כאב פיזי או רגשי הוא מניסיוני סימן לכך שהחיבור שלנו לאנרגיית חיים התרופף . אבד הקשר עם הסקרנות, התשוקה, האהבה ללא תנאי, ההעזה, ההגשמה. נתק שנוצר כתוצאה של מציאות חיים כואבת בעבר או בהווה וסדק את האימון בתנועת חיים.
את כוחה הפלאי של אנרגייה זו הכרתי דווקא מהמקום שבו לא ראיתי אותה. האתגר שלי ללוות אנשים ב"דרך אנרגיית חיים" בחזרה לחיבור.
Psychotherapy for a physical illness
A book by Frans Depestele (2022)
Chapter with Irit Tessel (translated from Dutch)
Abstract
The Role of psychological factors in the onset and cure of a physical illness
In the case of physical illness, we want to address the question of the role of psychotherapy. We can ask two questions psychotherapeutically. First: “What does it mean to me that I have this physical illness?” But we can also ask the question: "Can psychotherapy have a beneficial effect on my physical illness itself, can it change it for the better?" This is a difficult question because at first glance it concerns two different worlds. We could say: It can change if the implicit that is underneath can be set in motion, if I want to express it more precisely.
That said, the question is: is this also possible with a physical disease of the body, not with a purely functional disorder such as intestinal spasms, but with a disease with a structural change – for example: an inflammation of the intestine?
In this essay we want to tackle this question and look for psychotherapeutic approaches to a physical illness. In other words, searching the way from mind to body, the way from experience to body, the way from body-subject to body-object. We tried to demonstrate that this is possible in Depestele (2020). We want to find out here, how is it possible.
Contents
B.3) Client's help to 'translate' the experience of his physical illness into the experience of a meaningful experience in his/her process
B.3.3) How does the Client get to the implicit generator of hers/his physical illness? Through which steps?
How does he/she get to the implicit element from which this physical illness arises, in such a way that it starts moving again. Through which steps?
B.3.3.5) Tessel: via activation of life energy
The question 'how does the client get to the implicit from which the physical illness arises (B.3.3), in such a way that it starts moving again?' We look at the following approach.
Tessel (2018) discusses three elements that guide her in her work with patients with physical complaints:
1) It begins by addressing the life force. Tessel states: feeling life energy or vitality is just as important for health and well-being as healthy food and exercise. She works in a hospital in Tel Aviv, and sometimes introduces her work to doctors; then she takes the patient with her.
Tessel believes that there is always life energy somewhere, even in people who are depressed. Instead of waiting for it to emerge automatically during a therapy moment, for example, she actively searches for it. It starts with the very first contact when a patient comes. She does not do an intake, does not ask about the problem, but focuses on her goal from the start: “I am interested and curious about you as a person, about how you are, about what you like to do, what makes you enthusiastic. For example, a book that you read”.
If a patient cannot continue with this, she tries an exercise: “Go to a time when you were so close to yourself that you felt 'wow, this is me', a moment when you really were yourself. It can be a small thing, eg a small trip you took. Feel the energy. And ask: how can I bring that energy more into my life?” Something always comes along: a book that the patient has read or the depressed patient who suddenly remarks in the room: “Oh, what a beautiful plant”. Or another patient who comments, "Wow, it's raining, I love the rain." Then she invites the patient to dwell on this for longer and try to broaden this experience: “Tell me more about it”. This involves offering small pieces of focus. In this way she tries to bring the patient to feel the energy that is in it for him and to let the vitality that it gives come through.
2) If the patient can feel more vitality, it can more easily bring his attention to an inconvenience ('discomfort') or a pain. Pain is an opportunity for development and self-growth. However, there is a natural tendency to want to flee from it; A pain can be so strong that it is very difficult to get to and be there.
But, says Tessel, as a therapist: there is something in me that wants to 'listen'. She asks the patient a question such as: “How does the pain want you to be there?” The invitation alone sometimes brings a shift. But if it doesn't work, she asks the question: "Is it the pain or something in you that doesn't want to be with the pain?" She gives the example of a woman who was suffering from cancer. When asked 'how does the tumor want you to be there?' the patient, who was a singer by profession, replied 'he wants me to sing' and she started to sing. This reminded her of her native region in Russia. The next sessions became singing sessions: “What do you want to sing today?” The patient survived.
After the tuning-in, the patients are invited to focus on a personal problem (discomfort, 'discomfort'). One of the participants told what came next: being tired far too often. A next Focusing question is then: 'what thoughts, emotions do appear?' the answer is: the desire to get rid of them. At that point, it is suggested to 'think of the positive experience (from the first Focusing exercise) try to feel it fully'. And then the question: "What do you see from this positive experience in the 'discomfort'?" What came was: to be closed off. Our comment: 'being closed off' is then a certain 'meaning' that emerges from the problem, from the pain sensation.
So, if the patient can feel more vitality, he can more easily bring his attention to an inconvenience ('discomfort') or a pain, and this in a way that a meaning reveals itself and a step of change.
3) But sometimes the 'gate remains closed': not wanting or being able to be with the pain. One patient experienced, as a sign of 'not wanting to be with the pain', dizziness and numbness in the legs instead; this was her discomfort. She had been separated from her parents as a baby of three months to live in a group of babies in a kibbutz. She had buried this trauma.
After working with her for a long time, she was able to recharge the elements of the trauma.
Tessel gives the example of another patient who is coming to therapy because of an issue she has in her life.
Via listening to the body, a pain appears and another sensation appears expressing something unconscious that says: it is dangerous to be with the pain.
The patient wants to be with the pain, but the therapist sees that she isn't prepared yet. She tries (first) to help her with an explanation: there are parts (unconscious parts) in you that don't trust your capacity to get to it, they want to protect you but protect too much.
So, Tessel gives a gentle invitation: "you can take as much time as it wants".
Another way of supporting is to tell the patient, “In many traumas you were alone; but now I am with you.” Tessel also uses touch to reinforce this, placing her feet against the outside of the patient's feet and her lower legs against the outside of the patient's lower legs; that provides security.
Tessel works a lot with what she calls 'listening to the pain'. A 27-year-old man suffering from cancer was suspicious about the invitation. He replied: "I listen to my body too much, I feel pain here, I feel pain in it". She asked him: "Would you like to try a different listening?" This approach brought his trust. It supports him to feel grounded.
The process began with his pain in the shoulders since it was the sensation that asked first for attention. The patient described his problem with his shoulders (which were in a chronic shrugged position) and physical interventions failed to lower the shoulders. Even a surgical procedure was delayed due to the find a proper harness to hold his shoulders down.
Tessel started 'listening to the shoulders': “If you listen to the sensation in your shoulders, what is it like? Can you describe what your shoulders feel?” Further process was done with Focusing. And as this process of "listening to the pain" progressed, his shoulders slumped on their own, much to the amazement of the patient himself.
Tessel, I. (2018). Focusing and health (workshop with Irit Tessel, Focusing Conference, Loutraki, 11 May 2018)
Tessel, I. (2020). Personal communication (email 22/10/2020).
