Chapter 3.

Therapeutic Experiences as Background

Chapter 3 of the book explores therapeutic experiences that provide the background for subsequent discussions. ……

A post-traumatic distress

45 minutes to complete recovery

I was contacted by a student experiencing post-traumatic reactions following an accident. As the head of outdoor work in a park and responsible for personnel, he had been involved in an accident with a woman driving a mini tractor. Since then, he had hardly slept and could no longer concentrate on his studies. For three weeks, he had vividly relived the incident in his mind, like a movie, day, and night. As he narrated the events, the tremors, anxiety, and nausea returned, along with the internal images of the young woman with severed fingers, the fence post through her thigh, the flowing blood, the sound of her moaning, and his sense of nausea and paralysis.45 minutes later, the client left. We spent 10 minutes on assessment, and approximately 35 were dedicated to therapeutic work. He was free from the trauma. No images, no sounds, no trace of anxiety, nausea, or tremors. He calmly recounted the experience once again. As he was my student, we continued to meet weekly for an extended period.

The last time we met, two years later, after he had completed his studies, I asked him how he was doing. He looked puzzled. The question seemed unexpected. The episode had been forgotten.

Depression

A feeling of tying shoelaces as a mental reality

Sometime later, I encountered a depressed client with significant coping difficulties and a self-image close to zero on a scale of 0 to 10. I attempted to elicit experiences in which he had accomplished anything just to establish a connection. I did this because I was concerned that he might carry his psychological discomfort into the treatment, hindering the initiation of the change process while in a negative mental state. He shook his head. His perception was that he had neverachieved anything. He was now over 50 years old. I felt confident that there had been an experience of mastery andaccomplishment at some point in the man’s life. More time passed. Through further questioning, I guided the client back intime to early childhood. Suddenly, he brightened up. His first and almost sole experience of accomplishment was when he managed to tie his shoelaces after many attempts. He remembered the neat bow, felt the good sensation, and smiled.

The ”shoelace feeling” became the foundation of the treatment. Gradually, we reconstructed a new narrative of the client’slife, where he mastered situations that he had previously perceived as defeats. Each time, we started with the question:How would you have coped with the situation if you had been in touch with the ”shoelace feeling” back then? If he hadaccessed the ”shoelace feeling” earlier, he would have mastered most things, even in adulthood. The ”shoelace feeling”became a symbol of various mental resources that he could now tap into. The client was mentally sound and had greatcapacity for change. After a few consultations, the depression disappeared.

Performance anxiety

From a mental experience to a physical reality

Then I got a new client, an accomplished leader and auditor in a major bank. The bank had lost several hundred million in the previous banking crisis in Norway, and he was expected to present the poor financial results to the bank’s board. Butintense performance anxiety led to sleeplessness and anxiety reactions weeks in advance. He even took sick leave. It hadbeen getting worse lately.

We worked on the fear of disclosing the red numbers and alleviated it, but a new challenge arose. The client did not trust that what he experienced during the consultation would also happen because he had never been without anxiety in thesesituations. I had a spontaneous idea and asked, ”Do you have a hot plate?” He smiled and confirmed it with a smalllaugh, feeling uplifted. Perhaps the therapist was not so wise? ”Are you sure? Do you trust, and do you have experiences ofthe coffee getting hot if you put the coffee pot on and turn on the burner?” He pondered. ”But if the stove is working?” Yes, then he was sure. ”Completely sure?” He smiled again, ”Completely sure.” ”Can you tap into that feeling of security andexperience regarding the coffee getting hot?” ”Yes,” he replied. ”Is it this feeling of experience you need when you start the board meetings?”

The client confirmed once again. Based on neuro-linguistic programming, I ask him to imagine taking that feeling ofexperience and security he has in connection with brewing coffee into the boardroom. Then I examine how he feels when he starts with the same confidence he has when he turns on the coffee. It works. We tried different ways and made someadjustments. The experience of the coffee getting hot when he turned on the hot plate was transferred to an experience ofhim giving several introductions at the bank’s board meetings without anxiety. The doubt about whether it would work in the future disappeared.

A couple of days later, he conducted the board meeting without anxiety. We later made some adjustments. He didn’t just want to get rid of the anxiety; he wanted to become more proficient in what he did.

Incest

Results without knowledge of the client

A young woman reached out for help. She had been subjected to incest in early childhood by a close family member, butthe breakdown only occurred in her late teens. Conversations with the police, doctor, nurse, and psychologist had not yielded any progress. She still carried feelings of guilt, anxiety, aggression, and betrayal by her parents. The first thing she expressed was, ”I’m in pain. I’m not functioning. I want to get rid of the thoughts and distress. I want a normal relationship with a man, but I can’t talk about it.” She experienced the repetitive and prolonged conversations with thepolice, nurse, and psychologist as a new form of abuse, with some individuals becoming more interested in the sexualdetails rather than her well-being. Her situation significantly hindered her ability to lead a normal life and pursue a music education.

I faced the challenge of treating an incest experience that had not been resolved through previous therapy withoutknowing what had happened or how the woman perceived her situation. I had to work without information. After fiveconsultations, the traumas were gone. We then worked on performance anxiety. The woman later discovered that she had long been in love with a man. She got married and had a child relatively quickly.

I still don’t know what happened during the years the abuse took place. I know the perpetrator in the family and a little about how certain family members reacted when the abuse was discovered. Still, I have no knowledge of the woman’sfeelings and experiences during those years. A few years later, I received a beautiful letter. She is doing well. The traumas and the subsequent psychological reactions have been gone since the treatment, and she shared that she had regained control of her body and life.

New questions arising from therapeutic experiences

Based on my understanding of treatment, these results should not have been possible. You shouldn’t be able to cure a post-traumatic disorder in 45 minutes or build a functioning mental life by addressing a ”shoelace feeling.” You shouldn’t beable to borrow a sense of experience for a situation you have no experience of and perceive the new situation as if you hadexperience with it. You shouldn’t be able to treat incest experiences without knowing anything about the client and whatthe client had been subjected to. These experiences led to the following questions:

Questions related to psychological distress:

• · What constitutes psychological distress?

• · What are the causes of psychological distress?

• · How is psychological distress mentally constructed?

• · What is the relationship between the normal psychological state and psychological distress?

• · Is what is common between the general psychological state and psychological distress more significant in understanding psychological distress than what sets these states apart?

Questions related to psychological changes:

• · How can we establish contact with and assess the mental material underlying psychological distress?

• · How can we modify the mental material that causes psychological distress?

• · How can we achieve lasting changes through treatment?

• · What occurs mentally when a psychological change takes place during treatment?

Questions related to scientific rigor:

• · What are the prerequisites for developing scientific knowledge about psychological distress?

• · What are the prerequisites for developing a scientifically sound treatment?

Some of these questions formed the basis for further research, while others emerged during the research. These questions are answered in this manuscript on the psychology of the brain and in the book on Linguistic Brain Therapy (LBT).

Literature reviews yielded no answers

Extensive knowledge, but no sufficient answers

The therapeutic experiences led to multiple rounds of literature reviews. I delved into six individual therapeutic traditionsand nine family therapeutic traditions, research literature, scientific theory, diagnostic literature, books on psychology, the history of psychology, research databases, journal articles, and the psychology curriculum at the University of Oslo. Theresult was negative. The literature could not explain the surprising therapeutic outcomes. Therefore, I returned to my treatments to investigate whether it was still possible to develop scientifically valid answers regarding the mentalconstruction of psychological distress and what happens mentally when clients achieve psychological changes through treatment.

New assumptions

Bold Assumptions, Inspired by Karl Popper

Based on Karl Popper’s recommendation (Karl Popper 1989, Pax 2007) to put forward bold hypotheses, over several years, I formulated a set of hypotheses about mental disorders and psychological change. One set posited that all mentaldisorders were mentally constructed similarly, resulting from contact with certain mental elements that triggered clients’ emotions. The mental-biological processes leading to either psychological normality or disorders were of the same type and could be identified and modified through language. These assumptions stemmed from my work with mentally healthy musicians and severely psychiatric clients using the same method, with the only difference being the application of words.

The second set of assumptions pertained to psychological changes. These assumptions proposed that various psychologicaldisorders could be altered in the same manner, that the psychological change process the client would undergo in treatment could be predicted, that minimal knowledge about the disorder could lead to modifying it if one knew psychological changes, and that psychological changes would be enduring if no new burdens arose between sessions.Additionally, the assumption emerged that the same mental processes occurred when achieving psychological changes in therapy, regardless of the therapeutic approach, whether psychoanalytic, psychodynamic, behavior-oriented, gestalt-oriented, cognitive, solution-focused, narrative, strategic, postmodern, multisystemic, or existential therapy. Analyzing therapeutic processes based on these assumptions from 1992-2001 led to the development of the theoretical foundation for brain psychology and linguistic brain therapy (LBT). I found no similar assumptions in the research literature, psychology, and psychiatry curricula or descriptions of various therapeutic traditions.

Conclusion

In addition to the remarkable therapeutic experiences and extensive psychological changes clients experienced, the mostimportant aspect of these experiences was the questions and assumptions developed regarding treatment, research, and diagnosis. The key assumptions were:

• · It must be possible to address the scientific challenges of psychology and psychiatry.

• · A sufficient scientific knowledge base for psychology and psychiatry can be developed.

• · A predictable and controllable treatment for psychologically rooted disorders can be developed.

Moreover, the assumptions emerged that the similarities between psychologically rooted disorders and betweenpsychological disorders and the general psychological state were more important for researching and modifying these conditions than the differences between them. It was deemed more practical to operate with a psychological distress thatencompassed as many variations as there were clients rather than dealing with the 300-400 different psychologicaldisorders as described in the diagnostic systems, ICD-10, and DSM-IV, now ICD-11 and DSM-V.

These assumptions led to an analysis of the therapeutic and scientific deficiencies in psychology and psychiatry, which will be described in the next chapter.