Jenaway, A., 2008. The â€˜Human Givensâ€™ Fast Trauma and Phobia Cure. Reformulation, Summer, pp.14-15.
I first became interested in this technique while working with young people leaving care. Many of them had been traumatised by their experiences and had flashbacks, nightmares and other symptoms of posttraumatic stress disorder. Although they wanted help with these symptoms, and the symptoms clearly were preventing them getting on with their lives, most of them felt completely unable to talk about the traumatic experiences. They were afraid of breaking down, or of becoming uncontrollably angry. The appeal of the Fast Trauma and Phobia Cure (the Rewind technique, as I prefer to call it) is that the client does not have to describe or talk about the trauma. Having been on a training day with the Mindfields college, and read around the subject, I also became interested in the theory behind the technique and what the Human Givens theory and CAT theory, might have to say to each other, and so that became part of the workshop too.
The technique itself involves the client allowing the therapist to put them into a state of deep relaxation and then guide their imagination to watch the traumatic memories in a particular way. Sadly, I have discovered that a client has to be quite trusting of the therapist to allow them to do this and so many of the young people that I work with do not trust anyone that much! Thus the importance of the therapeutic relationship rears its head again and I have not found it possible to use it very often. However, when I have been able to use it, the results have sometimes been surprisingly good. First a word of warning – please don’t try this at home without going on one of the Mindfields one day courses which can be found via their website (1).
The theory has been developed by Joe Griffin and Ivan Tyrell (2). They claim to have taken into account all therapies that have been shown to be effective and also scientific research about human functioning. The theory has an evolutionary psychology feel to me and perhaps that is why I like it. The human givens are simply the emotional needs of humans, over and above the basics of food and water and air (such as the need for attention, security, intimacy etc.). If most of our Human Givens are met, then we will generally be happy and healthy. If few of them are met then we will start to feel unhappy and may get ill. Depression is seen as a powerful social signal to other humans in our “tribe” that our needs are not being met. Human Givens theory would say that, years ago, when we lived in smaller, more stable tribes, the rules of behaviour were much clearer and life was generally less stressful, with most people getting their human needs met somehow. Now, many of us are constantly part of many different tribes and have to relate to people from another tribe many times a day. This is seen as much more stressful, and some people don’t even have a stable tribe at all, due to the rapid mobility of our population and the breakdown of extended families. I’m not sure how this fits with what we know about the stress of living in a close-knit dysfunctional family? I suppose that if all members of the tribe are getting their human needs met then the families will not be so dysfunctional, but I suspect that in any human tribe some high ranking members get more of their needs met than those of lower status! Human Givens therapists seem naturally optimistic about human nature and perhaps do not always see the darker side.
Although they do not have a hierarchy of needs, like Maslow (3), I suppose it is likely that some needs are more important than others, or at least certain needs will be more important to certain people than others. For me the list provides a kind of grounding when I start to feel that CAT goals are becoming too abstract. For example, I often talk to young people about the goal of being a better parent to themselves than their parents have been. I am talking about a better reciprocal role with the self, “caring about myself, listening to my feelings, setting limits on myself and others when I need to”, but what do I really mean by that? What am I hoping that will achieve? I think that being a better parent to themselves will encourage them to think about their basic human needs and make efforts to get their needs met. Perhaps for some clients, who are not sure what is wrong or what they need to work on, looking through the list of human givens may help to focus them on which needs are most important to them and which are not met in their life at the moment.
The human brain is seen as having evolved with two distinct systems. There is a primitive brain, which is highly instinctive and very open to psychological conditioning. This is necessary for animals that live in tribes or social groups, as it is important that children can be conditioned to believe, communicate, and react in the same ways as the rest of the tribe. However, humans also have a higher, more modern, thinking brain, which has an observing self and can examine and question the conditioning if necessary. In situations of high emotional arousal, the primitive brain is more likely to be in operation and the organism thinks in very black and white terms, finding it hard to see any point of view other than their own. Flexible, open thought is suspended. In Human Givens terms, I think reciprocal roles would be seen as the early conditioning process that we went through as a child. They are powerful and primitive and not generally open to thought or reflection about them, until the person grows up. As CAT therapists, we would be seen as helping people to stand back and examine their conditioned responses, and learn to over-ride them when necessary. However, in emotionally charged situations those primitive responses are likely to come into play again blocking the self-reflection. We might do well to spend some time helping our clients to relax before encouraging them to think.
After an extreme trauma, the primitive brain has been instantly conditioned by a life or death situation. In order to keep the organism safe, this part of the brain then takes over in order to remain vigilant for anything that pattern matches the life or death situation. The attention is all focused on this task and there is no spare capacity for thought or logical reflection. In cognitive behaviour theory, the interpretation of the stimulus is seen as leading to the feelings of anxiety, but in Human Givens theory the primitive pattern matching comes first. This locks the attention of the organism on to the threat and prevents thinking or interpretation at a higher level. The task of the therapist with any highly emotional client is to try to reduce this high level of arousal so that the thinking brain can come into play, and this is especially true of clients with post traumatic stress disorder. Once the client is relaxed, the thinking brain can be drawn into examining, and analysing the traumatic memories and laying them down as calmer, autobiographical memories. In healthy people (who have all their human givens met) the process happens automatically as the person is supported by their “tribe”, has opportunities to talk over the trauma and is helped to create meaning from it. This person is much less likely to develop PTSD symptoms.
The technique is derived from elements of NLP and is specifically for the treatment of flashbacks and other symptoms of post traumatic stress disorder. Any other problems, which a client may have, will need additional therapy. The first step is to build a relationship with the client in which they can trust you and feel able to relax in your presence. They will need to identify a safe place to go to in the relaxation process; this could be a favourite beach, a forest or a garden. The next step is to identify approximately three traumatic memories with the same basis. For example, the memory of a train crash, a subsequent train journey when the client had flashbacks, and a recurrent nightmare about a train crash. Asking the client briefly about these should elicit symptoms of anxiety and a feeling of discomfort. Now the client is encouraged to relax, first focusing in on their body and breathing, and then encouraged to visualise walking towards their safe place as the therapist counts slowly from 1 to 20. The client is now told that in this safe place there is a TV set and a video recorder, and they are asked to nod when they have found it. They are asked to float out of their body in their imagination and watch themselves watching the TV set on which is playing a video of their traumatic memory. The memory is playing from a time before the trauma, when they felt safe and OK, through the memory to after the end of the trauma when they felt safe again. They are asked to nod when they think that they have finished watching it. This process (known as double dissociation) is a first gentle exposure to the trauma memory and the client’s reaction can give an indication of how difficult the rest is going to be. Some clients look visibly distressed, screwing up their face and with rapid eye movements in response to the exposure. At any time, they can be encouraged to move away from the TV and wander around their safe place, breathing calmly and relaxing. They can nod when they are ready to come back and do the next bit.
Following the double dissociation, the client is encouraged to enter into the video image and rewind the trauma memory, again from safety to safety. They nod when they have finished and then float in front of the TV screen and watch the memory on fast forward from safety to safety. This is repeated around 3 or 4 times with each memory. Lastly the client is encouraged to walk back from the safe place into the room as the therapist counts back from 20 to 1.
A brief conversation then takes place about how it felt, how easy it was to do and whether anything feels different. Clients usually find it easy enough to do, although not pleasant. They often say it feels weird and something feels different, although they are not sure what. It may be easier to think of the traumatic memories and they seem more distant. I have had one client for whom the technique brought up new memories, which she was not previously aware of, and that has made me quite cautious. I have also had one client who was very upset after the rewind and for about a week following it, although in the long run she felt it had helped with the flashbacks. I have not had any complaints, or anyone state that they wish they had not gone through with it.
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Dr Alison Jenaway Consultant Psychiatrist in Psychotherapy and “Nick”, Service User and Expert by Experience, 2016. Incorporating Eye Movement Desensitisation and Reprocessing (EMDR) into Cognitive Analytic Therapy - Reaching Reciprocal Roles that other therapies cannot reach. Reformulation, Winter, pp.21-28.
Therapeutic Change that is Dialogically Structured, Mediated by Signs, and Enabled by a Relationship â€“ A Case Example
Bristow, J. and Reason, A., 2010. Therapeutic Change that is Dialogically Structured, Mediated by Signs, and Enabled by a Relationship â€“ A Case Example. Reformulation, Summer, pp.31-33.
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Ruppert, M., Birchnall, Z., Bruton, C., Christianson, S., 2008. Integration of Cognitive Analytic Therapy Understandings. Reformulation, Summer, pp.20-22.
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Hayward, M., McCurrie, C., 2008. Metaprocedures in Normal Development and in Therapy. Reformulation, Summer, pp.42-45.
The â€˜Human Givensâ€™ Fast Trauma and Phobia Cure
Jenaway, A., 2008. The â€˜Human Givensâ€™ Fast Trauma and Phobia Cure. Reformulation, Summer, pp.14-15.
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