Integrative Trauma Therapy

What You Can Learn from 2,500 Years of Buddhist Wisdom

Arguably the most important figure in Western psychology was Sigmund Freud, who developed his psychoanalytic theory of the mind about 130 years ago. And arguably the most important figure in Eastern psychology was a man we call the Buddha, who lived and taught in Northern India around 2,400 years before that. Let’s think about that for a moment. Over two millennia before Freud saw his first patient, the Buddha and his followers had created a rich, sophisticated theory of the mind and how it worked.

Long before Freud’s ideas about neuroses and how to cure them, Buddhist psychology gave us a step-by-step guide to freeing ourselves from dukkha, which is the Pali (the language of the Buddha) word for suffering. As the Buddha himself said: ‘I teach one thing and one thing only – dukkha and the end of dukkha.’

It’s important to note at this point that you don’t have to be a Buddhist to find these ideas helpful. In fact, you don’t need to have any interest in Buddhism at all! One of the reasons I am so enamoured with Buddhism is that it’s very different from religions like Judaism or Catholicism. For starters, the Buddha was just a human being, not a god. And although many Buddhists do believe in transcendent ideas like karma, heaven, hell and reincarnation, I don’t think that was the Buddha’s point, really. It was more that he existed in a time when these ideas were normal and universally accepted, like we believe in gravity, or the nutritional benefit of vitamins. They were the zeitgeist of his age.

As I have written before in these posts, if I had to name my particular brand of spirituality it would be to call myself a Buddhist atheist. I believe in Buddhism. I think it’s a wonderful theoretical framework for understanding the mind – and especially what can go wrong with it. I also believe that the Buddha was a real person, a great psychologist, teacher and healer, like Jesus. But I don’t believe in heaven and hell, or reincarnation, or any of the more mystical, religious stuff. If you do believe in those things, of course that’s absolutely fine – I’m not saying I am right, it’s just how I was raised and educated to perceive the world.

How Buddhist psychology can help you

Most of my readers are either struggling with mental-health problems, or trying to help people with these problems. And whether you are a client, therapist or concerned family member, there is so much in Buddhism you might find helpful. Let’s circle back to that idea of dukkha – like all Pali words, there is debate about the exact English translation, but suffering is close enough. In his Four Noble Truths, the Buddha taught (not wrote, as his was a time before books and paper) that to live a human life is inherently painful. Pain is unavoidable, for a whole host of reasons, but one of the simplest is that we are all mortal. We will all age, get sick and eventually die. This is, of course, the hardest truth we all have to face – but facing it is both important and healthy, as once we accept this idea we can get on with maximising our brief but wondrous existence on this planet.

So we can’t avoid pain. But the Buddha then explained that we can avoid suffering, because most suffering is human-made. He gave the famous example of twin arrows – the first arrow is something painful, like injuring your knee playing football. This just hurts – it’s called ‘the pain of pain’ – so there’s not much we can do about that except to rest it, use ice, see a physio, and so on. But what the human mind does is then create more pain by trying to avoid or push away the original pain. We think, ‘Why is this always happening to me? I’m so unlucky! God, I hate my life,’ or ‘I can’t stand this pain, it’s unbearable! These painkillers aren’t touching the sides, let me go back to the doctor and get some oxycontin, quick.’

In the first example, we now add feelings of frustration, anger and bitterness to the physical pain. In the second, we are desperately trying to avoid the pain at all costs, which can be a slippery slope to addiction – especially with opioids. In the Buddha’s teaching, it’s like we then shoot ourselves with a second arrow. And so physical pain becomes emotional suffering.

If not the arrow, then what?

Another wonderful thing about Buddhism is the emphasis on developing positive mental states, which anyone can do with enough persistence and determined effort. These include metta (loving-kindness), karuna (compassion), mudita (sympathetic joy) and upekkha (equanimity). These four ‘sublime states’ build on each other, offering a profound sense of peace, calm and protection from the inevitable pain of life. If you would like to know more, I strongly recommend the wonderful Sharon Salzberg’s classic book, Lovingkindness: The Revolutionary Art of Happiness. Sharon is a world-leading expert on metta and how to develop it – it’s her USP.

She explains that, instead of shooting ourselves with that second arrow whenever life hurts or disappoints us, we can learn to treat ourselves kindly, patiently and warmly. This is like a soothing balm for the first-arrow wound, which helps it heal. Of course, this is not easy! Take it from a long-term meditator and student of Buddhism. Developing these beneficial mental states is not a simple thing, or I wouldn’t have to meditate every day.

But it is possible. And this is another great gift from that remarkable teacher 2,500 years ago – he gave us concrete tools and strategies we could all use – monastic or lay Buddhist, Christian or atheist – to transform our mind. Two of the (deceptively) simplest of these tools are developing mindfulness and metta, so here are two of my Insight Timer practices for doing just that:

I hope you find them helpful – and wish you ever-increasing peace and happiness as you follow your own unique path to healing, whatever that may be. And this is my last post before Christmas, so wishing you all a wonderful holiday season. Rest, recuperate, recharge and I will be in touch in the new year.

Love,

Dan ❤️

 
 

Do You Struggle to Accept Kindness? How to Let it into Your Heart

What do you do when someone offers you a compliment? How are you with praise, appreciation and expressions of pride? I hope you are able to receive these offers of love and validation with grace, taking them into your heart so they nourish and replenish your spirit. But I suspect that, for many of you, it’s not so simple. You may feel a little embarrassed and bat them away: ‘Oh, that’s nice of you, but anyone could have done it.’

You may even squirm, finding praise deeply uncomfortable. I have some clients who actually wince when I say something nice to them! This confused me for a long time, until we addressed the problem directly and I began to understand why it’s so hard for some of us to take in the good. Here are two of the things my clients taught me about why compliments and praise can evoke such negative reactions.

It jars with a critical sense of self

Sadly, many of my clients have a highly negative sense of self. They think they are somehow defective, dislikeable or in some other way uniquely weird, different or lesser beings. This has been hard-wired into their brains through repetition, over many years. They have spent so long thinking critically and negatively about themselves that these ways of thinking have developed quick, direct neural pathways – this makes it habitual and all too easy to think they are stupid, weak or pathetic. Heartbreaking but true.

So when I tell them how proud I am of them for managing a tough homework task like standing up to their verbally abusive boss, or finally saying no to their boundary-disrespecting family, I am offering them what’s known as a ‘corrective emotional experience’ – something unfamiliar and the opposite of what they are used to. Because many of my clients were never praised or lifted up as children. They were attacked, shot down and invalidated, over and over again. So parts of them learned to believe these unkind, untrue messages, until those parts held beliefs that they were stupid, weak or pathetic.

For these people, my offer of love and respect has nowhere to land. It doesn’t compute in their brains. So I have to find more creative ways of offering it, perhaps titrating my level of warmth and validation so it is just enough, just the right amount and can sneak through their defences, allowing just a little warmth or the unfamiliar sense of being seen and accepted for who they are, which they so badly need but struggle to take in.

trauma makes them suspicious

People who experience a great deal of trauma in their childhoods develop protective parts of themselves which are hypervigilant, wary and mistrustful. They have good reason to be this way – caregivers hurt, abused and betrayed them, so it was highly adaptive to be mistrustful around these people. I always say that if you are growing up in a dangerous, hurtful, threatening environment, it’s a great idea to be mistrustful. Thank god for those protective parts, because they probably kept my clients as safe as they could have been, despite the verbal, emotional and sometimes physical grenades that were lobbed at them on a daily basis.

Unfortunately, these parts can also make my work tricky, because developing ‘earned secure attachment’ is a key healing ingredient in therapy. It’s also a fundamental part of the integrative trauma therapy approach I have developed, because all the research shows that the relationship between therapist and client is the most important part of any effective therapy. These protectors make connecting with my clients tricky, so a lot of patient, painstaking work is necessary to help them see that I have no intention of hurting or taking advantage of them, like their caregivers did.

The brilliant Dr Janina Fisher, a trailblazer in the trauma-therapy field, once said that if you have been profoundly hurt by those closest to you, all the things we therapists think are helpful – trust, connection, feeling either positive or negative emotions, focusing on your breath or becoming mindful of somatic symptoms – feel threatening and unsafe. So when I tell someone, ‘I know you worry that everyone finds you weird and annoying. But you seem like a really nice, kind person to me,’ those protectors scent danger and can get spiky, dismissive or shutdown in return. I’m trying to offer an – honest, heartfelt – corrective emotional experience and it makes them angry, passive-aggressive or dissociated and numb. Not ideal.

The practice: Taking in treasure

Another thing I learned from my clients is a practice I developed to help with this very problem. It’s called The Treasure Chest and you can listen to it on Insight Timer by clicking the button below. This offers a concrete strategy to help you stop pushing away praise, compliments or other good things that come your way. Because these are little pieces of treasure. A kind word or warm comment can be deeply healing, if you learn to take them in.

An accumulation of these small offerings of kindness will, in time, help those protective parts relax. And whether you are at the milder or more severe end of the trauma spectrum, learning to tell a different story about yourself is crucial. How does it serve you to tell that critical, self-denigrating narrative, over and over? Far better to make the story of you something kind, compassionate and understanding. And taking in these little pieces of treasure will help you do that, because other people – especially those who know and love you – see the real you. Flawed and messy, like all humans, but also unique and wonderful, in so many ways.

I hope the practice helps – my clients seem to love it, so I very much hope you do too.

Love,

Dan ❤️

 
 

How to Develop a Compassionate Mind

How do you feel about the person you see in the mirror? Do you like them, love them – or loathe them? Are you kind and compassionate to yourself, on a consistent basis, or do you treat yourself harshly, jumping on every perceived flaw and failing? If you’re like most of my clients, very sadly you are probably more prone to harshness than healthy self-appreciation. And if that’s true, how do you go about changing it? Is it even possible to develop a kinder, more compassionate way of relating to yourself?

These thoughts have been uppermost in my mind recently, as I research the chapter on self-compassion in my new book. As well as bringing in all the techniques and ways of thinking I have used with hundreds of clients, I am re-reading some brilliant psychology books and drawing on the wisdom and richness of leading figures in the field. As part of this highly enjoyable research I just re-read The Compassionate Mind, by Professor Paul Gilbert. It’s a brilliant book and I strongly recommend reading it, if you haven’t already.

Prof Gilbert is the founder of compassion-focused therapy, a warm, wise approach that combines the best of Western psychology with the 2,500-year-old healing methods of Buddhism, especially the Dalai Lama’s Tibetan school. In Buddhism, compassion is just one of a number of positive mental states that can be generated, along with metta (loving-kindness) and equanimity (having a sense of resilience and balance). This idea, that these are skills which can be learned and then developed over time, is such a positive, hopeful one. It helps us all remember that compassion – for yourself and others – is always accessible, if you learn to mine the rich seams of your heart and mind.

Old brain vs new brain

Prof Gilbert draws on evolutionary psychology to explain that one reason we end up so self-critical, depressed or anxious is because we all struggle with an old vs new brain battle inside our skulls. Your old brain is ‘subcortical’ – structures that are not dissimilar from a lizard’s, or cat’s brain. The new brain is your cortical layer, which is uniquely well-developed in humans. As I wrote about in my last post, much of the world’s current volatility can be explained by what Prof Gilbert calls old-brain emotions and drives being implemented by new-brain capabilities.

For example, if you feel jealous rage at some guy speaking to your girlfriend, that’s old-brain stuff – powerful, territorial, protect-what’s-mine emotions and drives. If you then go on Facebook, find out the guy has a small business and leave a bunch of one-star Google reviews, that’s your complex new-brain capabilities doing the old brain’s dirty work!

But we can also use all the wonderful skills and capabilities of your new brain to do what Prof Gilbert calls ‘compassionate mind training’. Because your miraculous, sophisticated, high-powered cortical brain also has seeds of kindness, altruism, love, prosocial behaviour and compassion, which can be nurtured so they grow and become ways of thinking and feeling you can use all the time, especially when you need them most.

Compassion in action

Let’s take another example. Let’s say you get some bad news, like hearing a beloved old friend has a life-threatening illness. It comes out of the blue and is a real shock – this is a young, healthy guy so you feel like a rug has been pulled out from under you. And you’re feeling some mixture of sad, upset, shocked and anxious about his chances of getting well again. If you have been developing a compassionate mind, you might pause and do some deep, calming breathing. You could mindfully scan your body and notice what you’re feeling.

You could then gently place a hand over your heart, feeling the soothing, supportive touch. And then think kind, compassionate thoughts like, ‘I really feel your suffering right now – this is hard, isn’t it? And that’s totally understandable, you really love your friend and are worried about him, of course. Just let yourself feel whatever you are feeling right now, that’s OK – but know that you’re not alone. I’m here, I care about you – and I’ll help you get through this.’

And using the power of your compassionate mind, you may just notice yourself feeling a little calmer, a bit steadier and more grounded. Those painful, contracted feelings may soften a little. Soothing brain chemicals like endorphins and oxytocin might start flowing into your bloodstream. Tight muscles may start to relax. These are all science-backed benefits of practising self-compassion in this way. And then, of course, you would be much better resourced to call your friend and offer him love and support in his hour of need. Compassion for you leads to greater compassion for him.

I hope you find that helpful. Self-compassion is such a wonderful, healing skill that it’s a key strand of my integrative trauma therapy approach. And I have developed many self-compassion practices for my Insight Timer collection, which will help you develop it. The Compassionate Friend Meditation is one of my favourites, so do click the button below if you’d like to practice now.

Love,

Dan ❤️

 
 

What is My Unique New Approach: Integrative Trauma Therapy?

It’s hard to believe, but it is 30 years since I started my first counselling training back in 1994. It was then a long and winding road to start practising, until I finally opened my private practice around 15 years ago. That first training was in a transpersonal, parts-based model called psychosysnthesis. I loved it and had an incredible time on the highly experiential three-year training, but the transpersonal focus wasn’t such a good fit for me and my more scientific worldview.

In the gap between doing that first training and starting to practice as a psychotherapist, after a series of underwhelming jobs I began working as a sub-editor and then a freelance health journalist for 10 years – writing for various newspapers, magazines and websites based in the UK and around the world. I see that decade as an invaluable part of my therapy training, because it helped me understand how to evaluate research and introduced me to evidence-based treatments for physical and mental health. I had the great fortune of interviewing world-leading experts in everything from psychiatry to cardiology, osteopathy to holistic approaches to health. It was fascinating and my hungry mind devoured all the new knowledge and ideas. That 10 years also taught me to write, which has proven very helpful for posts like this and the book I am currently working on.

My new treatment model

As a mental-health professional, I have always sought new approaches to psychotherapy, as well as grappling with how best to put them all together. In a by-no-means conclusive list I have trained extensively in cognitive behaviour therapy (CBT), compassion-focused therapy (CFT), schema therapy and internal family systems (IFS); as well as learning Janina Fisher’s excellent trauma-informed stabilisation treatment (TIST), psychosynthesis, integrative psychotherapy, polyvagal theory, mindful self-compassion (MSC), mindfulness-based cognitive therapy (MBCT) and Buddhist psychology.

If I’m honest, one of the hardest aspects of this journey of discovery was figuring out how to fit all these models together – it was like a puzzle with lots of parts, some of which fit seamlessly while others clashed in some ways. But I’m happy to say I have finally figured it out. This has been made possible, largely, because I have been writing a book on an integrative approach to healing childhood trauma. Nothing helps you clarify your thinking like writing a book – it really helps you figure out what you believe and why.

My new model is called integrative trauma therapy (ITT), because that neatly sums up everything I believe and am passionate about. It’s based on the three phases of trauma therapy, which I have found to be the best structure for any therapy I offer my clients, especially because most of my clients have small t or Big T trauma histories. It’s important to note that other therapists use this description for their trauma-focused work – my unique contribution is the particular blend of models I combine. I would also add that many practitioners do amazing work using pure versions of, say, schema therapy, CBT or IFS.

On the shoulders of giants

This development in no way criticises or undermines these incredible approaches to healing – I am simply standing on the shoulders of giants such as schema therapy’s Dr Jeffrey Young, CBT’s Dr Aaron Beck, or IFS’s Dr Richard Schwartz. In fact, I have always found it odd that practitioners of approach A feel the need to criticise approach B, to claim that their model is superior. I believe that every approach has its own strengths and weaknesses, as well as great richness and depth.

Why not combine the best of them, in a way that seems to help my clients and supervisees, as well as fitting my therapeutic style, which has always incorporated new ideas, theories and strategies to optimally help my sometimes hard-to-help clients?

I will be posting often about the key elements of ITT and how it can help you, as a client or clinician. If you would like to know more about the details of my approach, check out this page on its fundamental principles, or click on the button below to read more.

I hope you find it interesting – and, of course, most importantly that it helps you heal your trauma, which is my greatest passion in life and why I do everything that I do.

Love,

Dan ❤️

 
 

Struggling with Upsetting News? A Sense of Perspective Will Help

I went to see Gladiator 2 at the weekend. It wasn’t exactly my cup of tea – a bit too much blood and gore for my taste – but I went with my son, Ben, so getting to hang out with him is always such a pleasure. And alongside all the sweaty torsos, sandals and swordplay, I found something strangely and unexpectedly comforting about the movie. It got me thinking about human history and all the tumultuous times we have been through, as a species. And how living in ancient Rome would have been much worse, scarier and harder for the vast majority of the population than being alive now.

If you, like me, are feeling a bit freaked out by the state of the world right now, we need all the help we can get. The seismic US election result, which made half the population happy but the other half – and much of the rest of the world – deeply anxious and uncertain about what comes next. War, that most pointless and awful of human creations, raging in the Middle East, Ukraine, Sudan and many other places not deemed worthy of the media’s attention. The rise of populist strongmen, around the world. Climate change, which is really scary. It’s already bad and will, I’m afraid, get worse over time.

I know many of you struggle with anxiety, so this post is not meant to make you more anxious! It’s just important to face reality, even if it’s scary and hard, as anxiety and avoidance are always intertwined – and avoiding scary things just makes them scarier, unfortunately. So, rather than hiding in a cupboard, here are three things that are helping me right now and will, I hope, help you feel a bit less bothered about the state of the world:

Develop a sense of perspective

One of the great gifts, but also curses, of our hi-tech age is that we can now access 24/7 news about anywhere in the world. This is very new, and very hard, for our hunter-gatherer-evolved brains to cope with. If there is a flood in Pakistan or train crash in Peru, we will know about it almost instantly. That means our highly threat-focused brains are in a constant state of alert, as if the threat might affect us or our loved ones. This is also, of course, how both mainstream and social media work – they scare, upset and outrage us so we keep reading, clicking and scrolling. This is built in to platforms like Facebook or Twitter. It’s not a bug. It is a deliberate and highly successful strategy.

I’m not going to offer advice about quitting social media, there is plenty of that available already. I’m just pointing out that, although we do face some very real and serious challenges right now, we are also made to feel as if everything is awful, all the time, and there is nothing much we can do about it except keep reading, clicking and scrolling. Instead, try to have a sense of perspective.

For example, something that often confuses me is when I hear people say we are ‘harming the planet’ with all our short-sighted human behaviour. That’s just not possible – the Earth has been around for 4.5 billion years and has experienced every kind of wild meterological and climactic change you can imagine – inconceivably vast volcanic eruptions that filled the atmosphere with noxious gases and dust, causing conditions that were deeply hostile to life; or Snowball Earth, when the whole planet was encased in a thick layer of ice on two occasions, the worst being around 600-700 million years ago. Scientists think this ice age lasted for millions of years. Somehow, life hung on – it has existed on this planet for four billion years and will exist long after humans do.

Of course, the fact that the planet has been through climate change before does not mean this, industry/human-powered cycle of change is not real. It very much is – and I am passionate about doing all we can to slow the course of climate change. And we can do this, the science tells us that, if we all stop eating so much meat, flying, driving polluting vehicles, pressure corporations and governments to act with more urgency, and all the other things we can to protect this miraculous, beautiful planet for ourselves, our children and grandchildren.

Enough with the doom-scrolling

In the run-up to the US election I was devouring everything I could find online about the race, as if somehow just knowing everything could magically influence the result. Since the result, which was not what I hoped for, I have taken a big step back from the news. I de-politicised my Instagram feed, for example, because I just don’t need a blow by blow of every scary thing that will be happening over the next four years. I also have stopped hopping from news site to news site, because it’s just too much for my frazzled brain right now.

That’s not to say we should just tune out or give up. Absolutely not. It’s vital to do all we can, about climate change and the natural world, social and racial justice, the welfare of immigrants and refugees, LGBTQ rights, abortion and women’s health, democracy – all the hard-won, precious things that are under threat right now. I have spoken often in these posts of taking compassionate action, when we feel anxious, upset or overwhelmed. That means marching, organising, writing to your elected officials, signing petitions, boycotting the worst corporations, and donating to charities/non-profits who are doing incredible things every day – you can donate to one of my favourites, the WWF, right now by clicking the button below.

Give love & Kindness in abundance

As the media becomes increasingly skilful at pushing the buttons of your evolutionarily ancient, threat-focused ‘subcortical’ brain regions – the structures in your brain that fire up during the fight-flight-freeze response, and are laser-focused on protecting your tribe and territory, not remotely rational or well-adapted for 21st-century life – my suggestion is that we do the exact opposite. The world does not need any more fear, hatred, hostility or division. It needs our love. Our compassion. Our prosocial goodness. Small example, but I was on the Tube, coming home from the movie with Ben, and saw one man tapping another man’s knee, pointing out the wallet he had dropped on the floor. The other man beamed with gratitude and it was just so sweet, so wholesome – the best of humanity on show in that small gesture.

There is a wise Buddhist teaching: ‘Every human mind contains the seeds of Jesus Christ and the seeds of Hitler’. Meaning, our old, subcortical brain can be fired up into fear, hatred, othering, blaming all our complex problems on immigrants, or trans people, or those with views and values we dislike. But our new, quintessentially human cortical brain has other capacities: love, warmth, kindness, compassion, trust, hope, finding joy in giving and helping others. I know which seeds I would like to help flourish in my brain and I’m sure you do too.

Love, randomly and abundantly. Help others, because it feels so good to you and those you help – like the men on the Tube. Spread ripples of kindness and goodness that start with your friends, family, community or a non-profit close to your heart. And our ripples will meet these scary waves of anger and fear and, bit by bit, dilute them into something better, more positive and hopeful for the future.

I will leave you with another profound, oft-quoted saying, from Martin Luther King: ‘Darkness cannot drive out darkness; only light can do that. Hate cannot drive out hate; only love can do that.’

Love,

Dan ❤️

 
 

I am a meditation teacher for Insight Timer, where you will find a wealth of resources (mostly free/donation-based) including courses, breathing techniques, guided imagery, mindfulness and self-compassion practices and much more.