Tuesday, November 18, 2014

Beyond Talk Therapy

In his first foray into psychotherapy Freud attempted to relieve young women of the pain of hysterical conversion symptoms.

By his theory, if certain bodily pains were not being caused by any medical condition they had to be manifesting repressed memories. It’s almost as though the body was speaking where the young woman could not.

It made for a good theory, but it did not produce very many clinical successes.

Freud was not alone in addressing the problem of treating hysterical conversion symptoms. Europe was awash in cases of hysteria in his day. Many other physicians were working on the same problem.

As it happened, the wave of hysteria subsided, eventually to vanish during the 1920s. In many cases patients had really been suffering from conditions that medicine did not understand.

Even if there were cases where emotions seemed trapped in different parts of the human body, psychoanalysis and psychotherapy have never really treated the problem. Consider the experience of Jessica Wolf.

In another time and place, Jessica Wolf’s ailments might well have been classified as hysterical conversion symptoms.

She explains:

I’d had many intractable physical problems in the last several years, the most recent being a pain in my knee that no medical professional could make heads or tails of. I couldn’t sit cross-legged on the floor or rise up out of a full squat, and I’d feel a sharp stab whenever I slipped that leg into my jeans.

Naturally, she had attempted to address this and more emotional difficulties with talk therapy. The results are not a ringing endorsement of talk therapy. If you are reading this blog, you are not surprised.

Here is Wolf’s description of her experience in therapy:

Although I have spent about three decades — nearly my entire adult life — in talk therapy, I have always felt fundamentally unfixable.

My longest therapy stint started in my late 20s. I was always sort of unhappy, but went to a therapist specifically to stop smoking cigarettes and to leave my job. At the end of six years, I was still at the same job and still smoking. Then, my company closed and I got pregnant, so my job ended and I quit cigarettes. But I don’t think I really changed at all.

I had always been skeptical of anything too “alternative,” until about eight years ago, when I first started to see the connections between mind and body. I’d been referred to a psychologist to deal with back pain. But even that experience, despite eliminating the distress in my back, felt like more of the same — we sat across from each other, I told my story, I talked about my “feelings,” I cried.

I could have gone on like that for years, just as I had with other therapists, because no matter what I said, or how I looked at my story, the emotional pain always felt fresh and new. I felt stuck.

Keep in mind… three decades worth of ineffective therapy. Surely, Jessica Wolf had had enough therapy.

Eventually, Wolf found her way to a healer named Ann E. With her Wolf found relief. Ann E. helped her by massaging and manipulating different muscles in the body.

Wolf reports:

Ann E. refers to her work as “unwinding” and likens the process to taking apart a big ball of tangled necklaces. Each tangle has come about through some emotional or physical injury from which our body has attempted to heal. But the body compensates in areas where it is weak, and those compensations turn into habits. The pain we feel is largely due to a once efficient system no longer working the way it should.

When Ann E. presses into fascia that has become gummed up like glue, holding parts of our insides where they don’t rightly belong, her touch somehow “dissolves” the gooeyness and allows the fascia to revert to its original light, fluffy nature. With each of these releases, the “necklace tangle” loosens and our bodies can start to sort out the mess that has been accumulating for so many years.

Was this real help or a placebo?

I do not know.

For now it does not appear that Wolf cares.

Would it work with other cases or was it merely a one-off success?

I do not know.

From the sound of it, Wolf is happy with the treatment she received:

I’m not quite sure how to explain how the emotions become unstuck, but as with my shoulder that first day, much of my lifelong pain now feels as if it had never been there in the first place. The main thing I feel is a kind of unfamiliar optimism, along with a lot more energy — energy that, Ann E. would say, has been freed up from letting go of longstanding trauma.

I continue to let Ann E. untangle me. I try to trust that she has my best interests at heart. I wrestle sometimes with how much I’m willing to let myself need her. But as I unwind, I sleep better. I breathe better. Parts of me that have hurt for years have stopped hurting. When I look in the mirror, I’m still middle-aged and my hair is still graying, but I feel able, possibly for the first time, to truly cope with life.


Ares Olympus said...

re: Was this real help or a placebo?

I agree, I don't know either.

I like the idea that the placebo effect IS real, but it certainly makes diagnosis hard, and analysing results impossible.

I know a small town medical doctor with her own practice, her husband is her assistant, and she talks of holistic health, so she'll spend an hour or more with each patient as needed, including asking personal questions, and perhaps even being a talk therapist, but at least it puts the physical symptoms in a context, and patients feel cared about.

Anyway, I see two problem with any sort of treatments.
1. Every learned technique can be a hammer that ends up seeing everything as a nail, so it's good to have many techniques and refuse to believe any of them as completely effective.
2. When healing doesn't appear, there may be unseen healing, and when healing does seem to appear, it may be unrelated to the treatment. So some sort of intuition would seem to be needed, while still needing some validation and you may have to accept you may never know.


Sam L. said...

Whatever and however, it works for her. This is good.