Richard
Good day you fantastic folk. Here we are with another episode of therapy natters where two psychotherapists natter away about therapy stuff inspired by suggestions and questions from you our lovely listeners out there in listener land. I'm Richard Nichols and my partner in crime is Fiona Biddle. Hi, Fiona how's tricks. 

Fiona
Very good. Thank you. How are you?

Richard
I'm all right. The sun is shining. Is it shining over you?

Fiona
just, just barely, but it's going to be good day.

Richard
Really? It's gorgeous here. I'm not I'm not that far away from you. I'm here in the Midlands.
Fiona
Maybe it's coming in this direction? 

Richard
Oh, I hope so. I'm in North Leicestershire is this classed as North Leicestershire. Well, it's North West Leicestershire. Yeah, that's where I'm at. So I keep thinking on North Warwickshire, but I'm not. You're not too far away from me.

Fiona
Well, I'm in Cheltenham. And Today's the big day in the racing calendar. 

Richard
It's today?
 
Fiona
And the weather is supposed to be really good. Which is lovely. makes it even better.

Richard
Oh, I didn't realise it was today. Oh, fantastic. Are you having a flutter? 

Fiona
Oh, I'll have a little little flutter. I don't spend a lot but a little flutter. But I don't know what I'm doing. I just choose certain jockeys and certain horses. I remember a horses name that I think oh, I remember that name. But I can't remember if it won or lost. So it's not very good.

Richard
But a lot of these big I mean, I'm not a gambler by long measure, because it's all nonsense, especially these big races, it doesn't matter what you bet on, the chances of you winning or losing are the same no matter what, it's just a free for all.

Fiona
There's a little bit more to it than that, but not a lot. 

Richard  
it does fascinate me without the gambling, what is horse racing? Let's just see how fast these animals can run. Why?.

Fiona  
They are lovely creatures that if you get up and see them close up, they are so beautiful. So beautiful.

Richard  
I've got some friends who keep horses. And if it wasn't for my son being allergic, we'd probably hang around them more. He swells up. Just properly explodes. It's crazy.

Fiona  
Gosh. Now, this is natters. But I think we need to get to the point sometimes yes,

Richard  
we've probably nattered enough because we have a submission. We have a question from from a listener Anonymous from London says. And it's quite a serious one. "Are there any techniques that can help with acceptance after being sexually assaulted, bearing in mind justice is so rare. It's been a good couple of years. And I still feel like I would just talk forever around in circles about it. And it causes a lot of anxiety and unrest which spills over into other areas of life. I don't understand how people can learn to accept these things. And I'd be interested in a podcast about this." Well, anonymous from London. First off, I'm sorry you went through what you went through. We don't know exactly what you went through. And we don't know. a gender here for definite. My first thought as soon as I read this was this is a woman who's been sexually assaulted.

Fiona
But it could be a man 

Richard
for definite, it could be a man. I wonder if it was he'd specifically say. But

Fiona  
but then he might specifically not. So we just we don't know. And we don't know any details other than what's been put there. So we are working blind. But that in one sense helps us to generalise. So that's okay. And I think we need to start with the concept of that word. Accept. What does that mean? I think it's something that gets bandied around as Oh, you just need to accept and move on. But acceptance doesn't mean that whatever it was was all right, or okay. 

Richard
It doesn't mean that it was acceptable 

Fiona
It was not acceptable. No. Once that part is clear, in your mind, anonymous, that will help you to get to the point where you can accept that it did happen, because you can't change it. We can't change the past however much we'd like to you can accept that it happened. Acknowledge that it was not okay. It was not acceptable. And having gone through that process, which sounds really straightforward, as I just say, of course, it's not that straightforward. But that's the starting point.

Richard
To me, the word accept means to come to terms with the fact that it happened. We have to accept that it happened. I think there is sometimes this this drive when we've gone through a trauma to almost not pretend that it didn't happen but to wish that it didn't happen to live in the if only's. If only I hadn't been there. If only I hadn't done that if only they hadn't said that or whatever the if only's are. And we have to accept the reality that it did happen. Because in that there's no denial, then there's no defence mechanisms trying to protect us from being re traumatised. defence mechanisms are useful, they're there to protect us to stop things that have been traumatic happening to us again. But if all it does is make us feel scared, and fearful and overly emotional, if that's even a thing, of course overly emotional is a thing. And maybe that's what acceptance is, we have to accept how we feel, in order to then change that feeling

Fiona
that the feelings that we have, were what they were, are what they are. And that that's okay, feelings are valid, because you've got them. I was also thinking that other people's attitude could really affect the ability to accept if other people who are close to you are colluding with a denial, colluding with a non accepting attitude. That could either be a denial or colluding in the talking forever around in circles part could be either end of the continuum.

Richard  
 Yeah, I wonder if other people out of their own pain, wish it didn't happen as well. And so can sort of belittle the problem, the pain that the victim is going through, and I don't like that word victim. I don't like that 

Fiona  
I had avoided it a sentence or two ago. But again, I think there's probably something we should address

Richard  
that's the terminology that's gonna get bandied about

Fiona  
victims. Yes.

Richard  
They're a victim of a crime that's what they get called.

Fiona  
Yes. I think the trouble is that that word gets used incorrectly or inappropriately at times. But if we just make clear right now that what we mean is the person who was subject to the crime 

Richard
subject 

Fiona 
now that's even worse, isn't it?

Richard
Um, this is why people talk about survivors. But when somebody's going through all that trauma doesn't feel like they're surviving. Sometimes. They feel like they're dying. Sometimes.

Fiona
I remember somebody saying that you could use the word target. I think it's a place where our language does struggle a little bit.

Richard
As therapists, I think it's important that it's important that because therapist are going to be listening to this not just people genuinely just interested in therapy. There'll be there'll be therapists listening. We have to get inside the client's mind, what did they think? What do they want to refer to themselves as? If they feel victimised And they feel like a victim to go Oh, no, we don't use that word in therapy. Well, that's what I feel! Be with me, sit with me understand me. And I think that's important. And yeah, as a therapist reading this message from anonymous, all I want to do is bring them into therapy. But, I can't, I can't see everybody.

Fiona
There are enough therapists, as we've said before, for everybody out there, but if anonymous, or anybody else in this sort of situation is thinking of finding therapy, it really is important that you find a therapist who is qualified in working with past trauma, different courses, different modalities, different ways of working, have different specialisms and just make sure that that is something that their training and experience has covered,

Richard
depending on whether somebody is considering reporting the crime to the police. It might be important when looking for therapists to just mention the phrase pre trial therapy. Do you work with pre trial therapy? So that then it weeds out some of the therapists who will just take on anything? Oh, yeah, I work with trauma. Yeah, I work with depression. Yeah, I work with post traumatic stress disorder. And new therapists and even established therapists will sometimes just say yes to anything just to get clients in. Yeah, I'd love to work with that come on in. And I get that every therapist has got to learn those things. But with some things with some issues, it's important that somebody's got some extra training and they fully understand the issue

Fiona
there can be in our field as in probably any field, some unconscious incompetence, ie they don't know that they don't know it. And Richard, your question there of free trial therapy is a really good one to weedle that out. So why don't you explain a little bit more about why that particular phrase is important as opposed to just not just weedling them out?

Richard  
Yeah, it's because in the UK, at the minute anyway, there is talk that it's going to change in the future. But as with anything in law, it takes could be a decade couldn't it before things change. But as it stands at current time of recording 2022, if you are living far in the future, then do please check with the Crown Prosecution Service. But at present, although somebody who is going to be a witness, as somebody who is going to be going to court to talk about a crime, they are allowed to have therapy, if they feel that they need it, at the minute, they're not allowed to talk about the case, because you're not allowed to talk about a case, whether it's with your therapist, whether it's with a friend, whether it's with another witness, you're not allowed to talk about it. And one of the reasons that is, is because it's long been known that the more that you talk about something, the more your memories can change about it now in therapy that can be quite useful, because what we want is for our brain, to learn to think about the past in different ways. But the police don't like that, because they want the truth, they want facts. And it is suggested then that even if you started therapy, because you've had a trauma, if you then disclose to your therapist, I'm going to be going to trial about this, I'm going to speak to the police about this, especially if it's about sexual abuse, because somebody can bring that up in therapy, that therapist could be the very first person they've ever spoken to about it. And of course, it's not impossible, then even the therapist could get called as a witness. Because we're the first person that was disclosed to. It does happen, it's never happened to me. And I don't actually know of any colleagues that that might have happened to. But that's not to say it hasn't happened to somebody that I do know, and we just haven't spoke about it for obvious reasons, because it's confidential. But when the client discloses, I'm going to go to the police about this, this is going to be taken further, the therapy has to change, they're not, they're not allowed to talk about the incident itself anymore, in case it alters the way that they think about it. But that's not to say they can't carry on with some sort of therapy, about the way that they feel right now. So they can talk about their emotions, they can talk about their day, they can talk about what's happened in between sessions, but they can't talk about the past. They can think about it, and maybe they can have treatment about it, but they're not allowed to talk about it. So it's a strange one. But it makes sense. It makes sense, doesn't it?

Fiona  
It does, it does make sense. Because we all know that. We've done that for ourselves. And we we have talked about things and it's changed our perception. And we would not want to change the perception of how we experienced a crime because then yeah, that you're not going to be presenting the truth of what happened at the time. So it does, it does make sense. But it also feels very tough. And as anon said, justice can be rare. But let's concentrate more on the people who are either post the trial stage or not going there. Let's think about what can be done. We talked about finding a therapist who can work with trauma. And the basic process when working with trauma is to reprocess it, so that the mind is dealing with the trauma in an ideal way, because of course some people go through a trauma and don't suffer very much from it afterwards. Certainly it doesn't all work trauma does not always lead to post traumatic stress disorder.

Richard  
There's one study I saw which had 40% experienced post traumatic growth, that a traumatic experience made them feel stronger and more empowered, that it made them cross a line to go. Okay, I'm not gonna let this hold me back. 40% is quite a lot.

Fiona  
It is a really good statistic. I hadn't heard that. But you know, what doesn't kill you makes you stronger phrase, isn't it?

Richard  
Nietzsche. The man himself.

Fiona  
Yeah I was thinking Kelly Clarkson. But, whatever. Both. Yeah,

Richard  
there was there's certainly cases in Oh, who's that lady I follow on Twitter. Jessica Hartnett, she used to work at a university in the States. And there was while she was doing some research there, into wellbeing, and happiness levels and confidence. And so on of the students, one valentine's day somebody went into the school with a gun and shot a lot of people absolutely horrific. But she was in the middle of a study into monitoring everybody's well being, obviously totally ruined the study, but I mean, small potatoes compared to the horrors that was going on. But it then gave the university some data that goes well look at the happiness of all these people before a shooting and look at the well being of them afterwards. And let's, let's see if there is a difference, actually, although there was some feelings of feelings of safety dropped a little bit but the reason I mentioned this is because what we find the students that had experienced that trauma were far more likely to continue with their studies compared to any other year that has ever been. As if the horrors that they went through knowing that their friends had been killed, that we're going to take every opportunity to grow, I'm not going to not let this hold me back. And so fewer of them dropped out of the university studies compared to any other year in the in the past. And since then afterwards as well. There's always a dropout rate at universities, but not that year. Weird. Post Traumatic Growth made them stronger in a way.

Fiona  
I don't think we can go into today, what makes one person go down a growth route or a disorder route. But suffice to say perhaps that there will be differences, and it's down to how the brain processes the trauma. So the therapy is about when it's necessary. reprocessing the trauma, there are various methods for doing so, perhaps the most evidence based is eye movement, desensitisation reprogramming, 

Richard
EMDR

Fiona
EMDR, which sounds a bit weird when you first hear about it, because it's eye movement. Usually, it doesn't have to be eye movement, but something about bilateral stimulation, either moving a finger in front of the eyes, so that your eyes move from side to side whilst thinking of the trauma. Or it can be done with sounds that are played to either ear alternately, or it can be done with tapping. So you can tap on your knees or shoulders, or there are actual things called tappers that therapists can provide that you hold in your hands. And it's creates a sensation of a tap on either hand. So there's different ways of doing it. But the whole process is to reprocess and to go back and get your brain to process the trauma in the ideal way that it could have done but didn't, for whatever reason, at the start, when it happened, it's very successful really can make a huge difference.

Richard  
one of the ways I think it can be so useful for people is because you might not have to talk about the incident so much, there'd normally would normally be a lot of talking about it in order to work on it. But in theory, it's going on in your own head, you're thinking about the trauma, you don't have to describe it and go into great details. You don't have to, am I right or wrong there.

Fiona  
I would say you're right. I do know of a couple of people who work extensively in EMDR. And they would say, Oh, they need to be talking. And personally, I've found it easier to work if they're giving the story. Because you can keep a track of where they are. Because with EMDR, you're often going off down tangents. You start with the core of an experience, and then you shoot off down a tangent of something else that was similar. And then you come back to the core and then you go off on another tangent and come back to the core. If the client isn't saying what those tangents are and what they are processing, it can be quite tricky to keep a hold of, to know what's happening. But it's still certainly possible. definitely possible to do it content free.

Richard  
People that have been traumatised often are quite scared about talking about it. Because their experiences have been every time they've started to talk about it. They've been re traumatised, and their week is ruined, and they've only spoken about it for two minutes, then their depression just plummets. And that's why therapy is so important because a trauma therapist will know how little to push you for want of a better phrase to know how far you can go. And although talk therapy is always about talking, trauma therapy does involve a lot of emotional regulation, learning how to ground yourself in the moment so that when if you're being re traumatised, you can slow your heart rate down and get back into your body back into the room and feel safe again and go okay, let's just leave that there. And then go on a tangent diversion about something else while you calm down. So you're not re traumatised. And that's important, whether somebody's going to go to therapy or not that they're not going to re traumatise themselves by going round and round in circles, causing a lot of anxiety and unrest as anon says..

Fiona  
One of the things with any trauma can be the the emotions that are felt afterwards can be difficult to handle, which compounds the trauma itself. So for example, I'll take it away from Anon because we don't know but somebody who's been traumatised could feel exceptionally angry, either with a perpetrator, but there isn't always a perpetrator. So they might feel angry with God or the universe or themselves. They could even feel angry with somebody completely unrelated who didn't stop it. For example, there are all sorts of different scenarios. So anger is one emotion that a lot of people struggle with because society frowns on anger a little bit. They could also feel shame, which is likely to be inappropriate. But there could be elements of shame that might sort of fit. But shame is a big one for being inappropriate. They might feel helpless, or hopeless, vulnerable, all sorts of things that can be very uncomfortable to feel. And a little while ago, I said, feelings are valid, because you've got, again, that's the first place to start is just to acknowledge, oh, yeah, I'm feeling really angry right now. And take away that judgement of the, well, I shouldn't feel angry, because that's a bad thing to do to feel like, take away the judgement of the emotion. And to just say, okay, yeah, that's what I'm feeling. It's there. So it might be appropriate, it might be inappropriate, but it's there. So just let it be. For a little while.

Richard
Often we talk about anger management, as if anger is unhelpful. But I think without anger, we don't take action. Sometimes. We don't know that, that there's something going on underneath. Because obviously, we're not. It's not just anger, no one just generates anger. What happens is we feel an emotion first. And that makes us angry. And sometimes it's feeling vulnerable. feeling powerless, makes us angry, feeling hurt, feeling embarrassed, feeling anything else can make us angry. And we tend to look below anger sometimes as a way of acknowledging it. But when somebody has been assaulted, they know why they're angry. They're angry at like you say, God, the universe themselves, the perpetrator, their friend for not picking them up the taxi driver for dropping them off in the wrong place. Whatever it is, there's a direction for their anger. But what Anon and others are trying to do is feel happy anyway, feel safe anyway, despite their experiences, they can be angry about something that happened, but they don't want it to infest their life, and spoil everything else. And I think that's reading that email from anon. I think that's what's going on there.

Fiona
Yeah, yeah, infest is a good word there's and it's an infestation from one thing to another. Anon asks about techniques. And I know that Richard and I both had the same initial reaction of crikey a technique for that, it seemed sort of that's to sort of trite almost. But then I was thinking, I do have a technique that I'll share with you. But it really is sort of down the line technique. It's not in place of therapy, reprocessing of trauma, it's not in place of that. It's afterwards when things come back in. And this can be used for anything that anybody is feeling that they don't really want to be feeling right now. So it's not just for these sorts of situations, it's for anything that you might feel, that includes some physical stuff as well. So if you're feeling a toothache, you can do it on that it's not going to make the toothache completely go away. But it'll make it a little bit better. It can be used for any feeling that you sort of sitting there and thinking, really not comfortable about having. this is based on this technique that I'm going to go through is based on one called the Sedona technique that you can find if you Google it, but I've adapted it somewhat, which I always hate to say, because it makes me feel arrogant, but I have. So there we go, I have a version of it. That's my version of it. Have a look at the original and see mine and see what you think. And it's completely up to you to decide. But this is the technique. And the first step is just few minutes ago described, which is allowing the feeling to be there. So let's use a different emotion rather than the ones that we talked about with this. Let's take envy, let's take envy as an emotion. mentioned about it being the Gold Cup day, it's Cheltenham and I can see from my upstairs window, the helicopters arriving constantly. And so I could feel envious of the people who can get a helicopter to the racing. I suspect everybody can understand the feeling of envy. So the thing is just to allow yourself to feel the feeling. So sit and just let it be for a few moments. Yeah, this is what I'm used to or this is not what I'm used to. don't often have this one, but just in some way, probably you don't really want it otherwise you're not likely to be doing this technique. And then you ask yourself three questions. I'll go through the questions. And then we'll come back and look at what they mean. The first question is, will I feel this feeling forever? The second question is, would I like to let it go? And the third question is, When will I, having asked yourself those three questions, you're likely then to feel a shift in how you feel, you may need to go round the process a couple of times, three times. But usually, that's enough to shift whatever it is into a better place, it could have completely gone, it could just be much more bearable. That's usually enough. But let's look at the questions. Will I feel this feeling forever? Well, as we are sitting here, logically, rationally, we can see that the answer is going to be no, of course not. There isn't any feeling that anybody will ever feel forever. Unless they're about to conk out within the next 10 seconds, I suppose then you could. But otherwise, whatever it is, however awful the feeling, it would always come and go, so might come back. But it's never going to be forever. But there can be times when we feel as though it's going to be forever. And that really tells you something. If you get that information. Oh, crikey. That's how serious this feeling is that I feel it's forever. It's information. That's important.

So the second question, Would I like to let it go? Well, you're doing this process? So usually, the answer is yes. I'd like to let it go. But sometimes you think, oh, no, actually, this is okay. This is the right feeling for me to be feeling at this moment. And then the third question depends on the answer to the one before so if you said yes, I would like to let it go. The question, When will I is when will I let it go? To which the answer is usually now. But if you've said, No, I don't want to let it go. The question is, When will I want to let it go? To which the answer might be in half an hour's time, this evening, tomorrow morning, a week on Tuesday? Whatever it is, and whatever your answers when you then think about, okay, how do I feel right now, there's usually a shift. It's quick, you can do it anywhere, anytime, walking down the street, driving, anything, because it's just thought process, you don't need to tell anybody you're doing it, you could be sitting next to your significant other, and they're driving you nuts. You do it there, they don't know. You feel better. Very powerful, very simple.

Richard  
It's a simple self therapy, how to get to know yourself. And just that little just those three questions just to get to know yourself and and what's going on in you in that moment. And some of the reasons why you feel the way that you feel because as anon is alluding to, sometimes an emotion is there because I want it to be there. And the question, when will I let this go? For some people it would be when justice is served. But as anon said, when it's He Said, She Said, and so many things get overlooked. Sometimes it isn't fair. And so you explore that deeper within yourself.

Fiona  
Because it could be sitting there with the feeling of this. It's not fair. And the emotions that come with that will be dependent on you and your circumstances. So you do it on that feeling.

Richard  
exactly that. Exactly that because then you eventually will get to the point where the question, when will I let this go is now I'm ready to let this go. Now. I'm ready to let this go.

Fiona  
Also important to point out that it doesn't have to be permanent. You can, it can come back. It's it's not an all or nothing. You might want it to be but that's not real life. Things will come back there will be times when an anger for example, reemerges. that you thought I though I'd dealt with that, oh, blooming heck that's come back. Do the method on that. And you'll find that it comes back less frequently, with less intensity.

Richard  
And as time goes on, it becomes the past an experience that you had that hopefully then does lead to some post traumatic growth potentially. A difficult subject. I mean, I'm quite a light hearted guy. You know me. Cheery, cheery isn't the world a great place to look at the sun is shining. Yay. But actually not always. It's not always a blue sky pleasant world. And as a therapist, we do hear some horrible stories. Sadly, we really really do. And I think maybe that's why my isn't the world a wonderful place shiny shiny me character needs to dominate me sometimes. So I don't get pulled down into the doom and gloom of everything so that I can filter the world. And not only see the horrible things that are going on, but also see that it's beautiful as well. And that actually there's a lot of humans that are kind and wonderful and beautiful. 

Fiona
Absolutely. OK. I hope they thats helped to answer anons question for today

Richard
i hope so i hope so and if there's any follow up questions that any of you have including you Anon do let us know. And if anybody else has any questions at all about therapy, about mental health, about anything related to what goes on in the consulting room then do let us know. Fire off some questions the link is in the show notes and we will be back before you know it. So take care folks have a lovely day

Fiona
Bye everybody