Help for the helper

We have many great therapists in Norway, and through courses and education I sometimes meet some of them. It`s often very inspiring, since they knit their theories together with their work in exciting tapestries. Last year we were on a lecture by a therapist called Per Isdal. He worked with violent men, and talked about compassion fatigue and the perils our work entails.

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 towards happiness inspire of the pain, 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.

 

We all have needs

We have thousand needs that we need to navigate around like a surfer keeping 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 veer too far away from the golden “middle way”.

When we struggle for balance

But what if this fine-tuned system malfunctioned, 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 clients

To 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, some control returns.

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 initial 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 clenched”. 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.

More:

Homeostasis Refers to More Than Just The Planet

Interview with Patricia Smith: Founder of the Compassion Fatigue Awareness Project

  Review: Hem Helpers Do Their Job at a Great Price (stilettojungleblog.com)

How Do You Know Your Shrink Is Helping You? (psychologytoday.com)

Some part of the body remembers

Courtis and Ford

You Will Help Others 

Daily Prompt