Nearly forgotten, but not quite

May 2018.

     Suddenly I realize I’ve practically forgotten the copy deadline for May’s article. It’s after midnight and Friday. Yikes.  I haven’t missed an issue of The Nimbin Good Times since writing for this paper in March 2009, and I can’t start now. So, what to write about?

     I’ve been thinking a lot about intergenerational trauma in recent times as I see the effects frequently among my clients. I have people coming to me with feelings of high anxiety, sleep issues, and accompanying digestive problems that are not easily simply understood from personal histories, per se, but suggest that something more is going on.  Some deep questioning from me often reveals a pattern of anxiety and depression shared by the parents and grandparents of my clients, and often shaped by war experiences and alienation from family at critical times.

     I remember working some years ago, with a man with sleep problems and associated weight issues (weight problems is identified in the literature as being associated with long term insomnia) whose mother experienced bombs going off in London as a little child. She couldn’t trust enough to sleep properly and was, and remains, always on edge and anxious. Her cortisol levels must have been through the roof.

     Cortisol is a hormone that is released in response to stress and is known as the ‘flight or fight hormone’.   It is also associated with maintaining blood pressure, and anti-inflammatory and immune processes. Interestingly, cortisol also works in tandem with the hormone insulin to manage constant blood-sugar levels, so it plays a part in digestion.  High cortisol levels are associated with diabetes, a condition my client also had.

     At an epigenetic level, my client was likely affected by the experiences of his mother a nearly three decades before his birth, and not just from the stories that she may, or may not have told her son. Epigenetics is the study of heritable changes in gene function that do not involve changes in the DNA sequence itself. Bodies don’t forget, it seems, and they hand down the generations their imbalances created by trauma. Trauma upsets nervous systems across the board that impact on the whole health of the descendents.  It becomes critical that those who seek counselling receive it with reference to trauma therapy and not merely symptom control. Good therapy is thus, in my view, a depth psychotherapy that really helps shift those levels of fright-flight-fight reactions to more than manageable levels.  Really good therapy frees up the whole self so that the energy previously captured in iterative anxious responses now becomes available for creative output and innovative work and play practices.  Clinical hypnotherapy is often useful alongside counselling in this process, but that is the client’s choice.

     I am always interested in that coming to a place of playfulness from the tensions of hardline panic because then the whole being of the self is softened, loosened, and ready for new experiences. The client can then move on to what really excites and motivates them, and, what’s more the memories of difficulties are practically forgotten.  It’s a curious thing, this forgetting, because it is possible to see that there has been fundamental change at a more than cellular level. The whole person is lively, fitter, glowing, and sort of bouncy. What was once a stuck problem story is now recounted with how things once were, with only a little bit of the pain previously experienced.

      Remembering the trauma experienced by an antecedent family member or members helps the client recognize that their own symptoms don’t necessarily reflect anything they themselves have done, or not done, and this fact often contributes to a freeing up from some aspects of the symptoms of anxiety they have felt. It shifts the experiences to a sense of something that can be witnessed as opposed to drowned in. So a chance to speak of such things to a therapist is really useful.

     Another side effect of doing therapy with a counsellor is that the changes experienced translate into changed family dynamics and even family members realign to more healthy choices. Interesting stuff. And now to bed.

    

The Resonant Voice

 The Resonant Voice by Dr Elizabeth McCardell, BA, BA (Hons), M. Couns., PhD.

     Some years ago over in Perth I attended a four day voice workshop where we explored many of the possibilities of voice: we sang in groups, in duos, alone, in large enclosed and open spaces, stainless steel cupboards,  narrow hallways, against wooden fences and brick walls, all the while experimenting with depth, pitch, resonance, and tone. It changed my life. It also brought a consciousness that I don’t think I had previously regarding the relationship between health and voice.  Since then I listen more to the quality of a person’s voice, including my own. I notice, for instance, that when I am being insincere, my voice pitch is higher and more hollow sounding. When I am concerned, my voice drops sometimes to a barely audible whisper, and down a couple of tones. There is nothing unique about this observation except that most of the time this kind of awareness is mostly unconscious. What I’m noticing more and more is that I’m noticing it more and more. I am interested in it and am starting to make a study of it, in order to enhance my counselling practice and possibly contribute further to the literature.

     I remember a fellow attendee at the workshop  whose voice was distinctly flat and one-dimensional.  It sounded as though she was deaf, in a way.  She wasn’t actually physiologically deaf, as she told us, but, effectively functionally deaf.   She was clinically depressed. Her whole demeanour was heavy, insular, passive, and lacking in reciprocity. In essence we didn’t get a sense of give and take with her, nor she with us.

     She and I partnered a few times, and it seemed she couldn’t hear me sing, nor could she tune her voice to my voice. What was more strange, she couldn’t, somehow, hear herself.  The quality of her voice was flat and colourless, and lacked resonance. It was like a dead thing; a clunk, not a ring.

     Over the course of the four days, it was apparent that her ears were opening. She was starting to sing in tune and as this was happening, her whole posture changed as well as a liveliness coming to her step. Her face started lightening and becoming mobile.  It seemed also that her skin was clearing. Before she had a sort of bluish-grey dull complexion; but now, breath and blood was clearing it away.  

     There was a profound change in the way she sang with us. Her voice increasingly became responsive to us, and stronger. From being flat as well as lifeless, her voice was entraining itself to be in tune with us.  The transformation was extraordinary and a revelation to me.

     This woman became a model for me of the possibilities of voice training, or just regular singing for the fun of it, as a therapeutic tool.  In my counselling practice, I’ll sometimes recommend particular clients join a choir, have singing lessons, or just make a regular practice of singing around the home, or even on the way to work to music on the radio. Those that have are becoming less distant from their engagement with other people and themselves; a revelation that they notice very quickly.

     In singing,  it is as though our  ears are opened up and a playfulness of encounter begins to happen. Importantly also, with the reciprocity of encounter comes a fearlessness and assertiveness and an ability to choose which behaviours of others should be agreed to, and which rejected.

     To use the voice consciously is the beginning, as  Alfred Tomatis (1920-2001), an ear, nose and throat physician, psychologist and educator  has said, of hearing oneself, and thus, hearing others.  It is the beginning of actively being in the world as a participator, and not just an observer.

Depression and Treatment

September 2015.

Depression  and Treatment by Dr Elizabeth McCardell, M. Couns., PhD

Depression is diagnosed as feeling sad or blue for two or more weeks. It is characterised by two things: self blame and rumination (thoughts that go round and round and round your head). Both paralyse decision making skills, feelings of well being, and the ability to move on in one’s life.

Depression, which is essentially a fear-based response to events, relationships and psycho-physiological conditions, can lead to dropping out of society, losing one’s job, ceasing to create, developing heart disease, over-eating, under-eating, smoking, chronic resentment against self and world, smoking and other addictive habits. Major depression is a growing concern, world wide. The World Health Organization identifies it as the fourth most significant cause of disability in the world.

So what is depression? There are many views on this, many perspectives and it rather depends on how you see the world. Contributing factors include biology: genetics (though no depressed gene has been located), biochemical contributions (serotinin, a breakdown in the auto-immune response, etc), health, exercise, and diet. There are the psychological factors: your individual temperament, coping style, attributional style (that is, how you view what happens to you in different circumstances), your personal history, and so on. And the social factors: the quality of your relationships, the culture in which you live, isolation, and so on. Depression is contextual in the sense that it arises in response to something. Interestingly, it seems to have a capacity to be spread (witness the proliferation of deeply depressed adolescents through online sharing of gothic thoughts and cutting). In other words, there are many contributors to whether a person becomes depressed or not.

Childhood experiences, including the quality of support you’ve experienced from your care givers, modeling and what you’ve learned from your family as to how they cope with loss and adversity may  contribute to the likelihood of having depression, but not necessarily. What’s more important is how a person responds ongoing processes, how they use information, how they form relationships, and how they interpret  the meaning of things that happen to them. Socialization continues throughout life and our coping skills are also being developed throughout life. This means we can learn not to follow a pattern that we used in previous times to manage life’s situations.

Treatment of depression ranges from medication, electroconvulsive therapy, diet, exercise and psychotherapy. A single-pronged approach is not likely to work, and doesn’t in many cases. Treating those diagnosed with depression with anti-depressants such as serotonin-reuptake inhibitors is often believed by patients to be sufficient, but, one, anti-depressants don’t work for everybody (they just don’t work in the way researchers thought they would) and the problems that exacerbated  the condition in the first place are still there.

Some interesting research is going on in Leiden, The Netherlands, on the thesis that depression is an inflammatory problem and the use of probiotics seems to have the effect of lessening the inflammation in the body. Probiotics have been found to cut down the propensity for rumination.

Exercise fills the body-mind with good endorphine hormones and feeling good clears the depression away. It’s hard getting oneself motivated, however. The use of hypnotherapy at this level is very useful, as it is on other levels as well.

Psychotherapies that concentrate on present issues are found to be more effective than those that go back over old stuff. This is because certain psychodynamic therapies work using rumination, and rumination, as I’ve indicated, is a characteristic of depression. So a therapy (eg cognitive behavioral, interpersonal and hypnotherapy) that refocuses on what takes a person out of their problem story is more likely to be successful here in changing things.

A metaphor might help. Imagine someone walking through the bush for the first time. This is like thinking about something in a novel way. If, for whatever reason, the person goes that exact same way the next day, and the day after that and the day after that, the pathway gets worn down: old patterns are repeated, negative thought patterns are reiterated, neural circuits become circular, and it’s really difficult to leave the pathway because it has created such a crevasse in the landscape that getting out is now really hard. The walker has sort of forgotten how to walk innovatively. Hypnotherapy can change that, using – possibly – this, or another tailor-made visualization. The creation of a means out of depression needs to be as individual as the person suffering depression. The reason for their depression is as unique to them as their remedy. The remedy, I think, should be holistic, but first and foremost, supported by a therapist who understands the interconnection of all these processes.