Friday, August 14, 2009

Black Holes

A friend pondering Jungian concepts of our dark sides developed an analogy of the black hole in our astronomical universe and its parallels with the black holes that can exist in our personal environments. Both have the destructive capacity to suck in everything in their path.


Not long ago, I wrote a paper on the Problem of Evil, and this black hole analogy brought to mind the ancient Sumerian/Babylonian mythology. This mythology saw chaos as the primary evil. Hesiod, around 700 BC, wrote that “Chaos was the oldest of the Gods—a shapeless mass who could not be described as there was no light by which it could be seen.” Offspring of Chaos and wife Nyx were Erebus (Darkness), Aether (Light) and Hemera (Day). From Ather and Hemera came Gaea (Earth) who created Uranus (Heaven). So Earth created Heaven--does that mean that Earth also created Hell?


This black hole, this shapeless devouring mass, is an interesting concept, probably because it ties in with the shadow side of our being, which we find difficult to acknowledge until it rises up and bites us. Winston Churchhill's description of depression as the "black dog" comes to mind.


One view from the field of addictions is that addiction, particularly the use of numbing drugs such as alcohol, cocaine, heroin,and food, can be seen as the driving hunger to fill the black hole within us, whether that black hole is seen as the need for love and acceptance, hunger for a spiritual ground, or the more macro view that addiction is a symptom of a culture that has lost its way. Alfred Adler would say that the answer is in “Social Interest.” Get out and be of use in the community, and stop with the navel gazing.


Negative space in art, is, in a sense, a black hole, a “nothingness” but it’s what defines the work. An artist once noted that, if you work from the negative space, you have to remain very focussed, that it is much harder than working from the positive objects. Music and sculpture both have their empty spaces, which are defining elements.


Where am I going with this? I don’t know—I'm still finding my way. One of the vital things is to become aware of the black holes, to find them by means of the behavior of objects around them. In other words, in order to locate the emptiness, one needs to study the “solids.” My friend discussed black holes as a vortex, sucking out energies, but the whole concept took on a larger life.


As I think about it, if I go back to the addictions model, addictions are the black hole, sucking out the life, so the vortex model fits there. The behavior of objects around is pretty easy--loss of family, friends, and self-respect as the whirlpool becomes tighter and deeper and the user's world consists of nothing but getting and using the anaesthetic.


The one big difference between black holes and addictions is that I have never heard of a black hole reversing, whereas it is possible to break free from addictions. An interesting visual is to see the whirlpool spitting out the good things!

Tuesday, June 2, 2009

Yoga and PTSD

Dangerous Moves
Is 'Yoga Therapy' an Oxymoron?
Tuesday, June 29th 1999 (Excerpt from the Village Voice Newspaper Via my TIR Newsletter)

"I was in triangle pose and experiencing a lot of sensation in my right hip," recalls yoga therapist Michael Lee. "I would have quit, but my yoga partner placed his hand on my chest and said to breathe. I began to shake and I started to get flashbacks of being eight years old, on the playground where I was beat up."

Some psychologists and yoga teachers are concerned that innovators like Lee, founder of Phoenix Rising Yoga Therapy, may be producing under trained therapists blithely chirping "the body has its own wisdom" while encouraging vulnerable clients to "open up." Especially at risk, they argue, are the people who may be most drawn to yoga therapy, like sufferers of post traumatic stress disorder (PTSD).

In India hatha yoga is practiced as a system of aligning oneself psychologically and spiritually— not just physically. Here, in contrast, yoga has been practiced mainly as physical exercise since its introduction a century ago. The growing dissatisfaction with traditional psychotherapy, however, has prompted American yogis to explore yoga's psychological power. Yoga-based therapies are proliferating, the most widespread being Lee's, created in 1987. Lee, whose company has trained roughly 800 yoga therapists, says, "The body has a knack of letting you into little pieces of yourself that years of talk therapy wouldn't get you into."

Because they express psychological distress with their bodies, trauma survivors "are strongly drawn to body-based modalities like yoga therapy," says Dr. Susan Shapiro, who lectures on PTSD at Manhattan Institute for Psychoanalysis.

Trauma is stored in the brain's primitive limbic system, which processes feelings and sensory input— but not language. The Vietnam vet startled by a lawn mower and the woman who retches when she smells the cologne worn by her childhood molester are being flooded with sensations triggered by traumatic memories stored in their limbic systems. The veteran may not realize his heart is pounding because the mower sounds like a machine gun; the woman may not even remember being sexually abused. During the original traumas they dissociated.

Dissociation protects us from an overwhelming experience of pain or terror. It's technically defined as the separation of one part of memory from another. As psychologists Jean L. Yates and William Nasby explain, "Dissociation is not forgetting— in forgetting, something is lost to a memory system through decay, whereas in dissociation the item is encoded but cannot be retrieved."

Hypnosis can override the code, according to Yates and Nasby. "[Hypnotized] patients seem to re-create the condition of memory at the time of encoding . . . a critical mass of excitatory linkages is made and . . . the patient's memory is flooded with the previously unavailable memories."

That's what happened to Lee, only he wasn't hypnotized— he was practicing yoga. "We're all walking storehouses of information," he believes. To access that storehouse, yoga therapy practitioners at Phoenix use supported yoga postures to bring clients to "the edge— where you know something is happening, but the sensation isn't so overwhelming that you want to run from it. We work there with focus and breath and see what comes up." Lee tells his staff "not to be alarmed if a client has a flashback. The body is a safe instrument to work with. It's not going to let you in too deep."

Shapiro disagrees. "It's not enough to say 'The body won't let you in too deep.' " In downward-dog, for example, the anus is exposed, which might bring up psychological trouble that a yoga therapist may not be prepared to handle. "Many have not been adequately trained in transference," Shapiro continues, "and the feelings between them and clients can become exceedingly intense."

Having used both yoga and psychotherapy to recover from PTSD induced by childhood sexual abuse, I thought a therapy that combined them sounded promising, despite Shapiro's reservations. When Lee offered me a session with yoga therapist Kathy Newton, I accepted.

First, Newton picked up my right leg by the heel. She slowly moved it toward my head in a gentle stretch, asking me to tell her when to stop. Next, she carried the leg to the left, stretching my right hip.

When she carried the leg to the right, it reminded me of my abuser pulling my legs apart. Newton noticed my quickening breath and asked whether I could stay with it. I tried but felt panicky until she put my leg down. When she began the same procedure with my left leg, I cut short the time spent with my legs apart. We concluded by talking about images and feelings the stretches had evoked.

Frankly, I found having my legs held apart closer to what Shapiro calls "retraumatization." According to Shapiro, "Many survivors will use whatever therapy they're doing to retraumatize themselves." Dr. Steven Knoblauch, who treats adults with PTSD, agrees, adding, "Survivors can be addicted to the calm after the storm of a violating or potentially violating situation."

When I raised these issues, Lee responded: "Phoenix Rising Yoga Therapy is not a substitute for psychotherapy. When evidence arises in a session that someone has suffered a severe trauma, the therapist must recognize his or her limitations and work with a qualified psychotherapist.

"Look, if the F.A.A. had been around when the Wright brothers were flying, they would've been grounded," Lee added. "The best we can do is learn from our colleagues and not duck when someone says, 'Hey, what's going on here?' "

What's going on here is what Sharon Gannon and David Life, directors of Jivamukti Yoga Center, wondered when a Phoenix therapist demonstrated there, with Lee observing.

"The student who volunteered had some deep issues," Gannon recalls. "In front of all these people she had a breakdown, and the person handling the workshop was fairly insensitive."

"Gave her a pat on the back and sent her into the audience," Life interjects.

"It was like, 'See, Phoenix Rising works, it gets people to open up and cry,' " Gannon says. "But all kinds of emotions can surface during asana practice. That's why it's so important to teach yoga along with sound advice based on Patanjali's Yoga Sutras, which is really a book of psychology."

Patanjali wrote the 196 Sanskrit sayings, or sutras, that form yoga's spiritual foundation several thousand years ago. "Unfortunately, most yoga teachers have never even opened the Yoga Sutras," Gannon sighs. "Yoga is a buzzword these days, so is therapy. Put the two together and, wow, you have a career. But most yoga teachers are not qualified to be teachers, much less therapists."

"I would recommend finding a good psychotherapist who likes yoga," adds Life. "Then, do yoga and go to the therapist. Don't try to find it all in one package."

Shapiro encourages PTSD patients to take yoga, although "it often takes a few years [of psychotherapy] before someone is ready to take a yoga class.

"Yoga is a great path for reclaiming your body," Shapiro adds. "You don't need anybody touching you. You don't have to trust someone else, so you can learn to trust yourself with your body. Also, survivors had to burst into another realm to survive. But they don't have a framework for that experience until they do some spiritual work. Yoga can provide that framework.'

Thursday, March 26, 2009

The Instant Fix

Walking home from the gym the other day, after a hard workout, I found myself really, really needing my second cup of coffee of the day. Not wanting, needing. Being a born navel-gazer, this sent me off into the realm of wants versus needs. Then, onto the cognitive behavioral path. Did I really need this coffee or was my mind sending me false messages? Followed, of course, by the final thought of the moment—all this for a lousy cup of coffee!


Lately, this “wants versus needs” translated as “to buy or not to buy” has been a topic on the minds of many as the economy nosedives and fear takes over. Separating want from need is not always as easy as the coffee. For a long time, as we rode the bandwagon of good jobs and wages, there was little thought. Many, particularly those born after the baby boomers, just bought , with little regard to the cost, with the assumption that the good times would go on forever. We brought up our children, Generation Y, with the expectation that they were entitled to the good life with little sacrifice.


In the workplace, the culture clash between those whose grandparents had lived the Great Depression, and Generation Y, created some interesting scenarios. There is no right or wrong, just the difference in philosophy behind those who work hard, probably give too much to the job and save their money, versus youth who see balance as all important and the job as something that can be easily replaced and hence not to be given much respect.


We used all these material purchases to fulfill what has been defined as “retail therapy.” Buying would fill all our needs. Sad? Lonely? Anxious? Need a pick-me-up? Go shopping! It didn’t work, but we kept on trying. Shopping became our vehicle to express ourselves, to explore who we really are. For some, it tipped over into a shopping addiction, where it was no longer a choice, but a driving necessity. This cultural obsession with an instant fix feeds into other addiction problems as well.


Our culture continues to push the creed of consumerism--the way to happiness is though things. It isn’t. Studies have shown that, as our economy grew, our sense of individual and social well-being has dropped sharply. See “The High Price of Materialism” by Hugh Kasser. AA says it well: “One is too many and a thousand is never enough.”


The answers are similar to those themes well known in the field of addiction. There can be no true peace and satisfaction without developing internal strengths. The search needs to be inside us. You can call it spirituality, faith, a philosophy of life, or whatever. We all find it in our own way. Joy is in the small things around us every day that we miss because we are worrying about tomorrow.


This time of pulling back can be very valuable as research time into what is really important—what we truly need compared to what we think we want.

Thursday, March 12, 2009

Watching the Mind - Working with Cravings

There is a hopeful new technique making the rounds of therapy recently. It is simple and easy to remember. It was originally formulated at the UCLA School of Medicine by Dr. Jeffrey Schwartz and colleagues for the treatment of Obsessive Compulsive Disorder. Dr. Gabor Maté, in his new book “In the Realm of the Hungry Ghost”, reports positive results with addictions using this approach, called by UCLA the”Four-Step Self Treatment Method.” It has good, solid theory behind it. Read Dr. Maté’s book for more.


There are four steps: re-label, re-attribute, re-focus, and re-value. Dr. Maté has added a fifth: re-create.


Re-label: Conscious awareness. See yourself as a spectator and watch your brain telling you that you need this substance or this activity. This is the step that takes practice, to break the cycle of immediately and unthinkingly complying with the order.


Re-attribute: “This is my brain sending me false messages. I don’t really need this. I may want it but I don’t need it” The brain doesn’t give up easily. The urges will continue, albeit with less intensity and less often as you work with the method.


Re-Focus: Cravings, like waves, do pass. Develop a list of distractions to get you through the next fifteen or twenty minutes. Exercise is good; crossword puzzles or Sudoku are handy; floors can always use a sweep or a vacuum—you get the idea. Whatever does not involve you in an addictive activity.


Re-value: Your brain has been telling you that this urge is the most important thing in the world. What has satisfying this urge done to your life? Be specific. Write it down and keep adding to it. Perhaps a small notebook you can carry with you. Dr. Jeffrey Schwartz says that the more thoroughly you examine the price you have paid, the more quickly the behavior will reduce. This is not about judging yourself. Be compassionate.


Re-create: As Dr. Maté puts it “Life, until now, has created you.” Now, take the time and thought to consider what values, what talents, what capabilities await you in your new life. Again, write about this, and take your time. Surprising things may result. Creativity may be what is missing. Dr. Maté has another great line in his book. (Actually, he has many great lines in the book, but this one resonated with me.) In many cases, substances and compulsive behaviors act to fill a great aching hole. Dr. Maté noted “A void I’ll do anything to avoid.”


This simple technique will need to be done many times, until it becomes as ingrained as the patterns of addiction were. Laughter helps.


The study of neurology has come a long way in the last few years. It is now clear that we can change some of the brain’s wiring by sheer persistence. That old cliché “You can’t teach an old dog new tricks” is wrong. I hope to discuss some of the more recent, and exciting discoveries in more detail in future blogs.