Writing Therapy (PartOne)

Hello all.

I was talking to someone a couple of weeks ago who once felt they wanted to bring things to an end for themselves. But then he began to write. Not a novel, short story nor a poem; nothing complicated. Just free-flowing words about life with an injured brain.

He got out of his head and onto his computer screen, all his thoughts as they swirled to the front of his awareness again. That done, he read through it.

With all the “c**p” in front of him, he was able to put his thoughts into a kind of order – cutting and pasting, creating a beginning and a middle.

The middle is where he still is. It is a middle made of challenges and support, ups and downs, downs and ups.

He’d stopped after a while. Two weeks ago he began again.

“Writing is something you find really helpful, then,” I observed. “Any idea what it’s doing for you?”

“Do-gooders mean well. But no one else can understand what it’s like being me. It’s hard to explain in any case,” he answered.

Here’s how I see it: A way of stepping out of one’s experience.

How? By taking what’s on the inside, placing it outside, looking back at it all. Uncluttered, one’s mind is free to organise, re-read, check out if it looks/sounds right, re-organise and read again. When it does look/sound right, mixed emotions and confusion have become more understandable.

Dr. Gillie Bolton is a therapist heavilly influential in Writing Therapy circles. Click here to learn her thoughts on its benefits. It’s a publicity video for one of her books, but even so…

Typing is not for everyone. There are packages available out there that can turn speech to text. If the right words don’t come, so what? Comics / graphic novels tell it all in pictures and bubbles.

Writing Therapy

Keeping a diary can be great for compensating for poor memory too. As well as appointments, some people put descriptions of new faces as well as their names. Blessings can be counted, addresses and phone numbers, doodles – anything.

Next month, Part Two with how story writing can help organisational skills and more.

Take care.

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Suicide Prevention

Hello everyone.

Monday, 10th Sept. 2018 was Worldwide Suicide Prevention Day. It’s a bit of a touchy subject for most people. It’s easier to give into the fear of giving people ideas andBlack hole of the soul not talk about it. Yet all too often it is the unheard voice that causes surprise. And pain.

With this in mind, let’s look at suicide in relation to acquired brain injury survivors.

Ordinarilly I address subjects with an even handedness: serious reflection on one hand, a bit of entertainment on the other. I cannot do it this month.

Instead, if you are questioning yourself in this way I urge you to reach out to someone you trust – someone who will neither discourage you nor encourage you, but will give you their caring attention.

Two helplines to turn to are Headway UK and The Samaritans.

HeadwayHelp
Samaritans

For one-to-one, face-to-face help in and around Norwich, Norfolk, my counselling sessions are available at these times:

Monday to Wednesday = 5pm to 8pm. Thursdays = 9am to 8pm.

Contact: sean@seanhindle.co.uk or on 0777 552 0302. If you cannot reach me immediately, please leave a message. I will get back to you after 4pm.

Spot the Signs

These are the most common signs. But let’s look again at them in respect of someone living with a brain injury. In this case, it’s helpful to keep in mind their new personality as you’ve come to recognise it.

  • Sudden calmness: Is this out of character? Following an ABI, some people’s body language becomes hard to interpret. Some people are left with a lack of emotion.
  • Excessive sadness or moodiness: Again, is this the new norm? With little or no short-term memory, there’s no dwelling on things for long; emotions change in stoccarto fashion. Social inhibition and emotional control may be a manifestation of brain injury alone.
  • Withdrawal: Choosing to be alone and avoiding friends or social activities are possible symptoms of depression. Though just as true of brain injury sufferers, I’d weigh this with their motivation – as discussed last month.
  • Changes in personality and/or appearance: The “new” personality, that is. A person considering suicide might exhibit a change in attitude or behavior. Has (s)he become less bothered about their own safety and/or personal appearance?
  • Threatening suicide: For some people, “I wish I was dead” is as much a casual expression as “Sometimes I could…”; they say it without meaning it. Even so, every threat of suicide should be taken seriosly.
  • Dangerous or self-harmful behavior: A sensitive time for those with a brain injury (especially if recent) is when he or she begins to realise for themselves the extent of their cognitive difficulties. Bereavement, anger, addiction, recklessness or intentional self-harm – any can be triggered around this time. Another key time is when depression reduces and motivation increases.
  • Making preparations: Often, able people deeply considering suicide will begin to plan. The plan may include “For after I’m gone” behaviours – to take care of loved ones “left behind”, for example. Even if such organisation is impossible for an individual they may, over time, learn where and when oportunities present themselves.

It’s easy to get alarmed reading these kind of lists. Has the list prompted a memory of something you found odd at the time? Has something someone’s said struck you as odd? Talking openly as possible to those that matter about any of the above can reduce the intensity of such discomfort.

Okay. I’ve rambled again. I’m a bit late with my posting this month too. Sorry.

I shall be quicker next month..

Busy Doing Nothing

watering holeThere are many pictures used to describe problems around motivation. One that’s used a lot is this: A horse led to water, who refuses to drink. Close to this is the picture of the proverbial “stubborn mule”. Mixing these pictures together, automatically thinking that the horse isn’t drinking because it’s refusing to – that it’s just being a nuiscance for the sake of it, can be a mistake.

Applying “stubborness” to someone with an aquired brain injury can be unfair and misleading. Yes, the person may appear disinterested, may well be unmotivated. But there are two important questions to ask:-

1) Q: What is motivation?

A: “A reason or reasons for acting or behaving in a particular way”. (O.E.D.)

2) Q: What motivates reasoning?

A: Feeling unsafe. Due to hunger, lack of shelter or being cared for, or craving social status.

Fear

NOT being motivated (as some people might see it) might in truth be VERY motivated.

The person “not doing anything” may in truth be doing many things. Things liMotivationke:-

1) Regaining energy after doing what they did yesterday

2) Avoiding standing out from the crowd

3) Stopping themselves making mistakes

4) Avoiding making his or her self see they are unable to do the things they used to in the way they still want to.

5) “Torpor”. Torpor is a tough one. I’m using the word to describe a state of disconnection between something that in the past would have been acted upon but which after their brain injury, there is a present indifference to.

Here’s a link to a vlog entry by a young woman talking through her own problems with motivation: Click here to hear what she has to say.

What’s important to note is her linking stamina to motivation. Her ongoing research is, I think, proof of her personal motivation. She is positive that she WILL achieve what she wants.

Just to end this month’s post, here’s a little story for rescuers and readers finding yourselves stuck. I found it a big help. I hope you do too.

Cocoon

Along a dusty road in India there sat a beggar who sold cocoons.  A young boy watched him day by day.  After some time, the beggar finally beckoned to him.

“Do you know what beauty lies within this chrysalis?  I will give you one so you might see for yourself.  But you must be careful not to handle the cocoon until the butterfly comes out.”

The boy was enchanted with the gift and hurried home to await the butterfly.  He laid the cocoon on the floor and became aware of a curious thing.  The butterfly was beating its fragile wings against the hard wall of the chrysalis until it appeared it would surely perish, before it could break the unyielding prison.  Wanting only to help, the boy swiftly pried the cocoon open.

Out flopped a wet, brown, ugly thing which quickly died.  When the beggar discovered what had happened, he explained to the boy: “In order for the butterfly wings to grow strong enough to support him, it is necessary that he beat them against the walls of his cocoon.  Only by this struggle can his wings become beautiful and durable.  When you denied him that struggle you took away from him his only chance of survival.”

butterfly

May the walls of your cocoon be just thick enough to allow you to struggle just long enough to emerge strong enough.

Empathy v Sympathy

Hello everyone. This month’s post is in response to another recent email. A counsellor who, unlike myself, prefers to keep her brain injury under wraps from clients unless they ask.

There is no hard rule about it. I had my own discussions over it in supervision. For me too, how I share my experience was and is important. My most important question was: “Who really benefits from my openess?”

Answer: My therapeutic relationship with whoever my client is at the time.

Empathy
Seeing through the eyes and walking in the shoes of someone else

On the back of my business card, and on my website, I highlight that there is more to my work / life experience and skills than brain injury. It’s just that I have a more instantaneous empathy when it comes to the issues around having a brain injury than a non-brain injured counsellor.

Of course, not all clients arrive having read my website. My limp and poor co-ordination make themselves casually obvious. Together they make a warm, but brief ice-breaker. The briefer, the better. If brain injury is the issue, it is as unique for that client as mine is to me.

(Mirroring)

Speaking of “instantaneous empathy”, I feel inclined to share a conversation I had with my neurologist about it. But before I do, here’s something to whet your appetite. Click here for a cartoon on empathy. It is narrated by Brene Brown, a reasearcher-cum-storyteller.

Here’s my own story: During one of my regular appointmets with my neurologist a few years back, he did his usual thing of asking how life was going, how well I was managing my everyday work, and if I’d yet finished my training.

“Not yet,” I told him. “But I am doing some voluntary counselling on placement. In fact, the funniest thing happened last month and I wonder if you can shed some scentific light on what happened.”

I then went into a bit of a ramble about listening to and observing my client – and myself. I realised whenever my body mirrored his way of sitting. Or copied one of his gesticulations. Anyway, in the middle of doing all this, I began to get a deep sense of my client’s wider world. By that I meant my client’s hidden emotions and his unspoken distractions. It all felt so tangible, it was as if I was being him.

“Read this!” said my consultant excitedly. He quickly scribbled me a yellow post-it note. It read: “Mirror neurons”. My neurologist told me some studies had been carried out on elephants and had discovered that they too may very well have empathy. It was all down to mirror neurons located in the frontal lobe.empathic elephant

I could go on about how sympathy is often unhelpful. But I’m sure that’s a given to a lot of you out there. Above all you want people to understand what it is like to see through your eyes, walk in your shoes. Or not get up from a wheelchair for the most part of the day.

I’ll leave you with a hero of mine, Dr. Vilayanur Ramachandran, and his Ted Talk on “The Neurons that Shaped Civilisation”. Be warned, though. It runs over 7 mins.

No yawning at the back!

Enjoy.

Baring Things in Mind (Part Three)

Hello all.

Thank you to those of you who’ve got in touch. It was especially nice to get an email from a fellow counsellor with cerebral palsy. Yes, I agree we should chat more about its impact and on us as practicing therapists. I’d be very happy for this here blog to be a place to come and share.

If you find Neurolations interesting, entertaining, dare I say useful, please do spread the word. How many of us brain injured therapists are there across the U.K? It’d be great to learn how you connect your chosen form of therapy to your brain injury.

That said, I will restate my blog’s other purpose.

You may not be a professional; you may have short-term memory problems, difficulties keeping track of days, appointments, budgeting, knowing who’s who, controlling your reactions and times when strangers think you’re drunk or just plain wierd. Neuronations is also about helping you.

With all of the above in mind, I thought I’d share an idea with you this month. A work-in-progress, really.

I am always interested by close similarities and cross pollinations of psychotherapy approaches. Psychodynamic therapists and analysts talk  of “personas”; cognitive behavioural therapists refer to “schemas” and “models of behaviour”; transactional analysists speak of “ego states”. The list could go on. But let’s keep things interesting.

Can the triune brain  (lizzard, limbic system and neo-cortex together) form the basis of a new way of looking at Cognitive Rehabilitation Therapy?

I think it can. But my thinking is only based on my experience. I’m wondering how much of your own experience and concepts you can attach to the triune brain. Today I found a thought provoking video about it on Youtube: “Therapy in a Nutshell”. (Don’t you just love it when Serendipity comes along?) N.B: The video does NOT represent the hard science of how the brain works. It is a SIMPLE WAY OF EXPLAINING the brain and personality working together.

triune triangle

The world already has loads of pyschological ways of dealing with what it is to be human. Does it need another one?

The thing is, I’m not sure if any counselling approach takes physical, neurological injury into account. A whole range of books have been written about emotional and psychological disorders. Entire training sessions are given to learning about depression, eating disorders, addiction, anger management and so on. But much less so the interelatedness of brain injury and personality changes, for example.

Anything that does deal with A.B.I, as far as I’ve found so far, is just concerned with the neurological function of lobes and the effects of damage to them – almost in isolation from the rest of the brain. Useful knowledge in an operating theatre. Not so helpful when someone describes to you the loss of balance caused by loud noise but you cannot sense that with them.

Until next month, take care for now.

Baring Things in Mind (Part Two)

One of my followers asked last month if I’d used the correct spelling in the post’s tbrain in handitle. Most people say: “Bearing things in mind” – with an “e” – meaning holding things in mind.

True, but I just cannot resist putting a twist on things. I love a good pun. Besides, where my brain is concerned I am overwhelmed with multiple goings-on and meanings all in the one instance. I’m  at once expressing  I’m  wanting to uncover the mind, put it on show AND let readers behold it.

As last month was all about our so-called lizard brain – that part of us that processes what we sense, this month, I thought I’d give a case study of a client unaware of his bodily senses. With his permission, I have changed his name to protect his confidentiality.

 (James)

James was caught in a mix of family feuding, physical and emotional abuse. Though he requested anger management he came across as quite nervous.

James had no problem retelling all the incidents and background facts leading to his present situation. He had no problem getting excited about his ambitions. But when it came to recognising his excitement as he lived it, or what he was thinking in real time, he was speechless. He simply agreed with my tentative observations.

It was only after some silence in his second session he fixed eye-contact. He asked what thinking was. My description of what thinking is to me, satisfied him. He decided to give guided Focusing a go as something to do other than talk.

Guided Focusing is a series of directions that lead the focuser into and around their body starting at the toes. Sharing their experience is optional.

The idea seemed strange to James. To him, people existed in their head; their bodies just carried them around. So it was enough for him to at first do no more than note for himself his body’s physicality. And even this came hard to him. When not Focusing I introduced him to Stephen Karpman’s Drama Triangle.Karpmans-Drama-TriangleStudying it on my whiteboard was easier for him, with its systematic take on relationships. He saw himself in it.

James used his third session to separate out negatives in his past and positives in his present life.

He was happy to try Guided Focusing again. This time we combined it with the head-held, theory based, Drama Triangle. Focusing became more instrumental in this when he reported feeling ‘composed’. This was his label for his embodied experience and abstract understanding joined together. I re-worded my ‘guiding in’ script to suit.

‘Composure’ became the theme over the following weeks. James grew able to acknowledge and identify his changing emotions in relation to the different roles on the Triangle he felt himself to be as he told me about his week.

When I asked how his smirk was making him feel while he relayed what he’d like to do to get his own back on a particular person, his perception of himself switched from Victim to Persecutor. He called taking himself to his room and listening to music whenever ‘things invaded [his] head’ his Rescuer.

James struggled throughout with very hypothetical stuff. The whiteboard helped us both. Session 10 came. James decided he no longer needed to visit. He felt more confident at work (something also remarked on by his boss) less angry at home and more in control of his life.

Summary

That’s it for another month. But just before I go, to sum the Drama Triangle up, click here for a bit of “Penelope Pitstop”.

‘Who?’ some of you may ask. Don’t worry. I’m just showing my age. Best wishes to you all.