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Emmy Van Deurzen in Paradox & Passion

“Even at the best of times, life is a constant cycle of ups and downs, achievements and failures, encounters and separations, joys and sorrows, hopes and disappointments. Exposure to these contradictions generates emotions that can easily swing us out of our precarious balance, bouncing us out of our comfort zone, pushing us towards the abyss. There are times when we just seem to hit one obstacle after another until we reach a new zentith of experience where we feel quite lost, despondent and at the mercy of fate” (p2).

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Family Systems

black sheep

This week I attended a course on family systems and the thing that stood out most was the ‘identified patient’ within families. So often one member of the family is seen as ill and acts as the scapegoat for the family’s problems, when in fact it is a family, systemic problem and all members are playing a role in the maintenance of this.  In fact, the ‘patient’s’ expressions of illness or madness are often adaptive attempts to survive in an intolerable situation and upon exploration make complete sense. Each family has its own ‘official story’ and this includes each individual members’ roles, where and with whom the problem lies and with this comes certain expectations and assumptions. What is your family’s story? What are your implicit family rules and values? For example, how might you answer:

We are the family that always….

We are the family that values…. and never is one that….

Families resist change and try to keep the homeostasis, so inevitably if you start to change, the system is required to change and the functionality of the family will be reflected in its ability to adapt to the changing needs of individual members.

Here are some questions that I found useful to consider:

What does family mean to you? What strengths have you gained from it, as well as how has it hindered the way you relate and see yourself, others and the world? Who is included in your family – are friends, cousins, or just immediate family? How do members in your family tend to communicate? How is conflict managed? Who makes the decisions and when? Where are the coalitions and who feels responsible for whom? As a child how were you responded to when you cried or expressed a feeling and what did you need? How has this informed the way that you manage feelings and express feelings today? How has your sibling position effected who you are today? We tend to operate in triangles where there are always two insiders and one outsider, but the switch between these dynamics can happen quickly. Where do the triangles exist within your family and what is it like to be in such triangles? What are the benefits and costs to your family role and how could you change your position?

We so often reenact our family roles in new groups and relationships. Where do you tend to respond in your family role? How is your identity informed by and differentiated to your family’s?

Where is home for you? Is it one place or multiple? Is it a physical place or an inner sense of home that you take with you? Where and who with do you feel a sense of belonging, if at all?

If you would like to explore some questions like these or do a Genogram of your family in a session just let me know.

The idea that the scapegoat, or identified patient, holds the family’s pain, when in fact each member of the family is hurting in their own individual way and it is pain and problems that has so often been passed down across generations, makes it so important to decentre the problem from one individual. The idea of reframing difficulties and understanding the personal meaning of symptoms and madness, though unrelated to families and family therapy, reminded me of a brilliant Ted Talk by Eleanor Longden on hearing voices:

 

Some interesting pioneers who researched into families and conducted family therapy:

Salvador Minuchin

Virginia Satir

Jay Haley

Ronald Laing

Gregory Bateson

Murray Bowen

Don Jackson

 

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Indecision

Procrastination and putting off making a decision is so often linked to a fear of making a mistake. That by choosing, you may choose the wrong direction and have to experience regret and loss. But with every choice and opportunity we take, we are closing the door to some other possibilities and we have to face those limits and losses. A choice is better than no choice, because even if it turns out to be a mistake new learning has occurred that can further inform your next choice. Spinning in circles trying to analyse how to make the perfect choice, keeping options open and by not choosing you end up just teetering on the edge of life. As C.G. Jung said “The right way to wholeness is made up of fateful detours and wrong turnings”.

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Pain and The Brain

So many of us have unexplained pain or chronic pain that ends up increasingly dictating  the way we live. There seems to be a misconception that psychosomatic pain and illness, somehow means that it is imagined and not real. This is not the case at all, the pain is as real as any pain, but it is influenced by psychological stress and pain. Where in your body is your anger, sadness, the weight of responsibility you might carry held?

Lorimer Moseley’s video below about the link between pain and the brain is brilliant for anyone wanting to gain a deeper understanding into their pain.

He speaks of pain being all about protection. Anything suggesting we are in danger, including stress and emotional pain, increases pain. Pain is in the brain, it’s not the level of tissue damage. The level of risk is assessed and the brain sends pain signals as this protects us by making us stop whatever we are doing, as pain is as you know unpleasant. He gives an example of how if you pinch your own finger it hurts more when a friend does it, and even more when its a stranger. This is purely based on the brain’s assessment of risk.

So you can have excruciating back pain, where you are bent over or unable to move in pain, but no tissue damage. This can feel the same as someone who does have tissue damage. Those that have life threatening damage often are pain free – think about that. This is because you will only feel pain once you are in safety again, as pain is all about protection you would not survive if you had your arm blown off and you stopped in pain to attend to it. The brain has a very complex pain and risk system.

Another interesting piece of research is how if you see your medical report saying ‘degenerative spine’ you will be in more pain, than if it is explained to you that degenerative merely means age appropriate changes. This is because with the former the brain says ‘danger’.

The brain also attributes meaning and therefore the same stimulus will hurt more with a red light flashed at the same time than a blue light. This is because in many countries we place the meaning of danger with red and blue with calm.

As you can see the pain system learns almost too well and the pain system can become over-protective so that you can be doing very little and have a flare up. People then tend to avoid all pain-associated activities or try to beat it. Both these options make you more and more disabled by pain and the range of what sets its off becomes broader and less predictable and manageable. Soon you have given up much of what you loved and your life seems less and less yours. This is because it’s the same brain producing pain whatever option you take, you cannot avoid or beat pain. There is a third option however – teaching and training your over-protective brain to become less reactive. It is possible to bring the system into being appropriately protective once again.

  1. Rethink pain – pain in the body’s protector, so EVERYTHING matters and is relevant (things do, hear, see, what friends tell you, medical professionals tell you, what you feel)
  2. Pain can become part of who you are and your identity – i’ve got danger in me (DIM), rather than safety (SIMS)
  3. The challenge that anyone has with persistent pain (pain not following expected trajectory) needs to work out what your DIMS and SIMS are. They require hard work to find them. They live within the bio-social model. In this you have the bio which is the true make up and state of body, the psycho (moods, fears, thoughts, belief, knowledge) and socio (community, culture, relationships, access to care). Pain sits in the middle of all of these. All of these apply to everyone, pain sits in the intersection, if you are human! It is very easy to think ‘my pain is different, it’s all bio”. The SIMS and DIMS can be found it all of these. You can teach the pain system to be less protective and rethink pain, but understanding takes a lot of work. Understanding is the first way forward out of pain. Pain is clearly in your body, but 100% it is produced in your brain, so understanding matters greatly.
  4. Then need to plan how you go about new learning, then need patience and persistence as its a learnt and adaptive mechanism so will be quite a journey to shift it.
  5. Active aspects are essential and protects you against many other problems that are increased with persistent pain. Even when things are a bit painful with an over-protective system, that is still better than passive aspects and having things done to you. Do not simply avoid movement, the risk of inactivity is much greater than activity. Find and become super aware of your safe baseline, your flare up line and at some points this may be very easily triggered. Then from this apply the rule – Always do more today than yesterday, but not much more take it slowly. This does not have to be aerobic activity, walking is the best, but you can even get benefit from imagining movement. Even the brain sending movement commands has significant effects. It’s all about finding balance and experimenting and become really conscious and attuned to your baseline and body.
  6. Support – a good coach and support groups with pain experts by experience. Interactions with others are essential, especially with shared experiences.
  7. Life can be better, but not with out time and work. Understand your particular pain meter, the triggers, the meanings, the functions and that is the start.

I really recommend the video below:

Some other useful websites and links:

http://bodyinmind.org/

https://wholeperson.healthcare/clinicians/

http://www.msk.org

http://www.painrevolution.org

http://www.tamethebeast.org

Simple sugars can be inflammatory of pain, dairy can too for some people. There might be certain things that you notice are particularly bad for you.