Anxiety

Anxiety    by Dr Elizabeth McCardell, M. Couns., PhD

    I’ve just realized this is the last Wednesday of the month, the deadline date for contributing articles to the Nimbin Good Times. To say I’m a bit stressed and anxious, is an understatement. I’ve contributed to this fine paper every month since March 2009 and really don’t want to miss an issue, if at all possible.

     Anxiety is my topic, appropriately. What a better way of working than working with material currently experienced.

     At the moment I am participating in an online international conference on the use of hypnosis in the treatment of anxiety. The tools we are adding to our repertoire are extremely useful and are available to any client wishing to work with me. So the matter of anxiety is close to me at other levels too.

     Anxiety has a structure that is pretty well universal. There is an internal voice that repeats messages of fear, danger, maybe lack of ability, that manifest alongside the mental reiterations, a physical component of tightness in the chest, perhaps some breathlessness, palpitations, dry mouth, and the like. The internal voice is quite high pitched, strained, and rapid. The message is not really rational and it repeats itself.

     Anxiety distorts and intensifies normal interaction in the world and with other people, so that our whole selves can feel overwhelmed with emotion and a sense of being out of control. The art then is to change those perceptions.

     For me, at the moment, my stress at needing to get this article written is being accompanied by fear of losing income. Ridiculous, isn’t it. These articles are one of my sources of income, so I have to write them (or at least so I think). At the forefront of my inner chatter are the words, “hurry, hurry, hurry”. There is, though, another voice that is taking the micky out of this and the “hurry, hurry, hurry” is acquiring a sort of sing song chant, “hari rama, rama rama, hari krisna, hari krisna” – and thus the tension is lessened. And here is a key to losing anxious feelings.

     It is impossible to maintain anxiety when other processes are introduced. There is a technique where the therapist suggests  the client writes down the words of stress in very small script. Then the client reads what she/he has written in a normal voice, and then re-reads the script in a very slow, bored voice. Such a technique changes the non-verbal qualities of the inner talk, and even changes how the body feels as the exercise is carried out.

     Neurological research is showing how this is possible. Changing a person’s experience of inner talk actually changes how the body-mind operates. Inner talk is iterative, that is, it has a quality of rumination, where stuff is thought of repeatedly. In terms of neural activity in the brain, the same pathways become entrenched and sometimes pretty difficult to get out of.  Worry that occupies us, occupies us more and more, unless we can break the looping that occurs. Breaking the pattern, as for instance, taking the micky out of the inner story (my “hurry” changed to “hari rama”), or slowing the words of worry down, or singing the story, or speaking the words in an ordinary  voice, have the power to actually disempower the rumination and the looping and thus forge new neural pathways. Breaking the pattern changes the body’s response to what used to be plain old anxiety and increases a relaxed state. The tightness goes, leaving a softness and a sense of being more fluid and easy.

     Other techniques are useful too. One technique  is remembering the tools we used to use to relax ourselves and learning to incorporate these tools when feeling stressed. For me, writing has this power. As I write this article, I feel more settled. Swimming is another means for me.

     A year or two ago, I had a client with a particular form of anxiety. I wont say what it was about, but I discovered she had a great love of running, down by the sea. In the hypnosis sessions, I “ran” with her in the wind, for in invoking such a scenario, she was able to enter into a deeply relaxed and yet aware state (which is what hypnosis is anyway); a state she was able to evoke whenever she needed to. The inner iterative voice lost its power and her whole demeanour changed in an enduring way. From week one to week three, her face was no longer pinched, her breathing was easy, and her skin glowed.  Along with these changes was a shift in how she worked with the people in her world and how she saw herself. She lost her belief that she was a weak/bad/anxious person. She become confident and looked it. Really fundamental changes occurred.

     Anxiety has a lot of energy connected to it. Unlocking that energy in a creative and helpful way can release and relieve a person very deeply so that they can live more fully and more easily in the world.

Not set in stone by Dr Elizabeth McCardell, M. Couns., PhD

     When I was an academic at Murdoch University in Perth, WA,  I came across a lot of people convinced they were imposters and that they would soon be exposed and kicked out. I didn’t really experience this myself, and felt this time of my life as being wonderful fun. This may be because I’d spent ten years or so prior to this working as a researcher and editor of the writings of academics and ordinary people alike and knew that I didn’t need to set myself up as an expert, for I had certain skills and certain failings as well, but I was always willing to learn and expand my expertise. This is the key, I think. If I had thought of my knowledge and position as static and immutable, I’d be terrified if it was questioned, for then my view of myself would come tumbling down.

     I am not fearful of what life throws at me. I don’t identify myself with status or label, or whatever tag might be attached to me. This is not to say I am free from inner stories that  come to bite me. This is the human condition, I think. What has become different, as far as I’m concerned, is that I go for the thing that might otherwise inhibit me from acting, something that allows me to roll rather than get stuck. I wasn’t always like this. I was in fact a very fearful child.

     This not getting stuck in ideas about myself is useful in many aspects of life. In an article I read recently, the non-identification of  oneself in a negative status allows for fast healing, particularly in terms of relationship breakdowns. Those people who self talk with “I’m no good at relationships”, or “I always choose the wrong guy/woman” take much longer to recover.  By not identifying oneself as the inevitable cause of the breakdown of a relationship we’re free to say, simply, “this relationship was not right for me,“ and move on.  This is sometimes easier said than done, and sometimes counselling is useful in freeing ourselves from the negative self talk.

     Nothing really is set in stone as far as life is concerned. Memories of past times are wrapped in the paper of many layers of personal history and these can inhibit us moving forward. Sometimes what we tell ourselves about who we think we are gets in the way of doing what we really want. I nearly had this experience recently.

     I went to Perth during my recent summer holidays and was taken on a couple of trips to my favourite place, Rottnest Island, a place  dense with history, my own included in with prisoners of war and, before that, aboriginal incarceration. There are parts of the island that I have known intensely at significant points in my life from infancy onwards; parts that evoke a complex mix of delight, poignant anxiety, and  pangs of longing. The beach rosemary is so intensely beautiful that each time I go, I break a little piece and conceal it in my clothing to take home: rosemary for remembrance of sunny days at the beach.

    On one of the trips, I travelled on a friend’s boat. We snorkelled and frolicked off Green Island, a small rocky stack off the south side of the island, and a couple of the men donned their diving gear and went crayfishing. I remarked that I would love to dive, if I could. So after their return I was kitted out with weights, buoyancy control device, cylinder, fins and mask. It felt so incredibly heavy, heavier than I’d remembered it seven years ago when I used to dive quite often. I thought, I can’t do this and my mind was thus ablaze with  conflict: to dive or not. Thousands of reasons why not to dive, the thousands of images of myself as “the fearless one” came and went along with “I’m just a little middle aged weak lady,” blah blah blah, images of dying, of living, of disappearing into the deep deep blue,  arose and fell, and so on and so on.. I contemplated flipping myself over the side of the boat, but had images of knocking myself out doing it, so in a near trance I edged my way to the jumping platform, sat down and let go into the water. There was a sort of inevitability in all this and I merely dropped to the sea floor breathing as naturally as a fish.

     Diving always throws up my inner talk, and throws out beliefs I have about myself , but  in the end, I just have to get on and do it. No escape. Once you’re in the water, that’s it. The weights drag you under, and though you can inflate your vest it is so uncomfortable the underwater beckons, and that is so lovely.

     There is no escape in anything one chooses to do, really. Doing psychotherapy (like doing teaching) as opposed to being a psychotherapist (or being a teacher), there are no “outs”, unless of course one actually wants to be completely useless. Doing psychotherapy means being there, thinking, making metaphor, analogy, and being present with the other person where they are and challenging that when appropriate. This is not the time to set in stone anything. Not a time for having an immutable belief about oneself, nor thoughts  that one is brilliant or bad, or insipid. All is changing all the time, just like being in water.  Nothing is set in stone.  Living is being, and not being a thing.

Prose Poems

I thought I'd add this link to some of my published prose poems in Episteme journal.

http://www.episteme.net.in/index.php?option=com_phocadownload&view=category&id=105:prose-poems&Itemid=625

Falling from the Cloud. by Dr Elizabeth McCardell, M. Couns., PhD

January 2016

     I’ve been wandering around for a couple of days thinking about what to write for this article, trying to focus the mind, but having difficulty. It’s between Christmas and New Year and I’m caught up in the bardo space of neither this nor that, which many of us feel at this time of the year. Some businesses are open, most are shut, the streets are quiet in the most part, and the place has a dreamlike quality. Topics rise up in my mind: guilt, shame, community, getting stuck and unstuck, and moving on and I’m moved to consider them in the writing, but a fall from the cloud  of community is the one that captures me.

In computer speak, the Cloud is a public WiFi provider that allows for the sharing of data and information for the benefit of streamlining resources and creating community coherence. Without public WiFi, the internet connects us anyway, however much we seek it. Within the internet are deeper, darker depths where few choose to wander.

In meteorological terms, the cloud is a visible mass of liquid or frozen droplets of water and various chemicals that gathers together to form types of communities of droplets.  Some droplet communities are very dense and some less so.

Issues can be cloudy, in that they are not transparent. Moods can be cloudy, where suspicion and worry lurk. There are clouds before a storm, and hunters of storms observe the clouds. I watch them: the clouds of meteorology, moods, and thoughts.  Being a cloud watcher all my life, I like the meditation practice, adopted by some hypnotherapists, including me, of thinking of thoughts and feelings like clouds, and watching them gather in cloud form and disappear.

Community has cloud-like characteristics. Community is a social unit of any size that is connected by durable relations, with rules, said and hidden, that work towards keeping the unit going.

I like to watch clouds. I gaze at them, endlessly, from my back veranda, watching them form and dissolve and form and dissolve. I saw a red dragon once. There it was, this red glowing dragon seen through clearly defined luminous clouds. He raced across the sky, and was gone.

Community is highly complex and can be studied by anybody and from a range of disciplines: ecology, anthropology, social science, information technologies, organizational perspectives, philosophy and psychology, for instance. I am, though, most interested, given my profession and inclination, to want to consider it from the perspective of the individual person.

shame and guilt and wondering about the given wisdom that guilt, as the feeling of having failed in some obligation and shame, as the painful sense of distress caused by the consciousness of wrong or foolish behavior, are individual phenomena. I question this, because underlying these senses are two things: an implicit belief in the rightness of something and a sense that we will be judged by other people in our community for feeling the things we do, even though it usually doesn’t ever come to that, as we keep our guilt and shame secret.  But keeping such things secret doesn’t mean they do not arise inter-relationally, even though they are rarely articulated. Being an inter-relational phenomenon also doesn’t necessarily imply an actual condemnation of one’s behavior, just a disturbing feeling that such a thing has, or is about to, happen.

     I’ve been mulling about certain intangible codes of behaviour that are apparently present among groups of women, for instance. I’m thinking of the “code of silence” that seems to operate, whereby some things are never spoken of, and when they are, individuals are singled out and expelled from the group. This dynamic shames and blames girls in the school yard and mature women in the workplace, and among friends.  It’s a code that is learned very early on and forms what sociologists call, “the hidden curriculum”.

     I, like a few, never learned this particular code and it gets me into a lot a trouble every now and again. I wasn’t present when that bit of learning took place. I was at home in bed with yet another childhood illness. And so I get into trouble by inbeing blunt and declaring things, things that seem to me as clear as day, when the code has it I be silent. When I break the silence, I do not feel ashamed nor guilty, even though someone says explicitly that I should (and say I’m sorry), for I see the dynamic pretty clearly. I’ve lost friends this way, and that is sad. It does, however, give me an insight into how groups work, and do not work.

     The inter-relational is difficult to pin down and codes of behaviour are rarely ever actually articulated. Much goes by at a sort ethereal level. Things are vaguely felt, except when things are said that are said against the code that inheres the group. It’s against this cloudy backdrop that the problems of guilt and shame are manifest.

     Much psychological literature identify guilt and shame as individually felt things. Guilt and shame certainly feel like they are individual. I may not know the code of silence, but I know other codes. I know how it feels to fall upon the guilt-edged sword of shame. It hurts in a nagging, dull sort of way. But, you know, how is it possible to have a sense of a conscience outside a code of practice lived by the rest of one’s community? A conscience arises in relation to beliefs and ideas about community for the benefit of community. Having a sense of right and wrong are relational, indeed, inter-relational within community, and, as such, are endlessly negotiated.

Martin Buber, the existential philosopher in his book, On Psychology and Psychotherapy, beautifully identifies the point at which an action of conscience is felt as being apparently objective truth. It is a point that we tend to attribute possible reactions to our personal stuff as a condemnation by the group, even when what we’re experiencing is an introjected idea of the mores of the group. To introject is to take what is outside into ourselves. The introjected idea can be very flawed. I think a code of silence is one of those: when not speaking up is lauded over saying what needs to be said for the safety of others. Sometimes the introjected idea has come via sources that should not be trusted. Examples of an untrustworthy source of ideas is the belief that plane travel is dangerous, or you should never step into the ocean because sharks will get you, or New York is a dangerous town, or all men are beasts, or women are all gold diggers, or whatever. Such are beliefs that interfere with good choices….

The Dance of Focus and Relaxation in Hypnosis by Dr Elizabeth McCardell, M. Couns., PhD

December 2015

     I remember, years ago, studying qi gong and being taken by the rhythm of yin and yang. In this Chinese practice, each strong movement is followed by a gentle one and every movement comes from a state of relaxation and focus, with a strong sense of balance and harmony and a centre point felt within.  I realized that this pattern was very powerful and set about employing in everything I do. It is there in my counselling and it is there in my clinical hypnotherapy work. As a conscious practice, I discovered that I don’t get tired when working with someone.  Enter the dance of challenge, support, challenge, support and it flows.

     What comes to mind right now is that wonderful scene in the film “Crouching Tiger, Hidden Dragon” where fighting goes on in a field of swaying bamboo. Each action is followed by an allowing, a swaying, a challenge, a swaying, challenge and a block, and a swaying; it’s hypnotic and very beautiful.

     The rhythm of relaxation and focus is similar to what occurs in exercises of mindfulness. This is very relevant for clinical hypnotherapy, as certain mindfulness techniques are employed in hypnosis. Mindfulness might be identified as putting a focus on what’s happening right now. After all, when

you’re in the moment you’re not ruminating about  the past, not in the future, not caught up in memories, nor thinking about  other things, judging anything, or making decisions about anything.  You are noticing what you’ve overlooked before and in bringing such awareness to mind, you are reprogramming yourself, or even repriming yourself, to noticing things (solutions, delights, insights) that you had previously been unconscious of.

     Mindfulness is a tool, but so is hypnosis. You can use mindfulness in meditational practices and your purpose there might be enlightenment. Using mindfulness in hypnosis (and counselling, for that matter), however, and the purpose is much more ordinary. You are doing it to dispel problem thinking. This is a solution focused exercise.

     Fundamental to both mindfulness for meditation and mindfulness for therapy is that it provides a means of dissociating oneself from everything extraneous to what is brought to one’s attention by your own choice and guided suggestions of the hypnotherapist; suggestions which I invite you to ignore, if you wish. The process of offering choice is critical for a person to feel they are not being manipulated (and I’m certainly uninterested in manipulating anybody) and for them to choose which course of action sits best with them. Choices made like this are most enduring and likely to be employed later on in ordinary life.

     Dissociation is a very useful, and very human, ability. It allows us to focus on whatever we are choosing to do, like, say, sewing a piece of tapestry and ignoring the lawn mowing going on next door.  Focus is a tool of awareness. If we lack focus it is hard to do, or change anything. The act of being mindful narrows down what we are experiencing and thus allows us to identify what is important to us and gives us the skills to go for it.

     Hypnosis is a relaxed and yet focussed state. I invariably tell my clients this at the start of a hypnosis session. I often tie this observation to the very act and awareness  of breathing: an inhalation is an inspiration and an exhalation naturally an act of letting go and feeling the wonderful spread of a deeply relaxed state. When we are inspired we can achieve  much, when we let go of  the problems that we used to have,  we can allow ourselves to feel nourished and supported. Both become a dance of yin and yang and a dance that sustains us throughout life.

Fear Itself

Fear Itself  by Dr Elizabeth McCardell, M. Couns., PhD

     I remember 30 or so years ago having developed a fear of heights. I’m not sure of the reason for it, but it had become quite apparent that my fear was getting in the way of doing the kind of things I really enjoyed, like climbing sea walls and up and over rocks in order to get to special swimming holes. I thought to myself, I must overcome this. So I set  to break the phobia.

      I challenged myself. I travelled to the tops of buildings and stood on balconies. I could feel myself  nearly losing balance, nearly teetering over. Nearly, but not.

     At the time, I worked in a tall building that, disconcertingly, had a glass lift in the middle of the place that took you from floor to floor in full view of everything. People could look in and people could look out. It was scary. Until my decision to break my fear, I used to ride it standing dead centre with my eyes closed. Afterwards, I’d stand exactly at the edge facing outwards and allow myself to go deep into the experience, immerse myself in it, and ride that elevator.

     This immersion therapy worked and I came eventually to really enjoy the experience of near flight by going to the heart of fear itself. There are kinder therapies around though, and hypnotherapy is one. Rather than exposing someone to the den of the lion of fear, the subject of fear is contextualized as part of ordinary, every day experience and it thus loses its ferocity.

     Fear is a useful survival tool and gives us the means to avoid situations that could be life threatening. Fear causes a flooding of the whole body of useful adrenaline and cortisol that allows us to get away from danger. It’s when the danger is not to the body, but to our emotional state that fear can turn into a psychological phobia. It’s then problems arise and it can cripple us.

    There is a very rare genetic problem, called Urbach-Wiethe disease. Sufferers don’t experience any fear at all, or so it is thought. There is a certain degree of evidence to suggest that some forms of fear may be experienced by these people.

Fear is processed in the amygdala, an almond-shaped part of the brain, as well as other emotions. In people with Urbach-Wiethe disease this part of the brain is calcified over, hardens, and shrivels up, and doesn’t function for fear, even though sufferers have normal cognitive function and can experience feelings of joy, happiness and sadness.  A sense of fear, though, can be induced been getting subjects to breath high concentrations of carbon dioxide, as a recent study has shown. The feelings of suffocation and panic were similar in both the control group and those with amygdala damage. It seems life is much simpler than brain physiology indicates, at least at a very basic level.

     The word fear is intrinsic to the English language.  In Old English, it was faer, in Middle English  it was fere, and meant a sense of sudden danger. It came to mean “to terrify and frighten”. A phobia is “an irrational fear, horror, aversion.” The word phobia comes from the Greek phobeo, “terror, fear, panic”. Phobos is the name of one of the moons of Mars. It is also the name of one the twins born to the Greek God Ares (God of War) and Aphrodite (Goddess of Love). Phobos (fear) was twin to Deimos (terror). I find mythology very interesting because here is a kind of psychological awareness of how it is with us humans; semi-aware parts of ourselves are personified into gods, goddesses and demi gods.  Here in war, in fear, love is met, and here is something more than mere survival. In this juncture profound change to a life lived, thus far, is possible.

     Continuing this line of investigation, the word phobeo contains within itself a mysticism, a reverence for something not yet known, something intimated, a mystery, respect, a sense of awe. It sort of reveals itself in Phoebe, daughter of the sky (Uranus) and the earth (Gaia) She is a Titan Goddess of Radiance and Brightness, and a  prophetess at the Oracle of Delphi. She foretells many changes, many hopes and dreams.

    A fear that seems to cripple can be a sign that a war is going on within and a life that brings delight isn’t yet being lived. People come, often bringing more than a fear. They sometimes bring depression and generalized anxiety. There is, in anxiety, a tremendous amount of energy; and energy that can release huge and fundamental changes.

From fear comes the possibility of real and  enduring shifts in perspective. From the darkness of fear, comes this lightsome being of light, so feeling and identifying fear is the beginning of some pretty fundamental change in a person’s life. It’s a very good place to start: from fear itself.

Hypnotherapy: entering the zone. by Dr Elizabeth McCardell, M. Couns., PhD

October 2015

 I’m currently participating in an online international conference on using hypnosis in the treatment of depression. We listen or watch or read several presentations, ask questions, attend coaching calls where we talk about cases, theories and approaches, and ask more  questions. I’m gathering, expanding, deepening my understanding of things, which only helps those I work with, and also layers on more dimensions to the work I do, which is very satisfying. I am thus moved to write more about hypnotherapy and how it works, because I think such knowledge is invaluable.

     Hypnotherapy, or hypnosis as the Americans call it, is nothing like the hypnosis dished up to audiences attending the latest stage show. It, or I, cannot make a person do anything they have no desire to do, and what’s more, what happens in a session doesn’t involve giving up your conscious awareness nor handing over the control of you to me. This is anathema to the healing principles of any good therapy. Change comes from within  you, from your conscious and non conscious processes. Hypnotherapy is a therapy of change.

     Hypnotherapy provides a wonderful context for moving beyond problems a person might have. The dynamic of a problem is a seemingly endless looping, around and around, with the same thing going over and over in your head, something that doesn’t seem to be solvable just by thinking about it. Indeed, the repeated thoughts, or habits, or whatever it is that dominates a person’s life creates a sort of inflexible space from which escape seems practically impossible. Hypnotherapy can help move a person out of this inflexible space and into fluidity and a certain joyfulness.

     Hypnotherapy facilitates, in a relaxed and yet aware state our mood, freeing and amplifying positive mood states, as well as giving us access to ways of  more flexible thinking and feeling in the future. Hypnotherapy is thus both a present and future oriented treatment. What might be honed in on during a session can become tools for what happens tomorrow, next week, and the rest of your life.

     There are several components of a hypnotherapeutic session. One is dissociation, while another is association, while a third is suggestion, and others. In the dissociative state the person doesn’t know how to produce hypnotic phenomena (eg creating an analgesia) by deliberate means, but can produce the desired effect with no awareness of how she did so. These processes are typically described as latent, or unconscious, and they point to the enormous resources we have at our disposal, though we generally don’t know we have them.  Think here of amazing stories of people finding in themselves enormous strength when faced with catastrophic events and getting out of these situations alive. In association, connections are made between apparently unrelated skills and experiences, connecting the dots, as it were, so that moving forward makes sense.  Suggestion is the added idea offered to the client to ameliorate change in their take on their life. It might be, say, for giving up smoking, that the cigarette tastes disgusting, like a rubbish bin, and that you have no desire to keep it in your mouth a moment longer but rip it out, crush it underfoot, and throw it away. Dissociation, association and suggestion already shift the way you think about things, and introduce into the mix, knowledges you didn’t realize you had.

     When you enter the relaxed and yet focused state that is the hypnotic trance, many things become possible. Changes are already happening to move a person out of the fixed state of a problem so that things can be better managed or removed altogether. The kind of problems beautifully worked on cover: pain management, anaesthesia, anxiety and panic attacks, depression, low self esteem, social anxiety and poor coping skills, problem solving skills, artistic and athletic skills, eating problems, sleeping problems, smoking, increasing mindfulness and relaxation, etc.

     A series of hypnotherapy sessions provides a zone, for experiential and behavioural change and entering into the zone is a pleasant experience: it’s safe, secure, comfortable, and usually easy.  I have a special chair that extends to a soft, supportive, wonderful couch. I call it the magic chair, for it is a tool in the furniture of change. Each session is tailored to each person and I do not use scripts, so I am present with you every inch of the way. You are unique and I work from where you are and what engages you, for engagement is the cornerstone of hypnotherapy. This is the context of learning, this is the zone.