A Sydney Newspaper from 1993 Describes the Experience of EMDR: "FINGERS OF THERAPY”

It seems too good to be true, yet it’s claimed to work in more than 50 per cent of difficult cases.  Not for everyone but Ron Hicks looks into the treatment that is revolutionizing psychotherapy in Australia.

Burly Navy Diver Bob Taylor religiously moves his eyes backwards and forwards, following the two fingers of the psychiatrist who rapidly passes them across his face 20 to 30 times at a distance of about 30 centimetres.

Taylor does as instructed and thinks of the most terrifying experience of his life, an event that he constantly relives in his dreams – he would talk about it in his sleep and wake his wife.  It even intruded into his everyday life when some seemingly inconsequential thing, like seeing a rope, brought a flashback – that feeling of terror and sheer panic as if it were happening again there and then.

The flashback is to a reef off Queenscliff Beach in Sydney – and what should have been a routine dive.  But that day, while he as 25 metres below the surface, a blood vessel in Taylor’s sinuses burst and blood flooded into his goggles so he could not see.  Then the blood flowed down his throat so he could not breathe.  In his bloodied darkness and with no-one to help him, Taylor desperately searched for the guide rope that was literally his lifesaver.

“I can’t grab it … come here you bastard!”  Taylor screams as he relives that black terror after Dr Kevin Vaughan’s fingers stop moving in front of his eyes.  Again, there in that office, the blinded, choking Taylor desperately grabs for the rope.  The seconds tick away; each seems like eternity.  Finally, his hands find the rope … and he pulls himself to safety.

“You’re at the top now … you’re safe … you’re safe,” Dr Vaughan, head of the Post-Traumatic Stress Disorder Unit at Hornsby Hospital in Sydney, reassures Taylor, who mind is still at sea.

“How do you feel now?”  Vaughan asks.   “I feel safe … I feel good … I feel relaxed … I feel relaxed all over my body … and in my mind.” The treatment is that easy.  There would be four sessions and each time Taylor relived that stressful situation Dr Vaughan would pass his fingers in front of his face and get him to follow them with his eyes.

This simple movement is revolutionizing psychotherapy in this country.   Therapists are claiming an astounding success rate – anywhere between 50 to 90 per cent – in some of the most difficult areas of psychiatry and healthcare generally:  fields littered with failure. This new treatment is being used primarily for post-traumatic stress patients: people who have been psychologically scarred by accidents, by rape and sexual molestations, by robberies, by wars and by massacres, including victims of Sydney’s Strathfield massacre.  But following its success with these patients it is now being used in a wide variety of anxiety conditions, including phobias, such as agoraphobia.  And the professionals are looking to extend it to even more complex areas, such as treating multiple-personality patients.

As the story, already lore, goes, the treatment was discovered by a Californian psychologist, Dr Francine Shapiro.  In 1987, soon after a divorce, she was in a park in San Francisco, very upset.  In this charged state she noticed that her eyes began to move rapidly and, to her surprise, “the disturbing thoughts began to lose much of their power”.  Shapiro, a psychologist, began to experiment on herself by repeatedly passing her hand before her face.  She felt better.  She decided to see what would happen if she used the eye-movement technique on some volunteer patients, mainly rape-molestation victims and Vietnam veterans.  It was similarly successful.

The technique was introduced to Australia by Don Heggie, a semi-retired Sydney multi-millionaire.  Over the years, Heggie had experienced unexplained problems such as extreme anger when anyone questioned him (see end of article), which was not in keeping with his character.  Heggie had repeatedly sought different types of psychiatric treatment, but to no avail.

In 1990, after hearing about Shapiro’s new treatment, he went to California.  After just one treatment session Shapiro was able to trace his problems back to the trauma he had suffered as a bomber pilot shot down over Germany at the end of World War II.  Heggie was so impressed with the success of her treatment, especially after so many failures, that he took his psychiatrist back to California with him for the next sessions, so he could learn the technique.  Indeed, Heggie has so far spent $180,000 promoting the treatment in Australia, including paying for the directors of the Vietnam veteran’s counselling services in each State to travel to California to learn the method.

Shapiro named the technique Eye Movement Desensitisation and Reprocessing, (EMDR), which ostensibly describes what is thought to happen.  The theory is that the rapid eye movement brings on abreaction: the reliving of traumatic events in a way that allows the mind to process and accept them.

At the end of his sessions, Bob Taylor told Vaughan: “I never used to talk about what happened because it always put me on edge.  I now realise that what was upsetting me more than anything else was the feeling of embarrassment and guilt.  I had a slight head cold and there was a build-up of mucus in the sinuses.  I should not have dived that day.  I did not tell anybody what happened.  But now I think:  ‘Why didn’t I tell somebody I made a mistake.’  It is no longer a threat.  I can look back on it now and accept it and learn from it.”

Vaughan, who has been interested in post-traumatic stress disorder since he practised as a psychiatrist in Sydney’s Macquarie Street, explains what happens to people who experience extreme trauma:  “If you undergo a trauma, the real problem is that you re-experience it again and again … you continually relive it.  It haunts you.  If you are shot, for instance, you continually dream about it, or you may have flashbacks where you actually re-experience it – pain and all.

“What the people who believe in EMDR theorise is that … because of the highly charged emotion that accompanies trauma, it does not get put in the right place in the mind.  It gets stored very close to the surface of the mind, that is why it pops to the surface, out of the blue.  And that is why it has such a sense of recency …

“So, in eye-movement desensitisation and reprocessing … you get the patients to think about the trauma and move their eyes about at the same time (and) it somehow causes the mind to re-sort some of these memories and helps them slot them into the right place.”

Well, anyway, that’s the theory.  But, with a laugh, Vaughan later concedes:  “I tell that to the patients who come to see me and it makes sense to them … but I’m not sure it’s true.  The reality is that we have not got to first base as far as the mind is concerned.  Our understanding is really at a primitive stage.  We are really at the stage of looking at the back of a television set.   No-one has ever localized where the memories are in the brain, so it is all very well to hypothesise about tings being stored in the wrong place or in the wrong form, when you don’t even know where the bloody things are.”  For all that, Vaughan believes in EMDR because “it works”.  He carried out a test to prove it to himself – and, he hopes, to the rest of the scientific community.  He and another psychiatrist, Dr Michael Armstrong, looked at 36 post-traumatic stress disorder patients and randomly put them into three groups, with each given a different treatment.

The first group of 12 has the traditional “exposure” treatment for post-traumatic stress disorder, where a tape is made of the patient retelling the traumatic incident.  The patient then, over a long period, repeatedly plays the tape while using coping techniques to try to overcome his or her anxiety and accept the incident.  (This exposure technique, without tapes and other aids but with the use of positive reinforcement and anti-anxiety relaxation methods to “detoxify the emotions” caused by the trauma, is actually part of the full clinical EMDR treatment).  The second group was, basically, taught different forms of relaxation therapies.

The third was the EMDR group.  The test showed that after only three months of treatment, the EMDR patients fared better on every criteria – they had fewer nightmares and flashbacks; they had less depression; they could accept the memory more readily; they had more self-esteem.

Vaughan and other psychiatrists and psychologists know that, by itself, the EMDR does not “cure”, and that these other clinical techniques, exposure and relation, must be used by skilled practitioners to make it work.  But, according to Vaughan, who is also a lecturer in psychiatry at Sydney University, the test and his own experience show that EMDR significantly speeds up the process and seemingly makes curable cases that seemed intractable.

Gary Fulcher, who has a masters degree in psychology and is successfully treating Vietnam veterans with EMDR at the Concord Hospital in Sydney, believes he knows, roughly, how EMDR works.  He researched the technique with colleagues and believes EMDR stimulates three sections of the brain:  the brain stem, which focuses attention; the limbic system, which controls emotion; and the cortex, the thinking part of the brain.

“Because of the saccadic (rapid) eye movement, the patient can focus on the distressing incident,” says Fulcher.  “But, most important, the door stays open because of the eye movement.  Therefore the patient is exposed to the full emotion, and they are able to rethink it (because of the involvement of the cortex).  As a result, the memory is released.  Led through it properly, the person can become detached and think about it in a rational way, rather than just be overcome by emotion, as normally happens.”

One of the tests that Fulcher and his colleagues carried out was to do EEGs, or electroencephalograms, which measure the brain’s electrical waves before, during and immediately after EMDR.  The researchers found that during the rapid-eye-movement stage, the subject’s EEG was like that of someone who was completely relaxed – for instance, someone meditating or doing yoga.  This feeling of relaxation accords with how the patients themselves say they felt straight after the EMDR.  Another finding was that the EEG reading of people after EMDR was similar to those taken of people during rapid-eye-movement, or REM, sleep.

As with any new method, there is controversy and doctors point out that REM eye movement is basically up and down, not sideways, and not all practitioners accept the REM analogy.  But the finding does accord with Fulcher’s theory.

In meditation, the mind focuses in an ever-deepening fashion on something, whether it be on a traditional mantra or something else in more modern techniques.  Fulcher believes that when patients re-experience the trauma in this more relaxed mode of EMDR, it has a calming effect, and people can accept it more readily.

A development from this research is that the Shapiro back-and-forth movement of the finger is not the only way to induce the EMDR effects.  Psychologist Robbie Corbett, who is doing her masters thesis on EMDR and uses the method in the counselling service at Sydney University where she works, tested two groups of patients using different stimuli.  Using a television monitor, the first group was shown a programmed moving stimulus similar to the usual regular horizontal hand movements used by Shapiro and other therapists.  The second was made to watch a pulsating, but static, regular flash on the screen.  There was no difference between the two groups – they both had the same EMDR effect.  While she maintains an open mind, Corbett believes EMDR may be similar to the effect brought about by Eastern meditation techniques.  So how new is Eye Movement Desensitisation and Reprocessing?  Is it really something old – even ancient – that is new again?

Critics, such as Dr Chris Clarke, senior lecturer in psychology at the University of NSW, who has written a book on hypnosis and regularly uses hypnosis in treatment – he used it to help discover the multiple personalities of Tracey Wigginton, the so-called vampire killer of Brisbane who picked up a man on the street in Brisbane, killed him and then drank his blood – believe EMDR may be hypnotism.  Clarke carried out his own “preliminary” EMDR research on 10 subjects.  Five were resistant to hypnotism but the others who, by well-established international standards were “highly hypnotizable”, fared far better under EMDR.

But most of the rest of the psychiatric and psychological profession do not want EMDR classified as hypnotism.  Says Vaughan: “The people who are doing it (under EMDR) do not seem to be in a hypnotic trance,” although he does not rule it out.  “The essential thing about a hypnotic trance is that people are highly suggestible.  But in EMDR people are in control, they are not in a highly suggestible state.  They seem to be in some other type of mental state whereby all these memories can be re-sorted.”

Corbett, who has used both EMDR and hypnotism, believes they are different.  “In hypnotism the person is basically passive – receptive to suggestion.  But in EMDR, the person is active – they talk it through and process the information.”

Clarke is highly critical of the way EMDR has been promoted as “a new Jerusalem”.  “Some years ago neurolinguistic programming – NLP – was all the rage and there were workshops held all over the place for this new miracle treatment.  Now nobody hears about it.  I am wary of this new treatment which is often promoted like a “miracle cure” or the new ‘magic bullet’, particularly because of the absence of a coherent explanation of how it works and the dearth of proper, independent comparative research which replicates the reported success rates.

“It is too early to tell yet how successful EMDR really is and how long the benefits will last.  There may be numerous reasons why the treatment may have helped patients.  It could be just the relaxation it produces or it even could be a placebo or bandwagon effect – it is amazing what can happen if people believe a treatment is going to be successful.  And the enthusiasm of the clinician for a new technique can be a very powerful therapeutic tool in itself.”  Clarke says that what particularly disturbs him is the secrecy surrounding the method, which he finds repugnant and against the values of the scientific brotherhood.

EMDR is now popular with nearly 1000 Australian psychiatrists and psychologists – more than 12 percent of the total.  Given that the treatment of post-traumatic stress disorder is a specialized field, the figure is high.  All of EMDR’s practitioners were taught the technique by Shapiro, who came here in 1992 and 1993.  Discussions are now under way to introduce a system of authorized Australian teachers.

Participants at the two 1992 and 1993 workshops, each attended by nearly 500 professionals from all over Australia, signed a pledge stipulating the workshops were for professional purposes only and would not qualify the participant to train others in EMDR.   They were also forbidden to tape proceedings and were enjoined not to talk to the popular media about the technique, but to continue any written work to professional publications.

Proponents such as Fulcher and Corbett say this approach has been taken for safety reasons.  They fear the consequences, for example, of somebody experiencing a deeply repressed trauma, such as sexual abuse, after EMDR given by somebody not properly trained – or not trained at all.

Says Fulcher:  “The eye movement is only 20 per cent of the therapy, which involves things like teaching patients how to relax and giving them positive reinforcement to lead them out of difficult situations.  EMDR can lead to very tricky situations.  In one case I had a woman who panicked so much when she relived a repressed trauma that her throat closed over and she began to asphyxiate.

“It is an extremely powerful technique which can be dangerous in the hands of people who do not have the proper training.  Imagine someone who had suicidal tendencies being left in this traumatized state.  The last thing we want is for this to be used as a party trick.”  The problem is that anyone can wave his or her fingers back and forth 20 times.

Freedom for prisoner of war

Don Heggie, normally an easy-going person, would throw a fit of anger whenever anybody questioned him.  “I would suddenly start screaming at people,” says the founder and chairman of the Heggie Transport Australia company.  “One day I started screaming at my wife in the kitchen and I did not know why.  It was then that I knew I needed help.”

 He would also have unexplained screaming fits when he felt cold.  He saw numerous psychiatrist and psychologists in Australia, but got nowhere.  Then he heard of EMDR, and flew to California for an intensive course of six treatments in eight days.  “It was like peeling back the layers of an onion.  I realised that all my problems dated back more than 40 years to the time I was a prisoner in World War II.”

 At first, Dr Shapiro had Heggie concentrate on the feelings he had during his last violent outburst.  Then, after she employed her eye-movement technique by passing her fingers backwards and forwards across his face, Heggie’s mind went back to the war, in which he was the pilot of a Lancaster bomber.  Six weeks before the armistice, he was returning from a mission over Germany when his plane exploded not far from Allied lines.

 He was not under enemy fire but he believes a bomb from one of his squadron’s own planes somehow dropped on his, ripping off the tail section in a massive explosion.  Five of the seven crew died, and Heggie was sure he was going to be the sixth.  The front section of the bomber went into a violent spin and when he tried to jump free to deploy his parachute, centrifugal force kept him pinned to the side of the plummeting plane.  With one last effort he managed to free himself only a few thousand feet above ground.  He injured his leg on impact and, after hiding out for a day, was captured.

 German Air Force chief Hermann Goering has ordered that no captured aircrews were to be retaken by advancing Allied troops.  There was also tremendous ill-feeling towards bomber crews among the German guards, many of whom had lost family through the bombing.  “They moved us around from place to place for six weeks and I was always afraid that I would be shot,” says Heggie.  “One man was shot just because he walked off the path to relieve himself.  One guard, who family had been killed in the bombing, shot any bombardier he found.” 

Advancing British troops finally caught up with the constantly moving column of prisoners and Heggie’s six-week nightmare, “which had more stress than most people have in their entire lives”, ended.

 Although he deliberately pushed those memories to the back of his mind, the reverberations from his wartime experience and the trauma and guilt over losing his crew remained.  It was only after the EMDR treatment that he realised what caused his problems, finally re-integrating and accepting them after Shapiro’s treatment.  “I am a different person today.  I feel whole and free.  My family is amazed with the changes in me.”

 Following the success of the treatment, the semi-retired millionaire committed himself to bringing the benefits of EMDR to the many people who suffer similar problems, particularly Vietnam veterans.

A Client Describes the Advantages of EMDR: An Adjunct to Trauma Therapy

The following is a report from a client who benefitted from help using EMDR. The intervention itself is definitely not a panacea but it can be of great use to enhance the therapeutic work already being done for many clients. Not all clients benefit from EMDR but many find it very useful:

I have been a patient of Phillip Milligan for just over 2 years being treated for PTSD as the result of my work in law enforcement. One particular critical incident I was involved in resulted in having constant flashbacks, re-occurring nightmares and serious psychological issues for over 30 years.

Early on in our sessions Phillip advised me of a procedure that he had just completed training in, being ‘Eye Movement Desensitisation & Reprocessing’ (EMDR) and he believed that this treatment would be a suitable help for resolving my issues. Phillip described the treatment and how it was applied, and to be quite honest I was sceptical and apprehensive to try it, as it seemed a bit  ‘quirky’ and I couldn’t logically see how it could work.  Eighteen months into our sessions and Phillip again mentioned EMDR and the benefits that he could see me getting from it - this time I agreed.

I was anxious and quite nervous when I attended the session that would see EMDR begin. Phillip put me at ease by comprehensively explaining the treatment and so we began. During EMDR I was dismissive as to how Phillips ‘finger movement’ and verbalisation was going to assist in repressing something that had haunted me for over 30 years, but it didn’t take long for that to start to happen. After only a couple of sessions I found that this traumatic incident was being ‘boxed away’ inside my brain to somewhere it would stop hurting me. I eventually found that the memory of this incident was tucked away in my memory for recalling when and/or if I wanted it! Seldom, if at all, does some outside noise or other influence cause flashback memories and nightmares and finally I feel like I am regaining ‘normal’ sleeping habits and a more relaxed life.

Though I was sceptical about EMDR at the start, I would have absolutely no hesitation in recommending this treatment to others.

Pandora's Box

In Greek mythology Zeus, king of gods, lived on Mount Olympus and men roamed freely there on the Mount and elsewhere amongst the gods. Living at that time was a man called Epimetheus and he was the wisest amongst the men for he knew the secrets of life. Epimetheus took the beautiful Pandora as his wife (Pandora was fashioned from water and clay by the gods and sent down among mortal man to punish them for Prometheus’s act of stealing fire.) Pandora moved into the home of her new husband, and took up her wifely duties…”

Now, said her husband “you have all my worldly goods. You can take care of the house and all the animals that I have. You can go anywhere on my property and clean and sweep every corner, but I beg of you, never go to the north room. Keep it locked at all times.”

Now, Pandora set about her duties and was soon finished. As there was nothing else left to do she became restless and bored and so she began wandering around the house, eventually coming to the north room. She tried the door but it was locked. She went away but thoughts of the room kept going around inside her head. “Maybe I can just take a little look", she thought to herself, "Just take a quick peek. Surely there would be no harm in that”. After a little while she decided she would get the keys and open the door. She returned to the room, unlocked the door and it opened noiselessly. Pandora peered into the room, but it was totally empty with the exception of a box in the middle. Pandora’s curiosity knew no bounds and she felt compelled to open the box, so she did and out came hundreds of creatures looking like insects. The insect-like creatures bit and stung Pandora all over her body then they flew up and spread out into the room. Quickly, Pandora shut the lid and sat on it. While sitting there on the box she heard knocking coming from inside it. Now she was reluctant to open the box again thinking that she had already done enough harm. “Let me out”, said a tiny voice, “and maybe I can help you”. Pandora thought about it and decided to take one more chance. She opened the box and out came a tiny fairy.

“I am Hope", said the fairy. "Pandora, due to your curiosity you have let out all possible troubles for mankind. There will be no peace of mind for humans from this day forth. There will be greed and jealousy, insanity and lust, there will be plague and hatred, men will fight each other, wives will be set against husbands, sons against fathers, brother against brother, there will be famine, pestilence, vice and destruction. The world will know great sorrow……………".

Hearing this Pandora started to cry and sob terribly, for the great harm she had brought upon herself and her fellow humans. "Do not cry so much Pandora", said the fairy, “Yes it is true that you have unleashed all manner of afflictions upon the world, but you have also let me out. I will always be there to bring hope to humans, whenever they are in trouble. I will always be there as the promise of Hope"!

Hope springs eternal in the hearts of humankind.

Lying within every disaster is Hope and from the Greek myth of Pandora’s Box we see that the ‘gods’ in their wisdom and kindness (even though the human race was being punished for the wrongs of Prometheus) saw to it that we would have hope and that it should still be found in amongst the evil, misfortunes and calamities that have beset humankind since the dawn of time. When we find life too hard, tough and painful, hope can be a temporary but calming sedative to the troubled soul. Initially it is hope, sometimes illusory, that gets us through the early stage of the misfortunes that befall us.  Often people who articulate hope well in times of disaster and turmoil are elevated to the status of heroes…

Following the initial phase of upheaval or disaster, the first task is turning hope into optimistic and realistic plans for the future that will possibly alleviate the problem and maybe prevent its reoccurrence. If responded to in this way and with specific goals in mind, hope is then outward looking and creates new opportunities from crisis, also adding to one’s emotional growth.

But hope also has another side to it. It is the side that can show it’s face when we are either unable or not willing to transform this illusory hope into realistic hope. It is a denial of reality, a flight into fantasy that someone/something will simply appear magically, making things better. A fantasy like this would be to pin your hopes on winning a lottery and solving all your money problems that way rather than to make some workable plan to deal with them. Now it would be fair to say that the majority of us are given to both forms of hope: illusory and realistic, although circumstance and our personal history will often be the decider as to which form will dominate. Perhaps we need to have a sense of hope in either form in order to survive but it is important that we know the difference between the two.

The opposite of hope and the most unbearable of the human emotions is hopelessness. It is said that “where there is life there is hope”, but might it not be that, “where there is hope there is life”?…..it would seem that with hope having gone, even rising from our bed each day would be futile……without hope what sort of life are we to have…? It certainly would be without love or meaning. It would be just a living death.  God in His wisdom has given a sure Hope in bringing Jesus to life again, so as to show us that whatever disaster faces us, there is always a hope beyond the immediate situation.

The Crisis Response & Recovery Cycle

Bob Montgomery in his book “Surviving: Coping with a Life Crisis” says that people typically go through a number of stages of adaptation as they come to grips with a life changing incident:

1/ Crisis response: Shock / Disbelief / Realisation / Non-emotional survival state.  This is the immediate response to an unfolding crisis.  Shock can affect a person so that they feel overwhelmed physically.   As with most stress reactions, blood is withdrawn from the outer part of the body as well as the brain, causing nausea and dizziness, perhaps fainting.  Breathing may become fast and shallow while the heart rate increases.  When extremely frightened, a person can lose control over the muscles of the bladder and bowel and although it may feel very embarrassing, this is a very common experience.  Disbelief, a coping mechanism used by the mind to protect itself from the full impact of the crisis, can give the mind breathing space to come to grips with the enormity of what has happened.  Realisation gradually emerges, triggering a non-emotional survival state where the victim can even become immobilized.  In this latter frame of mind many people will remark on how calm the person has been during the most intense part of the crisis.  In this state, a victim will do almost anything they think will keep them safe-sometimes resulting in actions which are later regretted.

2/ Release or escape: once a person escapes from the initial phase of the crisis, they can then find themselves left with a task that most people would actually be unprepared for and even unaware of while it is happening – the need to cope with the emotional aftereffects of having been in a crisis.

3/ Recovery cycle: Shock / Depression / Mood swings / Anger / Philosophical reflection / Bringing it All to Rest.  After escaping the crisis, people will often fall back into a state of shock, often marked by a dull, flat emotional state.  Friends and family may actively but unwisely encourage the apparent emotionless façade by suggesting that the person forgets about it at that point.  As time goes on and with a little less social support, the victim can be unable to sufficiently express anger and other intense reactions to their experiences and may slump into depression, which only adds to the victim’s sense of emotional isolation.  Toward the depression face many victims experience marked mood swings, up one day and down the next and these mood swings can cause extreme anxiety if they are misinterpreted by the victim as being abnormal or undesirable.  Mood swings will pass more quickly if the victim, as well as everyone else, accepts them as normal for a person in this position, and no one will try to resist them.  In time, anger can emerge almost as a natural attempt to regain control-perhaps an attempt to gain a healthy sense of management but at this stage it may produce defensiveness in friends and further isolate for the person.  Someone on the receiving end of the victim’s anger can easily become distressed themselves-particularly because the anger will seem unfair and unprovoked. Three basic truths in normal life have been challenged by a trauma: the assumption that regardless of attempts to remain safe, we are all continually vulnerable; secondly the awareness of the possibility of an inevitable death is often suppressed; and third we discover that events occur without notice and seemingly at random.  As the victim comes to a realisation of their essential vulnerability, a new perspective through philosophical reflection will emerge and at this stage questions about God and ultimate destiny will inevitably be asked.  As a result of accepting and working through normal distress reactions, a victim can finally lay their crisis to rest as a bad but fading memory.

Phillip's take on things

It seems to me that change in a person is facilitated mainly in the context of a safe emotional environment, where there is as much affirmation and acceptance as possible.

Research points to the existence of four main factors common to all forms of psychological therapy regardless of any special theoretical orientation (dynamic, cognitive, etc.), mode (individual, group, couples, family, etc.), dosage (frequency and number of sessions), or specialty (problem type, professional discipline, etc.).

Extra-therapeutic [40%] i.e. elements outside of the counselling situation are of great influence.  Actually, counselling is a humbling experience and many times I have had a sense of helplessness in my experience as a change facilitator. It is the person who makes the changes and the counsellor simply facilitates the process.  The up-side of it all, though, is that a client is empowered to find her own way through and as a result new pathways and attitudes are taken on board with a boosting to self – esteem.

Quality of the Therapeutic Relationship [30%], where in this context, the sharing of words and experiences in a safe environment make for change, bringing new meanings about one’s life to awareness, especially when recovering from trauma.  Words shared in conversation can put unmentionable pain into context and help us grow as we not only feel emotionally safe enough to explain what is going on in our lives, but when explaining it to another person (“Iron sharpens iron”), we can obtain feedback in the process so as to come to new conclusions and directions in order to avoid repeating negative reactions in the future.  Therapists need to be experienced as genuinely caring, showing that each person matters – offering something ‘over and above’ the problem, with hopefully relaxed warmth, openness and adaptability as well as competence and safety.  Clients want to know that what they want from therapy is respected, so that there is a growing desire to finally do the work of change.

Placebo, hope, and/or expectancy [15%], an element once again generated within the person but which can be enhanced through support and encouragement.

Structure, model, and/or technique ([15%].  The theory of the presenter actually only counts for about 15% of change and this is where what we think we can do to a person to bring about change pales into insignificance compared with the myriad of other influences coming from elsewhere, including the person’s own efforts.  The final factor to consider, then, is that the individual client has the last say in the change process, as quoted in the following: “There is evidence that self – help therapies can do as well as or almost as good as a therapist/client relationship.  Also, the therapeutic relationship is not determined by the therapist alone – it is what the client puts in that is a major factor.  The way a client attaches to the process and other factors from the client are things to consider.  The therapist is more a catalyst than a cause and the active journey of the client is a very important factor”.  The question is, does the therapy work or does the client work?

1. Each person is an individual and we can only work with what is in the person and what is already at work – a person tends to hear what already resonates in him and he will reject what appears to be personally irrelevant to him.  However, the stimulus that a counsellor gives can expand the health that is already there in order to work together for new perspectives.
2. A client’s view of the presenting complaint, potential solutions, and ideas about the change process form a ‘theory of change’ that could be used as the basis for determining which approach would be the most effective for each person and by whom it can be delivered, in relation to that specific problem, under that particular set of circumstances.  The ‘Client’s Theory of Change’ is best understood as an “emergent reality” that is unfolded through conversation structured by a therapist’s curiosity rather than a static entity such as a psychiatric diagnosis.  In a therapeutic relationship that honours the client’s theory of change, therapist and client work together to implement the solutions required or they select ideas and techniques from available treatment approaches that provide possibilities for change unique to the person.  I continually find that there is a mystery as to how this works but there are principles involved that can be clearly followed.  Curiosity about peoples’ hunches not only provides access to their ideas of the change process, but gives extra clues about each individual’s uniqueness while encouraging active participation. This requires a sensitive ongoing relationship above all.  As a Christian, I believe this will mean that the person and their own complexity needs to be respected and taken into consideration if significant help and influence can take place, with patience and the consideration that there is always a Bigger Picture than my own when dealing with my fellow humans.
3. People often take on board ideas about themselves and reality through the small focus of their childhood experience and unless this focus is examined, questioned and changed for the better, inaccurate and dysfunctional beliefs about life can remain unnoticed and unchanged for a lifetime.  In other words, the inner ‘child’ continues to control the adult and in the light of a safe relationship, change is slowly encouraged.
4. Finally people will do what they will do. We see the world the way we are, not the way the world is and we filter information according to our prejudices and mindset.  So influence comes out of going along the path with a person and then at the same time adding the difference in collaboration.
5. Finally, a central principle for change is that of the need to come to an acceptance of that which is. A counsellor’s work is often to gently invite the person to face what is, to grieve, hurt and also to laugh and then to move to new perspectives.  Through all of this mysterious process called counselling and psychotherapy, people who persevere with the process of change usually get places, either to solve or resolve their challenging issues until light and joy returns.  There are no guarantees but the good outcomes I have seen encourage me to persevere as well!

Much of the above comes out of the work of Scott Miller (http://scottdmiller.com/wp-content/uploads/What%20Works%202010.PDF) and Barry Duncan (https://heartandsoulofchange.com/ )

The journey of psychotherapy

A Client’s View:
Psychotherapy can be challenging, disappointing and encouraging all in the same process.  An ex-client has written a letter describing the long term outcomes from a therapeutic relationship that spanned several years, after an 18 months gap:

“I miss our conversations but I am (now) coping OK in my ‘real world’.  I have had a few challenges over the last couple of months which would have been ‘fodder’ for much counselling.  However I have come through relatively unscathed and with friendships intact.  My husband tells me I have been very ‘good’, which is comforting.  My focus is still on making my family life my number one priority and although work has tried to creep in and cause chaos, I have stayed very aware of the importance of my physical and emotional well being and have managed to keep the work in perspective, maintaining adult reactions rather than gravitating back to a ‘reactive’ child mode of emotionalism.  There has been a notable increase in feeling my emotions in the present instead of ignoring them and going into a split off, detached, mode.

It feels good to release the emotion-happy or sad or angry and I have also managed to express them in a socially acceptable and healthy manner which has not interrupted harmony too much and has (I can’t believe it) allowed me to reveal some of the raw, real, me to people: I would have frequently put on an act or a front in the past.  This is great, of course, but I realise the other side of that is I get to see and feel all aspects of human nature as an adult and not in my ‘fantasy world’ of when everything and everyone was ‘pure and perfect’ as I tried to convince myself.

My emotional connections with people are deeper and with that comes responsibility-again my only words to describe the feeling of this is like I have woken up or someone has snapped their fingers to bring me to attention from a hazy day dream.  When I am interacting with people, I feel a strong sense of being in the present (the ‘here & now’), responding and expressing emotion and receiving the other person’s responses, accurately listening to their words and their feelings.  I am down a path I have not been before and it is all new and sometimes scary, as I am experiencing Life for the first time.  You helped me switch on my ‘cognitive brain’ and it has turned the key to unlock that part of me that had stayed hidden and protected but in a real sense, ‘dead’, so in summary I feel ‘alive’ for the first time!!

I am letting people see I am not perfect and that I do have flaws and that’s OK because I am OK.  The best part is I don’t have to pretend and I don’t have to manipulate to get my way and I am not allowing people to manipulate me in return – a huge weight off my mind.  I have let go of control and found that I am just like everyone else, trying to fit in with life and discover who I am.  I can still feel the ‘little girl’ in me but she is no longer the dominant being, keeping me subjugated and needing to please authority figures.  My boss has tried to manipulate and influence my emotions as usual but I have not responded and complied and I can see that I have definitely dropped a few rungs on the ‘V.I.P Ladder’- and scary as it is, that is OK too!!  You did tell me I was text book ‘normal and average’ but I just didn’t believe it.  Now I can see it and I have a few more friends as a result.  I do not work anything like the way I used to and my perfect standards have dropped and that’s OK too.  My key word is ‘moderation’ and I say it over and over when sorting out what Ineed to do and what I am able to do.

I have drifted away from a few people as well as they have given up on trying controlling me with no disastrous end result and that has been liberating!

Recently my mother actually directly displayed affection for me in front of other people and family members.  She put her arm around my shoulder, introduced me as her beautiful daughter and did not let go for at least a minute and even when I moved slightly, she hung on.  This is a first and she did appear to be comfortable with this.  I did not know what to do at first and my emotions initially stiffened but I breathed and gave in to the moment and allowed her to hug for as long as she wanted and I moved only when she let her arm drop.  This is a big step for mum and I hope a step in the right direction in her own emotional healing.  She told me she enjoyed the day and loved having me as company-it was a lovely day.

I am not drinking alcohol in huge quantity like I used to and this has been a major difference and it has been a major difference and had the most positive effect with my family and I believe this is only the beginning.

Good, hey!  Thank you for accompanying me on the journey.

This is not the end but the beginnings of new and healthy ways of dealing with her life.  Everyone is different and stories are always unique, but this story hopefully encourages us all to consider that change is in fact possible despite the perceived challenges!

Understanding trauma - The hard way!

It was a busy work day on 19th November 1996. I was driving to work, preparing to counsel my first client – A woman with post-traumatic stress disorder, as the result of a head-on collision on a freeway. I was carefully calculating my speed to ensure I would make my appointment on time, when her trauma suddenly became my reality. I collided head on with a car travelling down the wrong side of a double lane highway. The combined speed of the accident was about 160kmph and I broke about 11 bones in my legs, pelvis, left arm and various other places. I don’t remember the collision itself, but woke up an hour later, as if from sleep, noticing people around me, the car a different shape and slowly realised that I was in a great deal of pain. I didn’t know what was going on. It was all a blur. I asked what had happened and they told me that I had been in an accident. I vaguely recalled seeing a flash of what I had thought was a yellow Toyota to my right and that is the only memory I have.

The car I was in was only small and the impact had caused the whole front to cave in and pin my legs. I was trapped. They decided that the only way to get me out was to lift off the whole roof and then cut off the steering wheel. I lapsed in and out of consciousness during this time and only have snippets of memory – someone holding up an intravenous drip, a fireman training a hose on the car at all times; a shop with a ludicrous model of Quasimodo hanging from it. All the time this was happening, my only concern was for someone to ring my receptionist and cancel my appointments. I figured I wouldn’t be making it to work that day! The emergency workers seemed to be a little more concerned about saving my life than ringing my office.

The struggle to part driver from car lasted a total of two hours. When they finally removed my crumpled body from the wreck, the pain was so severe that I blocked it from my memory! I was then airlifted to the Alfred Hospital Trauma Unit by helicopter. My only ride in a helicopter and I missed most of it! The next few hours came and went without much of it making sense on my part. I thought that I would have to wait in casualty for hours – I didn’t realise that my injuries were far too severe for me to be left lying on a trolley in a corridor. Doctors came and went. My clothes were cut from me, including a pair of shoes I had only just proudly bought at an Op Shop!  Scans and x-rays were taken, drips put in – all done before I realised the implications of what had happened. The next few days in the high dependency unit helped me to become stabilised. I had to have an operation on my foot, bones were set, traction put on, a tube was put into my side to drain all fluid as I had received a pneumothorax injury, due to one of the drips having pierced the lining of my lung.

I thought this would be the start of a few weeks in hospital and then back to my life – how wrong I was! I was in hospital for 3 months and spent the following 6 months rehabilitating.  I am now back at work but the recovery process became long and draining, although compared to many severe accident victims, the first phase of my recovery was reasonably quick. I still struggle with generally more sensitivity to anxiety and my wife is still struggling to relax after the shock of it all, especially when I am driving!  During my hospital stay she carried the load of the family for both of us, so that there are after-shocks still continuing to this day.

Having to be on my back for 6 weeks and largely in a wheel chair for another 8, made me feel very vulnerable. The helplessness experienced meant that I needed frequent doses of encouragement from those around me. Frequent short visits were appreciated – long ones were tiring. It was a new lifestyle, this recovery process, and it needed to take up every ounce of energy I had. Recovery was my whole life. To recover well, I understood that I would need to accept the trauma, the resulting physical limitations, my labile emotions and go with it rather than resist what was happening to me. For quite a while this meant that I often thought of little more than my injuries, making it necessary at times to consciously resist a tendency toward becoming too introspective. However, this is often a natural stage of recovery because little extra energy is available to do more than work on healing. Many times I wanted to recover more quickly and yet improvement has only occurred smoothly as I have accepted the natural pace of healing.

The need was constant for my wife and I to be able to discuss the accident and related events again and again. To outsiders, this may have seemed monotonous, but for us an important part of recovery. Both of us needed to have the chance to tell our own stories as each has had a different experience. The time spent in the rehabilitation centre was valuable for this to occur as everyone there was in the same boat and everyone wanted to tell and listen to each others stories.

One of the hardest things to do, not just for me but for my whole family, was to return to ‘normal life.’ Humpty Dumpty fell off the wall and not all of the pieces fitted together again. Some are now missing or floating around in the wrong places. Adrenaline gets you through the crisis and although this was an extremely difficult time, I manage to cope, but the adrenaline for me has tended to form a habit of continuing to surge to this day. Nobody warned us about how hard getting back into life would be. Feelings of fear and inadequacy accompanied the long-term physical limitations that have taken months and even years to overcome in certain ways. Questions about my life and purpose have been frequent.  This trauma has forced me to look at my foundations, lower my self-expectations and accept my own frailty. My thinking processes were affected in that it was harder to maintain focus for some months, after so much time out of circulation. I have discovered that appearances can be deceptive in that although I looked alright, mentally and emotionally I was not 100% for quite some time.  It was difficult feeling pressure from people expecting me to have fully recovered just because the bones were knitted together. It has been a real relief when others indicate understanding that the amount of recovery time required can be a long while.

So, what of facing life? I’m a little more edgy about facing everyday situations – you never know when you’ll wake up after an accident! However, I must say that fear of driving has not been that great. It has probably affected my wife’s driving more than mine.  I believe that because I was knocked out, perhaps I don’t have the data in my brain that tells me that driving is dangerous. No data – little fear. My wife on the other hand was fully conscious when she was trying to find where I was when I hadn’t turned up to work as well as when the police pulled into the driveway. The shock of all she went through that day has made her very wary when driving and she finds it hard to trust that drivers are conscious of what they are doing. She was experiencing some degree of secondary post-traumatic stress for some time as well.

The accident has brought about another surprise – the overwhelming insecurity that I now feel because I am acutely aware of life being so precious. I am tempted to feel my great insignificance in relation to the hugeness of the reality of life that I face day by day. Things that ordinarily would not have bothered me sometimes become very big issues and I often feel like giving up. Things that happen on the news or to others I know have left a huge impact on me (although 12 years later the stress has diminished quite a bit) and I feel very fragile in relation to my life, still. The fact that I am a fragile human being has been brought home to me and amplified a hundred times more than previously.

I still believe in a God who is bigger than my reality and that He is deeply interested in every detail of my life. Hope comes from this and also seems to come from the little things that I am capable of doing from day to day. My acceptance of my feelings and limitations as well as the challenge of living in the here and now have given me a way of life that enables me to take pleasure in simple things so that I can continue on. Numbness and slight pain still remind me of the event.  I have discovered recovery to be ongoing and the story continues.

By Phillip Milligan

Experiencing D.I.D

There is an analogy between dissociation and Lord Nelson.  It was at the Battle of Copenhagen when Lord Nelson ignored the retreat signal by looking though the telescope with his blind eye. “I really don’t see the signal”, he said, so he wasn’t lying… sort of.  History shows Lord Nelson stayed and had a great victory over the Danish Fleet.  Maybe that’s where the expression “turning a blind eye to things” originated?

The reality of coping with overwhelming emotion and memories and using dissociation to help with the coping is, nevertheless, an extremely challenging thing.  A client has described her experience in the following passage.  Thank you, R C for doing this.

“I am one body, one brain with many personalities, thousands of parts, (our others) names and memories and we have DID, we’ve collaborated in writing this personal information. What’s written comes from our years of experiences. We have renamed DID as DIO because for us, we now have a certain order, understanding and management in life so we like to see it not as a disorder, although that’s what it is, but as a chosen “order”.

Growing up with DID, “other parts” has meant we didn’t remember most of our life until things became really messy. We didn’t just lose minutes or days, but years, which is really frustrating when you’re at school, raising a family or working.

We believe for anyone with DID to start and continue healing safely, that trust and communication, both internally and externally must be explored. The internal dimension is especially valuable and mapping how you connect with each other really helps e.g. Drawing and writing. Although we choose to live with all of us in a collaborated existence it doesn’t mean it’s easy or without stretching us to the very limits. Healing is about acknowledging the traumas and pain of our life and learning to live each minute at a time. Slowly we began to make sense of our life!

When we started meeting those who shared our life we had many reactions and not all positive.  The feelings and actions ranged from anger, hate, violence, towards myself and others, reliving traumas and pain both physically and emotionally, being very scared and confused, to lots of switching between personalities. Healing has involved knowing the truth and telling it as it is! Being listened to without judgment, especially when” parts”  tell  their own story. God is also a key in our healing and having faith in God wasn’t always completely the case for us all.  We were very divided in our beliefs because of the way we were raised, so faith has been a growing thing within our personality system, but we do believe that without God we would be dead.

In our healing we have learnt many ways to cope and probably the most important one has to be becoming “grounded”.  Grounding —- coming back to a personality that can cope, e.g. the host

personality.  Staying in the present moment is something that’s really important because it’s a way to stay focused on the present or on a goal we’ve chosen. Grounding and mapping is done in many ways and each method works or helps different “parts”.  Sometimes we draw – very complex drawings – or produce paintings from an adult perspective, or from a childs’ view with a large piece of paper and textas, this allows the children to tell their own story and express themselves. We use grounding stones, which might be a colored stone or one from the garden: something to hold on to; or a collage of torn up magazines that come together to tell a story. We also like to run because we feel our body working together and we wear bangles because again it’s something we can feel. We like to sit in our garden and feel the sun on our skin, which is good when we’re really down because it reminds us that God gave us beauty and we love to feel the earth under our feet. Sometimes when we are really confused we just write words, in no order, just whatever pops into our head – “brainstorming”.

We also like the routine of going to work and we’ve had a number of jobs which have been incredibly varied – different work for different personalities.  Working helps keep us connected with people and pay the bills, it also allows us to travel. Working hasn’t been without its unusual challenges so that there have been times when I found myself unexpectedly in hospital which can be interesting but difficult to explain.

Travelling is also very grounding because it allows us to learn about new people, situations, cultures and mostly a sense of freedom and I guess for us it’s a way to escape normality for a while. There’s nothing like being grounded when you’re in another country!

We have also turned some of our grounding skills into a business: we draw, design and make jewellery for other businesses. Recently we sold some paintings for the first time which was really rewarding. It seems that now we’ve started to write about grounding we’ve so many ways that can be shared.  Other things come to mind and one of the most important things in our life is being involved in other people’s lives that are worse off than our own. We help start an orphanage in Nepal many years ago, where we met some really poor kids.  These kids had nothing but a plastic bag for their belongings and a smile and now with support we have built a house, bought cattle and now they are working towards self-sufficiency.  Just this year we have our first child going to university to become a teacher.  This has certainly taken us out of our comfort zone and made us really happy. Happiness, fun and laughter are very grounding and when all else fails we go see a movie because it transports us for a couple of hours. Learning grounding and mapping skills has definitely changed our commitment to life.  When we look back at what we’ve learnt we can’t help but thank God-there’s nothing better than to be grounded in God.  Trust has been extremely important too because without that we wouldn’t be able to connect with people or all our “parts”. These things took years and we trust each “other” fully to function in whatever role we need to be in. Everyone learns to survive in various ways and these are some of ours.”

R.C.

Message of the Maples

Edgar Jackson is famous for this classic story, as relayed by Edward Ziegler, a Readers Digest writer, which contains an enduring message.  At the time of writing, Jackson was struggling to overcome the huge challenge of having had a stroke and the loss of his speech:

I knew him to be a wise man, living in seclusion with his wife. But willing, he said, to receive me if I were ever in his part of the country.

I had heard him speak years before and recently had read several of his books. Now I was seeking him out because I had hopes his wisdom might relieve the gnawing melancholy that darkened my days. Financial losses and an old disability had combined to take much of the savour from my life.

On a clear, late-winter day, I found him on his farm. After years of writing and lecturing and helping others, as a minister and ‘physician to the soul,’ Edgar Jackson was now applying his own wisdom to himself. He had been struck down by a severe stroke. It left him paralysed on his right side and unable to speak.

The early prognosis had been grave. They told Estelle, his wife of 53 years, that recovery of speech was unlikely. Yet within a few weeks he had regained his ability to talk and he was determined to recover still more of his faculties.

He rose to greet me. He was a distinguished-looking man of middle height, moving slowly, aided by a cane, with an unmistakable sparkle in his gaze. He led me into his study. It was lined with books, new and old, all surrounding a desk on which sat a word processor and reams of paper and magazines.

He said he was glad to hear that his books had helped me. They had indeed, I said, but still, a series of setbacks had added up to a sorrow I wasn’t sure I could master.

“Then, in a sense, you’re grief-stricken.” He said.

But I hadn’t lost anyone close to me, I protested.

“Nevertheless, what you’re going through is related to grief. What’s essential is to mourn your losses fully and find solace by learning to live with them.” People who don’t, he added, wind up bitter and disillusioned by sorrow. They’re unable to find solace. But others who creatively use the act of mourning can gain new sensitivity and a richer faith.

“That’s why you so often hear that we have to talk out our feelings; express our emotions. That’s part of the mourning process. Only then can healing follow.”

“Let me show you something,” he offered, pointing through the window to a stand of bare maple trees, solidly facing the sharp winds that plucked at their barren branches. A former owner had planted the maples round the perimeter of a pasture.

We walked through a side door and out to the pasture. It was a rocky expanse rife with grass and wild-flowers in summer, but now brown and wizened by frost-kill. Strung between each large tree, I noticed were strands of barbed wire.

Master or victim. “Sixty years ago, the man who planted these trees used them to fence in this pasture, and saved a lot of work digging post holes. It was trauma for the young trees to have barbed wire hammered into their tender bark. Some fought it. Others adapted. So you can see here, the barbed wire has been accepted and incorporated into the life of this tree – but not of that one over there.”

He pointed to an old tree severely disfigured by the wire.

“Why did that tree injure itself by fighting against the barbed wire, while this one here became master of the wire instead of victim?”

The nearby tree showed no marks at all. Instead of the long, anguished scars, all that appeared was the wire entering one side and emerging on the other – almost as if it had been inserted by a drill bit.

“I’ve thought a lot about this grove of trees,” he said as we turned to go back to the house, “what internal forces make it possible to overcome an injury like barbed wire, rather than allowing it to distort the rest of life? How can one person transform grief into new growth instead of allowing it to become a life-destroying intrusion?”

Edgar could not explain what happened to the maples, he admitted. “But with people,” he continued, “Things are much clearer. There are ways to confront adversity and work your way through that mourning period. First, you try to keep a youthful outlook. Then you don’t bear grudges. And perhaps most important, you make every effort to be kind to yourself. That’s the tough one. You have to spend a lot of time with yourself, and most of us tend to be far too critical. Sign a peace treaty with yourself, I say. Forgive yourself for the silly mistakes you’ve made.”

After another pensive glance at the maple grove, he led the way back into the house.

“If we are wise in the way we handle grief, if we can mourn promptly and fully, the barbed wire doesn’t win. We can overcome any sorrow and life can be lived triumphantly.”

Estelle appeared with a piece of cake and a cup of coffee.

“I try to keep a growing edge on my life seeking new knowledge, new friendships, new experiences,” Edgar continued, glancing over to the new computer and half a dozen new books on his desk. He had been waging his own battle. He was still frustrated by his partially paralysed right side, but he wasn’t conceding defeat.

“We can use our painful experiences as excuses for retreat. Or we can accept the promises of resurrection and rebirth.” His gaze turned towards the pasture across the road.

“You have your problems. I have my own struggles. I’ll work on mine,” he offered, “If you work on yours.”

“Thanks, I will.” I promised, and we shook hands. We had a deal. I felt I had won some new understanding – and now had a strategy for handling my sorrows.

As I drove down the valley, I could glimpse his farm across the meadows. The wind toyed with the lofty tops of those living fence posts, which, though still mysterious, had so much to say to all of us.

Anger

IN ORDER TO CONTAIN THE IMMEDIATE FEELING OF ANGER AS SOON AS POSSIBLE, SO THAT IT DOES NOT EXTEND TO VIOLENCE (GENERALLY SEEN AS AN ACT OF POWER, ATTEMPTING TO TAKE INORDINATE CONTROL OVER A SITUATION OR ANOTHER PERSON), ASK:

1/ What is the actual source of irritation? What is it that is making me feel angry?

2/ Why am I feeling anger and not some other emotion?

3/ Am I jumping to conclusions about the situation or person who is making me angry?

4/ Is my anger really justified?

5/ Do I really need to feel inferior or threatened in this anger-arousing situation? Am I really as inferior as this situation or person might suggest?

6/ How might others including the person who is angering me, view the situation?

7/ Is there another way in which I can look at the situation?

8/ Are there things I can do to change the situation in order to reduce my anger?

9/ Whenever someone belittles, acts superior, or is hostile towards you think of who or what has been bugging them! Your awareness of the forces responsible for any person’s behaviour will help you feel less inferior and thus less hostile.

PREVENTION:

1/ Discipline the mind-avoid negative ruminating!

2/ Avoid anger-arousing situations!

3/ Continue to evaluate situations and see things from others’ points of view.  Quickly deal with situations when it’s needed.

4/ Learn self-respect!

5/ Let go and give it over.