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Relational Injury. Part 1. Recognition · Inside The Consulting Room - Understanding the Child Behind the Behaviour

• 0:00
  SPEAKER_00: I am offering you episode one of a three-part series which has to do with recovering from relational injury.
• 0:11
  SPEAKER_00: Now the first in this first episode I want to talk about stage one, which is recognition and what recognition means.
• 0:22
  SPEAKER_00: Because I think this is probably the most confusing part of the recovery process, because I think people inevitably find it incredibly hard to make a usable kind of sense when they have been injured probably in a way that has occurred over time, sort of repeated things that have been tolerated or sort of explained away, or in some way have been dismissed as insignificant.
• 0:58
  SPEAKER_00: And yet, over time, what happens is that this unresolved series of wounds forms a realization that something is very wrong, and it could be that the relationship has come to an end either because the other person has initiated this or indeed you have.
• 1:21
  SPEAKER_00: Nonetheless, there is a recovery process that needs to take place.
• 1:29
  SPEAKER_00: Now I'm going to be looking at this from certainly a human point of view, but I think from a clinical point of view as well, because if we understand what's happening internally, psychologically, neuropsychologically, what happens to the central nervous system, and how the sense of disorientation and disorganization in the internal world, if we understand why those things happen, then what it may do is to provide listeners with a sense of so this is known about.
• 2:06
  SPEAKER_00: This is it's a bit like grief, I suppose, that you know there are recognizable stages.
• 2:12
  SPEAKER_00: And in a way, uh this is similar, but I think not the same because although there may very well be grief, feelings of grief, feelings of loss, I think there are a lot of other things as well.
• 2:27
  SPEAKER_00: So in this in this first episode, I'm talking about realization when the truth can no longer be ignored.
• 2:37
  SPEAKER_00: And I think what happens is you begin to notice that something just doesn't sit right inside you, and it's not necessarily anxiety and it's not sadness, and it becomes a kind of persistent disturbance and a sort of sense that something is being or has been done to you.
• 2:58
  SPEAKER_00: It's almost like you're starting to wake up to a reality that you've had to deny.
• 3:06
  SPEAKER_00: And this is where realization begins.
• 3:10
  SPEAKER_00: Because we have to understand that relational injury occurs when harm is experienced within a relationship that should have provided safety, recognition, care, appreciation, mutuality.
• 3:28
  SPEAKER_00: It's not simply that something painful has happened, it is that something happened in the presence of someone who you thought mattered and who you assumed felt the same way about you.
• 3:43
  SPEAKER_00: And more than that, it happened in a context where you were psychologically open, receptive, and undefended.
• 3:53
  SPEAKER_00: And this is why relational injury cuts so deeply.
• 3:57
  SPEAKER_00: If we think of the work of John Bowby, the attachment theorist, we understand that human beings are wired to seek safety in others.
• 4:08
  SPEAKER_00: Now, when that system is compromised through neglect, inconsistency, criticism, betrayal, or emotional absence, the the injury isn't just emotional, it's structural.
• 4:23
  SPEAKER_00: Now, when I say that, we form a kind of architecture, an internal architecture, a structure, uh, when we when we are in a relationship.
• 4:34
  SPEAKER_00: And that that has a kind of shape and it has expectations, it has routines, it has all manner of things which become, I suppose, anticipatory.
• 4:45
  SPEAKER_00: We start to form beliefs about how things are and how they will be.
• 4:50
  SPEAKER_00: But that architecture, which then has a kind of structural quality, is damaged.
• 4:59
  SPEAKER_00: And it is very hard initially to see it, particularly if we're open, because we're more likely to make allowances for the kinds of things that have happened.
• 5:13
  SPEAKER_00: Relational injury disturbs the continuity of the self.
• 5:18
  SPEAKER_00: So, from a psychodynamic perspective, we might say that the internal world becomes reorganized around the experience of not being held in mind.
• 5:29
  SPEAKER_00: Now, when I say that, what I'm referring to is that this sort of tolerating, accepting, and not seeing, making allowances for how the other person is, is normal.
• 5:42
  SPEAKER_00: And we we are almost, I wouldn't say we're immune, we're kind of blinkered in our understanding because we are not, for all manner of reasons, recognizing what is actually going on.
• 5:57
  SPEAKER_00: And it could very well be that other people are, but we're not.
• 6:02
  SPEAKER_00: And that's not a criticism, it's just what happens.
• 6:06
  SPEAKER_00: Now, Winnicott talked about the importance of good enough, both in relational terms and environmental, and that's one that allows the child and later on the adult to feel real.
• 6:22
  SPEAKER_00: Now, when that fails, something begins to split.
• 6:26
  SPEAKER_00: The felt self, which is what I experience, and the presented self, what I show, something happens there, and over time the individual may doubt their own perceptions, minimize their own needs, feel too much or not enough simultaneously.
• 6:47
  SPEAKER_00: And the question that then starts to emerge, often quietly, is a kind of was it me, is it me?
• 6:56
  SPEAKER_00: Now there's another significant element to that, and we'll call it the part where the body keeps the score, quite literally.
• 7:05
  SPEAKER_00: Because relational injury isn't just psychological, it's biological.
• 7:10
  SPEAKER_00: When relationship becomes a source of threat, the central nervous system shifts into a state of vigilance, and that vigilance is very powerful.
• 7:24
  SPEAKER_00: And if we look at the work of Steven Borges, he would say that the ventral vagal system, which has to do with safety and connection, becomes compromised, and the system shifts towards sympathetic activation, which is fight or flight, or what's called dorsal vagal shutdown, which is collapse and numbness.
• 7:48
  SPEAKER_00: And we don't have any control over these things.
• 7:50
  SPEAKER_00: They're what's called autonomic reactions, but this is happening in the body.
• 7:55
  SPEAKER_00: This is not thought, this is experienced because that is the way that the central nervous system is configured.
• 8:04
  SPEAKER_00: Now, this can present physically in a number of different ways.
• 8:09
  SPEAKER_00: Chronic muscle tension, often neck, shoulders, headaches, fatigue that doesn't resolve with rest, and a heightened sensitivity to stress.
• 8:21
  SPEAKER_00: But also the immune system can be affected because prolonged relational stress leads to what's called low-grade systemic inflammation.
• 8:32
  SPEAKER_00: So the body begins to behave as though it is under threat.
• 8:36
  SPEAKER_00: Now, research across psychoneuroimmunology, that's a mouthful, suggests that there's increased inflammatory markers, these are called cytokines.
• 8:48
  SPEAKER_00: There's a reduced immune resilience and a greater susceptibility to illness following emotional strain.
• 8:55
  SPEAKER_00: And people will very often say stress isn't good for you, it will make you ill.
• 8:59
  SPEAKER_00: Well, you know, you know this is underpinned by research.
• 9:03
  SPEAKER_00: It's a fact and it's not a fault.
• 9:05
  SPEAKER_00: And this is why people often say, I only get ill once everything is caught up with me.
• 9:11
  SPEAKER_00: And this is because the body's been holding what the mind can't process.
• 9:16
  SPEAKER_00: As signs of emotional injury tend not to announce themselves directly.
• 9:25
  SPEAKER_00: They appear in patterns.
• 9:28
  SPEAKER_00: So a person will find themselves experiencing hypervigilance, reading the tone and expression and pauses of other people, the anticipation of rejection or criticism, emotional volatility, so suddenly feeling overwhelmed, or the absence of feeling anything altogether, which we call emotional numbing.
• 9:54
  SPEAKER_00: There's also something else that happens which is curious because it shows that the mind is trying to process something, and it's called cognitive dissonance.
• 10:03
  SPEAKER_00: And it means that when the person reflects, they say it wasn't that bad, but why do I feel so awful?
• 10:10
  SPEAKER_00: It's almost like holding two incompatible realities.
• 10:15
  SPEAKER_00: Somatic or body expression.
• 10:17
  SPEAKER_00: It's very commonly people will describe neck and shoulder pain, jaw tension, gastrointestinal disturbances, and a series of sensations which can't easily be understood.
• 10:35
  SPEAKER_00: And some of this has to do with the central nervous system trying to recalibrate.
• 10:41
  SPEAKER_00: But what it demonstrates is the person is holding on to things which quite clearly are stuck and need processing.
• 10:52
  SPEAKER_00: Sometimes people get into relational repetition where they find themselves in similar situations again, but also conversely, they may pursue or avoid closeness.
• 11:10
  SPEAKER_00: And this is interesting because those can be two extremes, and it is entirely understandable, but of course, this is if this is happening when the processing hasn't occurred, then that can be problematic.
• 11:28
  SPEAKER_00: Now the beginning of truth is important here because the realization isn't dramatic, it's often quiet and it can be deeply unsettling.
• 11:39
  SPEAKER_00: Because to recognize relational injury is to confront something profoundly difficult, and that is that the personal people you turn to for safety and connection were also the source of harm.
• 11:53
  SPEAKER_00: That creates an incredibly powerful sense of disorganization.
• 11:59
  SPEAKER_00: But this moment matters because without the realization, there can't be any reckoning.
• 12:06
  SPEAKER_00: The reckoning is when we come into contact with the truth and how we manage the truth.
• 12:17
  SPEAKER_00: I'm reminded of the film A Few Good Men and Jack Nicholson saying saying to Tom Cruise, You want the truth, you can't handle the truth.
• 12:26
  SPEAKER_00: But actually, yes, you can.
• 12:28
  SPEAKER_00: The truth can be handled because the truth is reality.
• 12:32
  SPEAKER_00: It may be painful, but nonetheless, it is a truth.
• 12:35
  SPEAKER_00: And oddly enough, when we face that truth, something really important happens.
• 12:41
  SPEAKER_00: Nine times out of ten, it's going to be actually, I wasn't wrong.
• 12:45
  SPEAKER_00: It wasn't me.
• 12:47
  SPEAKER_00: This isn't something I did to myself, it's not my fault.
• 12:51
  SPEAKER_00: Now, it's a it's a slow process.
• 12:55
  SPEAKER_00: I work with people with with sometimes with parents who when they examine the way that they parent, they very often are self-critical.
• 13:09
  SPEAKER_00: And when we look at how they were parented themselves, what we see is that a lot of their experiences have been injurious.
• 13:21
  SPEAKER_00: And this then influences the way that they parent, not because they behave injuriously to their children, they will more often than not overcompensate, but they will be hyper-vigilant, they will be trying to be perfect, and that just is an illusion, and very often they will carry significant amounts of anxiety, and the quality of their lives is affected.
• 13:53
  SPEAKER_00: The really powerful truth here is that we are the collection of all of our experiences, and although we can't change what we've experienced, we can't change history, we can't rewrite it.
• 14:07
  SPEAKER_00: However, when we understand it and we understand how it's put together, then our relationship with it can change.
• 14:19
  SPEAKER_00: But that only happens once we allow ourselves to experience realization.
• 14:27
  SPEAKER_00: Thank you for listening.
• 14:28
  SPEAKER_00: And I will be back with episode two entitled The Reckoning Quite Soon.