Help for the helper

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Inspiration comes from a variety of sources

We have many great therapists in Norway, and through courses and education I sometimes meet some of them. It`s usually very inspiring, since they knit their theories together with their work in exciting tapestries. Last year we were on a lecture by a sden1156ltherapist called Per Isdal. He tried to help violent men, and told us about burn-out or compassion fatigue in that regard.

Yesterday we had a meeting were one of the lead psychiatrist at our clinic, talked about the same theme, and we had to fill out a questionnaire that asked about felt tiredness, stress and satisfaction with our work. Luckily I was in the “no risk” group, which I think comes from the meaning I derive from my work. I truly feel that I can help, and nothing is better than seeing my clients blossoming. To see them walking forwards through strive, and to be there when its extra rough, is an honor, and I try to remember that every time I`m afraid, have too much to do, or just think about everything that is wrong with the world. I also think that going to lectures and reading relevant books, has helped support my sanity and ability to help.

Help for the helper

I`ve read many good books this year, and one of them is “Help for the helper”. It is packed with quality advice and knowledge, and is also easy to read. P. Isdal recommended it himself, so I immediately ordered it and prioritized reading it. The ideas from the book were reawakened today, after reading “treating complex PTSD`by Courtis and Ford. I came to a part about sensorimotor psychotherapy, and it reminded me on features from “help for the helper”. I then remembered one of the sessions where I applied the theory, and wanted to share it with you. Some have said it would be good if I shared more from my clinical practice, and I want to do that, at the same time as I keep the privacy of my client and duty of confidentiality. 

My office.
We all have needs
We have thousand needs that we need to navigate around like a surfer who has to keep his balance in the waves.  Trauma-patients who dissociate find this harder than most: They can be immersed in something so intensely, that they forget to eat, be social or even sleep. When this happens a lot, the body and mind`s needs create a state of constant tension.
Most people know that balance is important; If we only eat sugar, we need salt. If we never saw white, we wouldn`t understand black. This principle of balance also has a name: Homeostasis. Homeostasis regulates a lot of the body`s needs, and also kicks in when people develop addictions and is generally alarmed when we start to wander too far away from the golden “middle way”.
When we struggle for balance
But what if this fine-tuned system could not work, since you had to keep needs separated to survive? For children who`re abused or neglected, it is indeed often necessary to ignore certain needs because having them is associated with danger. If neglect and abuse has been severe, they might split feelings, needs and actions apart from each other, and the machinery that once went smoothly, starts to misbehave. Many of them don`t register what happens with their bodies at all, especially after sexual abuse. It`s better to  float above the body and it`s feelings, than to experience and face the abuse. The only problem is: Some part of the body remembers anyway, and those parts also have needs.
Working with abuse is a lot about listening to signals from the body again, and that means that we have to explore memories and feelings that might awaken fright or terror.
How I used the book to help both myself and my clientsTo help my patients explore their own needs, I have to use myself: What happens inside me? What can I notice from their words and body-language? For example: When they talk, without  emotions about how they could not escape from a violent father, and at the same time raise their hand a little, I might say: “I see you`re raising your hand. What do you want to do with that hand? Can you complete the movement”? If they do, they might discover that they wanted to raise their hand, to protect themselves. By directing attention to this movement, and asking them if they could just do what they want, they might actually do just that and then feel better afterwards. Instead of frozen terror, energy and control starts to thaw up.shame
An example of an emotional reaction I often see with clients, is shame. It can for example come when they finally manage to say something that scared them to say. Their initiat reaction will often be looking down. They “shrink” together as if to protect themselves, and don`t meet my eyes. This is understandable, since their innocent gaze was met with hatred or ridicule before. Shame is many clients middle name, and I wish I could have been there when the mis-labeling happened.
Unfortunately, I can`t go back in time, but I can do everything I can to help them live the life they never had.
So there they sit, weighted down by shame and fear. I look at them, seeing the little child that never got what it needed. And so, softly I ask: Do you dare to look at me now? Painfully slow they turn their heads toward me.
Changing yesterday by being in the now
In addition to using their body-signals as a compass that shows me where they are and need to go, I also use my personal reactions to enlighten me about their feelings. I might sit there, and suddenly realize that I`m gritting my teeth. My reaction to this can be telling them about it. “Do you know what just happened? I suddenly find I`m sitting here with my teeth clenced”. A client can then look at me in surprise and say: “I do too!”
By being observant on what happens inside me, I actually help them realize what happens with them. It can be subtle things: That I suddenly breathe slower, or that I need to push my chair back, or maybe that I feel uncomfortable. When I get unusual reactions like, I ask myself like Rotschild recommends: What is going on right now? Maybe I have picked up on something they are feeling?
Working and thinking about this has been as surprising for me as it for them. It shows how easily we are influenced by others.
We are mirrors
Did you know that women who live together, start to menstruate at the same time? That people who live together start to talk the same way, and even change their gestures? Since we have mirror Neurons in our brain that actually repeats movements of others, we actually make it more likely THAT we move or do other things like the people we observed.
 8badc05312854ed310fbba54cb6ee6caWhen we see someone play the piano, some of the same nerve-cells for moving the fingers are activated in our brain as in theirs. When I subconsciously register that my client feel scared, I will “mirror” this and start FEELING scared myself, and often too a degree where my heart starts to speed up or my breathing starts to change. Monkeys who never showed fear toward some object, might actually feel fear for the same object later if they see another monkey react that way.
We are social in every way, and I must use my reaction to understand and feel what my patients do. When we both realize what`s happening, we can use the information to take a step back and do something different. We can slow down the fear before it spirals out of control, or we can realize anger is marching forwards, and calm down before we start to shout at each other. By repeating patterns like this, again and again, we lay the first stones of new knowledge that give clients more freedom to act in similar situations. Awareness means possibilities and flexibility, something that often lacks when “things just happen”. The extra bonus is that this also benefits the helper. By realizing where feelings come from, we lessen the risk of compassion fatigue and are more able to stay in the “now” ourselves. 

6 thoughts on “Help for the helper

    brokenbutbeingrepaired said:
    October 2, 2013 at 19:20

    Really lovely post, as ever
    This is a bit random but…..wonder if all therapy rooms across the world look the same!? (Yours looks just like our T’s).

    Your clients are blessed to have you share their ‘journey’, it’s clear reading and other posts this how much they matter to you as people rather than ‘just another client’.

    Thanks again for writing this.

      mirrorgirl responded:
      October 5, 2013 at 18:25

      Dear Elle.
      Thank you so much. I just read your last posts, and felt my heart swelling for your scared and vulnerable part. It was so brave to write this, I know it must have cost more than you can ever describe, and that takes so much courage.

      I feel as blessed as them (if they do), for I`ve met many of the most special and wonderful people I`ve ever encountered.

      They are maybe more real and alive and people to me, than many others. Something else would be unacceptable to me, and should be for any helper (or they aren`t).

      Thank you for commenting.

        brokenbutbeingrepaired said:
        October 5, 2013 at 19:23

        Thank you.

        Our posts are all a bit desperate and ‘help’ at the moment. We’re hanging on, though.

        It’s lovely, the way you write about those you support. It gives us hope that alongside our T and you, there are more helpers out there who truly care.

        Thank you for being you.
        We think you’re a * 🙂

        mirrorgirl responded:
        October 5, 2013 at 19:56

        I think you are the real stars.
        Only light from stars reach beyond oceans

    rudyoldeschulte said:
    November 2, 2013 at 15:21

    Reblogged this on Rudy Oldeschulte.

    […] other health professionals out there, I would highly recommend a book called “help for the helper ” by Rotschild. But it might not be enough to just read, sometimes therapy or supervision is […]

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