More than Words (Part Two)

My apologies. I should not have ended Part One saying I’d post Part Two in July.

I spent longer than expected working on my CPD this summer. Then I’ve had lots of distractions since. Now I’m slowly getting back on track.

We began looking at how Logotherapy has nothing to do with designer labels and everything to do with meanings. Soul II Soul summed it up nicely. Click here to listen to what they say. We also looked at Frankl’s meaning of “free will”, “spirit”, and what he called “Existential Vacuum”.

Let’s look deeper at meanings.

Existential Frustration

This happens when someone’s will is denied freedom. More to the point, the meaning to their life (and what represents its meaning – the thing(s) the person decides they need here-and-now) is unfound or taken away. Brain injury obviously causes such frustration. And the loss of meaning is spiritual, without cognitive realisation. The person’s cognition is in despair as it fails to work as their long-term memory recalls sense of perpose. When meaning was found in the role of child, sibling and / or friend, coleague, and so on.

Meanings

(Meaning of Life)

To do what?

Being personally responsible. It’s not freedom from; it is freedom to.

To “be” the potency within them. To be that, the person needs to be aware of their spirit and their capacity to choose which personal potential they want to achieve. In ” The Doctor and the Soul: From Psychotherapy to Logotherapy “ (1955:85) Frankl says no-one can “escape the mandate to choose among possibilities”. Life constantly presents potentialities, even in the face of adversity. Despite brain injury’s cognitive hurdles, the spirit will still strive.

Frustration motivates towards acceptance and rehabilitation. It’s a process of submission and conquering – in a word, “adaptation”.

(Meaning in Suffering)

Oooh, I feel another metaphor arising.

Imagine we are inside a damaged brain. Imagine that inner landscape as a road network of spaghetti junctions, B roads and country lanes. A car is “free willing” so far, but suffering an exhausting, boring journey of delays and stopages. The person’s unconsciousness is the driver, their consciousness, the navigator. The pair are bickering over which one of them is responsible for getting them lost, and whether the navigator’s map is up-to-date.

Meaning comes with reminding themselves why they set out in the first place, the need to find where they are “now”, learning to suffer the point of no return and how far it is to the next service station.

At the service station is the therapist manning the petrol pump. While the driver takes the opportunity to nip to the loo and stock up on crisps and sausge rolls, the navigator considers the pump attendant’s info’. The driver returns relieved and with, as the phrase goes, “something to fill a hole”. The consciousness bravely reflects on the choices for the journey ahead. Back inside the free willing car there can be cause of renewed sense of adventure. The suffering has been a revelation.

(The “Supra-Meaning”)

The over-all meaning of life and suffering is beyond human understanding. We can only conceive a personal definition of the Divine. Frankl himself does not advocate the existence or non existence of God. He uses “supra-meaning” to label that which cannot be proven by our level of science – the meaning of life and suffering that comes by experience.and faith alone. The true supra-meaning is personal to the individual, defined by their own use of words and reasoning – their logos.

On that note, I wish you a Merry Christmas and a fulfilled New Year.

Take care,

Sean

More than Words (Part One)

Summer is here.  Hoping you’re able to make the most of it.

After last month’s theme of brain injury invisibility, I thought I’d return to finding an altered or new identity –  the physicality of being a self and building a life around it.

Existential Analysis, “Logotherapy” is the brainchild of Viktor Frankl.  Frankl grew up looking for meaning to his own existence.  His use of the word “logo” is not about some bright, stick-in-yer-mind, corporate badge.  Frankl harps back to the original Greek definition: “word; reason; plan”.  (It’s where we get “logic” from.)

You see where we are heading?

Free Will

Here’s the scene: Waking up in hospital. The mind is befuddled. It’s telling you what people are, how doctors and nurses dress, what hospital wards look like.  But short-term-memory is unable to connect with long-term memory.  Fear and doubt come crashing in as the mind realizes it does not know who is looking at it and talking at it.  Panic overwhelms.

Over some barely noticed period, dependency is established.  At the same time, what I call “neurolations” (neuron relationships) occur to try and compensate for the damage done to day-to-day brain function.

Where does Logotherapy come in?

Frankl uses “existential” to name the way humans are – the subconciousness and consciousness together putting meaning to sensation. This sets will power in motion. Will power leads to personal meaning in life.  Unlike Psychoanalysis which focuses on pleasure and power, Logotherapy analyses the direction the person takes towards meaning.

(In person-centred terms, it’s the actualising tendency to the social mediation process and onward.)

As for freedom, it comes of what Frankl refers to as our “unam necesse”. (“The one thing that is required.”) In the realisation of the here-and-now, that is. It’s the “I/you” and / or “Me/it” positioning of the self.

As such, freedom has a fluid relationship with everything outside the self, including other personalities.

You get the picture.  I don’t want to disappear too far down my intellectual anorak’s rabbit hole.  Instead, let’s think about motivation.  Especially in relation to brain injury, as we have before.

Click image for “Busy Doing Nothing”

Meanings

Human minds form ideas, of course. We do it by relating bits of information with others; we put things in context. Once we have a context in mind, we can say what’s meaningful to us.

Frankl’s theory is that both our unconscious mind and conscious mind find their own meanings.

(Unconsciousness)

The unconscious mind (that part of us stimulated to act without reason) exists in spirit.* In other words, A says to B: “Hey, what are you doing?” B answers: “Nothing”.

Someone with ABI might even go on to argue that they’ve stopped being who they were, that they are a stranger to themselves. Yet, with reflection they accept their voice saying so comes from someone.

*N.B: Frankl uses the word “spirit” outside of any religious context; his idea is to simply express the embodiment of our natural drives. But we are more than our drives.

(Consciousness)

N.B: “Logos” is deeper than logic. It begins in spiritual existence.

How come? Authentic, congruent decisions have no personal reflection to them; such decisions are intuitive. But this intuition can inform an “ethical instinct” – that thing inside saying: “The one thing required here and now is…”. It is then when our conscious minds turn away from reaction; they turn to response. The higher their cogitations go, the greater meaning they find in life.

I’ll say more about Logotherapy’s dealings with meanings in Part Two. For now, let’s draw to an end this month with the key concept of the “existential vacuum”.

Existential Vacuum.

The very state so many brain injured survivors describe – feeling empty, lost. Maslow had his pyramid of needs. Frankl has his “abyss experience” – the person’s sense of nothingness.

Logotherapy follows three suggestions of what causes an existential vacuum:-

• Humans being treated as no more than drives and responses to conditioning. Assumed incapable of independent thought.
• Our capabilities being ingnored. Humans have evolved beyond animal instincts. We can think what to do.
• Sense of agency, of free will not being respected. Although someimes we conform to what others do, or tell us to do, we can ignore traditions and set our own values.

The goal of Logotherapy is to educate. Dare I say rehabilitate? Clients are helped to confront their vacuum in order to redirect themselves towards what matters to them.

A Metaphor

It’s lovely when you come across something matching your own metaphor – or at least comes close to it.  Mine involves sailing to a paradise island.  But life isn’t plain sailing.  The wind is blowing in cyclones, the tides are playing with the rudder.  Getting to the island involves negotiating with, not fighting against the real world.

In other words you have to tack into the wind, play with the direction of the tide.  It can seem you’re going away from where you want to get to.  But by negotiation you finally get there.

Here’s Frankl’s own take on it.  The footage is old.  He is a man of his time and culture.  Sexism aside, what he has to say, especially in the context of ABI and the hope of adaptation, is well worth noting. Click here if you’d like to.

Bye for June. More in July.

See the Hidden Me

This is the theme for this year’s Action for Brain Injury Week. Brin Injury Awareness Week will run from the 16th to the 22nd of May.

I encourage you all to support your local Headway branch. If the closest to you is too far for your liking, maybe you might like to get one started.

This post is my own take on “See the Hidden Me”. I don’t want to simply repeat Headway’s publicity information. You can click here for that.

My Own Take

A couple of weeks ago I fell into a conversation about social rehabilitation. To my mind, “Rehabilitation” means reintroduction to the (Human) habitat – from social exclusion to social inclusion. Most of our energies and focus are on “earning a living” – being valued by society and ourselves placing a value on our lives by our ability to work.

How difficult is it for brain injury survivors to get back into the workplace? Is counselling / Cognitive Rehabilitation Therapy enough?

My answer was that, for society to really do what it preaches – be inclusive of diverse people, including brain injury survivors, it needs to learn its own lesson. The “reasonable adjustment” Employment Law requires employers to make is not being done by many. I put my opinion in metaphor.

I said: “If society truly wants to include disabled people, it needs to learn to walk with a stick.”

What do I mean by that? Walkingsticks are obvious indicators that something’s not quite as is expected – we expect to walk well on two legs. But in many ways employers (and other social enablers) are not adapting to the effects of their would-be workers’ A.B.I.s.

One private client told me his former boss had tried being helpful. But that help was all about my client’s productivity. His boss had tried to mend him so he could do a job as well as his colleagues. All be it on good terms, my client had left.

I’ve heard from other sources, stories of colleagues treating disabled colleagues as lazy. Or as lame dogs who just get in everyone’s way. Brain injury survivors feel politicians view them the same way. There’s no point in trying to explain or expect help because the truth is, no one really wants to notice.

This is not true of every employer. The client I mentioned admitted his boss had tried to help. There are politicians who have themselves a disability.

But lived experience is the real experience of those who in counselling tell it as it is for them..

So here we are with a whole week of “See the Hidden Me” – Headway’s Action for Brain Injury. What then?

The What

Dignity does not go away; becoming unhidden, becoming known, is not the end of it.  The ideal is that becoming visible means the whole person gets recognised.  “Re-cognised”;  the person being re-considered, might we think?.  What might such consideration reveal?

Perhaps the revelation of what was behind / under my client’s complaint: His boss, for the most part, wanted to hide their own difficulties with brain injury.  Maybe this week, this year and beyond, we progress from the hidden “me” to the “hidden reasoning”.  Perhaps then, society might adjust its own reasonability, fit jobs to those wanting to rejoin the workplace.

I very much hope so.  There is some illumination ahead.  Here and there, the word “diffability” is used, not disability.  Different ability equals different demand.

To End on a Lighter Note

Q: What do you get if you cross “Seeing the Hidden Me” with an international musical competition – that other regular May event?

A: “Neuro-vision”.

Sorry.  The pun was too much to resist.  Well done Ukraine.  And well done Sam Ryder

Brains of Distinction

For those of you in the know, World Autism Week ended the first week into April. (2nd of April was the actual World Autism Day.) But why not continue raising awareness?

For the past few years I’ve been working with neurodiverse clients as well as those with Acquired Brain Inury. It’s often struck me how similar traits present themselves in clients from both camps. This is not to say that, for example, anyone with autism has a brain injury. Nor do I mean anyone with a Traumatic Brain Injury (TBI) will, by default, display autistic behaviours.

But I ask myself this: Can the same counselling and psychotherapeutic interventions help both autistic people and people with brain injuries?

Let’s settle on a neurological Rome. From where we stand this Rome has two roads to it. Walking around this city, we begin to appreciate the local culture. Of course, I am speaking in metaphor. Shall we pay a visit to Cerebellum Square?

If you’d like to, click here. (4 minutes long.)

It’s a simplified neuroscientific explanation, with input from Sam Wang, Professor of Neuroscience at Princeton University. Also Peter Tsai, Assistant Professor of Neurology at the University of Texas, Southwestern.

Before going on, as I’ve said before in previous posts, I am not a neuro-psychologist; my training is in psychotherapy. But let’s go with what the Youtube video points out – the new research findings regarding the role of the cerebellum in providing us social communication skills.

(Purkinje cells)

It now seems that these signal carriers are important to our social skills. Especially to prediction and emotion. Studies are showing that fewer purkinje cells means increased likelihood of autistic behavours. What kinds?

1. Difficulies with flexible / lateral thinking
2. Learning from mistakes
3. Repetative behaviours
4. Making conversations deeper than small talk
5. Recognising non-verbal signals and personal space.

These difficulties can present themselves for those with brain injuries too. But here’s the thing: Someone who acquires a brain injury has, arguably, more chance of getting in tune with body language. Someone whose purkinje cell development was uncommon from birth, most likely won’t.

(So what?)

This new learning goes a long way in explaining why classic person-centred counselling alone is not enough for some clients. Other person-centred ships may find better courses. What clients want from therapy is, of course, up to them. Let the process be collaborative and creative. Actively listen. Co-create a model of the neurotypical world that works for both of you.

Work towards improving confidence. An abstract understanding of body language and different types of social space can help.

More help for those in crisis or unsure if you have autism, and for other kinds of help related to autism, click the logo.

Before I go, here’s another video you might find enlightening. Called “The Party” it lasts 7 minutes.

Until next month, Happy Easter!

Not Everyone’s Reality (Part Three)

Hello, everyone.

So far in looking at Reality Therapy, we’ve covered mental capacity, Choice Theory and the five basic needs and of course, A.B.I.  Now we come to what William Glasser calls our “”Quality World”.

Nowadays we take a great number of throwaway selfies.  For the most part we keep them on our phones.  The most we do is WhatsAp them, then forget or delete them.  Not like the old days.  In the old days we had to be more selective.  We thought about how we should pose and how we wanted others to pose before clicking the button.  Sometimes we chose more natural shots of one another just being ourselves.  And we set favourite snaps together in prized albums we got out time and time again to recall fond memories.

It’s the old fashioned albums Glasser refers to.

Quality World

(Two Types)

Harmful = As you’d expect, negative “albums” of negative “pictures” of things that satisy genuine needs – the five needs discussed last month.  Such things might be alcohol / drugs (freedom); casual sex (for want of love); a knife (power and survival) and / or gang membership (belonging).  It’s not hard to see how vunerable people can be lured into the last example.  It actually satisfies more than one need.

Helpful = Collections of positive images gained by way of the ten beliefs – the self-evident truths Choice Theory is based on.  The measure of helpfulness tells us how positive or negative our choices are.  Positive “pictures” might be of  a job (survival); a beach (freedom).  Realizing our choices are our own is itself an empowering process.  The carer or therapist who supports that process (belonging).  (“Connexion” might be an alternative name for what’s at the bottom of love and belonging.)

Nowthen, let’s get a feel for that process – the measuring of helpfulness.  After all, most of us live in a world mixed with harmful and helpful relationships to things and people, don’t we?  Life is never perfect.

(Total Behaviour)

Behaviour is, as I understand Glasser’s use of the word, is our motivation towards the choices we make.  In respect to degrees of acquired brain injury, we can either choose to do nothing, or have links between stimulus and reaction broken – emotional, not only physical reactions.

For the client or patient, there needs to be present some expression of will power.  We discussed that last month too.

Desire for the reduction of harmful pictures and an increase of helpful pictures is key.  To be fair to Glasser, he may as well have been alluding to ABI by naming “physiology” as one of his four components of “Total Behaviour”.  The physiological sub-components include for our consideration, the involuntary neurological processes perhaps more than the voluntary ones.

Other components to “Total Behaviour” also encompass: Feeling; thinking and acting – the weighing up of pleasure and pain, advantage and disadvantage before the doing.

That’s basically it.

But before I sign off, here’s a picture of a beachball.  Click on it if you’d like to be taken to a short cartoon courtessy of “Cassie + Friends”.  Although it encapsulates “total behaviour, it also reminds me of the Gendlin-esque “being with” stage when Focusing.

Take care for now

Not Everyone’s Reality (Part Two)

Well, wuddya believe it?  I’ve managed another post.  On time, no less.

Continuing on from last month, Part Two of this look at Reality Therapy and A.B.I. gets more to grips with “Choice Theory”.

Response-ability

Let’s cut to the crux.  Acquired / Traumatic Brain Injury presents an immediate challenge:  Stimulus and response verses self motivation and control.  How much self awareness can be coaxed?  And how well can clients motivate themselves after their brain injury?

Glasser himself expresses (belief #1) we cannot change other people, only ourselves.  Brain plasticity can take place.  But, stimulated by experience and self awareness it is mostly a law unto itself.  How much will power survives within a new personality is unknown, even by the personality’s owner. Discovery alone is not enough. But it is a start.

The owner’s words might be confused, a flat “I don’t know what you mean”. Or a curve ball googley kind of a thought – meaningful and certain to the owner, but garbled to anyone else. Readers who are counselling or caring for such an owner in any way, I say this:  Even if all you get is a shrug, mirror it back.

However slightly, the person in front of you, the owner of that shrug has informed you.

Where and who exactly did the shrug come from?

5 Basic Needs

Glasser also speaks of five genetic needs.  These are constantly motivating our behaviour; we are constantly wanting to satisfy them.  They are:-

• Survival
• Love and belonging
• Power
• Freedom
• Fun

Going back to the Principles of Mental Capacity (note the link) we cannot assume that none of these are at work within those we work with – the shrugger or seemingly nonsensical speaker.  After all, we all have an unconscious mind.

Glasser recognises the “Triune” brain – that the survival need is handled by our “old brain”, the other, more complex needs by the “new brain”.  For more info’ on that click here.

Evolution has not swapped new for old.  They ordinarily  communicate with one another – processing the weighing up, for example, of time with family and friends (love and belonging) verses time alone (freedom).  Though our neo cortex may find choosing hard, our uninjured brain area still finds a need to survive.  With a brain injury an “I don’t know what you mean” knows that it requires meaning.

And on that note, we’ll end it there for now.  Part Three next month.

Not Everyone’s Reality (Part One)

Hello, everyone

With only the pandemic uppermost in our minds for so long, much has gone unnoticed.  One thing you might have missed is the “Mental Capacity (Amendment) Act 2019”.  This updated the 2005 “Mental Capacity Act” and introduced a new concept – Liberty Protection Safeguards.  A new Code of Practice is being formulated on the back of them.  As I understand it at the time of writing this post, that is.

It’s human to not trust ourselves from time-to-time. Anyone believing they’re absolutely never wrong  is regarded with raised eyebrows.

Brain injury can often mean justifying a personal opinion. It can feel like we own it, but only after others have considered it for us before giving it back. Even then, there’s a self questioning that goes on. So much so that taken to the extreme, a person might question their whole understanding of events.

It can bring confidence, decision making, rehabilitation to a standstill.

How much choice do people have after a brain injury?

I may as well ask: “How long is a piece of string?” All brain injuries are different. The slightest lesions make real but invisible changes.

The public can’t see the way we think, the reasons we make our choices.

Sometimes we act without thinking; we don’t always perceive the consequences of our actions. I say that as member of my species, not because of my brain injury. WE ALL MAKE MISTAKES.

No one is super human. We can be wise and silly in all kinds of situations. Sometimes we’re too tired to think straight. Sometimes we’re overwhelmed by emotions. Sometimes we are, as the phrase goes, “firing on all cylinders”… The genetic ones our families gave us.

And that’s where laws such as the Mental Capacity Act 2005 matter.

Principles of Mental Capacity

This Act has 5 princicples:-

1. Assume a person has mental capacity unless proved otherwise.
2. Do not treat people as incapable of making a decision unless all practicable steps have been taken to help.
3. A person should not be treated as incapable of making a decision because their decision may seem unwise.
4. Always take decisions for people without capacity in their best interests.
5. Consider the least restrictive decision that can be made for someone without capacity.

Reality Therapy

Theorised by William Glasser, Reality Therapy has little to do with the past; it has everything to do with what’s making us choose to do what we are doing now. 

(Choice Theory)

Choice Theory is based on ten beliefs:-

1. The only person’s behaviour we can control is our own.
2. All we can give or get from one another is information
3. Psychological problems are relationship problems
4. Those problems are always part of our present lives
5. Revisiting painful past events
6. Five genetic needs drive us: survival, love, belonging, power, freedom & fun
7. It takes our own best picture these needs to satisfy them
8. All our behaviour is made of physiology, feeling, thinking and acting
9. Our “total behaviour” is determined by our use of  words
10. All total behaviour is chosen

And now, as Monty almost said, for something slightly different: “The Lion Tamer” sketch. Click here... (There are adverts first.)

See you next month for Part Two.

Round Robin

Hi, all.

It’s been almost a year since I’ve posted, but here we are, two years since Covid-19 came to light..  My gratitude to Laurie for her contribution and continuing friendship.

I’m sorry for disappearing. It’s been a year of losses and big life changes. These have all taken priority, I’m afraid. But I do hope to resume normal service next month.

I’ve a post almost ready to publish, focusing on Reality Therapy. And as always, through the eyes and for the eyes of someone with an injured brain. And those of their support network.

So I am truly looking forward to blogging throughout 2022. ‘Til then everyone, here’s to a Christmas as best as best can be.

Sean

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Hi, everyone.

Not gone away. Like everyone else, I shall be glad to see the back of 2020.

These past three months I’ve been busier than ever. I always tell others to pace themselves, and that’s what I’ve had to work on since September.

Laurie has herself been extra busy – helping people make their vote count in the U.S. presidental elections, and supporting through her own country’s struggles with the pandemic.

We both hope to finish the interview when we can.

‘Till then, I’m sure she won’t mind me wishing you a much happier New Year on her behalf as well as my own.

Take good care. Tier 4, as most of us in the U.K. now are, means managing the same restrictions as our first lockdown. So stay safe. Write a reminder to yourselves that the vaccine is on its way, and we can all put our hope in 2021.

Best wishes,

Sean