Both Bessel van der Kolk & DSM-psychiatry miss a trick (the same one Freud did).
“It’s actually this inability to kick start cognition that allows the ‘trauma’ to persist.”
In a recent exchange on an email grouping, Professor Kolk’s video, at https://www.youtube.com/watch?v=53RX2ESIqsM , was mentioned. It reminded me of my visit to Boston in 1988. In the video the professor explains how trauma makes the frontal lobes “go off-line” — that is to say the sufferer can no longer think straight. One of my psychiatric colleagues, in defending the professor, stated that with traumatised people — “Cognitive approaches miss the point”, which is, generally quite correct.
I explain why. Indeed as it happens, I told Bessel the answer to this challenging question way back in 1988, and, somewhat surprisingly, it’s the same answer I still tell all my customers today, including, now, those with psychotic symptoms. The beleaguered child says “this isn’t happening to me” — so in adult life, they are unable, most of them, to say “this has stopped happening to me”, which it has. Only when they can, does it stop, and then their frontal lobes can get back to doing what they need to do — thinking things through.
Back then Bessel was too busy scanning brains to hear, and even then, like so many today, it all sounded far too simplistic. But since it works, both with psychosis, psychopathy and all manner of emotional disorders (including suicide), a little simplification is in order. And, since it entails “believing in ‘intent’”, which is the least simple notion in the entire galaxy, some simplifying should be welcomed.
Now if you believe, as too many do, in a Clock Work Universe, then you scrabble around among the molecules for a spanner or drug — if, however, like me (and the entire legal profession), you celebrate choice, intent, self-decidings or whatever — then the question changes, subtly, but decisively. Once you accept ‘intent’ as real, something that live healthy people use every minute, then when their frontal lobes go blank this is THE lesion, the one thing which cripples. Thus — my view of all mental disorders is misplaced/distorted ‘intent’ — not terribly fashionable, I have to admit, but beautifully simple. Heart disease is when your heart won’t let you do what you want, and mind disease does the same.
That children instigate ‘denial’, dissociation, “this isn’t happening to me” goes without demur. They are using a mental ‘weapon’ against overwhelming physical force — the traumatiser is always bigger than them, that’s part of being an infant. They turn off their contact with reality — psychotic symptoms most obviously, lesser mental diseases, less so — but this ‘not-thinking’, this frontal lobe ‘going off-line’ is there in every case — it’s how you can tell if your mind is disabled.
This has three crippling handicaps for the standard medical approach. Firstly, since they are not telling themselves what’s really gone wrong — to do so re-enacts the original trauma, and vitiates their ‘denial’ protection — sufferers will not volunteer this info to their doctor — oh no, they’d rather die, which they sometimes do. In my unique pivotal case, I had been in general practice for 19 years, and had known the traumatiser (her father) before he died. The sufferer, a 40 year old, then blurted out the episode when he had appeared to threaten her life with a hatchet, aged 6. Magic.
She trusted me enough to let me into her most lethally dangerous secret. (In 1988 I showed Bessel a video of her doing this.) And this is the second handicap — how many doctors or therapists cultivate a strong enough, trustworthy enough bond to protect the damaged child in front of them long enough so that the sufferer can let down their guard far enough to adopt a more realistic, more adult, response. My commonest question is “how old are you?” The ‘homework’ I give them, is to recite, three times a day before meals “I’m 52, not 2” or similar. [I even had one repeating “I’m 82, not 2”, and it worked.]
Not only must this bond be strong — only powerful people would have any chance against the outsized abuser, but being more powerful than the abuser, they are thereby also more dangerous. More, the therapist must have 100% confidence that this toxic memory is the sole cause of frontal lobes going off-line. Where none of these three factors operates in full, all the time, 100%, then indeed, and inevitably, “Cognitive approaches miss the point” , as my psychiatric friend so rightly pointed out. However, unbeknownst to the majority of my colleagues — in the right hands this is stunning — tee hee. Even, to my delight, with psychotic symptoms.
So in a nutshell, Bessel and Sigmund (& DSM) both underplay ‘intent’, which turns out to be the only possible key to psychiatric success. I use my own ‘intent’, WITH CONSENT, to persuade the sufferer to re-programme their childhood weapons, rid themselves of their toxic memories, which they don’t even want to bring into consciousness, (they are generally too fearful) — and they then blossom. And it works, blissfully. At least that’s my story, though given the ascendency of lunatic governments, tick-box managerialism, wonky GMCs, the hegemony of DSM, then the chances of it seeing the light of day anytime soon, shrivel.
Dr Bob Johnson : Tuesday, 28 February 2017 : www.DrBobJohnson.org
Note: DSM is Diagnostic And Statistical Manual Of Mental Disorders (DSM-5); GMC is the body which removes UK doctors for malpractice; lunatic governments are those that don’t think straight about ‘austerity’ which hasn’t worked for 10 years, and entails we live in a plutocracy, and shouldn’t/needn’t [we all know where the money is, and where it isn’t].