trauma


high riseAnarchy in the sky, but could it ever happen? When all responsibility is taken over by the management, would people revert to childhood, trash their homes and services, and resort to drunkenness, violence and aggressive, opportunistic sex. Would the lack of external constraint release our basic emotional animal selves?

These are the questions, being asked in J.G. Ballard’s novel, ‘High Rise’, which my daughter, Esther, gave me for my birthday. He describes the latest concept in inner city living for young professionals: new high-rise apartment blocks designed to take over all the responsibility for domestic life. Not only are all the utilities and services provided by the company, but the blocks also contain their own recreation facilities – swimming pool, gymnasiums, restaurants, cinemas, a play area for children and meeting and event space for their parents, and their own supermarkets, shopping centre and banks. Each tower block is a self contained town; 1000 full equipped homes in the sky with views over the city. There is no need to go out except to work, but nowadays many could work on-line from their apartment. It is a new concept in living; an architects dream that within weeks turned into a nightmare.

It starts innocently enough with noisy ‘get to know each other’ parties. Bottles are tossed over balconies, casual liaisons formed and then broken. Then within days, delays in getting elevators lead to tensions.  Those living on the top few floors have their own express elevators, epitomising  a vertical gradient in status and income, the richer celebrities and top executives on the top, the professional classes in the middle and the nurses, air hostesses, shop managers, bank officials towards the bottom.  This leads to factionalism and eventually conflict.

As the inhabitants lose control, so the building itself starts to fail, first the electricity – whole floors are blacked out for a time. The garbage disposal chutes become blocked. People dump their rubbish in the foyer or throw it over the balcony. The cars in the front few rows of the car park are wrecked by falling bottles. Then the elevators fail and the stairwells are blocked by rubbish, the water supply is cut off, the sewage system fails and  swimming pools become open sewers.

People form themselves into gangs, raiding parties that trash the apartments on the upper floors, attacked the inhabitants, rape the women. There is no food, the shelves in the supermarket have been cleared. People resort to killing pets that are by now running feral throughout the building and cooking them over open fires lit from broken furniture on the balconies.  The furniture that is not burnt is used to barricade the apartments and stair wells.  As the violence escalates, people are killed and most likely also eaten.

Into the chaos, comes  Wilder, a self appointed war lord, his loins bare, his insignia emblazoned in lipstick across his chest, accompanied by his entourage of followers and sex slaves. The apartment town achieves a kind of stability, organised by violence and fear, as strict rules are established, punishable by death.

High Rise is a disturbing and unrealistic dystopia. Realists might question how people go  to work as normal during the day, but always return to their urban jungle at night, why many find the gang warfare and permissive sex exciting, why nobody informs the authorities and when asked, denies there is any trouble. Even the newsreader who reads the one o’clock news every day says nothing of the anarchy at home. The way Ballard wrote it, they just don’t care anymore, but wouldn’t their upbringing have equipped them with the self imposed constraints to live together?  Isn’t that what civilisation and socialisation imply?

I can’t imagine that Ballard meant High Rise to be taken literally. It is science fiction, what-if, a metaphor to think about, but close enough to other examples of societal breakdown in Berlin, Stalingrad, the Congo, Ruanda, and more recently in Mosul and Aleppo. Axel Munthe wrote how during the plague in Naples, when all civic control had broken down and people were dying in their thousands, the survivors were openly having sex with each other in the city squares, on fountains, benches, everywhere. Trauma disconnects the thinking brain so that people can behave  like animals and follow their basic emotional drives until somebody asserts strict control, which they follow without question, like Bettleheim’s Musselmen, the walking corpses, who marched to their death in the gas chambers in Buchenwald or the followers of ISIS.

But when people first moved into the tower black, they were not traumatised, they could still think. The trauma came later. So what caused them lose control? Was it some kind of mass hysteria, like an unstoppable contagion? Helen Wilder said it was the tower that made them behave so out of control, but it is difficult to see how or why.  Why would everybody become so irresponsible just because they were living in a luxury high rise? There would surely  be some who wouldn’t.

I cannot agree that High Rise is JG Ballard’s best novel, though there are echoes of the Japanese camp in ‘The Empire of the Sun’ The themes of vandalism, sectionalism and flagrant sexuality are somewhat repetitive and disturbing. The high rise society deteriorated too rapidly The best metaphors have to be credible. This is too divorced from reality to suspend disbelief. The metaphor is flawed.

Ballard wrote High Rise in 1975, at around the time, high rise tower blacks were being constructed in every major city in Britain.  His apocalyptic vision has not been realised, but only this year the vulnerability of high rise buildings to fire has been exposed in West London.

 

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A Quiet Revolution

There is a quiet revolution taking place in psychotherapy – a movement from mind to body. Recent insights from neuroscience have shown how often life trauma, which few of us escape, may be expressed through the bodily symptoms but not acknowledged in conscious thought. Research has also demonstrated how communication can take place between human brains without language.

Psychoanalysis was always about the relationship between the mind and the body. Freud claimed that things that cannot be thought about may be expressed through the body, though more recently body mind psychotherapists, such as Susie Orbach, tend to consider that trauma is expressed in the body before it can be brought to mind and thought about. The body can, in many different ways, influence the mind.

Psychotherapy, the listening cure, has for too long been caught up in its own arcane language and abstinent attitude. Yet many studies have shown that effectiveness is based, not so much on what the therapist says, but more on the feeling relationship that is established between the therapist and the client. The therapist is not just ‘the brain box in the corner’, observing, judging, interpreting. Talking can sometimes get in the way and may even re-traumatise. We are all influenced by the emotional state of others. Intuition, our proprioceptive and visceral consciousness, is our sixth sense. Therapists need to engage with their body as well as their mind; they have to be aware of their own gut feelings so they can discern what is created with their client.

People who have been traumatised often don’t know and can’t talk about what has happened to them. There is often a disconnect between mind and body. A person may say one thing while their body expresses another, though it is the always the body that ‘tells the truth’. Thus the feeling of what happened can only be accessed and resolved by observing and working though the body.

Body based therapies are more spontaneous than reflective. Sensorimotor psychotherapy is a talking therapy that does not so much explore the narrative of past events but observes the changes that take place in their client’s body and uses those to draw attention to what is happening now and how to control them. These include changes in facial expression, posture, involuntary movements and even intestinal squeaks and growls.

This needs to be done with great sensitivity since if a client gets too close to the reality of what happened, it may traumatise them all over again, making them panic or shut down. So the therapist monitors the level of arousal in the clients body using their own intuition and works just inside the window of tolerance. If it looks like their client is becoming agitated, they will pause the discussion and use deep breathing or yoga to bring the mind back on line. If, on the other hand, their client begins to shut down and dissociate, they will bring them back into the window of tolerance by getting them to stand up, stamp their feet or move around.

The acceptance of mindfulness meditation, sensorimotor psychotherapy, eye movement desensitisation and reprogramming (EMDR) and emotional freedom technique (EFT) has prompted a rapprochement between talking cures and a range of body based complimentary therapies. Many holistic therapies can be helpful in modulating levels of arousal to where clients can think with safety, reduce symptoms and build a trusting connection. Some such as Yoga, Pilates and Tai Chi can change mental attitudes. Some postures and movements are assertive and can empower a patient. Others encourage openness and relaxation. The feeling of being held during therapeutic massage can be so comforting and containing. Reflexology or foot massage has the same effect. But patients may find their own activities, hobbies and pastimes, which ground them, and help them cope better. These might include, running, swimming, yoga, breathing exercises, music, art or cooking. We all need space to unwind and think.

Nevertheless, if patients want to bring about a more fundamental change in their pre-morbid character, then an integrated body mind therapy, that encourages ‘enactment’, the playing out of a particular engrained patterns of behaviour on the stage of the consulting room may create a space in the present that where the behaviour can be questioned and changed.

As I have explained in previous posts, trauma shuts down the thinking and reasoning part of the brain and expresses what happens in the body as actions, disabilities and symptoms. These effects may not be accessed either by medicine or traditional mind based psychotherapies but are available to novel techniques that utilise bodily communication.

musselmannThe old ones of Auschwitz Birkenau, the survivors, called them the ‘Muselmann’ (german for Muslims); the weak, the inept, the ones who distanced themselves from suffering by giving up.  Deprived of any expectation or hope, they no  longer suffered, they just existed, shuffling along like zombies to the inevitable conclusion;  already dead in spirit.  Any hope had been destroyed together with their humanity and dignity.  . 

Jenny fell passionately in love with a man, who abandoned her.  So she declared War on Want by refusing to submit to her own emotions and with that her need for  sustenance?   This is Jenny’s way. Others use drugs to fill the void left by the loss of hope, others eat or drink too much, others seek sex and others find refuge in illness or madness. In a moment of clarity after the storm, Lear expresses that it is better to lose his mind than to be preoccupied by devastating grief.  

David has been my client for twenty years.  He first came to see me because of persistent abdominal pain and constipation, which he was convinced was caused by a cancer of the bowel that his doctor had failed to diagnose.  No medical tests could convince him that he did not have a disease that would kill him unless promptly and properly treated.  He was very suspicious of any notion of any psychological cause but never stopped coming to see me.  David has never   given up, but he has been a hostage to fortune and he suffers for it.  He clings on to the idea a notion that life has to be fair.  He believes in trust and in spite of everything, retains expectation and hope.  If he were religious, this might give him peace of mind, but he’s not and it doesn’t.  Instead his expectations condemn him to torment of frustration and disappointment as life lets him down yet again.  For David, the pain and mental anguish represents his life force, a continuous grudge against the ineptitude of doctors, the neglect of society and the unfairness of life. . 

It was only recently that he came to the realisation that he doesn’t have to be a victim; the passive recipient of what life delivers. People rarely do what we want. They are much more concerned with their own needs. In that respect, life can never be fair.  It’s a world in which those who shout loudest often get all the prizes.  So if David wants to get what he needs out of life, he has to create the conditions that provide what he needs. 

Those who survived the dreadful conditions in the Nazi concentration camps were the ones who were able to retain a sense of their own identity and adapt to the environment without giving up.  They had no expectation of kindness from the prison guards, but they could gain sufficient life force from a brief glimpse of the mountains, the sound of birdsong, the memory of a melody or composing a poem.  Life is what each of us can make of it.  David’s wife was recently seriously ill with cancer, but this gave him a sense of purpose and worth as he negotiated with the doctors, looked after himself and the house and kept up a email commentary to friend.  .  

Life is never easy,  but we don’t have to submit to its cruelties and injustices. Neither do we have to make ourselves ill by railing against the world and suffering the torment and the illness.  There is a third way.  That is to adapt and take responsibility for our own destiny.