This well-meaning attempt at positive psychology really sums up my mistrust of it.

I’m sure that the person who created it is rightly proud of their post-trauma achievements in the world and wanted to demonstrate that although they have experienced many more wounds since childhood they are now an adult, strong and capable and no longer felled by suffering.
 
But look at what is actually there.
 
A puppy has been shot with an arrow. S/he is nearly killed and certainly horrifically injured by it.

​Imagine a puppy being shot. 
 
Next to the puppy is an adult wolf. There are 22 arrows in her back. Her tail is between her legs and there is blood pooling beneath her. The caption is the equivalent of “What Doesn’t Kill You Makes You Stronger.”
 
What that puppy and the adult wolf need is emergency expert care. A lot of time, money and attention need to be spent on both of them. They need to be removed from danger, forever. In the UK that’s what animal shelters do: we don’t offer that to traumatised children or to many adults.
 
Apart from the obvious skill of the artist, the only thing I find useful in this image is that the wolf is looking at the unconscious puppy with something like compassion. As adults, that’s what we need to try to emulate for ourselves.

Often in therapy a person will try to look on the bright side, comparing themselves to starving children in Africa or drowning refugees and say, “Well, at least my life is better than theirs.” Perhaps. We can go on for many months saying, “Things aren’t so bad. I don't know why I'm getting these panic attacks/ feel so unhappy/ get so angry.” When the relationship between us is trusting enough and deep enough a client might remember a childhood trauma or relive it beyond their cognition – beyond it all being a memory – and really feel it again. They become vulnerable.
 
At this point a person can feel desperate for me to solve their problem, a problem that responsible adults did not treat with the respect or attention that was as necessary as food at that time. It can be heart-breaking to help the client understand that I cannot stand in the place of those adults from the past. My aim is to help the client find their own resources, from a place of vulnerability rather than from steel in the spine, to offer the love, care and comfort to their younger selves.
 
It is painful.
 
It is painful to acknowledge that we have been waiting all our lives for someone to do the right thing 50 years ago. It is painful to give up on that hope. It can be god-awful to know that we will never be rescued. It seems necessary to go through a period of protective cynicism, to say “Well fuck the world, then. What a bunch of shits everyone is.” And whilst this may have an element of truth to it we also need to move beyond cynicism and into a place of deep self-care.
 
Some clients will have spent time already speaking with their younger selves and found it beneficial. But when that speaking becomes listening, when it becomes a relationship of compassion between a frightened, injured little child and an empathic, loving, gentle adult then real healing can begin.
 
What doesn’t kill us can weaken us nearly to death and sometimes beyond it. Nietzsche, who coined the original phrase, spent the last years of his life in a catatonic state collapsing after witnessing a horse being thrashed almost to death. Nietzsche was a sensitive human being who, in addition to suffering widely debated medical conditions, experienced maddening horror when he witnessed cruelty.
 
You don’t have to turn into a wolf or become psychotic after trauma though there’s no blame if you do. Remaining fully human takes incredible bravery and hard work. Sadly, this kind of hard work doesn’t make you respectable. It just makes you a decent, loving, thoughtful, whole human being.
 

Some months ago a friend and I were talking about his experience of Flooding as a treatment. He very kindly agreed to share that experience here. 

I had a really awful time at school, for a while I would wash taps before washing my hands, just to make sure I had clean hands, then return to my pit of a bedroom with no hint of hypocrisy at all. Then I got a thing about my Achilles tendons, probably from a lesson describing what Achilles did to his tendons, (still makes me shudder to this day!), and would walk in an exaggerated manner that I felt made them less prone to injury. I had no evidence that this was the case, but nor did anything bad happen. 

Then one time we had inoculations, I didn't like it but it was no big deal. Soon after however, I went on a family holiday to Morocco that required two courses of six jabs, three in each arm, the arm would swell up and become a target for any pillock who was looking to cause someone pain, and hey presto, my needle phobia reared it's head, leading to a morbid terror of any sharp surgical instrument. Even knowing this, being reasonably certain of why I felt the way I did, and rationalising that hypodermic syringes were used to inject preventative medicaments, I could not shake the feeling of utter terror to the point where, when visiting people in hospital, I would try to sit with my back to the wall, or as far from anyone walking behind me just in case they tripped or decided I needed a jab from something.

My fear kept me away from the dentist for over ten years even when I had a gaping cavity, made me think twice about visiting anywhere there might be medical tools and forced me to look away when syringes appeared on TV: if I wasn't quick enough, I'd feel jittery for hours. When I did go to get my tooth filled I mentioned my phobia, so the well-meaning dentist caught me by surprise with the syringe, I don't think his nurse was too pleased with me crushing her hand though! I stayed conscious, but if my Mum hadn't been to hand I'd have had to sit in the waiting room for the next six hours, I was white as a sheet, jittery and weak as a kitten.

I think it was the dentists episode that sold me on the idea of getting referred to a psychologist. I've a sneaking suspicion that my GP didn't take me entirely seriously and  I'm fairly certain my psychologist was newly qualified. In any case, a large proportion of my treatment was talking therapy and the use of a clean hypodermic to touch on my skin which was actually reasonably helpful now I think about it. The Flooding part of it wasn't: watching videos of surgical procedures, the lung biopsy just freaked me out! It didn't help much.

Being the sort of person who's an obstinate bugger at heart, I pushed myself to have a vasectomy, my wife would've gone for sterilisation and said as much, even going as far as to try talking me out of it, but I was sick and tired of being scared, I was facing redundancy and going though stress at work so it wasn't like I was feeling balanced or strong. I'd just tried every other way and thought that voluntary flooding in the form of the vasectomy under local anaesthetic  would be kill or cure.

As it turned out I could cheerfully watch injections on the TV for over a year after without a flinch, it's resurfaced but only as a discomforting anxiety, rather than an overpowering horror and I'm not left feeling shaky afterwards. I still hate having the undersides of my fore arm touched, that comes from the idea of blood being taken, but I don't think I'd be a screaming mess if I woke up in hospital with tubes in my arm which could not have been said of me 20 years back!!!

Thinking about it, I did try a little flooding soon after seeing my psychologist, I got my ear pierced, which was ok, and a tattoo (the first of six, they're addictive!), but the needles and procedures, not to mention environments, were entirely different as were the outcomes, so the experiences were of little practical use, other than to demonstrate that fear can be overcome, you just have to be a stubborn bugger!!

 

Phobias and the ensuing panic attacks are horrendous. If you have a phobia you’ll know just what ‘horrendous’ means and if you don’t it’s very unlikely that you’ll have any understanding of what being in the grip of a panic attack is like. You’ll have read that people feel like they’re dying when they have a panic attack but what does that really mean?

Christopher Hitchens couldn’t believe that waterboarding was all that awful. Be honest, you know that if you just stay calm and control your breathing you can blow the water out of your nose and breath in carefully through your mouth and you’ll cope with what is called ‘simulated drowning.’ Because you know it’s not drowning. Hitchens lasted 10 seconds when he volunteered for the experience. This is similar to a phobia induced panic attack – if everybody just keeps calm and rational then everything will be fine. But the definition of a phobia is that it is an irrational fear i.e. it cannot respond to logic.

Take half an hour and listen to this, a very thorough exploration of phobias and their treatment.

It was heartening to hear Professor Paul Salkovskis, after a number of face to face sessions in his office, accompanying Susie to a tube station, down the escalator, onto the platform, into a train and travelling on it then out in another station and back up to street level, where she was elated, proud, excited and had made serious inroads to curing her phobia. This technique is called flooding and it takes much more than the 50 minutes of the therapeutic hour. 

(It is also something to be done with care, consent, compassion and frequent checking to see if the consent still stands. It is NOT locking an arachnphobe in a room of spiders, no matter what some webpages say. They confuse the torture of Room 101 from the novel 1984 with a therapeutic technique.) 

Prof Paul Salovskis is Professor of Clinical Psychology and Applied Science. He is also Clinical Director of the Maudsley, the UK’s preeminent mental health hospital. Not many of us are going to meet him. One of the reasons why CBT has a 30% success rate is that it’s not done completely by someone who has the authority to go outside of an office. Too many people, often at the end of their tether, are left stranded and feeling hopeless after their allocated 6 sessions (5 hours over 6 weeks) when what they needed was complete, skilled work rather than a ‘computer says no’ approach to mental health.

I’m absolutely not suggesting that you don’t take advantage of CBT if it’s offered to you. But approach it rigorously: ask if the sessions are limited. Ask if flooding is part of the therapy and precisely what that means to the therapist. As Susie says at the end of the programme, addressing a phobia can be hard work: part of that might be resisting what’s on offer until what’s on offer is based on therapeutic principals rather than cost.