually described as the “way”, which doesn’t really tell you much. I like the description of the Tao as the watercourse way, the way of simplicity, the way things happen when water finds its path naturally, from where it is at now to where it becomes and how it changes its way in a simple process of becoming. The Taoist way is not forced and doesn’t impose things that are not already present in some form.

     So I inquired of my client with the sleeping problems what imagery was used by the previous practitioner. He said he had to visualize a waterfall in a forest and imagine the sound of water tumbling down. I asked if he had any particular liking for waterfalls and he responded that he didn’t particularly. He said it was an image he had to work at conjuring up. I then asked him what his favourite pastime is, and he replied fishing offshore in his boat. It is an activity he doesn’t get to do much, but when he does it, it relaxes him profoundly. This was the way of Tao for him and thus became the image I used in my session with him: sitting in a gently rocking boat, throwing a line overboard and waiting for a fish to nibble. Fishing from a boat is something he knows and it is something that he does already for relaxation. What a better resource than a imagining with difficulty a waterfall prior to drifting off to sleep!

      The fundamental of good therapeutic practice in general is to start with their lived experience, their phenomenology, not an alien idea taken from a text book. This is why taking a case history really matters, and why intelligent questioning and conversation is needed throughout the sessions of working together. What happens in a psychotherapeutic and a clinical hypnotherapy session is thus shaped around the client’s experience, and the resources they already have, albeit ones they may not be aware of. Change happens from this starting point, in a very concrete way and not in any abstract sense.

     Hypnotherapy has come an incredibly long way from the traditional method of the hypnotist requiring the patient to gaze at a candle or swinging pendulum and then to go into a deep trance and receive suggestions without an opportunity to respond to them during a session.  By contrast, in modern  hypnotherapy developed from the wonderful work of Milton Erickson (1901-1980), the client might be invited to speak about what’s happening for them as the therapist works. They may be invited to comment on the direction the session is going, or to speak about their experience at that particular time, or amplify or clarify some aspect that the therapist doesn’t fully understand, or they themselves need further explanation. This invitation is a hallmark of an approach that isn’t top-heavy, like traditional hypnosis tended to be; it is, instead, collaborative. The client can choose, and express it aloud, whether to take up suggestions made during the session. In other words the client is active in the process. Things are not being done to him against his will. His own experience, matters and this is what is employed in the sessions with the therapist. Change happens through choiceful engagement in a process, not because somebody else dictates it.

     In other words, modern clinical hypnosis, is less dependent upon the development of a trance state (though this remains part of it) and more on bringing focus through awareness of other ways of seeing things and of shifting an emphasis that is getting in the way of ordinary life. Problems like smoking, insomnia, pain, hoarding, low self confidence, compulsive behaviours, panic attacks, and depression are all helped by hypnotherapy sessions. I emphasize, though, the collaborative aspect of this kind of therapy. Hypnosis isn’t a magic pill that cures without the person wanting change. Change happens because the person wants it. The sessions are deeply nurturing and the person generally expresses feeling wonderfully relaxed

     Therapeutic change has a similar feel to the way water courses through a landscape, organically transforming everything it meets, for it uses the already present yet tangibly shifting blockages and stagnations and problems that used to go round and round and round one’s head, to a new fluidity, a lightness of being, and an a delight in something young and new and very exciting. This therapy is deeply transformative.