A general post on many newer therapies from Scott Siskind at Astral Codex Ten: The Precision of Sensory Evidence.
One of the first
things that occurred to me about the sensory input in depression and
trauma was manics wearing sunglasses indoors. Many an argument I had
with psychodynamic therapists early in my career trying to convince me
that this was because of their narcissism and/or desire to feel
protected from being seen by others. It is one advantage of having
worked on the units at the beginning of my career, where you could see
these guys wince when they had to come out into brighter areas or they
had to take the glasses off for some reason. I was pretty sure it was a
largely physical, not psychological response. So now there is evidence that depressed people actually do see things less brightly. They are grayer.
1. It looks
at first like it could veer into blaming the victim - "Are you sure you
didn't just make most of this up and are a touch overdramatic, honey?"
Yet I think if you follow it out it actually bypasses it. What actually
happened turns out not to matter as much as the schema that was
installed. We seldom have contemporary records, video, credible
witnesses anyway. We are never going to know exactly what happened. We
only know what we have now. And really, we don't need to know. The
victim can sometimes get obsessed with knowing, and with proving to the
important others that yes they were too abused, and too much of the
older intervention focused on this too, as if everyone had to know all
the details before anyone could go forward. It might feel that
way, but that feeling might itself be a symptom. Therapy should focus
on resolving the now. Once that is completed the patient may or may not
wish to go back and explore. Yet almost always not. They decide it doesn't much matter.
1A. So it's
not quite the Body that keeps the score, it's the Schema that keeps the
score. The body is an imperfect report card.
2. This also
nicely gets around all the discussions of whether emotional abuse is
worse than physical or sexual worse than all. The question might matter
someday to the patient, but it doesn't have to matter now, and in fact
shouldn't matter now. This is because it gets into all the side
questions of what other people think of them, of how much they should
trust their own thoughts and feelings, and how they are going to
describe all this to others. Yet we know from the get-go that these are
things that are likely impaired in the patient - that's why they have
pain and make bad decisions (or are unable to make decisions). That's
what they came into the office to find a solution for. All of those
unanswerable side questions should be the student, not the teacher in
This is similar to some other treatments. I had many an addict who wanted to put a lot of time into understanding why they drank. But You won't have any idea why you drink until after you have been sober a while. You
will think you know and will have guesses, but you will be wrong. And
it is a waste of your time, probably an evasion of the pain of facing
you. You won't know why you feel depressed, or anxious, or insecure or
whatever until those are largely gone. And then you might say "Y'know?
I think it was mostly just genetic/food-based/that one incident/my
mother's chronic pain/those first school years at the commune."
My further points are still to come (Points 3 & 4) about the connection to Christian understandings and whether the value of these practices as treatments implies anything about every day use.
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