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What is Trauma and How We Try to Master It


In one of his earliest essays, Beyond the Pleasure Principle (1920), Sigmund Freud discusses the case of a boy, one and a half years old, who develops a game to deal with the trauma that he suffers for the first time when his mother, who he is very attached to, goes away for a prolonged visit and then returns.

He throws the ball over the bed and it goes out of sight. He makes a sound to show his surprise and wonder. After it is found and brought to him, he does an ‘ooo…’ in a delighted way.

Freud is promoting the theory that there is an economic motive involved-the need to restore ‘pleasure’ by which Freud means ‘equilibrium’ in the psychical system which has endured a sudden shock of not seeing his mother for an unpredictable time.

Sigmund Freud

This is how the game helps him to master the trauma of seperation and loss. Says Freud: “..At the outset, he (the boy) was in a passive situation-he was overpowered by the experience; but by repeating it, unpleasurable though it was, as a game, he took on the active part.” 

This observation -deduction has paved the way for the development of the idea of trauma. Not many credit Freud anymore. With new approaches, the original thinker is ‘deleted’. Do read his works. Elegant writer.

From this game, he also deduced that an object thrown away by this child is his/her way of mastering his anger, owning it. If you can imagine that the object/toy stands for mother or father or anyone who he/she is attached to and leaves unexpectedly, causing uncertainty and pain, a child can at least take it out on the object/toy and throw it away or break it. This little boy had heard that his father had to ‘go away to the front’ as it was war time. He would throw the object away and say, ‘go to the fwont!’ In this way, he was able to master, at least in his mind, a situation he had no control over-his father going to war, his mother leaving him for a visit.

Relationships ?

When couples fall in love, sex and passion is not far away. It is present and overwhelming. The test for real wellbeing benefits of couple life-and there are many proven benefits of a long term relationship- is when they can voice differences which, however unpalatable to the other, demonstrate how you can be robust, flexible, containing of the other. The easier thing for some is to close down when it gets unpleasant. At times, most human beings simply don’t like to hang around when things get bad. Others get stuck in and go for the long haul. This ability to weather the storms and stay together, smile and find mutual things to do creates a great foundation for good relationships.

It is when we open our thoughts and minds to others and see them as human beings that we really becoming richer as human beings. One has to work 24/7 to keep expanding and not contract -against the impulse to shrink when things get rough. To go against the instinct to keep the circle around us from shrinking.

People gain more depth and personality when they allow themselves to create more space for the other person to be and the other person returns the gesture. Judgment ought to give way to expansion in understanding the other and accommodating what feels odd at first. The growth of civilisation depends on this give and take.

However, when that generously given space is used in a parasitic way- i.e. the other invades and takes over rather than shares in a mutual understanding, the relationship loses the balance which makes the relationship healthy. The  scale becomes lopsided, the see saw weighs more heavily on one side-the person who takes advantage of their partner’s goodness and kindness, does it far too long and there is an end to it. The sweetest of people come apart under this kind of stress.

Enduring couples allow arguments and quarrels and the love and passion that comes in its aftermath, when anger ebbs away. If this anger remains and ferments in a toxic way, perhaps because this is the way the persons involved have seen their parents behave, then the relationship will spiral downwards. Time must be made for increasing wisdom, understanding and kindness for the relationship to go on and encompass children and elders in its folds.

Is your Therapist Mindful?

According to the Wiki, ‘Mindfulness plays a central role in the teaching of Buddhist meditation …described as a calm awareness of one’s body functions, feelings, content of consciousness, or consciousness itself, it is the seventh element of the Noble Eightfold Path, the practice of which supports analysis resulting in the development of wisdom. The Satipatthana Sutta (Sanskrit) is one of the foremost early texts dealing with mindfulness. A key innovative teaching of the Buddha was that meditative stabilisation must be combined with liberating discernment.

Mindfulness practice, inherited from the Buddhist tradition, is increasingly being employed in Western psychology to alleviate a variety of mental and physical conditions, including obsessive-compulsive disorder and anxiety and in the prevention of relapse in depression and drug addiction.’

How does a therapist incorporate mindfulness?

‘Congruence’ and ‘countertransference’ are concepts that come close to a natural and organic incorporation of mindfulness. Through an inner knowledge of himself/herself and how one is feeling with the client in the present moment, a therapist is able to help the client process difficult feelings in the room.

How does a person incorporate mindfulness in everyday life?

A quiet spot in a busy day is enough to become aware of one’s feelings, who/what triggered them and letting go of their clinging negative properties, like allowing a ship to let go off the harbour. Mindfulness is the important punctuation needed to move from reaction to reflection. Reactions are lively, reflections are calming.

However, sometimes a deeper exploration cannot be embarked on when there is a crisis and life becomes a set of reactions. At such times, an effort at reflecting may stop a spiral of destructive reactions.

Migration, Displacement, Stress

Increasingly, people find themselves having to migrate to other areas of the UK or from one country to another, in order to find jobs that are suitable for them. This migration has a history and goes back to the beginning of the human race and the wandering, nomad that some of us might identify within ourselves has long term ancestors.

Milton Keynes can feel ‘modern’ to the newcomer

Moving to a new city may be an exciting venture. Milton Keynes, for example, attracts quite a migrant population, not just from other countries but from different parts of the country. It has a good success rate in employment and seems on the surface to be a buzzing city with lots to offer to someone who is new here.

The underlying issues that accompany a migration is the loss of a secure base (if there was one before). However big the reward for such movements, the human cost is high. Separation and loss cause the human to regress to some of his/her earliest experiences of loss and the response to such losses.

Our infancy is like this pic. Someone familiar is ‘holding’ us

If you observe a baby who is still at the very earliest stages of life, the eyes constantly find its mother/caregiver because that is how he/she finds an emotional and psychic anchor in the aftermath of the loss of the womb life.

If you observe yourself in a new place, you may find yourself searching in a similar way for familiar things – a McDonalds’ sign, familiar landmarks, a nice smile from someone to make you feel welcome etc. I have often heard talk in the local gym of how friendly everyone is here and how they would not want to be in that other place where no one smiles at the other. 

These are the things which bring relief to the soul that searches for a home where it can feel safe. With the relative feelings of safety come the need to perform and make one’s mark on the environment. The healthy normal human will make a seemingly unfamiliar, even hostile environment into a place they begin to feel at home in.

An ethnic word can bring relief to the homesick

Some people may never make a new place their home because all the goodness is left behind in the place they left to come here.
This is called splitting and projecting goofy shopdness into an idealised place.
Such splitting can occur with people as well. You may often hear stories of how good the previous boyfriend/girlfriend/mother/father/brother/sister/teacher etc was and how no one can ever take their place now.

Such a splitting harms the experience of the present and the potential to live and enjoy something new in the present.

Counselling/therapy can help to work through the idealised lost experience of someone or something and open up the capacity to live life more deeply and fully.

But the bottomline sometimes is that no two things are the same and we, as living organisms, require some amount of sameness and familiarity in order to feel secure and grow. Letting go of things one cannot have anymore and ushering in the new is an art that may enrich one’s experience of life’s constantly changing parameters.

Depression-Not so Blue ?

The predominant medical view is that depression is a mental disorder and anti depressants and psychotherapy maybe prescribed to manage it.

Depression is characterised by sad mood, the inability to derive pleasure from activities such as seating or sex, and changes in psychomotor, sleeping, and eating patterns.

This may sound all doom and gloom but research is re-evaluating depression and asking some important questions. The unusually large numbers of people who now get diagnosed with depression leads to the question whether it is not a bit of over-diagnosis and can we step away from resorting to medication where possible.

Therapy seems to be a more healthy alternative and can be a good space to take inner rumination to, avoiding too much isolation.

According to an article in the American Psychological Review (2009) ‘The bright side of being blue: Depression as an Adaptation for Analyzing Complex Problems’, the authors (P.Andrews and A. Thomson Jr ) suggest that depression maybe a natural response to help an individual avoid outside stimulus and apply his/her mind to resolving complex inner problems.

They say, ‘Depression is the primary emotional condition for which help is sought. Depressed people often report persistent rumination, which involves analysis, and complex social problems in their lives.

Depressed people may withdraw into an internal state of preoccupation where they seem to ruminate. They may slowly isolate from others and insulate themselves from the outside world.

According to the article, ‘Analysis is often a useful approach for solving complex problems, but it requires slow, sustained processing, so disruption would interfere with problem solving.

The analytical rumination hypothesis proposes that depression is an evolved response to complex problems, whose function is to minimise disruption and sustain analysis of those problems by (a) giving the triggering problem prioritised access to processing resources, (b) reducing the desire to engage in distracting activities (anhedonia), and (c) producing psychomotor changes that reduce exposure to distracting stimuli.

In other words, the authors suggest that a certain amount of preoccupation and privacy may be required to think about and resolve life’s complex problems, whether it is at the workplace or in domestic life.

As a society we have ensured that workplace meetings be relatively without interruptions and have maximum privacy. This is to encourage a more focused and deeper thinking about workplace issues by avoiding all other distractions.

However, popular ideas which dictate how social and family life should be do not make space for such a condition. The sometimes stereotypical mingling with others is encouraged to fight what is considered an illness and anyone who wants to opt out maybe considered either ‘boring’, a misfit, unwell, antisocial or unpopular.

It is difficult to live with someone who is depressed. Family and close friends begin to feel the pinch of being with someone who is quite unavailable emotionally. They may experience useless, angry and pent up feelings.

According to the authors, depression as it is defined medically, is prevalent in industrialised societies where such a study was held but it also exists in small societies wherever it was possible to conduct such a study.

They go on to say ‘such evidence suggests that much of what is currently classified as depressive disorder represents normal psychological functioning (Horwitz & Wakefield, 2007).

One likely factor contributing to over-diagnosis is that clinically significant impairment is not conclusive evidence of disorder (Spitzer & Wakefield, 1999). Impairment can be caused by biological dysfunction, but it can also be caused by properly functioning stress response mechanisms.’

Though clinical and severe depression over a long period of time is not to be taken lightly, the usual bouts of milder depression maybe seen as a human and natural response to the need for resolving complex issues.

Coming Soon! Freud Study Group – September 2021

Sigmund Freud was the founder of psychoanalysis that formed the basis for all subsequent talking therapies up to the present day. His writing is original, and his ideas helped to shape the modern world to such an extent that we now take such concepts as the unconscious for granted as it has become adopted by western culture in art, movies and advertising.

Yet many of us, even as trained therapists, haven’t really read Freud’s own writing. This study group will provide a space to explore four important papers which still have plenty to say about current issues and concerns.

The papers will be sent out in advance and each week in September we will be talking about a paper, introduced and facilitated by Smita Kamble who is a BPC registered psychoanalytic psychotherapist, supervisor and trainer.

Attending the study group you can expect:

  • To feel more anchored within the psychodynamic framework
  • To feel Freud is more accessible and to talk about his ideas in simple language
  • To interest anyone who wants to understand Freud and his impact on the history of ideas and human psychopathology

The group will be on zoom on Monday evenings at 7pm in September for 90 minutes a session. You can join for all four sessions or choose individual sessions.

WEEK 1: 6th September – The Interpretation of Dreams

WEEK 2: 13th September – Beyond the Pleasure Principle

WEEK 3: 20th September – Narcissism

WEEK 4: 27th September – Mourning and Melancholia (Depression)

COST:

The cost will be £25 per session, or a discounted £90 for all four sessions. Each session will count as 1.5 hours certificated CPD or 6 hours CPD for all four.

PAYMENT: 

Pay by direct bank transfer to Coop Bank, Bedford Counselling Centre,sort code 089299,account number 65682890 putting FREUD SD as a reference.

 

Book now and receive the papers in advance to allow time to read, they are a mixture of short and long papers.

We hope you will be interested.

Getting It Right-New Associations, BPC journal, March 2014

Getting it ‘right’ –afterthoughts on completing a psychoanalytic training

Indian Classical Music 101 With Ravi Shankar : NPRWith a comparison between Indian classical music training and a psychoanalytic one  

This article appeared in ‘New Associations’, a BPC (British Psychoanalytic Council) journal in its 2014 summer edition.

“During my psychodynamic training at Rewley House, Oxford, a visiting lecturer exclaimed in the middle of her presentation about transference and countertransference ‘ your training is only two or three or five years old, you have lived much longer than that and brought all that with you !’

A classical training is long and arduous, like the psychoanalytic one,  and seems to renegotiate ‘all that you have brought with you’. Any training can be long and arduous but the psychoanalytic one becomes more so maybe because it does not have the assured ‘pot of gold’ at the end, an assured job or income, and tests one’s limits of mental endurance like few other trainings can.

It reminds me of the other classical trainings where one has to spend more time to just set the first note right with no assurance of income, knowing well that you may perform to a small, critical and select audience while the rest go off and listen to something short and popular, a bit like the shorter approaches to therapy which lead to immediate gratification, what we call ‘flight into health’.

In Indian classical music, students undergo a tremendous amount of training to set the first note ‘sa’. This takes precedence over everything because if the first note is not right, the rest of the rendition will fall apart. It is a bit like the first position in Tai chi where you spend time trying to hold a space between your hands but cannot get the tension right. And like the psychoanalytic session, where if you don’t hold the tension and think before saying something, the session may fall apart.

Indian classical music has its origins traced to 1500–1000 BCE, in the sacred Hindu scripts called ‘Vedas’. The student lives at his chosen guru’s home and performs household duties, like cleaning and cooking, to learn the art form. To reach its highest accolade, which is to be considered a Pundit (for Hindus) or Ustad (for Muslims) in India, you must have practised for many years and shown what we call ‘lagan’ or devotion to your art form.  The performer will prove how he has learned the classics –the ‘raagas’, which manifests in a 45 to 60 minute performance,  and possibly made his/her own improvisation as well as how or what he/she did to spread the art form in the world. Indian classical music or dance is not an assured form of income and it is understood that its continuity depends on individual achievement and marketing which will inspire others to follow and therefore keep it alive.

These days, in an Indian post modern world, students continue with normal school while they live at the guru’shouse. Recently, a famous Indian vocal performer who happened to be my guest  before her performance in London, told me how she scolded her students when they got caught up in schoolwork and did not practice, with ‘do you forget to breathe? No? Then don’t forget to sing!’ how else can an art form which does not bring income like other lucrative professions, survive without a bit of attitude from the guru?  It is probably this kind of ‘native conditioning’ which has seen me through the various ‘attitudes’ of supervisors and therapists during my psychoanalytic training.

During a public performance, the Indian classical performer does not rush into his performance. The audience is treated to a pre performance act where the artistes, while sitting infront of their audience, tune their instruments quietly or engage with each other sporadically, creating a mood, a concentration and tension which forms the preamble to the performance.  These are just a few of the details of Indian classical art life.

Before coming to the UK, this is what I knew to be a good and ancient training. Being one of the few Indians born and brought up in India, training to be psychoanalytic here, I had my moments of complete disorientation and the dreaded feeling that I was ‘losing my culture’. This coincided with the fact that I had actually lost my physical environment completely and  at such times, trips to Southall help only marginally.  In India, you can have the option of walking down a street where culture can waft out of windows and pervade your consciousness. You may be fortunate enough to live next to classical performers or have one in your family. I have been fortunate.

To reassure myself in my training years, I thought of drawing parallels from similar Indian traditions like Indian classical music.  I compared increased frequency of sessions in therapy and supervision to living in a psychoanalytic ‘home’ made up of therapist, supervisors, training institute and training patients so that I could try to ‘internalise’ a tradition without too much resistance- breathe it, digest it, internalise it, till it was as natural as breathing itself- like the Indian singer expected her students to do.

It is only when the Indian performer has got his note right, will he/she perform and then there will be a thunderous applause and personal satisfaction. The waiting and tuning creates the tension needed to sink into something deeper, more unconscious and infinitely more satisfying.  As a trainee, one loses one’s ‘notes’, including one’s beliefs, flails helplessly on the surface and cannot sink into a deeper connection. At such times, in my anxiety to perform, I have said things which were not personally satisfying and received a thunderous criticism from my supervisor, greeted in various ‘notes’ –from silence to censure and sarcasm, and then the rare compliment when I got it right again.  How much more welcome it is then!

Now that my training is behind me, I find myself more  quiet, less pressurised and less concerned with my client’s immediate demands. Like the audience at a performance who come into the auditorium from various settings with things on their mind, clients come in from the outside world under tremendous pressure at times but it is I, their therapist, who must tune into a psychoanalytic environment, sink into the inner world and set the mood ‘right’, either with my silence or my words.

Going back to the length and time it takes to establish the first note and the atmosphere for rendering it, I value this first moment and the setting up of the session more than anything that follows afterwards. Only in psychoanalytic therapy have I experienced that special moment when one anticipates one’s session and the therapist ushers you into this empty live space which is different from the outside world because it makes no social demands – you can be quiet if you want, not say ‘good morning’… whatever…It welcomes you to shut out the outside world and develop an inner meditative stillness, a little like the Indian performer who tunes himself infront of his audience and silently invites them to slow down and wait or like Tai chi, where you learn to hold an imaginary space between your hands. It is a very special space and it takes a long training to hold it and get it right.  And I think it would not be the same if there was an assured ‘pot of gold’ at the end.”

 

 

 

 

 

 

 

 

 

 

 

 

 

Psychoanalytic Therapy Evidence?

Psychoanalytic based treatments are evidence-based forms of therapy which can effectively treat emotional problems and a wide range of mental health conditions such as depression, eating disorders and anxiety.

Psychoanalysis started with the discoveries of Sigmund Freud a century ago, but its methods have changed and developed a great deal since then. It has the most developed theoretical base of all the talking treatments and has had a significant influence on all talking treatments.

Psychoanalytic therapies involve talking to a trained therapist, usually one-to-one, but sometimes in a group or with a partner or family members. This kind of therapy addresses underlying issues and causes, often from your past, which may be concerning you, or affecting your relationships with others. In your sessions you will be encouraged to talk freely and to look deeper into your problems and worries. It differs from many other talking therapies in that it aims to help people make deep seated change in personality and emotional development, alongside relieving troubling symptoms. It can help you discuss feelings you have about yourself and other people, particularly family and those close to you.

Some people seek help for specific reasons, such as eating disorders, psycho-somatic conditions, obsessional behaviour, or phobic anxieties. Some seek help for underlying feelings of depression or anxiety, difficulties in concentrating, dissatisfaction in work or in marriage, or for an inability to form satisfactory relationships. It may benefit anyone. It can help children and adolescents who have emotional and behavioural difficulties which are evident at home or school, like personality problems, depression, learning difficulties, school phobias, eating or sleeping disorders.

Read more : https://www.bpc.org.uk/information-support/what-is-therapy/

Is Psychoanalytic Therapy useful ?

Was I mentally ill? I suppose I was, though the first time someone in my family used the phrase “verge of a nervous breakdown”, or something like it, I was taken aback. Probably I was about as far from well as it was possible to be while still going about my business: essays, lectures, friends and so forth (I was a student at the time). A broken heart – that, is, a rejection so disappointing I couldn’t bring myself to accept it – was the trigger. But it brought up all manner of shit. By the time I went to talk to a psychoanalyst, I had feelings so muddled that sharing them with anyone else would have been weird.‘After, I feel ecstatic and emotional’: could virtual reality replace therapy?Read more Eight months later, the shrink and I had somehow decided that once a week wasn’t enough, and I signed up for the full whack: 50 minutes five times a week. This was cut down to four, but I carried on going until I was 26. It was a huge help. I know lots of people who see, or have seen, a psychotherapist or counsellor of some sort, but hardly anyone has psychoanalysis. Literally, hardly anyone. There are no official figures, but I’d be surprised if there are more than 500 people in the UK currently “in analysis”, or intensive psychotherapy, by which I mean appointments at least three times a week. There are loads of good reasons for this. Non-neurotic, uninhibited people who cope well with life – family, work, money, sex, food, other people – don’t need any help. (Well done, those people.) But plenty of others, for reasons that range from obvious to unfathomable, don’t manage all that well. Some of those become ill, and mess up their lives and other people’s as a result. I think shrinks could help many of these people. Everyone should have psychoanalysis – that is, the chance to dig into their past and reflect critically on their personality, helped by a professional – if they want it.
A government-funded study found it to be as effective as psychiatry and CBT at treating depressed adolescents
It doesn’t have to be five times a week in a private consulting room, either. Fiercely divided in their views of human nature, psychoanalysts also disagree about what psychoanalysis actually is: just how much time and money do you have to spend on the couch for it to count? But in the real world, including in the cash-strapped NHS, therapists have developed a variety of ways of working (once a week, therapy groups and so on) that don’t take years and cost the earth. Grouped under the broad heading psychodynamic – which refers to the idea, derived from Freud but with many twists and turns since, that human beings have unconscious as well as conscious minds – their aim is to provide insight and relief from distress. The prospect of so much state-sanctioned soul-searching will send many, perhaps even most people, running for the gym, the medicine cabinet or the hills. After all, there are plenty of therapists out there and if more people wanted to employ their services then presumably they would. While there is reams of interesting anecdotal evidence about psychoanalysis, not to mention The Sopranos, clinical trials have been thin on the ground. That is changing and a recent UK government-funded study found it to be as effective as psychiatry and cognitive behavioural therapy (CBT) at treating depressed adolescents. Read more : https://www.theguardian.com/commentisfree/2017/oct/09/access-psychoanalysis-help-mental-illness

How Psychoanalysis influenced the field of Psychology

Psychoanalysis is defined as a set of psychological theories and therapeutic techniques that have their origin in the work and theories of Sigmund Freud. The core of psychoanalysis is the belief that all people possess unconscious thoughts, feelings, desires, and memories.

Psychoanalysis suggests that people can experience catharsis and gain insight into their current state of mind by bringing the content of the unconscious into conscious awareness. Through this process, a person can find relief from psychological distress. Psychoanalysis also suggests that:

  • A person’s behavior is influenced by their unconscious drives.
  • Emotional and psychological problems such as depression and anxiety are often rooted in conflicts between the conscious and unconscious mind.
  • Personality development is heavily influenced by the events of early childhood (Freud suggested that personality was largely set in stone by the age of five).
  • People use defense mechanisms to protect themselves from information contained in the unconscious.
  • Skilled analysts can help a person bring certain aspects of their unconscious mind into their conscious awareness by using psychoanalytic strategies such as dream analysis and free association.

Read more : https://www.verywellmind.com/what-is-psychoanalysis-2795246

Sticking plaster over a deep wound

Listen to the BBC Radio 4 coverage of the joint BPC & UKCP survey on quality psychotherapy services in the NHS, published earlier this year 

Service user Louisa, shares her experience of psychotherapy services, both in the NHS and privately, poignantly describing lower intensity treatments as a sticking plaster over a deep wound and that psychoanalysis gave her a language for the things that she couldn’t speak of before. here

Valued psychotherapy and counselling services are currently facing closure, threats of closure or various forms of downgrading. Some of these are psychoanalytically-based but the cuts are being experienced across the board.

A survey of over 800 members of the British Psychoanalytic Council and the UK Council for Psychotherapy working in the NHS found that in the last year there has been:

Increased negative outcomes for clients:

  • 77% of therapists reported negative outcomes for clients as a result of cuts to psychotherapy services such as longer waiting lists, premature ending of treatment and reduced choices around therapy types.
  • Therapists reported that waiting too long for therapy or getting the wrong type of therapy or not enough of the right type could lead to increases in clinical symptoms.

Greater need but fewer services:

  • Over two thirds (68%) reported that they are being relied upon to deal with increasingly complex cases.
  • But at the same time there is an increasing pressure to use much shorter term (CBT informed) interventions that are not suitable for all clients.
  • Fewer psychotherapy services are being commissioned (48% noted decreases in the number of psychotherapy services commissioned, with only 5% reporting increases). 63% of therapists reported decreases in the number of psychotherapy posts.

See the summary findings of the joint survey on the BPC site : here

Why TherapyFriends?

I thought I would pen a few lines for those who are wondering if I have gone ‘off’ and created TherapyFriends and whether this means I don’t practise as a psychoanalytic psychotherapist.

I do practise as a psychoanalytic psychotherapist. I am rooted in it and in fact, TherapyFriends demonstrates this amply. It hopes to circumvent the over interference of the superego and create a space for all of us neurotics!

If this means I am ‘off’ to some, I will further argue, that actually I am ‘on’ and able to embrace my neurosis and therefore, open to the neurosis of others.

I used to work in print and television before and in a way, TF brings together my past and present professional life.

Anxiety Symptoms?

The Clinical Symptomatology of Anxiety Neurosis. This list is compiled from – Freud,S. (1925-26). In Vol.10, Inhibitions, Symptoms and Anxiety. P.94-97.

The first person account, the ‘I’, mentioned at times in the list is Freud’s voice.

 The clinical picture of anxiety neurosis comprises the following symptoms:

 

  1. General irritability. Common nervous symptom. “Increased irritability always points to anaccumulation of excitation or an inability to tolerate such an accumulation-that is, to an absolute or a relative accumulation of excitation. One manifestation of this increased irritability seems to me to deserve special mention; I refer to auditory hyperaesthesia , to an oversensitiveness to noise-a symptom which is undoubtedly to be explained by the innate intimate relationship between auditory impressions and fright. Auditory hyperaesthesia frequently turns out to be a cause of sleeplessness, of which more than one form belongs to anxiety neurosis”.
  2. Anxious

“Anxious expectation, of course, shades off imperceptibly into normal anxiety, comprising all that is ordinarily spoken of as anxiousness–or a tendency to take a pessimistic view of things; but at every opportunity it goes beyond a plausible anxiousness of this kind , and it is frequently recognized by thepatient himself as a kind of compulsion. For one form of anxious expectation -that relating to the subject’s own health-we may reserve the old term  hypochondria.

A further expression of anxious expectation is to be found in the inclination to moral anxiety, to scrupulousness and pedantry.

Anxiousness-which, though mostly latent as regards consciousness, is constantly lurking in the background-has other means of finding expression besides this. It can suddenly break through into consciousness without being aroused by a train of ideas, and thus provoke an anxiety attack. finally, the feeling of anxiety may have linked to it a disturbance of one or more of the

 

bodily functions-such as respiration, heart action, vasomotor innervation or glandular activity. the feelingof anxiety often recedes into the background or is referred to quite unrecognizably as ‘being unwell’ ‘feeling uncomfortable’ and so on.

  • Anxiety attacks accompanied by disturbances of the heart action, such as palpitation, either with transitory arrhythmia or with tachycardia o longer duration which may end in serious weakness of the heart and which is not always easily differentiated from organic heart affection; and, again, pseudo­ angina pectoris-diagnostically a delicate subject!
  • Anxiety attacks accompanied by disturbances of respiration , several forms of nervous dyspnoea, attacks resembling asthma, and the like. I would emphasize that even these attacks are not alwaysaccompanied by recognizable anxiety.
  • Attacks of sweating, often at
  • Attacks of tremor and shivering which are only too easily confused with hysterical
  • Attacks of ravenous hunger, often accompanied by
  • Diarrhoea coming on in
  • Attacks of locomotor vertigo.
  • Attacks of what are known as congestions, including practically everything that has been termed vasomotor
  • Attacks of (But these seldom occur without anxiety or a similar feeling ofdiscomfort.)
  1. Waking up at night in a fright (the pavor nocturnus of adults), which is usually combined with anxiety, dyspnoea , sweating and so on, is very often nothing else than a variant of the anxiety But thepavor can also emerge in a pure form, without any dream or recurring hallucination.
  2. Vertigo’ occupies a prominent place in the group of symptoms of anxiety neurosis. In its mildest form it is best described as ‘giddiness’; in its severer

 

manifestations, as ‘attacks of vertigo'(with or without anxiety), it must be classed among the gravest symptoms of the neurosis.

Furthermore, I am not sure whether it is not also right to recognize alongside of this a vertigo a stomacho laeso [of gastric origin].

  1. On the basis of chronic anxiousness (anxious expectation) on the one hand, and a tendency to anxiety attacks accompanied by vertigo on the other, two groups of typical phobias develop, the first relating to general physiological dangers, the second relating to locomotion. To the first group belong fear of snakes,thunderstorms, darkness, vermin, and so on, as well as the typical moral over-scrupulousness and forms ofdoubting mania . Here the available anxiety is simply employed to reinforce aversions which are instinctively implanted in everyone.

The other group includes agoraphobia with all its accessory forms, the whole of them characterized by their relation to locomotion.

  1. The digestive activities undergo only a few disturbances in anxiety neurosis; but these are characteristic Sensations such as an inclination to vomit and nausea are not rare, and the symptom of ravenous hunger may, by itself or in conjunction

with other symptoms (such as congestions), give rise to a rudimentary anxiety attack. As a chronic change, analogous to anxious expectation, we find an inclination to diarrhoea, and this has been the occasion of the strangest diagnostic errors.

The behaviour of the gastro-intestinal tract in anxiety neurosis presents a sharp contrast to the influenceof neurasthenia on those functions. Mixed cases often show the familiar ‘alternation between diarrhoea and constipation’. Analogous to this diarrhoea is the need to urinate that occurs in anxiety neurosis.

  1. The paraesthesias which may accompany attacks of vertigo or anxiety are interesting because they, like the sensations of the hysterical aura, become associated in a definite sequence; although I find that these

associations, in contrast to the hysterical ones, are atypical and changing. A further similarity to hysteria is provided by the fact that in anxiety neurosis a kind of conversion takes place on to bodily sensations, which may easily be overlooked-for instance, on to rheumatic muscles. A whole number of what are known as rheumatic individuals-who, moreover, can be shown to be rheumatic- are in reality suffering from anxiety neurosis.Along with this increase of sensitivity to pain, I have also observed in a number of cases of anxiety neurosis a tendency to hallucinations; and these could not be interpreted as hysterical.

  1. Several of the symptoms I have mentioned, which accompany or take the place of an anxiety attack, also appear in a chronic form. In that case they are still less easy to recognize, since the anxious sensationwhich goes with them is less clear than in an anxiety attack. This is especially true of diarrhoea, vertigo and paraesthesias (an abnormal sensation, typically tingling or pricking (‘pins and needles’), caused chiefly by pressure on or damage to peripheral nerves. Just as an attack of vertigo can be replaced by a fainting fit, so chronic vertigo can be replaced by a constant feeling of great feebleness, lassitude and so”

 

Anxiety – Symposium -BCAT

This event is now over. Thank you to all at BCAT for a wonderful morning!  Pleased about how it went-the facilitation by Nick Hall and the people I met.  

Saturday, March 20th 2021 –  Zoom

https://www.bcat-team.org.uk/training#SYMPOSIA

Anxiety Symposia with Smita Rajput Kamble

Anxiety affects daily life. Development and growth is that rare human achievement when we can overcome anxiety and it’s debilitating affects. This symposium will get to grips with understanding anxiety via a psychodynamic lens.

WHEN: Saturday 20th March, 2021 – 10am to 1 pm (with breaks).

WHERE: Online  COST: £60.

Payment:

You can pay by direct bank transfer to Coop Bank, sort code 089299, account no. 65682890, putting your own name as a reference and email us to say you have done this, or send a cheque payable to Bedford Counselling Centre to Bedford Counselling and Training, 71 Gwyn Street, Bedfordshire MK40 1HH.

Why do this workshop?
We experience anxiety and fear every day of our lives-whether it is about work, our health and safety and/or our relationships with others. Anxiety and generalised anxiety disorder almost always tops the chart of most browsed mental health subjects. This symposium will give you an in depth understanding of anxiety and its roots in guilt, hate and fear of castration. In the therapeutic space of group and individual work you will be able to understand how you as a practitioner help people manage their anxiety and begin to heal.

Aims

  1. To understand what is anxiety –its function in normal and abnormal conditions. The effect of fear and anxiety on possibilities of growth and development.
  2. The psychodynamic lens: pre-oedipal and oedipal anxiety. Klein and Freud on anxiety.
  3. To discuss how and why we help clients become less anxious and more contained.

Process for symposium

There will be a speaker presentation on the history of and psychodynamic theories about anxiety as well as examples of its presentation in the consulting room. The presentation will be followed by participant discussion. The speaker will then

facilitate pair and group work so that participants can apply theory to their own clinical practice examples.

Target Audience

This symposium is suitable for qualified and training psychodynamic psychotherapists, counsellors and mental health practitioners. The primary theoretical focus will be psychodynamic, but practitioners of other modalities are welcome to attend as long as they have made themselves familiar with some of the pre-course reading.

Smita Rajput Kamble 

Smita is a psychoanalytic psychotherapist in private practice. She is a training supervisor at Bedford Counselling

Foundation. In the past, she was one of the faculty at WPF Therapy, London Bridge where she taught the Advanced Clinical and Theoretical Issues seminar to Year 3 and 4 psychodynamic psychotherapy trainees. She also conducts CPD activities within the psychodynamic community in London.

*Please note that this symposium may either be held at the University of Bedfordshire in Bedford or on Zoom, depending on the state of Covid 19 restrictions by March.


CONTACT US TODAY TO BOOK A PLACE:
TEL: 01234 219905 – EMAIL: enquiries@bcat-team.org.uk
Please email us if you are interested in receiving up to date information about our CPD programme, courses and conference and we will add you to our mailing list.

Meditative Method

Like a water lily, grounded, looking upwards

Meditative methods are as numerous as there are beliefs and approaches in this world. Most of them will expect that you can still yourself and concentrate on something to calm yourself. If this works for you-concentrating perhaps on a ray of light, or white light or a point on your forehead etc, start this way. Starting any way possible is a good step forward. Meditation has too many known benefits. Hypertension and many other diseases are known to become less problematic-blood pressure and heart rate fall considerably with meditation. Once you have learned to marshall/collect your thoughts, then try the method below:

The best method is to let thoughts pass by, without judging them. You are only an observer. You do not have to act on them. You can say to yourself ‘this is my thought’ but you don’t react. These thoughts might be alarming, disgusting, upsetting…triggering action…it does not matter. They must pass by like an assembly line – where you watch them but don’t exercise restraint or do anything to change them. After some time, gaps will occur. Like the glimpse of sky between clouds. A time will pass and there is no thought. These gaps are restful, the result of lack of judgment and manic pursuing of thoughts. It is the free space in which you will feel liberated, timeless. Savour the gaps. Enjoy them. They will pass and other thoughts will come – things to do, jobs to get back to.

Let thoughts come in now. It is alright now to go back. You have meditated, even if it is for a minute. You will not have to force yourself to make meditation a part of your routine anymore. Your body will like to go to that place again. You can do it anytime, anywhere. It will be an enjoyable restful activity.

At times, you may fall asleep. Some views suggest that it is not meditation of you fall asleep. I say that anything that helps you to go into a deep sleep is a good thing. Clearly, your mind and body needed it !