"The world isn't created of atoms and molecules, but of stories. Maybe I wanted to create a world. A new one … where I, and we, could be happy and safe."
C. Anthony Martignetti. Beloved Demons: Confessions of an Unquiet Mind.
Anthony Martignetti is a psychotherapist, who came to writing late in life. He had the good fortune to be close to Amanda Palmer, who introduced him to the well-known writer Neil Gaiman, when Amanda and Neil became a couple.
I do understand why so many psychotherapists begin to write. It's a chance to re-visit, to make new pilgrimages to old places. So much of therapy is about hints and clues passed back and forth. Your pivotal moments. My pivotal moments.
Sessions unfurl like the thread of Ariadne, leading us deep into the maze of our own self-remembrance. With each successive new encounter, we are offered another chance at re-creation and re-imagining.
I was sad to hear that, shortly after the Winds of Change conference, Jim Duvall announced that he will no longer maintain his active affiliation with Hincks-Dellcrest. I imagine him down somewhere in the American south, taking it slow, reflecting under glistening stars. I heard Jim once say: If there's pathology, it's the system, not the patient. It's good to remind ourselves that such is so.
I did promise I'd share Jim's relating of a pivotal moment, taken from his clinical practice. I don't have a lot of the details, but his story told of a musician who severed his relationship with music for many years, after suffering a trauma. Much later, along the post-traumatic path of his own string of pivotal moments, he saw his relationship with music-making in a new, transformed manner. Finally, he started playing again. Now, he possessed an alternative relationship with music, which had taken on new meaning in his life.
If we stand in the ambiguity and uncertainty of the pivotal moment, we are offered a chance to re-incorporate old gifts and identities with the fruits of new learning. Something shifts. Jim recalled how someone asked Ray Charles how his music had evolved. Ray answered that there were less notes and more space between the notes - that's what made his music sound better.
During the workshop, we asked ourselves if we could imagine what might be happening in the brain when we stay in a pivotal moment long enough to achieve new meaning and outlook. I'm not that enamoured by what we know at this point in neuroscience to struggle too hard with this question. But I have heard enough from people like Pat Ogden, Daniel Siegel and David Grand to believe that there can be a powerful re-orginazation of brain structures during these episodes, with the undoing of old, restrictive defensive dissociations.
At best, our goal is to help these moments of growth to stick. Brain scientists know that neurons that fire together wire together, which challenges us to find ingenious ways to deepen the experience of this new organization of experience.
As a sensorimotor-trained psychotherapist, I sometimes see big shifts come in a different manner than the narrative therapists do. Working with traumatic cues as they arise, we utilize clinical skills to engage the brainstem and to re-organize truncated animals defences that have been disabled during events where patients were unable to complete an active defence before an immobilizing one (freeze or feigned-death) took over. These patients - without this kind of work - continue to manifest these thwarted and disorganized defensive patterns decades after the traumatic event, leaving them at risk in the world.
I remember in one case we were completing a truncated defence in session. The patient had been severely abused by her father, and carried many scars and embodied traumatic beliefs with her as sequelae. When these techniques work, they are quite dramatic to watch, because there's a reorganization that starts in the primitive brain and then shifts into cognition. You can literally see (if you've been trained to see this sort of thing - I happen to have been an emergency physician for over two decades, which helps a great deal) the autonomic nervous system cycling back and forth and finally settling into a more balanced and calm state.
As her nervous system re-set itself, my patient began to see her father in a different light. She did not see him as better or different, but was able to form a more nuanced, less emotional view of him. She could see his own wounded-ness, and sense the abuse as less personal, less a reason to remain held in an oppressive victim consciousness.
So, in sensorimotor psychotherapy, we don't stop there. We note the shift in the body and the transformed belief that goes with the new somatic state. We deepen this new, stronger state and we then help the patient to begin a daily practice, linking the five core organizers of thought, emotion, internal body sensation, five sense perception and movement. We bring it all together into a new, more resourced way of being.
As I complete this series, I am reminded of watching what seems to me to be my first display of how powerful a pivotal moment can look. It comes from watching Gary Craig, the masterful founder of Emotional Freedom Technique, a form of energy psychology. Gary was working with a Vietnam vet who had been overwhelmed by guilt after shooting a child who was preparing to throw a grenade at him. Years of talk therapy had not helped him and his life was stuck until, during the meridian point tapping, he stopped trembling, his body came out of hyperarousal and he said, matter-of-factly: I get it now. It was either him or me. I had my own children back home and I needed to get back to them. Was it the tapping helping to activate both hemispheres simultaneously, or was it the calming delivery of Gary Craig. It's impossible to know.
What I do know is that these moments are unmistakable. The shift in the body and in stubborn and deeply held beliefs are profound and quite sudden. They cannot be forced but we can be midwives to their appearance. They define the work of good therapists and good therapy. They invite us to slow down and to pay attention.
A few notes:
- in the workshop, Jim Duvall also mentioned that one of his patients had experienced a pivotal moment after contacting the memory of making snow angels. I had just watched the movie The Perks of Being a Wallflower a few days earlier, where the troubled main character leaves a party to make his own angels in the snow. Sometimes, different threads come together like this, and I ask myself who is doing all this cosmic weaving. Have even the heavenly beings taken up needlework for stress relief?
Anyway, as I promised earlier, I will be blogging about this touching and heartfelt movie soon.
- for those of you interested in these things, you can read an article entitled, Research as Retelling: Capturing Pivotal Moments in Therapy and Training, at:
One of the authors is Faye Mishna, MSW, PhD, who presented one of our Wednesday evening sessions in March, 2012.
Angel Yuen, from the Narrative Therapy Centre in Ontario, presented a Wednesday evening talk entitled: "What is Narrative Therapy" in October, 2012.
- I thank one of my patients for introducing me to Anthony Martignetti last year. My patients do seem to be quite enthusiastic in recommending books (and movies and articles) for me to read. For the last few years, I've been so behind in reading everything I want to read that it hardly seems to matter if I add more to my list. But, if you, my reader, decide you too want to recommend a book to me, please take brief pause. Hopefully, if you do recommend something, I'll be seeing your suggestion after my first coffee of the day.
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