This case study is a follow-up to our article on Post Traumatic Stress Disorder (PTSD), and will be used to demonstrate the highly effective technique of Eye Movement Desensitisation and Reprocessing (EMDR)
EMDR is a therapy that assists in the processing of traumatic memories using rapid eye movement. During the therapy the client attends to emotionally disturbing material in brief sequential doses while simultaneously focusing on a rapidly moving stimulus, in this case the therapist’s finger moving in front of the patient’s eyes.
How it works
When we sleep, short term memories are processed into long term memory through the rapid eye movement of REM sleep. Traumatic memories often skip this step, staying in short term memory. During EMDR impactful memories and psychological distress associated to the event is eliminated, and negative beliefs are reformulated into positive ones.
The most effective way to understand how EMDR works, and why it might be the right form of therapy for you, is to understand by example. If you haven’t read our last post on PTSD https://wordpress.com/post/therapyandtrainingdotcomdotau.wordpress.com/106, you might want to go back and read that now.
To explore EMDR by example, we will use Kate as our case study. Kate is a real person who came to me for a full day intensive EMDR session last year. When we discussed using her as the case study for this article, she decided she wanted to write about it herself. The following is Kate’s account of the process:
Kate the Paramedic
I came to see Jenny with many undiagnosed symptoms of PTSD. I had been a first responder for 13 years, and had resigned 2 years prior to our session. I had decided to resign due to a sudden onset of physical tension and anxiety about 12 years into my career. I’d been to a run of awful calls and somehow my body wasn’t recovering. It took 6 months of dealing with this new anxiety (I’d never experienced anything like it) to resign. The tension and anxiety continued for another 18 months after I left.
I had been mostly anxiety free when I came to see Jenny. I was unmedicated, had received very little therapy and had used meditation, yoga, coaching and personal development work to heal. While this was working beautifully (and I was very proud of myself), I felt that there was some kind of “misfiring” occurring in my mind. It’s hard to describe, but it was like something was a little “off” and needed fixing. After hearing repeatedly that EMDR had helped others when nothing else worked, I wanted to give it a try.
Even though I was anxiety free, my system was fragile. I avoided TV, I never watched the news, and I struggled to hear about any form of death, violence or tragedy. I became highly triggered when I went to any of the areas where I used to work and I felt stressed if I talked to old coworkers.
I didn’t suffer from textbook nightmares or flashbacks, but I would get extremely disturbing memories that felt like they bombarded and overtook my mind. When I would remember one memory, the whole line-up of 13 years of them would play like a movie reel.
I was tired of carrying this burden. I still identified as a happy person, yet I struggled to feel the old “easy going” nature I used to have. Over the last two years I’d felt an increasing sense despair and hopelessness about the world. I wanted to stop having to avoid potential triggers all the time, and I longed to feel normal again.
Jenny asked me to come in with three main memories in mind: the most recent, the first, and the worst. We chatted for a while to get comfortable, then sat opposite one another in a chair. We began with the worst memory. Jenny asked me to bring to mind the most impactful moment of that memory and to screenshot it, or lock it in.
I had been avoiding this memory, and as I brought it to mind I began to sob, shake, and tense. There was so much emotion, grief and horror there. Jenny coached me to breathe, and let me know we would take our time. She asked me rate the level of disturbance, and I immediately gave it the highest number.
Then, Jenny asked me what the negative belief I held about myself in that moment was. I was confused, what did this horrible moment have to do with me? I couldn’t come up with anything: I was so inside the memory. Jenny gave me a piece of paper with a list of beliefs. I read down the list thinking: I don’t know what these have to do with that woman dying, but ok. And then one line jumped out at me
I am inadequate.
“Holy shit. I think that’s it,” I told her. Something inside me broke open, as I realised I didn’t think I had done a good enough job that day. I secretly thought that being so horrified on that call made me an inadequate paramedic, an inadequate person. If I were better, I wouldn’t have been so disturbed.
Each negative belief has an opposing positive belief, and in that case it was I am adequate. I did a good job. Jenny asked me to rate how true I felt that was. I gave it a low score. Then she asked me to hold the belief together with the memory, and to look at the index finger she was holding out in front of my eyes. She moved it back and forth, and I simply followed.
She stopped, and asked me to recall the memory again. It was somehow less. We kept doing this over and over. Each time we repeated the eye movement, the memory lessoned, change, lowered, and the emotion around it changed too. Eventually, it was like the woman in my memory was a friend: she wanted me to know she thought I did a good job, that I was not just adequate but excellent, that I had honoured her. She wanted to say thank you to me.
We kept going: back and forth, back and forth, until eventually I realised that the woman was me. I was the one who wanted me to know I was excellent. I wanted to say thank you to myself for the good work I had done.
We went through so many memories that day, all of which had their own negative beliefs. They were somewhat similar: Feelings of inadequacy, incompetency, or weakness. Ridiculous beliefs that I could have done better. And each time, without fail, we transformed them into the truth.
I had been an amazing paramedic. I had done the very best I could. I was a good person. At times I cried or laughed with the realisation of it. It was like angelic lightbulbs were going off everywhere. And with each one, a release from the secret burdens I’d been carrying. All those years I’d had these shameful secrets hiding away in my unconscious mind where I couldn’t find them.
That was the trauma.
There was magic in the eye movement: the memories themselves becoming further away, more distant and hazy. Each of those memories faded away into something that still existed, but didn’t hold me so tight. I still remember all the things I’ve done, so nothing has been taken away. If anything EMDR gave me back my truth.
Still, many months later, the disturbance is gone. And still, many months later I know my truth: I did a great job, and I’m a good person.
Like Kate, most people do not understand that they have formed negative beliefs about themselves through their trauma. EMDR was created to reprocess not just the memory itself, but also the negative beliefs associated with the memory.
Through multiple studies, EMDR has seen incredible results.A study funded by Kaiser Permanente found that 100% of single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six 50-minute sessions. In another study, 77% of combat veterans were free of PTSD in 12 sessions. (SOURCE EMDR Institute: http://www.emdr.com/)
Each of us have sustained countless trauma’s in our lives, and in each one we formed beliefs about ourselves. Given how effective the results of EMDR are in treating “big trauma,” imagine what it can do for all the events in our lives, from our childhood and our youth, that led to our low self-worth, unlovability, insecurities and fears.
EMDR is for anyone who has formed a negative belief about who they are. And that, my friends, is everyone
If you’ve made it this far in your life without sustaining some kind of trauma, then you are one of the lucky ones. Most of us are experiencing different kinds of trauma all along the timeline of our lives. Some of these are big traumas, some of them small. And whether they leave a lasting mark or scar is difficult to predict.
What is Trauma?
The word trauma is subjective based on experience, so I’d like to take a moment to define it before we move on. Trauma is what occurs anytime we take on injury. This could be a physical injury: a bruise, a broken bone, a cut to the skin. Or it could be an emotional or metal injury that causes damage to the psyche: feelings of inadequacy, lack of safety, or an experience of hurt or pain.
Most of the time, a traumatic event leaves both physical and emotional wounds. For example a car accident may leave you with broken bones and a head injury, along with complex emotional scars from the fear, pain or loss that occurred. Likewise, a sexual assault leaves a complex array of physical and emotional wounds.
What is PTSD?
Post Traumatic Stress is what can occur after a physical or emotional injury. “Post” simply means after, indicating that there is a stress associated in the wake of a traumatic event. Post Traumatic Stress Disorder, or PTSD, is a diagnosable condition based on set criteria outlined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
You can see the full criteria here https://www.brainline.org/article/dsm-5-criteria-ptsd, though to summarise: a person experiences distress, upsetting memories or flashbacks, becomes unsettled or hyper-vigilant and has difficulty feeling positive about themselves or the world.
In addition, the person experiences a sense of depersonalisation or derealisation: as if things are not real or are not happening to them. PTSD is longer term: being diagnosed only after six months post event, with symptoms occurring for months or even years.
Another way to look at PTSD
There is another way that we can look at PTSD that I find very helpful. It is the program that didn’t get to run, and the dream that never happened. Let’s look at these two concepts.
The dream that never happened.
Each night, as we sleep, we take our memories from the day and reprocess them into long term memory. This happens via the rapid eye movement of REM sleep (REM stands for Rapid Eye Movement, and is the deep, dreamless stage of sleep). REM takes the memories from our cortex and moves them to the limbic brain, where they reside as long term, less impactful memories.
Traumatic events do not integrate in this way. They remain closer to our minds: more impactful, as they refuse to go to the long term memory. This is what leads to the feeling of reliving the event, of life-like flashbacks, visual and auditory hallucinations or embodied experiences of the frightening memories. The events stay up close and intense, as if we are still right there with them.
The person loses the ability to see ‘that was then’ and ‘this is now’. During trauma, the cortex can’t process complex language, so the person experiencing a flashback can’t use the appropriate language to communicate what’s going on to others.
The program that didn’t get to run
As humans we create “programs” that allow us to function with whatever is happening. These programs are created and are the best available at the time. For example, a six year old who suffers an abuse creates a program that helps them to cope and feel as safe as they can inside their environment.
Many years later that program is still running to keep them safe. However the program is out of date. The adult is still using a six year old’s program to guard themselves against an environment that no longer exists. They may avoid powerful people, stay small, do what they’re told, never step out of line, even though it is no longer required of them. They are trying to stay safe and cope with life, using an outdated operating system.
They may still see themselves as “bad” because when they are six, they were unable to understand that bad things can happen to anyone. They would’ve believed that they were bad and wrong, as that is the only thing that would’ve made sense then. As an adult, the old program needs to be re-integrated, or it will continue to run as them, their inherent belief about themselves
We can think of PTSD as the program that didn’t get to run. In the case of a traumatic event, the person may have created a program of panic, of paying attention, or of doing something. Then, as the event ended, that program did not get to complete.
And example is one of my clients, Kate, who was a paramedic for 13 years. Kate created a program of being highly functional, always paying attention, judging her performance harshly, and being emotionless during times of heavy emotion.
Later, two years after resigning, Kate was still trying to hide her grief, stay alert, and be capable. Kate had adopted a negative view of the world, was having difficulty feeling optimistic and held unconscious negative beliefs about herself within the traumatic memories.
Kate was exhausted, and all she longed to do was soften, let go of judgments about her performance as a paramedic and cry all the tears she’d had to hold in over the years. Kate’s programs were out of date. She no longer needed them in her life. We had to integrate the program so she could let them go.
Case Study on EMDR
In order to integrate Kate’s outdated program we did a full day of intensive therapy called EMDR. In our next blog we will be sharing the Kate’s story in greater detail.
Often, we look “upward” for advice and modelling. Yet If we’re open anyone can teach us a lesson. The less privileged man on the street, a neighbour we always thought of as simple, or in my case recently, my own child.
The lesson came packaged up in a playground session, and the teacher was my four year old daughter, who completed the whole length of the monkey bars for the first time.
She didn’t mean to teach me anything, rather she was simply being herself. Lining up behind her big sister, watching carefully as those seven year old arms swung that seven year old body easily from one bar to the next. My four year old’s eyes were intent, her forehead burrowed as she prepared herself to follow.
For the last year she had been attempting to make it to the other side. She’d been watching her older sister, cheering her on and trying, trying, trying, until this day, she finally got it. As I watched the whole thing from beginning to end; the concentration, the determination, and the completion of the goal, the lesson sunk in.
You see, over the last year, my four year old didn’t see someone doing better than her and give up. She didn’t decide that the monkey bars were her sister’s thing and not compete. She watched and she learned. She modelled and practiced and got better until she nailed it.
That day, that made her my hero.
I sometimes look at other professionals in my game – ones who fill the big training rooms and charge the megabucks and command the highest paying high profile clients– and I think, “It’d take me forever to get to that point”.
In these moments I forget how far I have come. I run my own business, I have other therapists that work with me, I have my own premises with it’s own staff. I run regular training events in my area and even if they’re not huge, they’re always a success.
That day, watching my daughter, it hit me. Next time, I might just model my youngest child.
I’ll see someone doing something I don’t think I can do yet and I’ll cheer for them.
I’ll watch and I’ll have a go.
I’ll practice and remain focused and determined, progressing in increments when time allows (we’re not always at the park after all).
It’s not like her path across the monkey bars was completely easy. There were times that she let go and started again deliberately, because of some factor unseen to others. She didn’t give herself a hard time, didn’t call herself a failure and walk away. She just knew she needed a rest, so she could get back up there and go again.
Next time, I’ll do that.
What my daughter taught me that day is that we always have a choice. We can either use our observations of others to measure ourselves against, comparing and diminishing what we are capable of. Once we’ve made our measurement, we can believe we’ll never make it to that level. We can decide we’re lesser than them. We can let ourselves be consumed with jealousy or feelings of unworthiness. We can give up and walk away.
Or, we can use our observations of others to motivate us. We can learn from them, watching closely how they do it, with the assumption that we’re getting there too, someday. We can model their behaviour, cheering them on as we go, knowing that we’ll all arrive eventually too, with effort.
In sharing this story with you, I hope to inspire you to ask these powerful questions of yourself: How are you comparing yourself to others? How do you feel discouraged by the success of those around you? Can you be encouraged instead? Determined? Patient? How can you believe that with effort, and encouragement, you will get there too?
Perhaps, we can be open to letting everyone be our hero. Watching closely and learning from even the most unexpected sources. Observing those who are great, and those who are still small. Watching for the lessons, the inspiration, and the motivation to get yourself across any gap. One day, if you just keep going, you’ll get there. That’s what my beautiful four year old taught me that day.
My daughter, my hero.
When someone takes their own life, the questions they leave behind are usually the same. Why did they do it? What were they thinking? Could I have stopped them?
Perhaps, you know the answers to these questions: Have sat inside your vehicle on a quiet night and thought the world will be better off without you in it. Maybe the thought of waking up to one more day of your private hell felt like too much.
Today, we’re going to explore why someone wants to take their life. We’ll talk about the three levels of suicidal ideation, and offer a place to go if you, or someone you love, is suicidal.
There are a few things to think about when it comes to suicide:
1. It’s permanent
People end their lives for one simple reason. They lose sight of the fact that a feeling is temporary. If I asked you, “Do all things change?” you would likely answer yes, because upon examination, we all know this to be true. Yet, in the moment of suicide, the person believes that their depression, hopelessness, despair, or frustration will never go away. They believe that there is no end to the hardship, that nothing will get better, ever. Completely overwhelmed by what they feel, by the unending nature of it, it makes sense to end their life.
All things change. In buddhism, the term impermanence is used to describe the changing nature of all phenomena. It is a law: nothing is permanent. The downside of this law is that joy, love, sunshine and pleasure will inevitably pass. But it’s opposite, the flip side of the coin, is that sorrow, hate, darkness and pain will also pass. When looked at this way, we can see that suicide is a permanent solution to a temporary problem.
2. Expectation isn’t reality
Have you heard the saying: happiness = reality – expectations. If you haven’t, read it again and let it sink in. We all have so many ideas of perfection ingrained in us from relentless propaganda. Television shows, commercials and magazines painting pictures of the perfect family. They paint easily resolved disagreements and vomit inducing happy endings. It’s all supposed to be so perfect isn’t it? And now we have social media, where most people chose to share only the joys, but never the sorrow.
The result is a cumulative expectation around how life, and the state of your mental health should be. You feel isolated and alone in your misery. But should doesn’t matter, what matter’s is what IS. As a therapist, let me tell you: most people aren’t always happy. Far more likely is that each of us have complex relationships, ongoing financial trouble, work challenges, and disappointing personal characteristics. Most of us wish we were somehow better. Most of us feel just as sad as we do joyful. And, because we share a common illusion that we’re always supposed to be happy, we become isolated and depressed.
It’s not an accident that we’re talking about suicide right now in the lead up to Christmas. There’s no greater time where our expectations are sky rocketing past reality. We’re hoping for postcard interactions with our families, but in reality the people we say we love disappoint us, hurt us, or trigger our wounded inner child. We hurt them, or fall into patterns of people pleasing or walking on eggshells. We overspend, causing insane stress all in the name of meeting the societal expectation for presents. We also tend to evaluate our life more, comparing who we are to who we thought we would be.
We have to be ok with what is. Every morning, my house is so disheveled, it looks like it’s been burgled. Sure, I’d love to have a perfect house. But I don’t. Instead, I have a good family. After I’ve worked all day on maintaining healthy relationships, I don’t have the time to work on the house. In accepting what is, instead of wishing it were different, I can be at peace.
3. Pride equals hell on earth
Many who plan to take their lives exist in a private hell, where they believe that no one can truly understands what they are going through. Yet, for most men who report being suicidal, their last option is to break down and tell their loved one’s what is happening for them. When asked why, most would tell you, “Pride”. To show emotion, to break down, is to do the worst thing of all: to be weak. Male suicide rates in Australia are staggering, and suicide is the leading cause of death for people between 15 and 45, with three times as many men than women taking their lives. (source: lifeline)
Unwilling to reach out to those around them, the person may feel like no one cares whether they live or die. They may become spiteful, angry, and convince themselves that the world is better off without them in it. If you find yourself thinking these kinds of things: they’re the biggest delusion of all. The world does want you in it: and your loved ones want nothing more than to help you.
The three levels
If you suspect someone is suicidal. Ask. If you can, find out where they are:
1. They are having fleeting thoughts about it. This is actually more normal than most people think: this is when someone is driving along and a semi trailer comes by and they think something like: I could swerve right out in front of it. Often, these thoughts are impulsive, and impulsive thoughts are driven by alcohol, substances, or extreme emotion.
2. The thoughts are beginning to take root. This is more likely to happen when you’re sober, yet the thoughts are becoming stable. It’s more than just at the height of emotion or when intoxicated. They’re beginning to think about it as a real possibility.
3. They have a plan. A plan is when they’ve put a strategy into place for how they intend to follow through. This stage requires immediate intervention.What do you do?
This Christmas, be on the lookout for anyone who appears to be managing a low mood. The extra financial pressure, unrealistic expectations, childhood triggers, and excess alcohol consumption can cause the kind of impulsivity that leads to spontaneous suicide. Don’t assume any one leaving an argument will be fine.
Tell your loved one’s how valuable they are the you, especially if you suspect they are down. A person who has a plan may do anything to cover it up, and may not tell you: but small powerful words of love and acceptance can unknowingly change a persons mind.
If you think someone is in trouble, seek assistance through a helpline, your local hospital or trusted therapist. If things seem like they’re escalating, don’t be afraid to call 000. Ambulance and police are experienced in handling such matters. If you are managing your own low mood, or find yourself having thoughts that take root, reach out to a professional.
Above all else, take good-will into your holiday season. You never know when your kindness could save a life.
The Suicide Callback Service 1300 659 467
The suicide call back service is an incredible way to get assistance. If you call their toll free number, they will ring you back, for 5 sessions free of charge, anytime of day or night.
Becoming a loving parent to you inner child is an imperative step in becoming a fully grown and psychologically healthy adult.
While everyone grows up to become an adult in a physical sense, many of us are still children in our minds. We act out from the unconscious and unaddressed programs we learnt in our past.
In this post we will learn how to become the loving parent of these inner children. But first, we need to get clear on what, exactly, an inner child is.
What is an Inner Child?
When we were young, we had powerful developing brains. As things happened to us, good or bad, we learned to categorise our experience. When an event was particularly impactful, we filed it away as “how things are”. For example: if you had to cope in an unsafe environment your child brain may have concluded “the world is unsafe”. If a kid on the playground punched you in the belly after you asked them to play with you, you may have concluded “people don’t like me”.
Sometimes, these are called defining moments, and they can be good or bad. Jim Carey, for example, talks frequently about receiving a bike when he was quite young and poor, the day after praying for one. That moment he saw the bike, he concluded that the world would give him anything he wants. This shows the power of the “how things are” beliefs we create as a child. Jim Carey is now one of the most successful men in the world (and reportedly, extremely happy).
Unfortunately, most of us did not have the Jim Carey experience. Later in this post, I’ll offer an exercise of how to uncover your defining moments, and sadly, for most of us, they’re pretty negative beliefs. Many of us did not receive the kind of love, support or nourishment we needed to grow up healthy and complete. Many of us were physically or emotionally abused or neglected.
To make it through each experience as a child, we created what I like to call a “program”. We could only create that program with the resources we had at the time. As young children, those resources weren’t very good.
A program includes our new beliefs about how things are, and also our damaging beliefs of how we are (I am bad, I am wrong, I am worthless, I am unlovable). Then, it creates an operating system to carry us through those new beliefs. This system, or program, may include a variety of mechanisms, like striking out at people first, or isolating from social situations, or becoming a people pleaser. We pick a program that works for us at the time, using the best resources available to us, and we lock it in.
How Your Inner Child plays out as an adult
As humans, our tendency is to only accept information that aligns with our existing beliefs. Therefore, as we grow into adulthood, we are unlikely to change the powerful defining moments we learned as kids. We will act out from these wounds as long as they remain untended to.
This is best demonstrated using an example: so let’s continue with our inner child that was punched in the belly at four years old, and let’s call him Jim. Jim is now 39 and has become a successful business man. He’s secretly a little depressed, but mostly, he thinks life has worked out for him. He’s just been invited to a party and his hands are sweating as he enters the room. His feels sick, and he can’t understand why this is so hard for him.
Jim has always hated parties, though he’s not sure why. His heart is racing and he wishes he’d just stayed home with a movie. Problem is, Jim is incredibly lonely, He’s been single since his last break up, over six years ago, and all he wants is a companion. He’s afraid he’s running out of time to become a father. Jim finds his friends and relaxes little. He smashes a shot and a beer and starts to calm down.
Jim has no idea that he is acting out a program that is thirty five years old. Since he hasn’t done any investigation into his childhood defining moments, he has barely thought about being punched in the belly. If Jim sat down quietly and did an inner child exercise, he would most likely remember the event clearly. Jim might even cry when he realises how much that punch hurt, not for the physical injury, but for the lasting scar in his heart. For Jim to realise his dream of being a loving partner and father, he will need to update his program to an adult version.
Creating a New Program
So how does Jim make the unconscious conscious? How does he update this belief he learned as a child that people don’t like him? The first step is the become aware of the inner children that are unconsciously running your adult life. There are a few ways to do this.
Parenting your Inner Child
Looking into your past in this way allows you to make contact with your inner child, or children. You may be able to specifically visualise, or feel, the different versions of yourself that are still present, running the show. You can ask, is there a child in me that was teased, beaten, neglected or assaulted that is still running the old program that it used to survive? Once you have found him or her, you can begin to be a loving parent to those children.
Parenting you Inner child means that you are attentive to their needs. You are aware enough to notice when they are hurt, or throwing a tantrum, or stamping their feet to be heard. You might be at a party, like Jim, and be conscious enough to acknowledge (when one is looking) that there is a scared little boy inside, longing to be accepted, and that it is HIM running the show.
When this happens, you can quietly acknowledge that version of you. You can give the child what he or she needs: whether it is love, attention, safety, or care. When you are there for your inner child, it’s like you put them to rest. Now the adult you can take the driver’s seat, which is far safer, and more appropriate than letting a kid run the show.
Although you have probably never heard of it, the Adverse Childhood Experience’s study is creating a paradigm shift in the medical community’s approach to disease.
The study, which began in 1995 and included more than 17,000 middle-class Americans, documented that adverse childhood experiences (ACEs) can clearly contribute to poor physical health outcomes and early death.
Recently, I took the test myself, which calculates a score based on the 10 most common or significant childhood traumas. I was staggered to find that I scored an 8. Usually, a result above 6 indicates early death (though the way I see it, this is what happens when childhood trauma’s go unchecked).
I attribute my good health to the way I have attended to my trauma over the years: seeking therapy when needed and engaging in self-care and self-love behaviours. This is the good news: the common effect of trauma can be undone.
I wanted to share with you the ACE study and to give you the test to take for yourself. At the end, I’ll offer my thoughts on the way we can undo the harmful effects of trauma and heal our lives.
The accidental beginning
The roots of the ACE study began by accident in San Diego, California, in the mid 1980’s. Dr. Vincent Felitti, the head of Kaiser’s Department of Preventive Medicine, was trying to figure out why 50% of his clients were dropping out of his obesity clinic, despite the fact that they were successfully losing weight.
During a line of questioning with one of his drop-outs, Feleitti slipped up. Instead of asking, “How old were you when you were first sexually active?”, he asked, “How much did you weigh when you were first sexually active?” The patient answered that she was forty pounds (18kg). Sobbing, she revealed she was only four years old, and it was with her father.
In 23 years of practice, Felitti had only come across 2 cases of incest. He decided to dig further, to see if he would find similar results in the other drop-outs. Of the 286 people whom Felitti and his colleagues interviewed, most had been sexually abused as children. He was shocked.
The study is formed
The ACE study was born from there. The initial surveys were from 1995 to 1997, with the participants being followed for more than fifteen years. The results showed that there was a direct link between childhood trauma and adult onset of chronic disease, mental illness, perpetration of violence, work issues and shortened life span.
There are 10 types of childhood trauma measured in the ACE Study. Obviously, there are many other types of childhood trauma: racism, bullying, losing a caregiver, homelessness, foster care, witnessing other abuse, and many more. These 10 were chosen for their commonality and because they are well studied in research literature.
It is also important to truly take in the staggering results: Two-thirds of the 17,000 people in the study had an ACE score of at least one; and 87 percent of those had more than one. In other words, childhood trauma is insanely common.
Take the test
Prior to your 18th birthday:
Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? Or, act in a way that made you afraid that you might be physically hurt?
No___If Yes, enter 1 __
Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? Or, ever hit you so hard that you had marks or were injured?
No___If Yes, enter 1 __
Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? Or, attempt or actually have oral, anal, or vaginal intercourse with you?
No___If Yes, enter 1 __
Did you often or very often feel that … No one in your family loved you or thought you were important or special? Or, your family didn’t look out for each other, feel close to each other, or support each other?
No___If Yes, enter 1 __
Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? Or, your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
No___If Yes, enter 1 __
Were your parents ever separated or divorced?
No___If Yes, enter 1 __
Was your mother or stepmother: Often or very often pushed, grabbed, slapped, or had something thrown at her? Or, Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? Or, ever repeatedly hit for at least a few minutes or threatened with a gun or knife?
No___If Yes, enter 1 __
Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
No___If Yes, enter 1 __
Was a household member depressed or mentally ill, or did a household member attempt suicide?
No___If Yes, enter 1 __
Did a household member go to prison?
No___If Yes, enter 1 __
Now add up your “Yes” answers: _ This is your ACE Score
What does my score mean?
A score over 3 increases your risk of psychological disorders, like anxiety and depression. With a score of 4 or more, physical disorders become common. For example, the likelihood of chronic pulmonary lung disease, or COPD, increases by 390 percent; hepatitis, 240 percent; depression 460 percent; attempted suicide, 1220 percent.
As your score rises, so does the risk of perpetrating domestic violence, being later raped, teen sexual behaviours or early intercourse, and decreased work performance.
With an ACE score of 6 or more, the risk of a shortened life span or early death sky rockets.
Why does this happen?
There are many theories as to why childhood trauma greatly increases the risk of mental and physical ailments and early death. First, it is commonly understood that stress can physically damage a child’s developing brain. When children are in fight or flight (and overwhelmed with stress hormones), they can’t learn or relax in school. They may not develop healthy relationships with friends, teachers or other adults.
When children can’t focus, perform or connect, they may develop anxiety, shame, or isolation. They may use chemicals or high risk activities in a failed attempt to self-soothe their wounds.
These develop into addictions, or repetitive comfort seeking behaviours. It is these very behaviours: overeating, drug use, risky sexual behaviour, violence etc that begin to damage the physical and mental form. Further shame, guilt and isolation are layered on top, and the cycle continues.
It is important to understand that addiction, or repetitive compulsive comfort seeking, is as natural a response to ACE’s as bleeding is to be cut. In other words, it is to be expected.
So, what do we do now?
The answer to how we reverse, or salvage, these proven and harmful effects of childhood trauma is vague, at best. But what we do know, is that it IS possible to lead a long and fulfilled life.
The very fact that I am here now, a fully functioning, healthy adult with an ACE score of 8, is the proof.
The way I see it, it is the neglect, abuse, and loss of self care that leads to illness and a shortened life. Knowing this, we can see the antidote: attention, affection, self-love and self-care.
We need to begin by starting to take care of our minds and bodies, or at the very least, to maintain our current standard of health. That may mean we need to get help. We don’t assume that the baseline of discomfort we feel, or the way we think less of ourselves, is standard. It’s not.
If you’re not relating to yourself with self love, and kindness: you need to look into that. If there is some way you are not taking care of you: this means there is some self-loathing going on.
As we learn to tend to ourselves: one little piece at a time, we sew the fabric of our life back together. Therapy, coaching, healthy friendships, long baths, good food, and nourishing activities all play a part in how we love and cherish who we are.
No matter how high your score, just know this: you are not alone. There is so much support out there for you. You can change your life.
If you’ve taken the test and your score is over one, we’d love to hear from you. We are here for whatever you need to begin your journey of self care, so please, get in touch now.
Substance Abuse and Mental Health Services: https://www.samhsa.gov/capt/practicing-effective-prevention/prevention-behavioral-health/adverse-childhood-experiences
Centre for Disease Control: https://www.cdc.gov/violenceprevention/acestudy/index.html
Right now as you’re reading this, there’s a voice in your head talking out these words. Can you hear it?
Even when you stop reading, you may find that the voice keeps talking. Let’s try it for a moment. Stop reading, close your eyes and have a listen to what that voice might say….
(Go on, really do it)
What did you hear? Was there a running commentary? An endless stream of words? Or was there silence?
Could you notice the quality of that voice. Was it curious and friendly? Was it judgmental and mean?
For many of us, the voice inside our head is a bit of an A-hole. It is unpredictable, needy, and incessant. Not only does that voice never shut up, it also struggles to keep a consistent message. It changes its mind on a whim, frequently contradicts itself and for the most part, is completely unreliable. When that voice decides to put on it’s judging cap, which is often, I like to give it a name…
The Inner Critic.
The inner critic is always judging, and the subject of it’s judgements is most often YOU. If you’re not careful that voice may berate, belittle, and shame you into a corner. It might disable your ability to live a full and meaningful life. It may tell you that you can’t have your dreams, go for what you want, or try something new. It will probably tell you that you aren’t really good enough, that you’re a fraud, or that no one likes you. Even a nice-ish inner critic can cause low-level unhappiness, doubt and discontent in its wake.
I mean, just imagine, for a moment, that you meet the voice in your head. You court, fall in love, and get married. And then every single moment of every single day, you had to live beside that voice in your head. How long would you tolerate the things she or he had to say? How long would it be before you got fed up and had enough? I guess I’m asking: would you tolerate, from anyone one else, the kinds of things you say to yourself?
Probably not, right? Yet there you are, living every moment of your life with that voice in your head, and then wondering why you’re not happy.
That Voice Isn’t You
Over the years I have discovered three powerful questions that bring my clients to an immediate and life changing awakening of their inner critic. These three questions are so valuable that I call them, “the three questions to being your own coach”. When my clients do this exercise I watch them become aware of how ridiculous their inner critic is. I watch them get some space from that incessant voice in their head.
I watch them understand that that voice isn’t THEM. That it doesn’t need to be listened to. That it can be changed.
I watch them not need me so much anymore, and not needing me means that I have achieved my goal. I want my clients to be their own coach, I want that more than anything, And I want you, dear reader, to be your own coach too.
So, get yourself into a quiet space, maybe even grab out a journal if writing is your thing. Take a few breaths and ask yourself this set of three questions:
Being your own coach: The three questions
1) Would you speak to anyone else like your voice speaks to you?
Take a moment to consider this, or write it down. Then, ask yourself why not? Why wouldn’t you speak to someone that way?
2) If someone stood next to you and spoke that way to you all day, what would you do with that person?
Take moment to write down, or just consider what you might do. Really get into it. You can even swear if you want to….
Or get rid of them (you want to, don’t you?)
If you felt the desire to get rid of your inner critic, then guess what, you’re normal, and you’re on the right track. Can you feel a sense of spaciousness from that pesky voice in your head?
3) Imagine you could be a coach, and you got to coach someone (like you). In order to get the very best from that person, to raise them to two or three levels above where they think they can be, how would you speak to that person?
Take a moment to consider or write it down: how you would speak to someone like you? Why would you speak that way?
You can consider these subquestions too, which may help you to identify other areas:
+How would you deal with this person if they made a mistake?
+How would you deal with this person if they’d been hurt or hadn’t measured up?
Are you worth this too? Take a moment to really consider this, or write it down.
Making a commitment
Many of my clients feel intense emotion after realising that they’ve been their own worst critic, so if this is happening to you, allow whatever arises to be. Maybe you’re feeling sadness, or love, or compassion for the hard time you’ve given yourself over the years. Maybe you’re still giving yourself a hard time.
Sometimes, there is apprehension or doubt that there can be another way to relate to yourself, but I promise you there can. Changing your relationship to the inner critic is one of the best things you can do with your life. So, can we make a commitment, you and me?
Can we make an agreement that you will aim to be your own coach from now on? It makes sense, right? A coach could only ever be with you one hour a week. But you, you’re with you all the time. Wherever you go, there you are.
Did you want to write this commitment down? Say it out loud? Find a friend and tell each other what you’re going o do? You can send me a message if you like, and let me know you’re going to keep asking yourself these questions, and keep being your own coach.
It’s likely that you’ll make mistakes, so don’t worry too much about that. It is counter productive to beat yourself up about slip ups (that’s really just your inner critic at work again). How would you speak to a toddler learning to walk? In that way, simply keep picking yourself up with kind words of encouragement.
Be efficient in your capacity to forgive yourself. And relentless in your ability re-commit, over and over, to being your own coach.
It might seem counter intuitive to allow ourselves to feel depressed or anxious. Neither of these conditions are comfortable or pleasant, and we may feel ashamed or weak for feeling them.
Yet, the statistics are out: Depression is the leading cause of disability worldwide. In Australia, around 1 in 6 women and 1 in 8 men will experience some level of depression.
On average, 1 in 4 people (1 in 3 women and 1 in 5 men) will experience anxiety, making it the most common disorder in Australia right now.
In addition, around 12 per cent of Australians will experience PTSD in their lifetime and up to 40 per cent of the population will experience a panic attack at some time in their life.
Yet, only 35 per cent of Australians with anxiety and depression access treatment.
Why? Well, let me ask you: would you go see someone if these unpleasant human conditions happened to you?
And if not, why not?
For many of us, we don’t recognise anxiety and depression as a normal part of the human experience. Thus, we usually think something is wrong with us when were feeling anxious or down.
We are likely to do anything other than accept these so called “negative” experiences.
I’ve seen this over and over again in my work as a psychotherapist. And I have a different way of relating that I’d like to propose to you…
We need depression and anxiety to survive.
It’s right there in the Darwin theory of evolution. Due to this theory: if we didn’t need a quality in order to survive, then we simply wouldn’t posses it anymore. Therefore all of the parts, functions and emotions of our current day body are exactly what we needed to get us here.
We have been passed down all the traits we possess by our ancestors, or what I call “the long line of survivors”. They passed down fear, so we could prevent harm or injury. They passed down sexual desire so we would continue to replicate. They gave us love, paternal instinct and attachment, so we would band together as community, raise our young, and work together.
Depression and anxiety are not just part of the human condition, they are necessary to it. It is the very rejection of this fact that keeps us stuck in these states, instead of allowing ourselves to efficiently experience them as they arise. Allowing them to come, and allowing them to pass.
Depression can escalate to the point that I call the “impossible task” state. In other words, the individual experiencing the state can no longer do simple tasks. Getting out of bed, showering, or even eating can seem impossible.
What is often happening in this state is a self criticism, judgement and berating. The person’s thoughts may be saying something like:
“You’re hopeless. Look at you, you cant do anything!
You will always be depressed.
You’re a waste of a life.
You are so useless that no one even cares about you anymore”.
The energy the affected person has towards themselves is harsh and unwelcoming. There is little to no acceptance of the depressed state. Under these conditions, the person is likely to remain, or progress further into the depression.
Have you ever experienced a state like this? Self criticism and judgement? Harsh and unaccepting energy?
The alternative to the above scenario is to let yourself lie there. You were going to anyway, right? But this time, you could do it with permission. Acknowledge that for whatever reason, this is what your body needs right now for its survival. It needs to be slow, it needs to rest, or it needs to be sad.
You could let it. You could grab a blanket and curl up. Stay home and read a book. Have a warm bath or cry until your eyes hurt
Then, be completely aware of your inner voice and your energy. What are you saying to yourself? Start to be as kind and nurturing as you can. If you could create the dearest, most loving caregiver in the world right now to be there with you and say all the right things, what would they say?
Then, say that. Be that type of caregiver to yourself, offer that kind of unconditional and loving energy.
Eventually, as you continue to practice this kind of allowing, your phases of depression will become more and more efficient. What used to take weeks to get through may simply take a day, or a morning, or maybe just an hour.
It is counter intuitive to go into depression willingly, to release all the judgments of your experience. But just remember, if states of depression weren’t what your body needed to survive, they wouldn’t still be here.
Now, lets take a look at anxiety
The nervous system is regulated by the limbic brain. This is the mammalian part of the brain responsible for alerting us to danger.
Bessel Van De Kolk, a leading trauma psychologist, referred to the limbic brain as a smoke detector. The detector is made to alert us when the house is on fire. For someone with anxiety, the smoke alarm is hyper-vigilant, sounding off wild screeches when we’re just cooking bacon or making toast.
IN this way, anxiety is what happens when we have an overstimulated sympathetic nervous system. The body secretes adrenaline when it senses fear, which like the faulty smoke detector, is far more often than average.
Once the body is full of adrenaline, it can be difficult to calm down. And because the feeling can be unpleasant, the likely response is to push it away by doing more, staying busy, or resisting rest.
As anxiety escalates, the person affected can become triggered by very small events or thoughts, becoming more and more anxious to the point of panic. Self-critical thoughts usually arise, and we don’t know how to rest, stop, or feel ok anymore.
Yet, if we learn to tend to the very small triggers with kindness and self-soothing, then we can begin to heal.
As with depression, the key to anxiety is allowing. This is counter intuitive, as almost all of the clients I have worked with want to push the feelings of anxiety away, or power past the symptoms. Instead, we need to turn toward anxiety and learn to be our own gentle elder.
It is important to note that the limbic brains language is emotion. Language and logic were developed with the prefrontal cortex, so the limbic brains stimulation cannot be soothed by words and thoughts. Rather, we must treat ourselves as we would a frightened animal. For example…
Imagine a dog trembling at the sound of thunder. How would you calm him down? Would yelling at him help? Or, would you use a soft soothing tone; approach lightly with kind energy; petting, hugging or holding him with a gentle touch?
In this way, we must soothe our frightened self. Rather than ignoring, we turn toward the fear, using a kind and loving attention. We can breathe softly, place a hand on our heart, or lie comfortably in a yoga pose or in soft blankets. The attitude we need to bring to the feeling of anxiety is of comfort and kindness, like a wise protective elder.
Getting in the Flow
The most important thing to do is to accept and face whatever feeling arises in you. It is resistance that causes the anxiety and depression to perpetuate itself. This can be difficult, and at first you may need the help pf a professional.
Yet, sometimes it can life changing to see the truth: That as long as we are in this human experience, this bag of flesh and bones, we are going to feel all of the spectrums of emotions. Joy cant exist with sorrow, elation without depression.
All things come and go, in a moment to moment flow. It is allowing them to move through you that prevents you from getting stuck.
SOURCE OF ALL STATISTICS:
Australian Bureau of Statistics. (2008). National Survey of Mental Health and Wellbeing: Summary of Results, 2007. Cat. no. (4326.0). Canberra: ABS