Frozen Personalities: Why Talk Therapy Needs More Than Talk

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The time-honored treatment for psychological trauma is to uncover the wound, then gently expose it to the light. The “infection” must be drained, ever so slowly. Healing should follow.

Perhaps. Yet this method is rather like digging a hole, uncovering a buried skeleton, and raising it to earth. No revival is guaranteed. The bones still need to be fleshed out. The heart must beat. The creature needs to walk — away. Otherwise, the perimeter of the territory around the hole circumscribes the rest of his life. As the blunt, sometimes too impatient saying goes, you must “move on” — away from the place you’ve been stuck.

Movement is the key.

The patient will survive, but must live for the first time. Psychiatrist Bessel van der Kolk describes the brain dysfunction produced by trauma: the victim is both more prone to agitation and less able to distinguish what is happening in the moment. Despite the chronological distance from injury, one’s life remains organized as if the danger were still present. Imagine an army after the war is over, forever in “stress mobilization” mode, ready for the next onslaught. The brain and body sense the world through the old, cracked lens of an ancient injury. Thus, rewiring the brain is now thought to be an essential treatment element for Post Traumatic Stress Disorder (PTSD).

The patient must become alive to the present. A number of methods might accomplish this, though research on how best to produce brain changes is in its infancy. Among the approaches suggested are neurofeedback, mindfulness meditation, yoga, and group theatrical or musical performance. These techniques engage the body, where so much of the damage is “felt,” almost as if it were written on the skin. Little is proven, but the field of recovery from trauma is buzzing with discussion.

In my own practice I treated those who took flight once the hurt wing was mended — and those for whom there was no bottom to the hole they had fallen into — pushed by an unkind hand.

For the latter group, the therapist’s office sometimes serves as both a refuge and a prison. One sees the dual function of the doctor’s consulting room for patients still afraid, wary, and worried. They continue to scan the environment for signs of the next disaster. Their lives are fraught with endless repetitions and imaginings of future grotesque events. The counselor can be like a magnet for them, offering a sometimes too tight embrace. The therapist becomes a metaphorical talisman in such cases, a rabbit’s foot one cannot do without. In effect, the therapy appointment itself is the only safe time in the only safe place; the shrink, the only safe person.

This is not enough. Both the doctor and the patient must recognize the goal is not only to grieve the trauma, but to reclaim a life; or to learn how to live for the first time. The participants in the therapy hour should leave rabbits’ feet to rabbits. They must recognize that, however lifelike, the client has not been living. He has been trapped in self-defeating routines. His life consists of traveling at considerable speed in a circle, always returning to the same place. Adventure, imagination, and joyful relationships are absent. The patient lives in his traumatized past or a fearful future, but not in the moment. Lacking the resilience to take on an imperfect world, he ventures nowhere.

Yes, you must talk about what happened. Yes, you must understand what happened. Yes, you must grieve what happened. But life, not an imitation, requires movement, change, and repeated abandonment of old ways for new ones. The therapist and her office, taken together, are like a stepping stone on your trip into the rough stream of remembrance: a place to land, but not a stopping place.

Nor is the shore the goal. The truth is, one never lands in a completely safe spot. Good therapy simply helps one become a better navigator in today’s waters, not yesterday’s or tomorrow’s.

You are safer not because of the place or the doctor, but because of yourself: newly designed, rewired, and outfitted, ready for the wind to catch your sails — ready for adventure even without the wind.

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The top image is called, Mr. Seafall’s Talk Button, by Mr. Seafall. The second photo is a Naval Ship of Brazil by the Brazilian Navy. Both are sourced from Wikimedia Commons.

Fear of Change: the Therapeutic Implications of Japanese Holdouts

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Things change. The question is, do we change with them? Or, do we instead, continue to operate by the same outdated rules of conduct.

I often said to my patients that they seemed to be behaving as if the conditions of their early life still existed. They had long since fashioned solutions to problems that they faced many years ago, and continued to use the same solutions, even though those methods of living didn’t fit with their current life situation. It is as if one were born in Alaska, learned to wear multiple layers of heavy clothing and then moved to the tropics without a change of attire. The warm clothes were helpful up North, but are a disaster down South.

What does this have to do with the “Japanese Holdouts of World War II? The answer is that these men lived by an outdated set of rules with heartbreaking consequences.

If you recall your history lessons, you will remember that the Japanese soldiers of that period were trained according to the principles of Bushido, a feudal fighting code that derived from the period of Samurai warriors. Above all else, weakness was condemned and surrender was disgraceful. Death by one’s own hand was seen as preferable to permitting oneself to be captured, so as to avoid both personal disgrace and family shame.

The Allied approach to the war against these very soldiers in the Pacific was one that involved “island hopping.” The strategy passed over certain islands, both to save men and ensure that the Allies would be able  to capture those islands that were of the greatest strategic value. When the Japanese surrender came in 1945, numerous Japanese troops found themselves stranded on out-of-the-way Pacific islands, cut-off from their command, and without the capacity for communicating back home. These men neither knew the war was over nor could imagine that any honorable soldier, let alone their entire nation, would surrender. Some were in small groups who gradually died from disease or starvation; others were, at least eventually, alone.

While many never surrendered and died still waiting for reinforcements that never came, it was not uncommon in the late 1940s and 1950s to read news accounts of isolated Japanese combatants giving themselves up. The photo at the top of this page is of Second Lieutenant Hiroo Onada, who finally surrendered in 1974, and would not do so until his former commanding officer, by then a bookseller, personally ordered him to lay down his arms.  At that point, World War II had been over for nearly 30 years.

Thirty years. Yes, 30 years dedicated to a war that was over and a life of desperation that was no longer required.

But how many years, if any, have you given up to a thread-bare, bankrupt strategy of living that has long since outlived its usefulness?. And, more to the point, how many more will you endure? When will you realize that your “solution” has now become the problem?

In my psychotherapy practice I saw numerous variations on this theme. People who were abused or neglected  or criticized as children and who continued to live in terror of disappointing others. Those who found substance abuse the only available way of treating the depression or anxiety they experienced when they were young, and who continued to do so. People who avoided challenges because they were scared of failure, having failed many times in the past. Individuals who wore a chip on their shoulder, forever sensitive to insults and injuries that reminded them of long ago attacks, but now were only injurious in their imagination. And those poor souls who expected rejection because of past rejection. Like the Japanese holdouts, the years pass but the fear doesn’t, and the possibility of satisfying relationships and happiness slips away.

If you still are responding to the present as if it were the past, with solutions that solve little (even if they were once necessary), then it is time to change your life. The barricade of your life’s defenses might be protecting you only from the phantom of an enemy who lives within you, not on the other side of the fortification.

A good therapist is likely to be able to help you develop a new way of living, one more appropriate to the world as it is, not the world as it was; to set aside and heal old wounds.

Is it time?

What is the continuation of your old way of living costing you?

The war, your personal war, might just be over and you don’t know it.