Category: Articles

By

DR Niall Campbell BDS MFDS Dip Clin Hyp PG Dip Psych

Communications manager DARA Thailand

 

 

SWIMMING BLIND

Two young fish are swimming along in the sea, minding their own business

An older fish swims by them and says – ‘morning boys – how’s the water? ‘

A few yards past one of the younger fish turns to the other, bemused, and says,

What the hell is water?

We are all surrounded by something as total and ‘all encompassing’ as water is to a fish in the sea. We are surrounded by an entity so complete it is as if it is hiding in plain sight. We live it, we breathe it, and we rarely notice it – because It is all we know. It is our  ‘medium’.

It is our cultures.

Now you might think there is a very obvious grammatical mistake in the previous sentence. Surely it should say, ‘It is our culture’.

But the truth is that there are countless numbers of cultures across the world. Whilst this great variety of cultures undoubtedly contributes to kaleidoscopic richness of our planet, they all have their roots in tribalism, and they can therefore also propagate the unsavoury ‘them and us’ mentality.

More specifically for people with issues related to addiction,

This world of contrasting cultures can also act as a significant barrier on the path to enduring recovery.  Before I explain why this is the case, we need to look back at the history of our species, and how our brains developed as we evolved from cave men and women, to the sophisticated, smart phone using, latte drinking creatures of the 21^st century!

 

HARDWIRED FOR TRIBALISM

There are countless cultures, and each one has been constantly refined and differentiated  (often in relative isolation from other cultures) over more than 125,000 or so human generations. Until the modern era of telecommunications and mass transit, humans therefore tended to be born, to live and to die, amongst a very small group of people (who were very similar to themselves in appearance ethnicity, behaviours, lifestyle etc.). Furthermore, when we swapped our nomadic hunter gatherer ways in favour of basic agriculture we started to ‘stay put’. We realised it was easier to pen all our animals in to a field and then just hit them over the head with a club when we got hungry, instead of having to actually hunt them down over hundreds of miles in the wild. We stopped roaming from place to place, and different tribes and collectives of people started to identify very strongly with where they were ‘from’.

These two things, – exclusively socialising with a small group of people, and becoming tied to a certain part of the world, meant that the ‘human way of life’ became to;

‘See the same faces, and live in the same places’.

This social and geographical stasis was the crucible in which disparate cultures started to form. It was also a time when our brains started to really ‘gear up’. We exponentially developed language and an ever-increasing ability to co-operate. Our big juicy modern brains  (refined for socialising in tight knit groups) really started to evolve.

We became hardwired to know that, if we wanted to survive,

we had better learn to fit in with the group we have been born into.

 

MODERN EXCLUSION, ANCIENT PAIN

So as you can see, our brains are therefore predicated on a need to belong to a group.  From an evolutionary perspective, this was an obvious survival necessity. If you were ostracised from the tribe, you were banished, and this meant death. Out in the wilderness all on your lonesome, you were easy pickings for predators (if starvation didn’t get you first). The following equation therefore became deeply encoded in our Neolithic brains:

Social death = real death

Now of course, in a societal sense, things have moved on. It is perfectly feasible to keep to yourself, to forego social contact with others, to think differently and independently and not get eaten by a sabre tooth tiger.

But the more primitive parts of our brains missed that particular memo.

This caveman and cavewoman part of the brain still thinks there is a significant ‘existential risk’ from exclusion. It hasn’t really caught up with our modern world.

And so these primitive parts of our brains get very antsy when we do things that constitute a break away from the communities and the cultures that we find ourselves a part of. If we are ostracised, even in our modern world, these primitive parts of our brain ‘fire’.

They neurologically scold us because they think that such rash actions may cause us to risk our very survival.

They cause pain.

Exclusion hurts.

Think about it. Lets say you go to have a good old Facebook stalk of someone you used to know; maybe an ex partner or a schoolmate, maybe a colleague who has just popped into your head. You type their name into the search bar and,Nothing.

Nothing.

They have unfriended you.

Ouch.

You haven’t given them so much as a second thought in over a decade. You might not even have been that close at the time. It was all but a fleeting curiosity that made you even bother to check in on them in the first place. You are not a part of their life and they are not a part of yours.

But still.

Ouch.

Being socially excluded – even from banal and inconsequential relationships –hurts. That is not a metaphysical claim, it is a scientific one. New research is showing all the time that the links between social isolation and our core physiology are perhaps more profound than we previously imagined. ^{1 2}

Researchers at the University of California invited people to join in with a little virtual ‘ball toss’ game called ‘cyber ball’. It’s a super basic game that looks like this:

They got participants to lie in an fMRI machine whilst they played cyber ball. This is a piece of equipment that tracks blood flow to different parts of the brain. It looks like this.

 

MRI machines can show in ‘real time’ what parts of the brain are active under different circumstances.

So the researchers had participants play the little ball toss game, but the participants didn’t really know why they were being asked to play. Scientists can be sneaky like that. So anyway, the little ball is being tossed around fairly evenly between all the players, but then, for no apparent reason, the participants little avatar doesn’t get the ball passed to it anymore. It gets left out of the little game. This is of course the true purpose of the experiment. The researchers wanted to see, ‘real; time’ what the participants brain response would be to this inexplicable rejection from the group.

The researchers then noted that the same parts of the brain that ‘light up’ on the fMRI in response to physical pain, started to light up in response to this trivial little social exclusion from a ball toss game.

Source Lieberman, M. D., Jarcho, J. M., Berman, S., Naliboff, B. D., Suyenobu, B. Y., Mandelkern, M., & Mayer, E. A. (2004). The neural correlates of placebo effects: a disruption account. Neuroimage, 22(1), 447-455.
Illustration – Samuel valasco 3

 

The same components and pathways of the brain that mediate response to physical pain are also implicated in the response to social exclusion.

This is why if you get rejected by a lover it can feel as if you have been shot, this is why being unfriended by a random acquaintance on Facebook can make you feel lousy all day, and this is why breaking away from a culture which contributed to your addiction (maybe a culture of workaholism in your company, a national culture of drinking, or a culture of drug taking in your music or arts scene) can be such a daunting thing.

You are afraid of being rejected and forgotten about by a group that you were previously a part of, because you know that it will HURT.

• Socially,
• Emotionally, and as it turns out,
• Physically

 

The truth about culture is that you can never really escape it, unless you choose to live in a cave. So what do we do? My suggestion is that you create a culture of YOU, and in part two of this blog I will outline not only more about how culture has perhaps shaped your addiction, but also how you can engineer a life of positive change. A life where you stand on your own two feet, a life that embodies the concept of interdependence – not being a depedant sheep, but not being an independent lone wolf either.

The key to achieving this is getting your new ‘personal culture’ to line up with your core personal values.

It might be hard in the beginning to shake things up so that you feel no dissonance between your behaviours and who you really are as a person, but once you become more independent in terms of the way you think about your social and cultural connections, the world really is your oyster.

You can pick and choose what you like about different ways of life, and leave the other components (that don’t resonate with the most authentic version of you), on the shelf.

Will there be some pain to begin with? Sure!   But when it comes to making the culture of YOU, it’s a case of a little bit of pain to begin with, but then massive gain on the other side.

 

Why live in a ‘one size fits all’ cultural suit, when you can tailor make your own?

 

References

1 Eisenberger, N. I., Lieberman, M. D., & Williams, K. D. (2003). Does rejection hurt? An fMRI study of social exclusion. Science, 302(5643), 290-292.

2 MacDonald, G., & Leary, M. R. (2005). Why does social exclusion hurt? The relationship between social and physical pain. Psychological bulletin, 131(2), 202.

3 Lieberman, M. D., Jarcho, J. M., Berman, S., Naliboff, B. D., Suyenobu, B. Y., Mandelkern, M., & Mayer, E. A. (2004). The neural correlates of placebo effects: a disruption account. Neuroimage, 22(1), 447-455.

IVA PERVAN

Msc Clinical & Health Psychology, YTT300 Yoga & Meditation Teacher

Program Manager AT DARA Koh Chang

In 2016 EMDR (Eye Movement Desensitization and Reprocessing) celebrated its 27^th anniversary. As is often the case with scientific breakthroughs, its discovery was accidental. In 1987, Dr Francine Shapiro, an American clinical psychologist, whilst walking in a park, realised that she coincidentally moved her eyes back and forth when she was having an emotionally disturbing thought. She noticed that in doing so, the emotional thought became less distressing. By this chance observation, she discovered that eye-movements could reduce the intensity of disturbing thoughts when practised under certain conditions.

She began the first research studies on this topic not long after that in 1989, whereby it became clear that EMDR (then called EMD or Eye Movement Desensitization) was an up-and-coming treatment for victims of trauma and patients suffering from Post-traumatic Stress Disorder (PTSD).  The newly discovered success of EMDR was published in the Journal of Traumatic Stress.

Since these first studies in 1989, EMDR has become one of the most well researched therapeutic therapies in the field of psychology. It has developed and evolved by and with the help of psychologists, therapists and researchers from all over the world. This form of therapy has been identified as a valid treatment for psychological trauma – in 2013, the World Health Organization recommended EMDR as a treatment of choice for PTSD. EMDR was initially used solely for the treatment of trauma and PTSD, but since then many uses for EMDR have been found.  The main focus of EMDR therapy is how to deal with how memories are processed and stored in the brain. EMDR is intended for use as an adjunct to other therapies, not as a replacement for them. Nowadays EMDR is used to treat a wide range of conditions such as anxiety, depression and addiction from substances like alcohol, drugs and prescription medication.

WHAT IS EDMR AND WHAT IS IT USED FOR?

EMDR is a psychotherapeutic approach that was developed for the purpose of working with distressing, disturbing or traumatic memories. Examples include psychological trauma arising from,

• Traffic accidents,
• Violent experiences,
• Various types of emotional, physical or sexual abuse

Even the unexpected passing of a loved one can warrant the therapeutic use of EMDR.

Disturbing memories from one’s childhood, like being bullied or harassed systematically, can benefit from EMDR. 

Traumatic incidents with parents and peers can have a very negative effect on a person’s sense of self-worth. These events can set the groundwork for the emergence of a wide range of mental health issues in later life, including vulnerability for clinical disorders like anxiety, depression, addiction and post-traumatic stress disorder. Eye movement desensitisation and reprocessing can help people come to terms with negative childhood experiences. When processing the memory with EMDR, emotional memories are reprocessed in a more constructive way. We could say that EMDR helps to store the memories in a more ‘neutral’ way, instead of eternally remaining in the mind as a chaotic and disturbing recollection.

FINDING THE RIGHT CLINICIAN

The theory behind EMDR is that present psychological difficulties are often the result of distressing life experiences that have not been stored in memory properly. Such recollections are referred to as ‘unprocessed’ or ‘blocked’ memories. These traumatic memories may need some help to become processed, and EMDR is one of the therapeutic ways to achieve this. A psychologist or therapist practising EMDR should have a solid background in mental health before they even embark on initial EMDR training.  Extensive further training in EMDR training (along with experience in dealing with clients with psychological traumatic recall) is highly desirable if the clinician is to be able to work through the protocol with clients in a truly successful way.

WHY ARE TRAUMATIC MEMORIES SO DAMAGING IN THE ‘HERE AND NOW’?

If someone is experiencing recurring symptoms from a psychologically traumatic event (and possibly correlated PTSD symptoms), it is possible that their brain wasn’t able to constructively ‘process’ the information at the time of the event (as it normally would have been able to with, say a more  ‘normal’ or ‘less traumatic’ experience).

When this processing of the traumatic event doesn’t happen in a constructive way, simply recalling the event or trauma, in any way, big or small, might feel as bad as it did when the event actually happened, with many of the negative emotions and bodily sensations reoccurring.

With every recollection of the event, the trauma might, therefore, feel as severe as going through it for the first time, every time.

This is because the feeling, images, smells and sounds remain unprocessed and still evoke the same distressing responses as they did at the time of the actual event. The improperly processed traumatic event (or in some cases multiple events) interferes with a person’s life, causing multiple negative symptoms.

Addiction, to either a substance (like alcohol or drugs) or addiction to an avoidant/compulsive behaviour (like gambling or porn), is a common negative outcome from improperly processed traumatic memories.

SYMPTOMS OF PSYCHOLOGICAL TRAUMA

Some of the symptoms of psychological trauma include (but are not limited to,)

• ‘Flashbacks’ to the traumatic event
• Significant disruption of life events,
• Sleep disturbance and nightmares,
• Irritability,
• Outbursts of anger,
• Difficulty concentrating,
• Feeling ‘jumpy’ or being easily startled, and
• ‘Hyper vigilance’

Some people turn to addictive substances as a way to avoid dealing with traumatic incidents. Using EMDR in a therapeutic way can have a profound effect on the way that the brain processes difficult information.

EMDR therapy can help addicts create a greater sense of daily ‘mental comfort’ by helping them properly address difficult memories and life experiences. This is often the key to helping addicts build enduring recoveries

HOW IS EMDR PERFORMED?

EMDR works very quickly and effects can be noticed from the very first session. The effects on the client can be intense and profound – and therefore being mindful of the possible thoughts, feeling and emotions that may arise in the aftermath of the sessions – is very important.

Whilst performing EMDR in session, therapists use a set of standardised protocols that incorporate elements from many different treatment approaches. In using the standardised protocols, the client and therapist are assured to utilise the therapy in the correct way and quality of the therapy is ensured.

EMDR is composed of series of phases. The clients’ problems are identified. The goals for the EMDR session are established and the client is prepared for the memory processing. During processing the client is directed to attend to aspects of the memory, while the information processing system is simultaneously stimulated with eye movement or bilateral auditory clicks. The processing starts and counterproductive emotions are resolved. New, more useful thoughts, feelings and memories are created.

WHAT IS AN ACTUAL EMDR SESSION LIKE?

Your psychologist or therapist will ask you to recall the traumatic event that you have like to work on. Special attention will be afforded to feelings and images that are strongly associated with that traumatic event. The rule of thumb is

‘The more detailed the recollection of the event(s), the better’.

After the processing has commenced, the therapist will ask you again to recall the traumatic event.

Whilst simultaneously recalling the trauma, you will be engaged with a distracting stimulus, such as the rhythmic movement of the therapists’ hand and/or listening to alternating left and right ear ‘clicks’ via headphones.

These distracting hand movements or sounds are called a ‘set’.

After each set, there is a little pause or break and the therapist will ask the client what sensations came up. Usually, this will be a stream of thoughts and images concerning the disturbing memory – but feelings and bodily sensations can also emerge.

After each set, the client is also asked to concentrate on the most obvious change and once again another set is performed. The sets will eventually lead to a decrease in the emotional charge of the memory and its present day ‘power’ over the client. It thus becomes easier to think about the event. In many cases, the memories themselves become somewhat faded or diminish in intensity. Sometimes less unpleasant aspects of the memory are in fact recalled, but the client and therapist are perfectly positioned to go ahead and effectively to deal with these revelations if they should arise. Another possibility is that new insights or thoughts may develop in the clients’ consciousness and these new perspectives can give the recollection a less threatening implication.

In this way, EMDR can profoundly help people to accept and come to terms with past traumatic experiences, and get on with the business of living the rest of their life as expansively and productively as they can.

 

Things like periods of active addiction, (which are often ‘downstream’ of past psychological trauma) lose their wellspring, and become,

well,

just another memory.