Many people I meet, whether in therapy or otherwise, are suffering, often unknowingly, from the effects of past trauma.
Most of us have had at least some degree of traumatic experience in the past; some we will have healed from, and others we might have pushed into a closed box because the memories are too painful for us.
It’s very wise to try not to relive the trauma, as doing so will re-traumatise us and not lead to the healing we desperately need. Historically, therapists used to ask clients to relive their trauma and describe it in detail as an attempt to learn more about the person and to explore their difficulties. Now we know that this is not therapeutic at all.
Instead, as psychotherapists, we have many ways of knowing that our patient is suffering in the present because of traumatic events in the past. Note that it isn’t always the case that our patients are suffering from past events; not every problem is related to a difficult childhood. Many, many difficulties I see in my patients are because of present and ongoing problems in their lives, and absolutely nothing to do with their past.
We are trained to be able to hear what’s in the words you say and what (if anything) is behind the words you say. We don’t just sit there and listen: talking therapy is very much about knowing what to ask, how to ask it and when to ask it, as well as listening in different and curious ways.
Gestalt therapy
You may have heard about Gestalt therapy. Fritz Perls, a German-born psychiatrist, founded Gestalt therapy in the 1940s with his wife, Laura. Fritz was trained in traditional psychoanalysis, but he was dissatisfied with Freudian theories. As such, he developed his own system of psychotherapy which is used by many therapists today, albeit with modernisation.
Therapists don’t use just one form of therapy and make our clients fit into that box. Rather, we have many tools, theories and methods to employ, and we fit these around you and your needs.
Anxiety, depression, attachment difficulties and post-traumatic stress injury can all be related to past traumas, and they can be related to present life circumstances as well
Gestalt therapy is a form of person-centred therapy that helps people suffering with chronic mental health disorders and substance abuse to heal and let go of issues in the past that have been keeping them from moving forward in their lives. Anxiety, depression, attachment difficulties and post-traumatic stress injury can all be related to past traumas, and they can be related to present life circumstances as well. Figuring this out is our job.
Unhealed trauma from the past can be such an inherent part of our psyche that it is often unrecognised by us. Trust issues, relationship issues, narcissism, anxiety, fear of failure and low self-esteem are some difficulties which can be related to past trauma. The list of present concerns which could possibly be linked to past events is endless.
Often we also have physical symptoms due to past trauma, for example nausea, hypertension, over- or under-eating, alcohol or drug dependence, and so the list goes on. Gestalt therapists work to help clients remove this pre-programmed response and to experience each situation in life as new.
Dual awareness
While Gestalt therapy is effective, popular and has stood the test of time, sometimes clients don’t necessarily “click” with it. In these cases, I introduce something called dual awareness.
Dual awareness can be simple for us to just sit with. Basically, it involves noticing and recognising that what we are feeling right now, emotionally and physically, is very real and very present, and yet it may be related to something which has happened in the past, sometimes the distant past. We need to start with being self-aware.
A 10-minute self-awareness exercise
Noticing plays a key role here, especially for us in the veterinary industry, because how often do we have time to notice anything? It takes such a massive effort to pause and check in with ourselves that we see it as a luxury that we can’t make time for
Noticing plays a key role here, especially for us in the veterinary industry, because how often do we have time to notice anything? It takes such a massive effort to pause and check in with ourselves that we see it as a luxury that we can’t make time for. It’s not a luxury.
In the ideal world, I would have persuaded all of us to meditate for an hour a day by now, but that’s not practical or even desirable for many of us!
So, I ask for much, much less. Say 10 minutes a day. This is doable for any of us and the benefits can only be realised if we try it for a few days. I suggest setting an alarm in the morning just 10 minutes before your normal time. 10 minutes is nothing. You will definitely not feel more rested throughout the day because you spent those 10 minutes unconscious.
This 10-minute period is spent sitting still, breathing and noticing our normal breath going in and out. It’s so difficult the first few times, but you will get better with practice.
Learning to steady the mind and take a break from the plethora of thoughts we routinely have tangled up in our heads is so valuable and therapeutic in itself. And it can form the platform for so much more once we get practised at it. If this is as far as you want to go, no problem. It will be surprisingly helpful for improving your mental well-being even if you don’t feel you need any help or improvement right now.
Going back to dual awareness, once you get good at noticing your breath and having that clear mind that is focused on only one thing, you can start to get better at noticing your somatic sensations, such as your heart rate (notice it without feeling your wrist or carotid), your abdomen… Do you feel your breathing at your throat, chest or abdominal level? Where are your shoulders? Here’s a good one: is your tongue positioned on the roof of your mouth indicating tension, or resting between your lower teeth indicating relaxation?
Now to your emotions: look them in the eye and name them. It may be anger, it may be fear, it may be yearning, it could be anything. Naming your emotions defuses the control they may have on you. It helps you to have an emotion without necessarily acting on autopilot to that emotion, as you’ve habitually done before.
Allowing anger to be one of the emotions that’s just there in your peripheral vision today, and yet not allowing it to rule your actions, is tremendously empowering
For example, I feel angry. That usually makes me physically stressed with a clenched jaw and a raised heart rate, and I may shout or snap at people. But what if you decided that although you feel angry, you want to respond to it differently, or not respond to it at all? Allowing anger to be one of the emotions that’s just there in your peripheral vision today, and yet not allowing it to rule your actions, is tremendously empowering.
You can do this with each emotion you notice, allowing them to just sit there.
Conditioning of past experiences
Supposing an angry, shouty client is in your consult room, and you are managing the situation with diplomacy and empathy. That’s great. But if, for example, clients like this make you want to cry or run out of the room, or you avoid seeing them, or shout back, or throw up… could that be related to anger and shouting from your past, which was directed at you when you were unable to defend yourself?
Could it be that you are feeling these emotions and physical sensations right here, right now in response to the present, but that they are exaggerated because of trauma that happened long ago?
Another example: does being vulnerable in a relationship terrify you? Someone having access to your soul and having the ability to hurt you like hell if they choose? You know the terror you feel after intimacy, the stripping back of all your defences making you feel like a sitting duck. It may look like everyone else feels great when they get close and intimate in a relationship. Is it possible that your massive fear of vulnerability is because you’ve been abused, betrayed or hurt beyond repair in the past?
And another example: do you have cravings for security and predictability in your life to such a degree that the unknown and unpredictable make you want to vomit? Is this proportionate to what’s happening right now? Or could it be because you didn’t have security years ago or even that you did have security and it was taken away from you?
These are just a few examples of possible scenarios where the emotions and physical feelings we have right now are indeed related to past events more than to the present moment.
What is happening is called dual awareness; you are aware of the present moments feelings in your mind and your body, and you are also aware that they are a response to the past
Making this distinction and allowing yourself to realise that this is what is happening is called dual awareness; you are aware of the present moments feelings in your mind and your body, and you are also aware that they are a response to the past.
This is not the cue to go delving into the pain and suffering of the past trauma. Not at all. It’s a way of noticing the detrimental effects it has on you and, therefore, defusing the hold it has over you.
Remember how we noticed an emotion, how we gave it a name and defused it that way? This is exactly the same. Using dual awareness, you are noticing the past trauma and also noticing the present effects it has on you, and separating the two: sometimes by miles or eons as one patient told me.
Final thoughts
By putting this therapy tool into the hands of someone, I am hopefully empowering them further. This is not a theory established by someone from the 1940s. Nor does it have a name that can have difficult connotations for other people. Although Franz worked with his wife, for patients who have suffered trauma at the hands of a man, they may reject a therapy designed by a man.
All of these subtleties and noticing the innermost feelings of my patients has led me to using dual awareness as a valuable therapeutic tool to gift to anyone who wants to explore it further in the privacy of their own mind.
