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“The first step, perhaps, is to take stock. Who are you? When you buy a house and prepare to live in it, you hire an inspector to list all its faults-as it is, in reality, now, not as you wish it could be. You’ll even pay him for the bad news.  You need to know. You need to discover the home’s hidden flaws. You need to know whether they are cosmetic imperfections or structural inadequacies. You need to know because you can’t fix something if you don’t know it’s broken-and you’re broken. You need an inspector. The internal critic-it could play the role, if you could get it on track; if you and it could cooperate. It could help you take stock. But you must walk through your psychological house with it and listen judiciously to what it says. Maybe you’re a handy-man’s dream a real fixer-upper. How can you start your renovations without being demoralized, even crushed, by your internal critic’s lengthy and painful report of your inadequacies?

Here’s a hint. The future is like the past. But there’s a crucial difference. The past is fixed, but the future-it could be better.”

“The engine in a rocket ship does not fire without a small spark first. We all need small sparks, small accomplishments in our lives to fuel the big ones. Think of your small accomplishments as kindling. When you want a bonfire, you don’t start by lighting a big log. you collect some witch’s hair – a small pile of hay or some dry, dead grass.  You light that, and then add small sticks and bigger sticks before you feed your tree stump into the blaze. Because it’s the small sparks, which start small fires, that eventually build enough heat to burn the whole forest down.”

I see lots of people who beat up on themselves for procrastinating while I slave feverishly away for usually the same result. So this, from The Four Hour Work week by Timothy Ferriss, resonated:

“Parkinson’s Law dictates that a task will swell in (perceived) importance and complexity in relation to the time allotted for its completion. It is the magic of the imminent deadline. If I give you 24 hours to complete a project, the time pressure forces you to focus on execution, and you have no choice but to do only the bare essentials. If I give you a week to complete the same task, it’s six days of making a mountain out of a molehill. If I give you two months, God forbid, it becomes a mental monster. The end product of the shorter deadline is almost inevitably of equal or higher quality due to greater focus.”

 

Sometimes, when people lose a limb, they still experience, sometimes in a painful or bothersome way, sensations in the missing limb.

 

In a similar way, aspects of the person who goes through trauma may be missing, cut off, from their conscious awareness, but still intrude upon the person at times. It’s as if there is a longing for wholeness; those missing aspects want to connect to the whole person, but are not able to in the same way as before. If they can’t find their way back in peacefully, they might crash into the traumatized person’s life or experience in some disturbing form, such as flashbacks, self-mutilation, compulsive sexual acting out, or other things we in the psychotherapy world refer to as “symptoms.” The cut off pieces might be sensations, perceptions, memories, feelings, or aspects of their “personality.”

 

“Illness is not the same as disease. Illness is the human response to disease. It refers to the person’s subjective experience of how they feel but does not assume any underlying pathology. Illness can be either organic or psychological. A person can have a disease but not be ill. For example, a girl with epilepsy has a disease, but if she is not having seizures and the epilepsy is asymptomatic she is not ill. A person with a psychosomatic disorder, on the other hand, is ill but does not necessarily have a disease.”

From “Is it all in Your Head?” by Suzanne O’Sullivan, MD

I continue to read the book “The Man Who Couldn’t Stop,” by David Adam, and found the information about serotonin and OCD to be quite hopeful.

“The brain needs serotonin because, as complex and marvelous as it is, most of its neurons can’t communicate directly with each other. At the business end of these neurons there lies a tiny gap that separates them from their neighbours. For neuron A to pass a signal to neuron B it needs serotonin. Spare serotonin sloshing around in the gaps is reclaimed (taken up) by the neurons for when they will need it again. That is about all we need to know for sure about how serotonin works in the OCD brain. Much of the rest of the so-called serotonin hypothesis for OCD is based on some reverse engineering. The logic goes like this: The SSRI drugs keep levels of serotonin in the free space between the cells higher than they would be otherwise. The drugs inhibit the uptake. This seems to relieve OCD symptoms, at least in some people. Therefore, the reverse engineering says, OCD must be caused by abnormally low serotonin levels.”

I found this interesting. A succinct way to understand OCD.

“Psychologists have identified three types of dysfunctional belief important in the development of OCD. The first is an inflated sense of threat and personal responsibility. The second is perfectionism and intolerance of uncertainty. The third is a belief in the over-importance of thoughts and the need to control them. To be clear, to have one of these dysfunctional beliefs is not to have OCD, but it does increase the chance that someone will develop OCD, because they will incorrectly process the intrusive thoughts that are common to most people.”

From “The Man Who Couldn’t Stop,” by David Adam

In my perpetual pursuit of trying to understand depression, this text taken from “The Untethered Soul,” by Michael A. Singer, resonated, made sense to me.

If anything happens that challenges how you view things, you fight. You defend. You rationalize. You get frustrated and angry over simple little things. This is the result of being unable to fit what’s actually happening into your model of reality. If you want to go beyond your model, you have to take the risk of not believing in it. If your mental model is bothering you, it’s because it doesn’t incorporate reality. Your choice is to either resist reality or go beyond the limits of your model.

 In order to truly go beyond your model, you must first understand why you built it. The easiest way to understand this is to study what happens when the model doesn’t work. Have you ever built your whole world on a model of life predicated upon another person’s behavior or the permanence of a relationship? If so, have you ever had the foundation pulled out from under you? Somebody leaves you. Somebody dies.. Something goes wrong. Something shakes your model to the core. When this happens, your entire view of who you believe you are, including your relationship to everyone and everything around you, begins to fall apart. You panic and do everything you can to hold it together. You beg, fight, and struggle to try to keep your world from collapsing.

 Once you’ve had an experience like that, and most people have, you realize that the model you’ve built is tenuous, at best. The entire thing can fall apart. The whole model and all that it’s built on, including your entire view of yourself and everything else, can start to crumble. What you experience when this happens is one of the most important learning experiences of your life. You come face-to-face with what made you build the model. The level of discomfort and disorientation you experience is frightening. You struggle just to get back some semblance of normal perception. What you are really doing is trying to pull the mental model back around you so that you can settle down into your familiar mental setting.

 But our whole world doesn’t have to fall apart in order for us to see what we’re doing in there. We are constantly trying to hold it all together. If you really want to see why you do things, then don’t do them and see what happens. Let’s say you’re a smoker. If you decide to stop smoking, you quickly confront the urges that cause you to smoke. These urges are the reason you smoke. They are the outermost layer of cause. If you can sit through these urges, you will see what caused them. If you can get comfortable with what you see, you will face the next layer of causation, and so on, layer upon layer. Likewise, there’s a reason why you dress the way you do. If you want to see why you care so much about what you wear and what your hair is like, then just don’t do it one day. Wake up in the morning and go somewhere disheveled with your hair a mess, and see what happens to you when you don’t do the things that make you comfortable. What you’ll see is why you’re doing them.

 You are constantly trying to stay within your comfort zone. You struggle to keep people, places, and things in a manner that supports your model. If they start to go any other way, you get uncomfortable. Your mind then becomes active telling you how to get things back the way you need them to be. The moment somebody starts behaving in a way that is outside your expectations, your mind starts talking. It says, “What should I do about this? I can’t just ignore what he did. I could confront him directly or ask someone else to talk to him.” Your mind is telling you to fix it. And it doesn’t really matter what you end up doing, it’s all about getting back within your comfort zone. This zone is finite. All attempts to stay within it keep you finite. Going beyond always means letting go of the effort to keep things within your defined limits.

So there are two ways you can live: you can devote your life to staying in your comfort zone, or you can work on your freedom. In other words, you can devote you whole life to the process of making sure everything fits within your limited model, or you can devote your life to freeing yourself from the limits of your model.

In trying to help depressed clients, I have needed to dig deeper into energy and spirituality. These clients are pushing me to learn more, to be open to more possibilities. This has lead me to listen and read more by Deepak Chopra. What a wonderful, brilliant man and mind.

I was moved by this quote: “You should be perpetually surprised that you exist and this should put you in a state of joy.”

The miracle of our existence….if we could let go of judgment and expectations and live in awe of life, we could let go of many of the things that make us feel failure and disappointment.

Quite often I see people with chronic pain. Some clients have no idea what caused the pain in the first place, others remember an initial injury. Either way Visceral manipulation seems to offer some hope in conjunction with hypnotherapy.

Visceral Manipulation in the Chronic Pain Patient

By Janice Webber, BScPT, Janice Webber Physiotherapy Services

Chronic pain patients typically show altered patterns of breathing such as apical with little to no lateral costal expansion. When assessed via capnography they often present with low CO2 values and have a difficult time in recovery of their breathing with stressed such as hyperventilation and talking.

They also show high autonomic nervous system levels such as sympathetic arousal of sweaty palms, increased pilomotor response, and easily irritated skin showing erythema. The vagal tone of the body has become altered.

The vagus nerve as part of the autonomic nervous system supplies the internal organs of the body. The internal organs are covered by a thin connective tissue membrane system which act as an interconnecting link from one organ to another. The internal organs are suspended from the diaphragm via this connective tissue membrane. The organs of the liver and stomach have direct connection to the diaphragm. The serous fluid with runs between the layers of connective tissue in the abdomen becomes more viscous after trauma such as motor vehicle accidents and surgery. As this fluid thickens, adhesions are formed. The adhesions restrict the movement of the organs in the abdomen. The organs such as the liver, stomach, duodenum, and large intestine can directly restrict the movement of the diaphragm. These organs are suspended are linked to the diaphragm via the connective tissue membrane system.

Visceral Manipulation is a form of manual therapy that addresses the anatomical and energetic relationships of the body’s organs. It is organ-specific fascial mobilization. Just like the more familiar joints of the body, our organs are designed to move against neighboring tissues; they slide and glide, and have normal range of motion. When a range of motion becomes compromised; whether on account of illness, injury, surgery or trauma; the body gets stuck and is forced to move around the restriction. In time, this creates a domino-like effect as the rest of the body compensates and shortens while trying to protect the underlying fixation.

Like a big snag in a sweater, the strain incrementally spreads outward across the very fabric of the body. Visceral restrictions are often the unexamined root of physical pain, as their musculoskeletal attachments and influences are structurally significant.

You may ask, “Why would you ever need your visceral organs manipulated?” That is a good question, which I will try to answer. There are definite links between somatic structures, such as the muscles and joints, the sympathetic nervous system, which is the “flight or fight response”, the visceral organs, spinal cord and the brain. An example is the sinuvertebral nerve, which innervates the intervertebral disk, and has direct connections with the sympathetic nervous system, which innervates the visceral organs. The sinuvertebral nerves and sympathetic nervous system are linked to the spinal cord which of course has connections with the brain. In this way someone with chronic pain can have irritations and facilitated areas not only in the musculoskeletal system (including joints, muscles, fascia, and disks) but also the visceral organs (including the liver, stomach, gallbladder, intestines and adrenal glands), the peripheral nervous system, the sympathetic nervous system and even the spinal cord and brain.

I think that attempting to discover each patient’s primary, or at least their least secondary problem or lesion is ultimately what we would all like to do. I feel if we are doing this, then we have a chance to be working on where the problem is located and subsequently giving the patient a better result.

With my own training, which is ongoing, I am able to many times locate the primary physical restriction, or primary lesion. I do this with a technique, Visceral Listening, which was developed by Jean-Pierre Barral, DO. This technique involves listening to the patient’s body with your palpating hand and feeling for the line of tension in the body. It is not a metaphysical type sensation. It is a direct physical line of pull that with instruction and much practice, is something that anyone can learn. In this way the practitioner can allow the body to reveal where the problems are located and which ones are more primary. The osteopaths have some sayings that I find useful and they are, ” Only the tissues know” and “Let the body speak”. The reason I find this type of evaluation so effective is that the body is much too complicated to “figure it out” with our heads; especially with chronic problems that have resisted treatment. But I have found that the story is all there in the patient’s body if you allow yourself to listen to it.

A final thought: I believe that each patient has an inherent ability to heal and function in good health. We don’t “fix” the patient as much as we take away the reason their body is not functioning well. Then, their body actually does the healing. I think this shows respect for each individual’s body and soul, and allows a more complete healing. This is a philosophy, based in osteopathy that I have found useful in my daily practice as a physical therapist.