Historic trauma focused talking therapy stages

Skills – Memories- Integration


I have learned about this specific way of dividing the process into 3 stages from the trainings with Complex Trauma Therapists Network UK which were absolutely wonderful and very informative.

I do hope this is going to be helpful giving survivors a greater sense of control over the process that might be initially perceived as “scary” and “unpredictable”.

Stage I
Learning The Coping Skills in response to unpleasant bodily sensations, unpleasant internal emotional responses and a sense of helplessness.

This is a stage when a patient builds their own sense of inner security and safety. We could use a metaphor in here of a patient and their personality being portrayed as a building that is not in a very good condition and needs a refurbishment. Stage one is like putting a scaffolding around the building. The scaffolding protects the building from any further damage and allows it to be well prepared for further works. Patient is supposed to learn how to set boundaries towards problematic people present in their life. Patient explores several ways of healthy survival strategies during difficult moments. Patients test these strategies to learn which specific strategies are going to be most effective in bringing inner peace experience for the patient. Stage one is essential and necessary for the treatment to progress to Stage II and Stage III. After the completion of Stage I the patient might be so very pleased with the level of their new balanced subjective experience of their inner self that they might decide to end the treatment at this stage. There is absolutely nothing wrong about it – many patients choose to end their treatment completing Stage I only.

Stage II
Processing of Unresolved Aspects of Patient’s Memories Referring to Historical Traumatic Events including internal conflicts and self-image

This stage could be compared to construction works inside the building. These changes could change the layout of the space which metaphorically means the way the patient sees themselves after the experience of the trauma. The construction works at this stage serve the purpose of establishing an inner comfort of the patient internally for them to feel comfortable in their own company. These works lead to self-acceptance of own internal aspects of personality and to openness and acceptance towards the new aspects of internal landscape that could have been created in response to traumatic events from the past.

Stage III
Process of Personality Integration, integration of the parts that got separated from the core during the traumatic experience. This stage allows patients to once again feel fully themselves internally and in contact with other people.

Stage III is all about the finishing works inside the building. It is all about the manifestation of patient’s ideas about the interior design of the building that belongs to them. This stage serves a purpose of creating such a version of interior design which fully reflects the true personality of the patient. Very often Stage III is the experience of getting rid of the mask/masks that the patient could have been wearing for many years pretending to be somebody else. This is a stage of final release of trauma from the patient’s personality. This moment of release addresses also any false believes the patient might have been holding on to about themselves for a very long time. This is also a stage when the patient is ready to effectively face the experience of having been moved away/rejected by their family of origin which might have happened in response to traumatic events. These sense of rejection and isolation is all about the patient feeling like someone “worse” than others when compared to other family members. During Stage III the patient makes an active attempt to rebuild their relationship with their family or, if impossible, with other people. This process is helpful in meeting their normal, natural, and healthy need for connection and belonging. The reconnection could take place with the old-changed or new-different group of people the patient is able and willing to trust.

Brexit Fears

The last day to register for the “settlement” scheme is June 30, 2021.

Postponing registration is a bad idea especially due to the nature of anxiety (fear) which intensifies as the time goes by. So there is no point in postponing this quick operation, especially if you have a simple situation with documents and you know some basic English. The questions are written in simple English and they are easy to answer.

Detailed information in English from gov.uk with other EU language options

The application for the Android phone can be downloaded from the Google store

Your smartphone must have the NFC (Near-Field Communication) option activated – just enter this NFC symbol in the phone settings Search window and the phone will find it for you. This will be needed for the phone to be able to read the micro-chip inside the passport. You will need to place the phone on the passport with the bottom of the phone touching the passport pages or its front cover. Sometimes it takes a while to make this work and you have to turn the phone on the passport, put the phone on an open passport, put the phone on a closed passport, etc.

You can also use the smartphone application if it is installed on your friend’s phone. What matters is the data entered into the system of the Home Office, not the phone which is being used for the data to be entered.

You need to have your home address, your e-mail address, your National Insurance number and your Permanent Residency Card number if you have one.

Remember that there will be a stage in the process when the application will ask you to take a “selfie” so dress nicely and find a good place at your house, where there will be a smooth bright wall against which you can sit/stand to take this “selfie”. This “selfie” will not be printed anywhere in documents. This is only for the use of the Home Office.

If you use your passport for the settlement application registration process, you do not need to send anything by post (unless they ask you later to send them anything else).

Please note that if you use your National ID Card, you will need to post it to the Home Office.

Ok, so now when it’s all ready to go, you can open the application on your phone and start answering questions and entering data.

The application will guide you on each step of the process with simple words.

After completing the process, which takes about 15 minutes, you will receive an email from the Home Office confirming that the application has been submitted.

After about a week you will receive another email confirming that you have been registered as a “settled” in the UK.

If you need to send additional documents to the Home Office, they will write to you and you will have to respond to their request. From what I’ve heard, this does not tend to happen with a standard registration without any complicated history of stay / employment / etc.

So put the fears aside and make it happen as soon as possible.

As far as I know there are no fees connected with this process.

Grief and sadness are natural parts of a loss

Feelings; Sadness

Sadness is the most common feeling found in the bereaved and really needs little comment. This feeling is not necessarily manifested by crying behaviour, but it often is. Crying is a signal that evokes a sympathetic and protective reaction from others and establishes a social situation in which the normal laws of competitive behaviour are suspended.

Feelings; Anger

Anger is frequently experienced after a loss. It could be one of the most confusing feelings for the bereaved, and as such is at the root of many problems in the grieving process. A woman whose husband died of cancer said to me “How can I be angry? He did not want to die”. The truth is that she was angry at him for dying and leaving her. If the anger is not adequately acknowledged it can lead to a complicated mourning. This anger comes from two sources: (1) from a sense of frustration that there was nothing one could do to prevent the tragic event, and (2) from a kind of regressive (disabling/helpless) experience that occurs after the loss of someone close. The bereaved might have had this type of regressive experience when he/she was a very young child on a shopping trip with his/her mother. The child suddenly looked up to find that the mother has disappeared somewhere. The child felt panic and anxiety until the mother returned, whereupon, rather than express a loving reaction, the child hauled off and kicked her in the shins. This behaviour is, according to researchers, a part of our genetic heritage, which symbolises the message “Don’t leave me again!”

In the loss of any important person there is a tendency to regress, to feel helpless, to feel unable to exist without a person, and then to experience the anger that goes along with these feelings of anxiety. The anger that the bereaved person experiences needs to be identified and appropriately targeted towards the person that is gone to bring it to a healthy conclusion. However, it often is handled in other less effective ways, one of which is displacement, or directing the anger towards some other person and then often blaming them for the tragic event. The line of reasoning is that if someone can be blamed, then he is responsible, and hence, the loss could have been prevented.
One of the most risky maladaptation of anger is the posture of turning the anger inward against the self. In a severe case of retroflection, an angry person, who is also down on himself might develop suicidal behaviour.

Feelings; Guilt and Self-reproach

Guilt and self-reproach are common experiences of the bereaved; guilt over not being kind enough, over not doing certain things in the past, etc. Usually the guilt is manifested over something that happened or something that was neglected around the time of the death. Most often the guilt is irrational and will mitigate through reality testing.

Feelings; Anxiety (fear)

Anxiety of the bereaved can range from a light sense of insecurity to a strong panic attack. The more intense and persistent the anxiety, the more it suggests the pathological grief reaction. Anxiety comes primarily from two sources, first, the fear of bereaved that he/she won’t be able to take care of themselves on their own. People who experience this type of anxiety often say something like that “I will not be able to survive without her”. Second source of anxiety relates to heightened sense of personal death awareness; the awareness of one’s own mortality heightened by the loss of a loved one (this could refer to some profound sense of inner change, being a different person for the rest of their life like a victim of trauma, a survivor of a very rough patch of life journey). Carried to extremes, this anxiety can develop into a full-blown phobia (also phobia of relationships). Well known author C.S. Lewis knew this anxiety and said after losing his wife: “no one ever told me that grief felt so like fear. I am not afraid, but the sensation is like being afraid. The same fluttering in the stomach, the same restlessness, the yawing. I keep on swallowing”.
Feelings; Loneliness (a form of sadness)

Loneliness is a feeling frequently expressed by the bereaved, particularly those who have lost a spouse and who were used to a close day-by-day relationship. Even though very lonely, many bereaved will not go out because they feel safer in their homes. They often say “I feel so all alone now” especially after losing their spouse after 50-something years of married life together; “It has been like the world has ended”

Feelings; Fatigue (a form of sadness)

We see this feeling of fatigue frequently in bereaved individuals. It may sometimes be experienced as apathy or listlessness. This high level of fatigue can be both surprising and distressing to the person who is usually very active.

Feelings; Helplessness (a form of sadness)

One factor that makes the event of a loss so stressful is the sense of helplessness it can engender. This close correlate of anxiety is frequently present in the early stage of a loss. Females (or very feminine, caring males) often feel extremely helpless. One woman left with a young child said “my family came and lived with me for the first five months- I was afraid I would freak out and not be able to care for my child”

Feelings; Shock (a form of surprise)

Shock occurs mostly in the case of a sudden, unexpected loss.


Feelings; Yearning (a form of sadness)

Yearning for the lost person is common experience of the bereaved, particularly among females (or very feminine, caring males). Yearning is normal response to loss. When it diminishes, it may be sign that mourning is coming to an end.

Feelings; Emancipation (a state of inner peace)

Emancipation can be a positive state after a loss. A good example here could be a young woman whose father was an unbending dictator over her existence. After losing him, she went through the normal grief process, but she also experienced a state of emancipation, because she no longer had to leave under his tyranny. At first she was uncomfortable with this feeling but later was able to accept it as the normal response to her changed status.

Feelings: Relief (a state of inner peace)

Many people feel relief after the loss of a loved one, particularly if the loved one suffered a painful illness. However, a sense of guilt often accompanies this sense of relief.

Feelings; Numbness (a state of inner emptiness)


Some people report a lack of feelings. After a loss, they feel numb. Again, this numbness is often experienced early in the grieving process, usually right after learning of the tragic event. It probably occurs because there are so many feelings to deal with that to allow them all into consciousness would be overwhelming. So the person experiences numbness as a protection from this flood of feelings. In commenting on numbness, researchers say “we found no evidence that it is an unhealthy reaction. Blocking of sensation as a defense against what would otherwise be overwhelming pain would seem to be extremely normal”

As you review this list of feelings, remember that all the items represent normal grief feelings and there is nothing pathological about any of them. However, feelings that exist for abnormally long periods of time and at excessive intensity may portend a complicated grief reaction.

Fragments from the old book considered to be the must-read regarding grief and grieving: “Grief Counselling and Grief Therapy” by J. W. Worden (1991), p.22-25

What is validation?

Validation is one way that we communicate acceptance of ourselves and others. Validation doesn’t mean agreeing or approving. When your best friend or a family member makes a decision that you really don’t think is wise, validation is a way of supporting them and strengthening the relationship while maintaining a different opinion. Validation is a way of communicating that the relationship is important and solid even when you disagree on issues.

Validation is the recognition and acceptance of another person’s thoughts, feelings, sensations, and behaviors as understandable.

Learning how to use validation effectively takes practice. Knowing the six levels of validation as identified by Marsha Linehan, Ph.D. will be helpful.

The first Level is Being Present.

There are so many ways to be present. Holding someone’s hand when they are having a painful medical treatment, listening with your whole mind and doing nothing but listening to a child describe their day in first grade, and going to a friend’s house at midnight to sit with her while she cries because a supposed friend told lies about her are all examples of being present.

Multi-tasking while you listen to your teenager’s story about his soccer game is not being present. Being present means giving all your attention to the person you are validating.

Being present for yourself means acknowledging your internal experience and sitting with it rather than “running away” from it, avoiding it, or pushing it away. Sitting with intense emotion is not easy. Even happiness or excitement can feel uncomfortable at times.

Often one of the reasons other people are uncomfortable with intense emotion is that they don’t know what to say. Just being present, paying complete attention to the person in a non-judgmental way, is often the answer. For yourself, being mindful of your own emotion is the first step to accepting your emotion.

The second level of validation is Accurate Reflection.

Accurate reflection means you summarize what you have heard from someone else or summarize your own feelings. This type of validation can be done by others in an awkward, sing-songy, artificial way that is truly irritating or by yourself in a criticizing way. When done in an authentic manner, with the intent of truly understanding the experience and not judging it, accurate reflection is validating.

Sometimes this type of validation helps someone sort through their thoughts and separate thoughts from emotions. “So basically I’m feeling pretty angry and hurt,” would be a self-reflection. “Sounds like you’re disappointed in yourself because you didn’t call him back,” could be accurate reflection by someone else.

Level Three is Mind-reading

Mind-reading is guessing what another person might be feeling or thinking. People vary in their ability to know their own feelings. For example, some confuse anxiety and excitement and some confuse excitement and happiness. Some may not be clear about what they are feeling because they weren’t allowed to experience their feelings or learned to be afraid of their feelings.

People may mask their feelings because they have learned that others don’t react well to their sensitivity. This masking can lead to not acknowledging their feelings even to themselves, which makes the emotions more difficult to manage. Being able to accurately label feelings is an important step to being able to regulate them.

When someone is describing a situation, notice their emotional state. Then either name the emotions you hear or guess at what the person might be feeling.

“I’m guessing you must have felt pretty hurt by her comment” is Level Three validation. Remember that you may guess wrong and the person could correct you. It’s her emotion and she is the only one who knows how she feels. Accepting her correction is validating.

Level Four is Understanding the Person’s Behavior in Terms of their History and Biology.

Your experiences and biology influence your emotional reactions. If your best friend was bitten by a dog a few years ago, she is not likely to enjoy playing with your German Shepherd. Validation at this level would be saying, “Given what happened to you, I completely understand you not wanting to be around my dog.”

Self-validation would be understanding your own reactions in the context of your past experiences.

Level Five is normalizing or recognizing emotional reactions that anyone would have. Understanding that your emotions are normal is helpful for everyone. For the emotionally sensitive person, knowing that anyone would be upset in a specific situation is validating. For example, “Of course you’re anxious. Speaking before an audience the first time is scary for anyone.”

Level Six is Radical Genuineness.

Radical genuiness is when you understand the emotion someone is feeling on a very deep level. Maybe you have had a similar experience. Radical genuineness is sharing that experience as equals.

Understanding the levels may be easy. Putting them into practice is often more difficult. Practice is the key to making validation a natural part of the way you communicate.

Consider this example

Joanna calls you and talks about her diet. She complains that she has eaten chocolate cake and other sweets and wants to eat more, but she doesn’t want to gain weight. What level of validation can you use?

Level 3 would be a good choice. Joanna didn’t mention any feelings though she is eating for emotional reasons. You could say, “Has something happened? My guess is you’re upset about something.” Then she might tell you that the cat she’s had for six months died yesterday. At that point you could use a Level 5 or 6, depending on how you feel about losing a pet.

When Shawna was a teenager, she almost drowned in a large pond. She was a poor swimmer and swam out further than she realized. When she stopped swimming, her feet couldn’t touch bottom and she swallowed water. She panicked and a friend swam to save her. Since that time she’s been afraid of water. A neighbor invited her to a pool party. A guy who was flirting with her pushed her into the pool and she panicked, even though she was only in waist high water. She tells you that she’s ashamed of her reaction and she hates being crazy.

Level 4 validation would work in this situation. “Given your history of almost drowning, of course you panicked when you were pushed into water. Anyone with a history of drowning would probably react the same way.”

Emotional Invalidation

Emotional invalidation is when a person’s thoughts and feelings are rejected, ignored, or judged. Invalidation is emotionally upsetting for anyone, but particularly hurtful for someone who is emotionally sensitive.

Invalidation disrupts relationships and creates emotional distance. When people invalidate themselves, they create alienation from the self and make building their identity very challenging.

Self-invalidation and invalidation by others make recovery from depression and anxiety particularly difficult. Some believe that invalidation is a major contributor to emotional disorders.

Most people would deny that they invalidate the internal experience of others. Very few would purposefully invalidate someone else. But well-intentioned people may be uncomfortable with intense emotions or believe that they are helping when they are actually invalidating.

In terms of self-invalidation, many people would agree they invalidate themselves, but would argue that they deserve it. They might say they don’t deserve validation. They are uncomfortable with their own humanness. The truth is that validation is not self-acceptance, it is only an acknowledgement that an internal experience occurred.

Verbal Invalidation

There are many different reasons and ways that people who care about you invalidate you. Here are just a few.

Misinterpreting What It Means to Be Close: Sometimes people think that knowing just how someone else feels without having to ask means they are emotionally close to that person. It’s like saying they know you as well as you know you, so they don’t ask, they assume, and may even tell you how you think and feel.

Misunderstanding What it Means to Validate: Sometimes people invalidate because they believe if they validate they are agreeing. A person can state, “You think it’s wrong that you’re angry with your friend,” and not agree with you. Validation is not agreeing. But because they want to reassure you they invalidate by saying, “You shouldn’t think that way.”

Wanting to Fix Your Feelings: “Come on, don’t be sad. Want some ice cream?” People who love you don’t want you to hurt so sometimes they invalidate your thoughts and feelings in their efforts to get you to feel happier.

Not Wanting to Hurt Your Feelings: Sometimes people lie to you in order to not hurt your feelings. Maybe they tell you that you look great in a dress that in truth is not the best style for you. Maybe they agree that your point of view in an argument when in fact they do not think you are being reasonable.

Wanting the Best for You: People who love you want the best for you. So they may do work for you that you could do yourself. Or they encourage you to make friends with someone who is influential when you don’t really enjoy the person, telling you that that person is a great friend when it’s not true. “You should be friends with her. She’ll be a good friend to you.”

There are also many different ways of invalidating. I’ve listed a few below.

Blaming: “You always have to be the cry-baby, always upset about something and ruin every holiday.” “Why didn’t you put gas in the car before you got home? You never think and always make everything harder.” Blaming is always invalidating. (Blaming is different from taking responsibility.)

Hoovering: Hoovering is when you attempt to vacuum up any feelings you are uncomfortable with or not give truthful answers because you don’t want to upset or to be vulnerable. Saying “It’s not such a big deal” when it is important to you is hoovering. Saying someone did a great job when they didn’t or that your friends loved them when they didn’t is hoovering. Not acknowledging how difficult something might be for you to do is hoovering. Saying “No problem, of course I can do that,” when you are overwhelmed, is hoovering.

Judging: “You are so overreacting,” and “That is a ridiculous thought,” are examples of invalidation by judging. Ridicule is a particularly damaging: “Here we go again, cry over nothing, let those big tears flow because the grass is growing.”

Denying: “You are not angry, I know how you act when you’re angry,” and “You have eaten so much, I know you aren’t hungry,” invalidate the other person by saying they don’t feel what they are saying they feel.

Minimizing: “Don’t worry, it’s nothing, and you’re just going to keep yourself awake tonight over nothing” is usually said with the best of intentions. Still the message is to not feel what you are feeling.

Non-verbal Invalidation

Nonverbal invalidation is powerful and includes rolling of the eyes and drumming of fingers in an impatient way. If someone checks their watch while you are talking with them, that is invalidating. Showing up at an important event but only paying attention to email or playing a game on the phone while there is invalidating, whether that is the message the person meant to send or not.

Nonverbal self-invalidation is working too much, shopping too much or otherwise not paying attention to your own feelings, thoughts, needs and wants.

Replacing Invalidation with Validation

The best way to stop invalidating others or yourself is by practicing validation.

Validation is never about lying. Or agreeing.

It’s about accepting someone else’s internal experience as valid and understandable. That’s very powerful.

This is a shortened version of the article published originally by Psychology Today: https://www.psychologytoday.com/blog/pieces-mind/201204/understanding-validation-way-communicate-acceptance

How does the survivor prepare themselves for confrontation with the abuser?

The below described considerations refer to adult victims of childhood sexual abuse who might be considering confronting their abusers in adulthood.

Survivors seek support before confronting the parent abuser:
– Conversations with therapists about recovery including confrontation
– Conversations with the siblings about support in confrontation
– The threat of “the abuse news” to the integrity of the family
– Survivor expectation of abuser“ acknowledging (validating) and apologising”
– Family expectation of survivor “forgiving and forgetting”

The aim of the confrontation is to step out of the victim position
– The confrontation is optional to step out of the abuse related victim position
– the content is about validation of memories / consequences of the abuse for the survivor
– sometimes the confrontation happens spontaneously with no preparation
– it is important to consider the option of the false memory syndrome (wrongful accusation)

The power of the confrontation should belong to the survivor:
– it is the survivor who initiates the time, place and the form of the confrontation
– the place of the confrontation has to be safe for the survivor (own home, own work place, therapist office, a public place like a restaurant)
– effective confrontation can be done in therapy with/without the abuser being present
– effective confrontation can be done in a phone call/a letter without the abuser being present
– it is the survivor who wants to set the records about past straight
– it is the survivor who says things from herself about herself to the abuser operates from within her own integrity
– the confrontation is supposed to provide closure to the victim/ a finished business
– the confrontation is supposed to clarify the relationships within the family

The doubts of the survivor about confronting the abuser could be caused by:
– a fear of hurting abuser’s feelings
– a guilt about putting herself first, before the abuser
– uncertainty about the past events (amnesiacs)
– fear of unexpected health consequences of the abuser (heart attack, stroke, etc)
– fear of rejection of the memories of abuse by the parent
– fear of anger reaction of the abuser
– fear of being socially ostracised/abandoned by this parent or by the whole family

The survivor has to stay realistic about the denial of the abuse by the abuser, which grows along with the level of social condemnation of the crime that had been committed

Contents extracted from the book by Catherine Cameron “Resolving Childhood Trauma. A Long-Term Study of Abuse Survivors (the US population research)” (Year 2000, Sage Publishing), Chapter 12 – Confronting the Abuser

Depression and genes

“Depression runs in families, we know. But it is only very recently, and after considerable controversy and frustration, that we are beginning to know how and why. The major scientific discoveries reported last week by the Psychiatric Genomics Consortium in Nature Genetics are a hard-won breakthrough in our understanding of this very common and potentially disabling disorder.

If your parents have been depressed, the chances that you have been or will be depressed are significantly increased. The background risk of depression in the general population is about one in four – each of us has a 25% chance of becoming depressed at some point in our lives. And if your parents have been depressed, your risk jumps by a factor of three.

However, controversy has long swirled around the question of nature or nurture. Is the depressed son of a depressed mother the victim of her inadequate parenting and the emotionally chilly, unloving environment she provided during the early years of his life? Or is he depressed because he inherited her depressive genes that biologically determined his emotional fate, regardless of her parenting skills? Is it nature or nurture, genetics or environment, which explain why depression runs in families?

In the 20th century, psychiatrists ingeniously teased out some answers to these questions. For example, it was found that pairs of identical twins, with 100% identical DNA, were more likely to have similar experiences of depression than were pairs of non-identical twins, with 50% identical DNA. This indicated clearly that depression is genetically heritable. But well into the 21st century, the precise identity of the “genes for depression” remained obscure. Since 2000, there has been a sustained international research effort to discover these genes, but the field has been bedevilled by false dawns and inconsistent results.

That is why the study published last week is such a significant milestone. For the first time, scientists around the world, with leading contributions from the UK’s world-class centres of psychiatric genetics research largely funded by the Medical Research Council at the University of Cardiff University, University of Edinburgh University and King’s College London, have been able to combine DNA data on a large enough sample to pinpoint which locations on the genome are associated with an increased risk of depression. So we now know, with a high degree of confidence, something important about depression that we didn’t know this time last year. We know that there are at least 44 genes, out of the 20,000 genes comprising the human genome, which contribute to the transmission of risk for depression from one generation to the next.

However, this raises at least as many issues as it resolves. Let’s first dwell on the fact that there are many risk genes, each of which contributes a small quantum of risk. In other words, there is not a single smoking gun, a solitary rogue gene that works like a binary switch, inevitably causing depression in those unfortunate enough to inherit it. More realistically, all of us will have inherited some of the genes for depression and our chances of becoming depressed will depend in part on how many and their cumulative impact. As research continues and even larger samples of DNA become available for analysis, it is likely that the number of genes associated with depression will increase further still.

Stress provokes an inflammatory response by the body, which causes changes in how the brain works

This is telling us that we shouldn’t be thinking about a black-and-white distinction between us and them, between depressed patients and healthy people: it is much more likely that our complex genetic inheritance puts all of us on a continuous spectrum of risk.

What are these genes and what do they tell us about the root causes of depression? It turns out that many of them are known to play important roles in the biology of the nervous system. This fits with the basic idea that disturbances of the mind must reflect some underlying disturbance of the brain.

More surprisingly, many of the risk genes for depression also play a part in the workings of the immune system. There is growing evidence that inflammation, the defensive response of the immune system to threats such as infection, can cause depression. We are also becoming more aware that social stress can cause increased inflammation of the body. For decades we’ve known that social stress is a major risk factor for depression. Now it seems that inflammation could be one of the missing links: stress provokes an inflammatory response by the body, which causes changes in how the brain works, which in turn cause the mental symptoms of depression.

Knowing the risk genes for depression also has important implications for practical treatment. There have been no major advances in treatment for depression since about 1990, despite it being the major single cause of medical disability in the world. We need to find new ways forward therapeutically and new genetics is a great place to start the search for treatments that can cut through more precisely to the cause or mechanism of depression. It is easy to imagine how new antidepressant drugs could in future be designed to target inflammatory proteins coded by depression risk genes. It is exciting to think that the new genetics of depression could unlock therapeutic progress in psychiatry as well.

Finally, although I think these genetic discoveries are fundamental, I don’t see them as ideologically divisive. They don’t prove that depression is “all in the brain” or that psychological treatment is pointless. The genetics will be biologically pre-eminent but, as we understand more about what all these “genes for depression” do, we may discover that many of them control the response of the brain or the body to environmental stress. In which case, the treatment that works best for an individual patient could be a drug targeting a gene or intervention targeting an environmental factor such as stress.

In short, I believe that a deeper understanding of the genetics of depression will lead us beyond the question we started from: is it nature or nurture, gene or environment? The answer will turn out to be both”.

Author: Edward Bullmore is head of the department of psychiatry, Cambridge University and author of The Inflamed Mind (Short Books). This article has been originally published on 29 Apr 2018 by The Guardian

Shadow in the light


This “3-2-1 shadow integration” process is a valuable exercise in discovering hidden and denied parts of ourselves. We often receive messages from our environment telling us about something that annoys us, disgusts us or something that keeps returning to us over and over again without any clear indication of what is really going on. If you feel like facing “it” – go ahead and try it! All you need is your honesty about the situation, a bit of acting skills and, if you choose so, a bit of writing skills.

First choose what you want to work with.
It is usually easier to begin with a difficult person to whom you are attracted or by whom you are repelled/disturbed (a boss, a parent, a friend).

You could also pick an image from your dream or a body sensation that distracts you or causes you to fixate on it (turn it in your mind over and over again).

Please note that disturbance could be either positive or negative.


A/ it makes you negatively hypersensitive, easily triggered, reactive, irritated, angry, hurt, upset. It may keep coming up as an emotional tone or mood that pervades your life

B/ it makes you positively hypersensitive, easily infatuated, possessive, obsessed, overly attracted or perhaps it becomes an on-going idealisation that influences your motivations or mood.


Observe the disturbing person/image/sensation very closely and then write on a piece of paper how does it look like/how does it feel in vivid detail using 3rd person narrative and present tense such as  “they are”, “they look”, “they smell”, etc. This is a way of detailed exploration of your experience with a clear focus on what bothers you about it. Do not minimise your disturbance. Do your best to describe your experience as fully and in as much detail as possible.

Enter a simulated dialogue with the person/image/sensation as if you were talking to somebody next to you (you /yours/etc). This is your opportunity to enter into a relationship with the disturbance. Talk directly to the person/image/sensation). You may start by asking questions like:
– Who are you/ What are you?
– Where do you come from?
– What do you want from me?
– What do you need to tell me?
– What gift are you bringing me?
Then allow the disturbance to respond back to you. Imagine realistically what they would say and actually write it down or vocalise it. Allow yourself to be surprised by what emerges in the dialogue.

Now, be the person/image/sensation. Depending on whether you chose to speak or write, express yourself in the 1st person (I / me / mine) as if you were able to see the world from the perspective of that person/image/sensation.
Allow yourself to discover not only similarities between the person/image/sensation and yourself but also how you really are one and the same.
Make a statement of identification i.e. “I am the zombie and the zombie is me”
This, by its nature, will almost always feel wrong (after all it is exactly what your psyche has been busy denying!). Try it anyway since it contains at least a kernel of truth.
Open yourself to the experience of the feeling that your psyche excluded – do it until this feeling starts resonating with you as your own. This is the process of re-owning your shadow. By engaging the shadow you integrate it (let it consciously be visible to you as yours).
If you complete this step successfully, you will experience a shift in awareness, shift in your feelings, and changes in attention/focus that was taken up by your denial. You will know that the process has worked because you will actually feel lighter, more peaceful and open. Sometimes you can also feel a bit high. It makes a new kind of participation in life possible.

XXX Practical example:

Scenario: I’m dreading going to visit my childhood best friend. I notice my sense of uneasiness about going there and my resistance to make a move and go there. My uneasiness is connected with his lifestyle.

STEP 1- FACE IT – I am horrified to see once again how my friend’s wife runs his life and how he seems to be happy about it. He’s got a super safe, dead end job and he is surely betraying himself. I am sure he’d be much more happy walking on the wild side of life once in a while. It makes me sick and it drives me nuts to be around him.

STEP 2- TALK TO IT – Start a dialogue with your friend about his lifestyle.
– “Why do you let your wife make all the decisions in your life?”
– “I don’t- I simply respect her perspective”.
– “What about your job- are you satisfied with it? It’s a dead end job to me!”
– “Hey- it’s a good, honest job- I really enjoy it.”
– ” Why don’t you form your own company and do something more advantageous?”
– “I prefer what I’ve got. It’s more secure and takes less work. What’s wrong with that?”

STEP 3 – BE IT – Become your friend and speak for him as if you were him. This is an exercise in empathy – go and see his life through his perspective.
-” I really want safety and security and a smooth, predictable life”.
– “My wife gives me a chance to have more time for myself. We understand each other very well and she knows what I want so she can decide well for both of us”
-” My job is not very challenging but that’s ok- I’m not very stressed and I have a life, don’t need to work late hours, I don’t have to compete in a hostile environment or speed to join the rat race”.

RE-OWNING YOUR SHADOW – Suddenly you might realise that you must have ignored and forgotten about your own needs for safety and security so much that your friend’s lifestyle triggered your disowned needs inside you.  Your friend, just like you, has needs for both thrills and safety/security, unpredictability and comfort. You could possibly feel more free inside after acknowledging both aspects of life- the wild side of life and the quiet side of life and a possibility to make choices re lifestyles. You could also possibly become aware of when you lost touch with your desire for safety/security in life – when your parents took charge for everything and when you had no good reason to create safety/stability for yourself.

INTEGRATIN THE SHADOW – In real life, when visiting your friend, you could stay with him for a day or so but then go to sleep in a hotel and go out in the evening to get a bit of a wild night life. In this way you could give yourself an experience of both aspects of life.

When visiting your friend you could think of your situational lack of opportunity to be independent in life and appreciate the comfort given to you by your parents. Being aware of your own circumstances might let you relax more while spending time with your friend. The feelings of dread and uneasiness would then be no longer valid when you are going to be planning to visit him at his place.

Source: Ken Wilber, Terry Patten, Adam Leonard, Marco Morelli, “Integral Life Practice – a 21st Century Blueprint for Physical Health, Emotional Balance, Mental Clarity, and Spiritual Awakening, 2008, based on pages 50-53