Övergrepp i terapi del 2/abuse in therapy part 2...

Now I have done a translation and summary (long though, so should one call it a summary?? :-)) in Swedish. I will come back to an English summary too! As long?? :-)

I think this topic is very important!! But abuse/violation in therapy can be of other kinds too, even those that don't lead to real intercourse... I guess there can exist emotional abuse too, and things that can be compared maybe to emotional incest?? There can really exist disrespect in many ways (not only concerning sex, but concerning feelings, emotions, thoughts the client have and express) and disrespect of different degrees too? More or less subtle?

Talking highly and openly about those issues are important; makes it easier for people who have been abused in therapy to raise their voices, talking highly lift shame away? And make people aware of what demands they are entitled to raise on their helpers!!?? Hopefully.

And those who has been abused are hopefully helped to process what they have gone through by a more and more open talk too!?

And maybe such an openness would also be good for the therapists, psychologists, psychiatrists etc. in the end? Would with no question be good!?

I think of what Pia Melody has said and written about violations and about codependency (what I know about her ideas I have only read in Jean Jensons book, the first edition, and in Swedish I want to mention too)... Applicable on this too? Probably developed further by others? A concept that can help one be aware of these things...

Now I am a bit tired, so I leave this issue for now... :-)

-//-

Nu vill jag försöka göra en sammanfattning av artikeln på norska om övergrepp i terapi… Litet trött gör jag denna, med allt vad det kan innebära. :-)

I Norge förlorade sju terapeuter 2002 sin licens på grund av sex med en patient. Och artikeln berättades om en professor i psykiatri, medlem i Norsk psykiatrisk förening samt också författare av fackböcker i ämnet, som miste sin licens p.g.a. sex med en kvinnlig patient i samma veva som artikeln skrevs (jan. 2004)

Artikeln berättar om en norsk kvinnlig psykolog, Mette, som när artikeln skrevs 2004 höll på att skriva en fackbok om gränsöverskridanden i terapi. Hon har personlig erfarenhet att som klient bli utsatt för övergrepp. Och hennes långa mara pågick i 15 år. 1984 började hon i terapi hos en psykolog för att hon ville reda ut sina egna tankar innan hon började arbeta med andras. Då höll hon själv på att utbilda sig till psykolog. Det vill säga hon var själv inte helt okunnig i ämnet!?

De första två åren var terapin normal. Hon pratade och han lyssnade. På så sätt vann han hennes tillit.

I sitt mest sårbara möter klienten sin terapeut, en terapeut som du ska kunna lita på, någon som lyssnar och ska vara uppriktigt intresserad av det du har att säga. En som finns där för att hjälpa. Men det är inte alltid en utsträckt hand är menad att hjälpa, varje år så drabbas någon av övergrepp från sin behandlare.

Vi anförtror mer till terapeuten än till våra allra närmaste, just för att det är en person som ska hjälpa. På så sätt skapas en väldigt stark relation. Det är naturligt att klienten får starka känslor för sin terapeut. Tillit och känslor som lätt kan missbrukas.

Som behandlare måste du vara professionell och inte missbruka makt genom att utnyttja klientens beroende och tillit!

Det är inte ovanligt att behandlare som begår övergrepp förklarar det med förälskelse, att det uppstod en kärleksrelation mellan terapeut och klient, med ömsesidiga känslor. Men det är kristallklart att ett hjälparepatientförhållande inte är ömsesidig på samma sätt som andra sorters relationer och som hjälpsökande måste klienten kunna lita på att terapeuten inte utnyttjar tillit till tillfredsställelse av egna behov.

Övergreppssaker har likhetstecken med religiösa sekter och gisslandramer. I en rättssak i denna veva blev en psykolog dömd att betala 7, 5 miljoner kronor i ersättning till tre manliga patienter som blev missbrukade i terapi. Psykologen planterade in falska minnen att mannen varit utsatt för sexuella övergrepp som barn. Sex med terapeuten var en del av behandlingen.

Det enda alternativet som gavs var att de skulle bli kroniskt sjuka och tvingas gå på piller resten av livet [om de inte gjorde som terapeuten sa?]. Denna upplevelse kan liknas vid ett tortyroffers. Psykologen rättfärdigade handlingarna mot klienterna med

”Jag vet att detta gör ont, jag vet att det går över gränsen, jag vet att jag bryter lagen. Men där andra inte orkar ta tag i sådana här problem är jag villig att ställa upp för dig.”

Piska-morot används.

En annan psykolog säger att det viktigaste för en hjälpare är att skilja mellan patientens och egna behov. Flyttas egna behov in i yrket är du i fara för att skada andra.

Sidokommentar: Alice Miller skriver en hel del om vikten av att terapeuten jobbar med sig själv och rentav att han/hon borde upphäva sina egna förträngningar för att inte riskera utöva omedveten manipulation!!! Se den reviderade utgåvan av ”Det självutplånande barnet…” Samt också berättelsen om Helga i Millers bok ”Vägar i livet…”. Samt det hon skriver om guruer i samma bok.

Mettes timmar hos psykologen började förändras efter två år. Han tog mer på henne och började berätta personliga saker om sig själv. Ändringen skedde så sakta att hon inte såg något galet i den. Hon sögs in i en tro att detta var helt naturligt. Vid denna tidpunkt gick Mette till terapi två gånger i veckan. Efterhand handlade livet uteslutande om dessa timmar.

Hon säger:

”Terapitimmarna övertog på många sätt mitt liv. Det var allt jag tänkte på. Han [terapeuten] gav mig en kassett han hade talat in, som jag lyssnade på mellan timmarna.”

[exempel på vad terapeuten talat in på denna kassett kan man läsa i den norska artikeln].

Mettes man märkte att något var galet, men förstod inte vad. Han kunde inte förstå varför hans fru verkade bli sämre av att gå i terapi. Mette berättade själv ingenting [se här också Helga i ”Vägar i livet”].

En kvinna, Randi Rosenqvist, jobbande inom detta (läkare eller psykolog?) säger att många medicinare är ambitiösa människor som har surfat genom livet på en våg av lyckanden. Läkare vaggas lätt in i tron att de vet vad som är bäst för folk.

”Vi vet att mycken psykiatrisk behandling inte har tillräckligt god kvalitet. Men vi är inte duktiga nog att påpeka när vi ser att kolleger inte ägnar sig åt det de håller på med."

Denna avsaknad av kritik öppnar för att övergrepp kan ske.

Varje år förlorar någon hälsoarbetare legitimationen på grund av övergrepp. Troligen är mörkertalen stora. I så gott som alla saker som Rosenqvist känner till menar läkaren själv att han varit på säker mark.

Alla har en ”god” förklaring till varför de bröt mot reglerna. Allt från en kärleksrelation till pseudopsykiatriska idéer om att patienten behövde en sexuell bekräftelse!!

En psykiater som forskat på erotisk beröring i det terapeutiska rummet säger att

"ingen av dessa förklaringar håller. ”

"En terapeut ska vara upptagen av klientens behov och känslor, inte sina egna. Att terapeuten själv tänker att det han/hon gör med klienten är positivt, legitimerar inte erotisk handling. Erotisk handling är obehaglig, förvirrande och skrämmande för en patient.”

Det hjälper inte att psykologen utvecklar känslor för den som går i terapi.

”Egen förälskelse är ingen garanti för att detta är bra för patienten”

understryker forskaren ovan.

1990, efter 6 år i terapi, arrangerade Mettes terapeut och en kollega till honom en adoptionsceremoni med Mette, där de klädde av henne och smörjde in henne med salva. Makten terapeuten hade fått över Mette var närmast allomfattande och terapin hade stadigt blivit allt mer intensiv.

Hösten 1992 bodde hon i två veckor på hans kontor, också detta som ett led i ”terapin”.

”Jag tror inte att jag hade kläder på mig under dessa fjorton dagar”

säger hon. Vid denna tidpunkt innebar den här terapin också att terapeuten klädde av sig och lade sig ovanpå Mette.

”Det kan gå flera år innan patienten som varit utsatt för övergrepp av behandlare klagar”

säger forskaren.

”De känner sig gärna som medskyldiga därför att de har varit med på de sexuella handlingarna. Många vet inte vad de kan förvänta sig när de går i terapi och senare är det lätt att tänka att ’det var en del av det’. Men det finns ingen jämlikhet i terapirelationen [Jennifer Freyd skriver i sin bok "Betrayal Trauma - The Logic of Forgetting Childhood Sexual Abuse" ISBN 0-674-06806-8 på s. 173-176 om något som hon benämner CSDM, Consensual Sex Desicion Mechanism, dvs. vad som är ömsesidighet i sex för att uttrycka det väldigt kortfattat.], bara utnyttjande. Reaktionen hos den som upplever patientövergrepp kan i några fall liknas de som incestoffer får.”

Detta skriver också Kirkengen, att denna typ av sex får samma skador som incest.

Offren anklagar sig själva, plågas av skam och skuld. Ibland är läkaren sjukdomen och inte kuren. Och terapi två gånger i veckan är intensiv terapi menar en expert i artikeln. I saken med de tre männen skedde behandlingen två timmar dagligen!!

”En sådan mängdterapi samt och att ha en terapeut som du kan ringa till dygnet runt skapar ett intensivt beroendeförhållande."

Enligt forskaren i artikeln så är det typiskt att övergriparen begränsar patientens kontakt med omvärlden för att skapa ett starkt beroende. Livet insnävas, maktövergreppet blir centralt. En annan känsla som verkar på övergriparen är att känna sig stor.

En god vän till Mette fattade efterhand oråd. Han frågade Mette rätt ut om det skedde konstiga saker på terapitimmarna och bad henne uppsöka en annan, kvinnlig psykolog. Gradvis berättade Mette för den kvinnliga psykologen vad som hade hänt. Detta förde till att hon våren 1993 skrev en officiell klagan.

I mötet med polisen hade hon svårt att dokumentera vad som faktiskt hade skett [se artikeln om trafficking och hur kvinnorna där reagerade!!?].

I terapirummet är det bara du och terapeuten i ett stängt/låst rum. Vad som föregår där inne blir ord mot ord.

”Och vem tror du blir trodd mest på?”

undrar Mette.

"En högt utbildad psykolog eller en 'spröd' patient?”

Mettes sak manglades runt ända till 1999. I juni 1998 hade Helsetilsynet riktat skarp kritik mot den behandling Mette hade fått; adoptionsceremonien, bristfällig journalföring och kroppsfixeringen i terapin. Slutsatsen var klar: Mettes terapeut fråntogs rätten att praktisera som psykolog – i ett år!! Mette drev saken vidare till civildomstol (?). Och då hade det gått 6 år sedan Mette för första gången sände in en klagan. Hon var nu fysiskt sjuk, utsliten och less på att kämpa.

Rosenqvist tror dock inte att straff har så stor förebyggande effekt. För alla övergripare har som sagt sin egen förklaring till varför just detta tillfälle var så speciellt.

För den som råkat ut för övergrepp är rädslan för att inte bli trodd det som hindrar många från att komma med sina historier och det är lätt för en terapeut att avfärda anklagelser med att detta är en hysterisk människa som fabricerar situationen.

En terapeut menar att deras etik borde vara strängare än lagens och påpekar att terapirummet är ett stängt rum och detta pålägger terapeuten ett stort ansvar.

Kirkengen skriver också om läkarens (och annan sjukvårdspersonals) maktposition, väl värt att läsa. Kanske återkommer jag till detta, liksom till vad Freyd har skrivit om CSDM.

Budskapet är helt klart: varje sexuell kontakt mellan patient och terapeut är oacceptabelt och det är terapeutens hela ansvar att inget händer.

Mette fick ersättning, men menar att

”En sak är skammen – du känner dig så ofantligt/ofattligt dum för att du inte märkte att något var galet. Dessutom mister du ju den person som du har gått till flera gånger i veckan i många år.”

Känslorna kan var outhärdliga. För henne kändes det som om en vägg bara försvann bakom hennes rygg och det inte fanns någon därbakom som tog emot henne.

Idag arbetar Mette som sagt som psykolog och skriver en fackbok om gränsöverskridandne i terapi. Hon fick högt blodtryck, svikande koncentrationsförmåga och talar om att hon inte har sovit en hel natt på över tio år. Hennes psykolog fick tillbaka sin legitimation efter ett år. Han praktiserar fortsatt som psykolog.

Jag tror att dessa saker är otroligt viktiga att prata om – öppet!!

Tillägg 25 november:

Alice Miller & Primal Therapy: A Summary

by Sam Turton

In 1981, a small, powerful book was published by Alice Miller, a Swiss psychoanalyst. Originally titled "Prisoners of Childhood," The Drama of the Gifted Child has become a classic, an inspirational wake-up call to childhood abuse. In Drama and eight other books, Miller has championed the rights of children and supported the arduous path of emotional healing through the recovery of repressed trauma.

When classic psychoanalysis did not uncover her hidden truth, in 1973 Dr. Miller began to get glimpses of her own painful history through spontaneous painting. Wishing to deepen her healing process, she began an encounter with primal therapy. Although initially enthusiastic about primal, Miller eventually became cautious and sometimes negative. Her shifting position has at times been confusing for her readers and for those in the primal community who have looked to her as a supportive voice for their pioneering work.

When Stephen Khamsi submitted his review of Miller's latest book, I felt it was necessary that her position on primal therapy be clarified for our members and newsletter readers. After a short email communication with Dr. Miller, I decided to create a summary by quoting excerpts from some of her books and other published articles.

My intention is to let Alice Miller's words speak for themselves. I understand that quotes published alone can create a different impression than intended in the original context. For a complete picture, I encourage interested readers to digest these works in their entirety. For the more obscure references, members are free to contact me for further information.

Books By Alice Miller

Prisoners of Childhood/The Drama of the Gifted Child, 1981
For Your Own Good, 1983
Thou Shalt Not Be Aware, 1984
Pictures of a Childhood, 1986
The Untouched Key, 1988
Banished Knowledge: Facing Childhood Injuries, 1988
The Drama of the Gifted Child, (Revised) 1997
Breaking Down the Wall of Silence, 1997
Paths of Life: Seven Scenarios, 1999
The Truth Will Set You Free, 2001

Although The Drama of the Gifted Child was published in 1981, it was not until 1988 that Miller began to speak at length about primal therapy. Here are some quotations from:

Banished Knowledge: Facing Childhood Injuries
Copyright 1988, Translation copyright 1990

"I was not out to paint beautiful pictures; even painting good pictures was not important to me. I wanted only to help the truth burst forth. I eventually succeeded, in 1983, with the aid of Konrad Stettbacher's therapy method, with which I deal in more detail later in this book." (preface, p. 7)

"Having just completed my manuscript of Shalt Not Be Aware, I devoted the last two pages to the therapy undergone by Mariella Mehr. Later I asked her for the name of her therapist, J. Konrad Stettbacher, and got in touch with him. He explained his method to me, and I decided to test his procedures on myself, since his concept embraced everything that during the last few years I had found to be true." (pp. 156-157)

"Apart from Stettbacher's recently published book, I know of no systematic description of primal therapy. When I visited the Institute for Primal Therapy in Paris in 1985 I addressed Janov on this subject. He accounted for the lack of a concept in his books by his concern that this form of treatment might be misused, and he considered only those students licensed by him as qualified to perform it. " (pp. 158-159)

". . . I am now free of physical symptoms, some of which I had suffered since childhood, and I have lost the fears that have also accompanied me all my life." (p. 163)

"After spending four years applying J. Konrad Stettbacher's carefully thought-out method to myself, I see ever more clearly that it amounts to the discovery of an inherent logical pattern in human beings, the functioning of which anyone can test." (p. 163)

"Thanks to its precision, Stettbacher's therapy offers a chance to track down the specific causes of those injuries and to carefully test accepted intellectual opinions and hypotheses on the subject of parents in concrete terms. But this can hardly be done without pain. If this pain cannot be endured because the emerging memories of actual abuse are so unbearable, one can understand that some patients abandon this treatment and remain locked in their self-destructive fixations." (pp. 165-166)

__________________________

In addition to supporting Stettbacher's form of primal therapy in Banished Knowledge, Dr. Miller also wrote a foreword and afterword in his book:

Making Sense of Suffering: The Healing Confrontation With Your Own Past, J. Konrad Stettbacher
Foreword September 1989 by Alice Miller

"J. Konrad Stettbacher's therapy furnishes proof that it is possible to resolve childhood repression safely and without confusion - something that has always been disputed by the most respected schools of thought." (p. 1)

"I have undergone this therapy myself and felt its astonishing, holistic effect on the body, mind, and emotions. Because I have done so, I have no hesitation about recommending it to others." (p. 3)

"As this therapy offers scope for the free, creative application of many possibilities, it will almost certainly help many of us make new discoveries - assuming, that is, that we are prepared to face the truth, whatever it may have in store for us." (p. 4)

__________________________

Breaking Down the Wall of Silence: The Liberating Experience of Facing Painful Truth

Foreword of First Meridian Edition, 1992

"The truth about childhood, as many of us have had to endure it, is inconceivable, scandalous, painful. Not uncommonly, it is monstrous. Invariably, it is repressed. To be confronted with this truth all at once and to try to integrate it into our consciousness, however ardently we may wish it, is clearly impossible. The capacity of the human organism to bear pain is, for our own protection, limited. All attempts to overstep this natural threshold by resolving repression in a violent manner will, as with every other form of violation, have negative and often dangerous consequences. The results of any traumatic experience, such as abuse, can only be resolved by experiencing, articulating, and judging every facet of the original experience within a process of careful therapeutic disclosure." (p. 1)

__________________________

The following are quotes from an interview with Alice Miller published in the German magazine Psychologie Heute. The interview is only available in German, but a representative of Psychologie Heute has permitted me to use an existing independent English translation. Dr. Miller was interviewed by Dr. Gerhard Tuschy, a neurologist and psychotherapist in Berlin.

The Psycho-Business and the Patient's Dignity
(Das psycho-geschaeft und die wuerde des patienten)
Psychologie Heute, April 1995

Miller: . . . since August, 1994, I no longer recommend Stettbacher's therapy and today I hold that primary therapy is fundamentally obsolete. In the epilogue to the new "Drama," I besides argue that primal therapy, even more than other forms of therapy, can be used to manipulate patients, because it begins with a several weeks long intensive phase, the so called 'Basis'.

. . . . . . . .

Tuschy: Have you had your own experience with the intensive phase called Basis which is so invasive?

Miller: Unfortunately, yes, not with Stettbacher, but with another primal therapist. I hold that what was expected of me was irresponsible. At the end of these three weeks my feelings were in a turmoil, so that I could not find sleep, that for the first time in my life I thought of suicide, and had anxiety verging on the psychotic. I was already fearful of this therapy that robbed my organism of sleep, but I could nowhere escape it. The ghosts that I called for did not allow themselves to be chased away. Despite this desperation, I wanted no medicine.

. . . . . . . .

Miller: . . . Today I would never more enter such a risk, because one can lose too many worthwhile years of life through such an experiment. I went then into Basis not adequately oriented, which today I describe as a trap. To get out of this trap, I tried to do writing therapy in accordance to the concept recommended by Stettbacher to me, and it helped me to bring some order into the chaos arising from the Basis. At that time I rewrote hundreds of pages. I wrote almost every morning. Writing helped me to save my autonomy. By this my anxiety was reduced and I learned better to live with my now broken up feelings.

Tuschy: And that won you over so much for Stettbacher's variation of primal therapy that you supported him in your publications?

Miller: Yes, the method he stood for appeared for the time being to avoid what in Basis I experienced as life threatening: total regression into earlier anxiety and the being delivered to a man who exploits this dependency of his patient, who uses the patient as a means to disguise his inner insecurity. My initial positive experiences and Stettbacher's assurances that he would be in a position to train therapists brought me to recommend these methods.

. . . . . . . . . .

Tuschy: Have you, in both your primal therapies, been able to lift your childhood amnesia?

Miller: Not really.

. . . . . . . . . .

Miller: . . . Today I see the cathartic road therefore as a wrong track, because in this work more defenses possibly are demolished than is necessary.

. . . . . . . . . .

Miller: . . . It depressed me very much that I have obviously contributed to this avalanche of nearly unfulfillable hopes of therapy. Fortunately today there are more effective and less risky therapy methods.

__________________________

Dr. Miller's growing reputation led to multiple reprintings of Drama. In 1997, a revised English version was released - with a strong Afterword that stated her new position.

Drama of the Gifted Child (Revised Edition)
From the Afterword, translated by Andrew Jenkins, 1995

"In the last few years we have been able to observe a veritable boom in the number of different approaches used. Body therapy, bioenergetics, gestalt, and primal therapy are only a few of the terms indicative of this new departure. In many cases noticeable successes were achieved merely by enabling patients to experience their own feelings and thus relieving them of the bodily pressures they were previously subject to. In other cases, however, the result was an addictive dependence on feelings of pain. This in its turn reinforced the dependence on the therapist as healer." (p. 121)

"Such things as the darkened-room setting and the intensive phase in primal therapy strongly encourage regression, sometimes to the point of total helplessness on the part of the patient and an attendant uncritical idealization of the therapist. This regression to the status of a small child puts the patient in an extremely vulnerable position where he/she can easily be taken advantage of by an insensitive therapist." (p. 121)

"It is not possible for me today to recommend one method over another or to assume responsibility for a particular therapist. This responsibility must be left entirely to the reader." (p. 122 )

__________________________

The following is an English translation of an influential article in the Swiss newspaper "DER BUND", 4.7.95, Berne:

KMB. At the time, the proceedings were the first of their kind to be instituted against a psychotherapist in the Canton of Berne and took place in February 1983. As early as August 1977, U. Sch. had made accusations against her therapist, J. Konrad Stettbacher, of indecent assault on various occasions, indecent acts, unlawful coercion and violations of the law on the practice of the medical profession. According to the report in DER BUND at the time, chief presiding judge Hans-Rolf Schweingruber referred to the proceedings in his summing-up as "a rare case that has been difficult for all those participating in it." Although the defendant was acquitted, Schweingruber conceded that a degree of uneasiness remained. Stettbacher, who was only found guilty of some time-barred infringements of the medical laws, was awarded compensation amounting to 20,000 Swiss francs for unwarranted damage to his reputation. The costs of the proceedings (8,000 francs) were borne by the State.

__________________________

In 1996, Miller wrote the foreword to another book:

Reclaiming Your Life: A step-by-step guide to using regression therapy to overcome the effects of childhood abuse
Jean Jenson, 1995, Foreword by Alice Miller, 1996

"Regression to the stage of early infancy is not a suitable method in and of itself. Such a regression can only be effective if it happens in the natural course of therapy and if the client is able to maintain adult consciousness at the same time." (p. ix)

"Jean Jenson's approach reflects her obvious awareness of this fact. It helps the adult to mourn the losses of childhood without at the same time losing himself in the chaos of his own feelings. In the seventies Jean Jenson experienced primal therapy in operation at Arthur Janov's Institute. Later, however, she went on to develop a therapy design that, in the all-important question of regression and the understanding of what actually happens in the therapeutic process, represents a notable advance on that particular method." (pp. ix-x)

"Today I know that a method that is successful for one person will not necessarily be successful for another. This applies to all methods, and primal therapy is no exception. Some people insist that it saved their lives; others say that they got nothing out of it, that in fact it did them considerable harm. Then again there are people who have benefited from therapy without being confronted with the past at all." (pp. x-xi)

__________________________

Breaking Down the Wall of Silence, (Revised)
May 1996, translated by Andrew Jenkins

". . . In the last few years I have come to the conclusion that primal therapy is not always free of dangers, that it is imperative for it to be embarked upon under expert guidance and not as a form of self-therapy. This conclusion is tantamount to a retraction of my earlier ideas on this subject.

. . . Numerous studies on cult groups have enlightened us on the latest methods of human manipulation. It transpires that these groups frequently use primal therapy techniques to brainwash the members they have recruited into a state of regression and thus make them completely docile and malleable. Thus primal therapy runs the risk of being misused for commercial purposes and reinforcing the individual's dependency on the group rather than encouraging his autonomy, as I had originally hoped. Today, however, therapists are using new approaches with awareness both of the advantages of primal therapy (its closeness to feelings) and of its dangers (manipulation and addictive dependency on pain), and they attempt to use this awareness to the benefit of their patients." (p. ix)

__________________________

The following are excerpts from a special communication published on the World Wide Web 10.9.1996.

Alice Miller - Communication To My Readers

"I should like to inform my readers that I no longer, in any way, support or recommend the therapy developed and practiced by Mr. J. Konrad Stettbacher."

"Only in 1994 did I learn that he had no formal qualifications in psychology. . . and as of June 1995 he has been formally prohibited from conducting a psychotherapeutic practice in Berne, Switzerland, his place of residence."

"I tried Stettbacher's method out on myself. At first I was impressed, and when I gave it my recommendation, I saw no reason to doubt that it might be helpful in other cases as well, as was apparently confirmed by case studies reporting major initial successes using this method."

"In the meantime a number of years have passed and I now have access to further information that has made me more skeptical about primal therapy as a form of self-help. The quick successes have not always had a lasting effect, and in many cases massive anxieties set in, so strong that clients found it impossible to cope with them without therapeutic support."

"My misgivings about the intensive phase were strengthened when I was confronted in 1995 by articles and interviews (cf.FACTS 26/95, Zurich and DER BUND, 4.7.95, Berne) reporting on accusations of sexual interference with patients."

"The main reason for my interest in a safe and effective self-help concept was the large number of readers' letters that I had been receiving daily since the appearance of Drama in 1979, many of them revolving around the abuse of patients during therapies of various kinds. I hoped that an effective form of self-help would be a way of counteracting this abuse."

__________________________

Paths of Life: Seven Scenarios
Translation copyright 1998

"Both Sigmund Freud, in his early years, and Arthur Janov were inspired by the hope that remembering and consciously re-experiencing a traumatic situation could bring about lasting relief from its consequences. This hope has not been entirely fulfilled. I know of cases where improvement has been achieved without recourse to the reactivation of memories, and others where the reenactment of the past and years of therapy has done nothing to alleviate the patient's condition." (p. 147)

"At all events, the primal therapists who have been trained more recently have increasingly moved away from the initial absolutism. Many of them combine primal therapy techniques with other methods. The techniques developed over twenty years ago are used less often today; many therapists have jettisoned both the "intensive phase" and the darkened room. Most of them have discovered that they have no need of such things in order to enable their patients to get in touch with their feelings." (pp. 147-148)

__________________________

The following is an official announcement posted to the Primal Support Group email list at Alice Miller's request:

Primal Support Group
Saturday, May 5, 2001 7:22 pm

"Dear Visitors: Today I should not be identified with any kind of regressive therapy. Since 1994, I don't support Stettbacher and since 1999 I have been trying to remove my preface from the book published by Jean Jenson. People who wish to know more about my reasons and my current opinions on therapy can visit my website www.alice-miller.com on page ARTICLES, or my letters to my forum."

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The Truth Will Set You Free: Overcoming Emotional Blindness and Finding Your True Adult Self, 2001

"I tried next to get on the track of it with the help of primal therapy. I succeeded in discovering many of the feelings I had had in early infancy but failed to understand the entire context of early childhood reality and to allow the truth to surface because I had no enlightened witness to stand by me in this endeavor. Today I would not readily advise anyone to pursue this course (unless they are very certain of the therapist's qualifications and expertise) because many apparently enlightened witnesses may arouse intense feelings in their patients without assisting them in extricating themselves from their personal chaos." (pp. 132-133)

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Conclusions

For Alice Miller, "Truth" has always been a key word, and this article is an attempt to summarize her truth. One person's truth, however, is not another's - we must attempt to find out the truth for ourselves. From reading Miller's words, each of us can come to our own conclusions. Feel free to send me yours. Mine will be published in the next IPA Newsletter.

---

Sam Turton practices Primal Integration in Guelph, Ontario, Canada, and co-leads therapist training programs at the Primal Integration Center of Michigan. His extensive writings on primal can be viewed at www.primalworks.com.

This article appeared in the Spring 2002 IPA Newsletter.

Bike tour in the rain...

Needed to come out in the day light really, so I took a tour out even if it rained...

Cycled out on a small peninsula, with a lot of stones and trees, though quite nice...

And cycled further out from town...
Water all around here - it feels... And sea-birds...

I wish the sun and warmth came.

English word of today "peninsula" which means halvö in Swedish (I had no idea whatsoever about this!!:-)).

Lunch concert at the museum...

Lunch concert at the museum with distribution of 19 scholarships... There are so many nice and fun things on this museum...

Old wall papers, painted by artists in these parts of the country. Site with old paintings and buildings from the middle parts of Sweden.

And an old automobile...

Wooden horses...And a newly awaken young man who came without having even eaten breakfast but played fairly nice nevertheless!! He played Libellentanz by Oscar Rieding on violin, and got one of the bigger scholarships...The Nobel-prize winning Swedish author Selma Largerlöf lived in this town for a while and the museum has her library. Dark in the style of that time!! The portrait on this site about Selma Lagerlöf is painted by the Swedish painter Carl Larsson! And this portrait hang on one of the walls here! In original? Or?

But her real home and the place where she was born was Mårbacka in Värmland.
After the concert we ate lunch and relaxed for a while... Nice. It's a soft rain, so one need to sit huddled up with lit candles!

The museum is very nice! Really! I want to give an image at least of this milieu!!! A bit impressionistic pictures taken with my cell phone camera... :-)

Övergrepp i terapi/abuse in therapy...

Overgrep fra behandlere - Dagbladet 10. januar 2004

TEKST: SUSANNE LOUISE KALUZA OG PER ARNE SOLEND FOTO: AGNETE BRUN OG JØRN H. MOEN

Hvert år mister helsepersonell lisensen fordi de forgriper seg på dem de skulle hjelpe.

Rom for overgrep.

FØRSTKOMMENDE TORSDAG MÅ EN

professor i psykiatri møte i retten og svare på anklager om sex med en pasient. Den høyt respekterte legen er tiltalt for å ha misbrukt sin stilling til å ha sex med en pasient. Han nekter straffskyld og hevder han utviklet et kjærlighetsforhold til kvinnen. Saken har sendt sjokkbølger langt inn i psykiatrimiljøet. Denne gangen dreier deg seg ikke om en tilfeldig kommunelege. Mannen som står under tiltale, var en anerkjent professor i psykiatri. Han har hatt verv i Norsk psykiatrisk forening og har skrevet lærebøker i faget. Nå har han mistet lisensen. Men saken er utypisk på enda en måte. Den endte i retten.

I 2002 MISTET sju helsearbeidere autorisasjonen på grunn av seksuell utnyttelse av pasienter. Mette Sundt Gundersen er selv psykolog. I tillegg skriver hun på ei fagbok om grenseoverskridelser i terapi. Hennes 15 år lange mareritt begynte i 1984. Da var hun halvveis gjennom embetsstudiet i psykologi. Hun ville rydde opp i egne tanker, før hun begynte å arbeide med andres.
«Jeg valgte meg ut ett bestemt frø som jeg la i munnen min og lot komme ned i magen. Og det lille frøet det var spiren til deg. Det begynte å vokse og vokse slik at en dag så måtte jeg på sykehuset. Der kom du ut av magen min, på en forunderlig måte uten noe som helst blod eller arr.»
Dette er et utdrag fra en kassett psykologen til Mette fikk laget til henne. Hun fikk beskjed om å høre på den mellom terapitimene.
- De første to åra var terapien normal. Jeg snakket, og han lyttet. Slik vant han gradvis tillit, forteller Mette Sundt Gundersen. Hun sitter i en stor ørelappstol i stua si. Ved siden av henne troner ei hylle med skinninnbundne bøker, under stuebordet står to pappesker med papirer. De er fylt med papirer fra behandlingen, gamle brev, notater og saksdokumenter. Mette har tatt vare på alt.

MØTET MELLOM en behandler og en pasient er privat, det skal være personlig. På ditt mest sårbare møter du som pasient noen du kan stole på, noen som lytter og er oppriktig interessert i det du har å si. En som er der for å hjelpe. Men det er ikke alltid ei utstrakt hånd er ment for å hjelpe, og hvert år rammes noen av overgrep fra sine «redningsmenn».
- Vi betror mer til terapeuten enn til våre aller nærmeste, nettopp fordi dette er en person som skal hjelpe, sier Kjersti Arefjord, leder av Norsk Psykologforenings fagetiske råd.
- Slik skapes en veldig sterk relasjon. Det er naturlig at pasienten får positive følelser for terapauten, sier Arefjord. Tillit, og følelser, som lett kan misbrukes. Arefjord sier det slik:
- Som behandler må du være profesjonell og ikke misbruke makt gjennom å utnytte klientens avhengighet og tillit.
Det er ikke uvanlig at behandlere som begår overgrep forklarer det med forelskelse, at det oppstod et kjærlighetsforhold mellom psykolog og pasient, med gjengjeldte følelser. Her er Arefjord krystallklar.
- Et hjelper-pasient forhold er ikke gjensidig på samme måte som andre typer relasjoner og som hjelpsøkende må pasienten kunne stole på at terapeuten ikke utnytter tillit til tilferdstillese av egne behov.
Lars Weisæth er professor i katastrofepsykiatri ved Gaustad sykehus. Han var nylig sakkyndig i en rettssak der Høyesterett dømte en psykolog til å betale sju og en halv millioner kroner i erstatning til tre pasienter som ble sexmisbrukt under terapi.
- Overgrepssaker har fellestrekk med både religiøse sekter og gisseldramaer, sier Weisæth. I den nylig pådømte saken plantet psykologen falske minner om at mennene var utsatt for seksuelle overgrep som barn. Sex med terapeuten var en del av behandlingen.
- Det eneste alternativet som ble framstilt, var at de ville bli kronisk syke og måtte gå på piller resten av livet, sier Weisæth. Han sammenlikner opplevelsene til de tre med torturofres. Psykologen rettferdiggjorde handlingene overfor pasientene sine: «Jeg vet dette gjør vondt, jeg vet det går over grensen, jeg vet jeg bryter loven. Men der andre ikke orker å ta tak i slike problemer, er jeg villig til å stille opp for deg.»
- Vi ser altså at det brukes både pisk og gulrot, sier Weisæth og snakker om det som på fagspråket kalles for «overføring».
- Overføring betyr at holdninger du har hatt tidligere i livet, gjenskapes i terapien. Dette gjelder all behandling. Vi ser ofte positiv overføring i form av tillit, pasienten får varme følelser, og den berømte forelskelsen oppstår. Lar terapeuten seg smigre av dette, kan det gå galt. Behandleren må skjønne at det ikke har noe med ham å gjøre, sier Weisæth.
- Det viktigste for en hjelper er å skille mellom pasientens og egne behov. Flyttes egne behov inn i yrket, står du i fare for å skade andre.

METTES TIMER HOS psykologen begynte å forandre seg etter to år.
- Han tok mer på meg og begynte å fortelle personlige ting om seg selv. Endringene skjedde så sakte at jeg ikke så noe galt i dem. Jeg ble sugd inn i en tro på at dette var helt naturlig. På dette tidspunktet gikk Mette til terapi to ganger i uka. Etter hvert dreide livet hennes seg utelukkende om disse timene.
- Terapitimene overtok på mange måter livet mitt. De var alt jeg tenkte på. Han ga meg en kassett han hadde lest inn, som jeg hørte på mellom timene. Her fortalte han meg at jeg var hans barn, og at jeg skulle ha ham i tankene mine hver dag, hele tida. Psykologen min spiste meg nærmest opp, forteller Mette.
Mettes mann merket at noe var galt, men skjønte ikke hva. Han kunne ikke forstå hvorfor kona tilsynelatende ble dårligere av å gå i terapi. Mette selv fortalte ingenting.

PSYKIATERE SOM TILHØRER et fagmiljø, jobber ifølge Lars Weisæth mye med seg selv, med egenanalyse og egenbehandling, for å fange opp eventuelle problemer.
- Det er verre med dem som driver en solopraksis og kanskje sliter med tunge personlige problemer. I tillegg vet vi at den første generasjonen psykologer som fikk lisens, ofte fikk den på et svært tynt grunnlag fra for eksempel USA, sier Weisæth.
Men at psykologen tilhører et fagmiljø, er ingen garanti mot overgrep, mener Randi Rosenqvist. Hun leder den rettsmedisinske kommisjonens psykiatriske gruppe og er tidligere overlege på Gaustad sykehus. Hun mener den medisinske laugskulturen må ta sin del av ansvaret for at overgrep skjer.
- Mange medisinere er ambisiøse mennesker som har surfet gjennom livet på en bølge av vellykkethet. Leger blir flasket opp til å tro at de vet hva som er best for folk, sier Rosenqvist.
- Vi vet at mye psykiatrisk behandling ikke har god nok kvalitet. Men vi er ikke flinkenok til å gi beskjed når vi ser at kollegaer ikke egner seg til det de holder på med, sier Rosenqvist.
Dette fraværet av kritikk åpner for at overgrep kan finne sted, mener hun.
- Da tar de seg til rette på en annen måte enn dersom de var vant til at oppførselen deres ble korrigert, sier Rosenqvist.
Bare en sjelden gang havner slike saker i retten, men hvert år mister noen helsearbeidere autorisasjonen på grunn av overgrep. Trolig er mørketallene store. I så godt som alle sakene Rosenqvist kjenner til, mener legen selv at han har vært på trygg grunn.
- Ingen tenker «nå skal jeg foreta et overgrep». Alle er nok enige i at overgrep er galt. Årsaken er at hver overgriper ser på sin egen situasjon som spesiell. Alle har en «god» forklaring på hvorfor de brøt reglene. Alt fra kjæresteforhold til pseudopsykiatriske ideer som at pasienten trengte en seksuell bekreftelse.
Professor Hanne Haavind ved Universitetet i Oslo er den eneste i Norge som har forsket på erotisk berøring i det terapeutiske rom. Ifølge henne er ingen av disse forklaringene holdbare.
- En terapeut skal være opptatt av klientens behov og følelser, ikke sine egne. At terapeuten selv tenker at det vedkommende gjør med klienten er positivt, legitimerer ikke erotisk handling. Erotisk handling er ubehagelig, forvirrende og skremmende for en pasient, sier Haavind.
Det hjelper heller ikke at psykologen utvikler følelser for vedkommende som går i terapi.
- Egen forelskelse er ingen garanti for at dette er bra for pasienten, understreker Haavind.

«JA, NÅ ER VI sammen her, Mette. Her på rommet mitt er vi sammen nå. Her er det bare oss to, det er vi to som skal være sammen på rommet mitt. Du er så liten, og kjenner hvor godt det er å være liten, og kjenne at jeg er her.»
- I 1990 arrangerte psykologen og kollegaen hans en adopsjonsseremoni på kontoret hans. De tok av meg klærne og smurte meg inn med salve over hele kroppen. Deretter dusjet de meg, og så undertegnet vi alle en erklæring om at han var pappaen min «fra i dag og for all framtid». Mette bøyer seg ned og roter i en av de to store pappeskene. Hun fisker opp et gulnet, maskinskrevet ark. Adopsjonserklæringen. Den er datert 25. juni 1990 og er tilegnet «kjære Mette» fra «pappa». Mette hadde da vært pasient hos den samme terapeuten i over seks år. Hun forteller at makten han hadde over henne, var blitt nærmest altomfattende, og at terapien ble stadig mer intens.
- Høsten 1992 bodde jeg på kontoret hans i to uker, også dette som et ledd i «terapien». Jeg tror ikke jeg hadde klær på meg i det hele tatt i løpet av de fjorten dagene.
Ifølge Mette innebar terapien på dette tidspunktet at psykologen kledde av henne og la seg oppå henne. Han skal også ha bedt henne ligge naken på kontoret hans og sutte på tommelen.

- DET KAN GÅ

Misbrukt: Mette Sundt Gundersen ble i femten år psykisk og fysisk misbrukt av sin psykolog. Hun har spart på alle saksdokumenter, notater og gamle brev. I dag skriver Mette på ei fagbok om grenseoverskridelser i terapi.

flere år før pasienter som har vært utsatt for overgrep fra behandlere, klager, sier Arefjord.
- De føler seg gjerne som medskyldige fordi de har vært med på de seksuelle handlingene. Mange vet ikke hva de kan forvente når de går i terapi, og i ettertid er det lett å tenke at «jeg var en del av det». Men det finnes ikke likeverdighet i terapirelasjonen, bare utnyttelse, sier
Arefjord. Reaksjonene fra de som opplever pasientovergrep kan i noen tilfeller
sammenlignes med incestofre, sier hun.
- De bebreider seg selv, er plaget av skam og skyldfølelse.
- Noen ganger er legen sykdommen, og ikke kuren, sier Lars Weisæth. Han beskriver to timer i uka som intensiv psykoterapi. I saken som var oppe i Høyesterett, foregikk behandlingen to timer daglig.
- En slik mengdeterapi, å ha en terapeut du kan ringe til hele døgnet, skaper et intenst avhengighetsforhold.
- Reglene er klare nok, sier Weisæth.
- I psykoanalyse håndhilser du ikke engang på pasienten, for å begrense faren for overføring.
Ifølge katastrofepsykiateren er det typisk at overgriperen begrenser pasientens kontakt med omverdenen for å skape en sterkere avhengighet.
- De innsnevrer livsutfoldelsen til ofrene sine. Maktovergrepet er helt sentralt, sier Weisæth.
- Der mennesker møtes, kan søt musikk oppstå. En annen følelse som virker på overgriperen, er behovet for å føle seg stor. Ofte gir vi ut fra egne behov, sier Weisæth.

«KJENN PÅ KROPPEN min og din, kjenn på varmen min og kjenn på lukten av meg. Kjenn på stemmen min, du hører den. Jeg er her.»

En god venn av Mette fattet etter hvert uråd. Han spurte Mette rett ut om det skjedde rare ting i terapitimene, og ba henne oppsøke en annen, kvinnelig psykolog.
- Gradvis fortalte jeg den nye psykologen hva som hadde foregått. Det førte til at jeg våren 1993 skrev en offisiell klage.
Klagen ble sendt til psykologenes fagetiske råd. Etter ett års saksbehandling rettet de skarp kritikk mot psykologens behandling av Mette og sendte saken videre til Statens helsetilsyn. Da Helsetilsynet fikk saken, meldte de straks fra til Riksadvokaten om at det forelå «mulige straffbare forhold». I møte med politiet fikk Mette problemer med å dokumentere hva som faktisk hadde skjedd.
- I terapitimen er det bare deg og terapeuten til stede i et lukket rom. Hva som har foregått der inne, blir ord mot ord. Og hvem ville dutrodd mest på? En høyt utdannet psykolog eller en «sprø» pasient? spør Mette.
Politiet henla saken «etter bevisets stilling». Samtidig gikk saksbehandlingen i Statens helsetilsyn sin langsomme gang. I juni 1998 rettet Helsetilsynet flengende kritikk mot Skogsstien både for behandlingen Mette hadde fått, adopsjonsseremonien, manglende journalføring og kroppsfikseringen i terapien. Konklusjonen var klar: Statens helsetilsyn fratok Mettes terapeut retten til å praktisere som psykolog i ett år. I tillegg gikk Mette som den første i Norge til sivilt søksmål mot sin tidligere terapeut.
- Det hadde gått seks år fra jeg sendte inn den første klagen på ham. Jeg var fysisk syk, utslitt og lei av å kjempe.
Kvelden før rettssaken skulle starte godtok Mette et forlik. Psykologen måtte betale henne til sammen 425 000 kroner. Et femten år langt mareritt hadde fått sin slutt, men for Mette var det langt fra over. Smertene bærer hun med seg ennå.

- JEG TROR DESSVERRE ikke andre straffesaker har en så stor forebyggende effekt. For alle overgriperne har som sagt sin egen forklaring på hvorfor akkurat dette tilfellet var så spesielt, sier Randi Rosenqvist. Hun er opptatt av forebygging.
- Vi må snakke om temaene, sier Rosenqvist. Som overlege har hun selv vært med på å håndtere beskyldninger om seksuell atferd fra nattevakter på sengeposter. Når historien kommer fra et lukket rom, er det ofte umulig å vite hva som har skjedd. Likevel flytter Rosenqvist personale som får beskyldninger mot seg.
- De opplever det selvfølgelig som svært urimelig og en veldig stor belastning. Men vi må vise overfor pasientene at vi tar dette på alvor, sier Rosenqvist.
- Frykten for ikke å bli trodd hindrer mange i å komme med sine historier. Det er lettvint for en terapeut å avfeie anklager med at dette er et hysterisk menneske som fabrikkerer situasjonen. Mange saker blir nettopp et spørsmål om troverdighet, menvi må samtidig ta høyde for falske anmeldelser, sier den tidligere overlegen.
- En mistanke om å stå bak enhver form for overgrep er helt ødeleggende for en behandlers karriere.
Kjersti Arefjord underviser studentene på psykologistudiet om etiske temaer.
- I rettssystemet er det loven som rår, men vår egen etikk må være strengere enn jussens.
I fagetisk råd, hvor vi behandler klager mot psykologer blir det noen ganger påstand mot påstand. Men vi kan ikke drive etterforskning, bare høre på det partene har å si. I noen tilfeller kan vi ikke konkludere med om det foreligger brudd på de etiske prinsippene, sier Arefjord.
- At terapirommet er lukket, pålegger terapauten et stort ansvar.
Lederen i Norsk psykiatrisk forening, Bjarte Stubhaug, forteller at foreningen ser alvorlig på risikoen for pasientovergrep. Han har selv engasjert seg sterkt i problematikken.
- Som leder av foreningen har jeg hatt innlegg om dette temaet på årsmøtet vårt og skrevet flere innlegg i medlemsbladet vårt. Budskapet er helt klart, enhver seksuell kontakt mellom pasient og terapeut er uakseptabelt, og det er terapeutens fulle ansvar at noe slikt ikke foregår, sier Stubhaug.
Også lederen i Norsk Psykologforening, An-Magritt Aanonsen, understreker at foreningen tar sterkt avstand fra erotisk kontakt mellom behandler og pasient.
- I spesialistutdanningen, som alle psykologer må igjennom, inngår seksuelle overgrep som et tema i fagetikken. Vi kan jo ikke gripe inn direkte, så vi mener dette temaet i stor grad dreier seg om å utvikle seg selv som psykolog, sier Aanonsen.
- I USA plikter alle psykologer å gi pasienten et hefte om hvor vedkommende kan henvende seg hvis hun lurer på om behandlingen er korrekt. Hvorfor har vi ikke dette tilbudet i Norge?
- Vi har tenkt på at vi burde lage noe sånt, men vi har ikke fått gjort noe med det, sier Aanonsen. Psykologforeningen har ingen oversikt over hvor mange psykologer som er blitt dømt for eller har mistet autorisasjonen på grunn av overgrep mot pasienten. De har heller ingen planer om å sette i gang noen ny undersøkelse for å kartlegge problemet.

«BILDET AV MEG vil dekke over og skyve andre bilder helt i bakgrunnen. Kjenn at bildet av meg er helt tydelig. Helt tydelig. Slik er det, hele tiden, i mange, mange, mange, mange, mange år. Alltid.»
En del av pengene Mette fikk i erstatning, har hun brukt til å starte en stiftelse som skal hjelpe andre pasienter som havner i samme situasjon som henne. Hun mener behovet for slik hjelp er udekket.
- En ting er skammen - du føler deg så ufattelig dum fordi du ikke skjønte at noe var galt. I tillegg mister du jo den personen du har gått til flere ganger i uka i mange år. Følelsen av å bli latterliggjort av en person du en gang har stolt på, er til tider uutholdelig. For meg føltes dette som om en vegg datt ut, og ingen sto bak og tok imot meg.
Og mens terapeuter som klages inn til fagetisk råd, får støtte til advokat av Psykologforeningen, står pasientene på bar bakke.
- Stiftelse 99 skal derfor dele ut penger til pasienter som er blitt misbrukt av terapeuten sin. Første utdeling skjer nå i januar, sier Mette.
I dag arbeider som nevnt Mette som psykolog og skriver ei fagbok om grenseoverskridelser i terapi. Hun har høyt blodtrykk, svekket konsentrasjonsevne og forteller at hun ikke har sovet ei hel natt på over ti år. Psykologen hennes fikk autorisasjonen sin tilbake etter ett år. Han praktiserer fortsatt som psykolog. Ukas rettsak vil i løpet av kort tid fortelle oss om nok en betrodd terapeut har misbrukt pasientens tillit.

-//-

An article from a Norwegian newspaper about abuse committed by therapists, both towards female and male clients... I will try to make a summary later in English, because I think this text is worth it. But I won't do it before tomorrow afternoon I think, because of work-things...

Från kvällscykeltur/from evening tour on bike...

Från en cykeltur efter jobbet, med regn hängande i luften!! Grått, men oj vad det grönskar!! Plockade en bukett liljekonvaljer.

-//-

From a bike tour after work, with rain hanging in the air! Grey, but wow how green it is!! Picked a bouquet of lilies of the valley...
Are the flowers possible to see on the photo, still not picked there? :-)

Morgonreflektioner/morning reflections...

Något slog mig angående utvärderingen vi gjorde med den grupp jag är en av de ansvariga för; att skapa en vikänsla ännu mer, vikten av en sådan…

Kom också att tänka på detta att stimulera och uppmuntra integration och samarbete mellan oss lärare och framförallt om ny verksamhet sätter igång. Speciellt om en ny verksamhet ligger litet utanför den tidigare och riskerar att bli liggande litet utanför… Och definitivt inte hindra en sådan integrering…

Som när dansverksamhet satte igång hos oss… Att tillåta brain-storming om hur man skulle kunna integrera i detta fall dansen med annan verksamhet i konserter bland annat. Men det kräver ju en del av dansansvarig och av ansvarig överhuvudtaget… Att inte hålla vissa grupper för sig och vara rädd för att andra ska komma med bra idéer…

Nu dryga femton år senare tror jag detta kan vara svårt… Danslärarna är utanför övrig verksamhet känns det och det känns litet som om det uppstått flera musikskolor i samma musikskola och det tror jag beror på högsta chef, som saknar förmåga (och kanske också vilja, medvetet eller omedvetet) av att stimulera äkta samarbete… För det skulle sätta igång kreativa processer som skulle nå långt över hennes huvud?

Verksamheten på en arbetsplats blir ungefär så bra som dess chef är… Och vi har en som inte kan få folk att blomma ut riktigt tycker jag (andra kanske inte skulle hålla med mig dock om detta) och en chef som heller inte har de konstnärliga eller pedagogiska eller ens de organisatoriska kvaliteterna… Vi har ”trevliga” fester istället… Och har en chef som är väldigt social och kan prata mycket.

Jo, det är en jäkla massa prat, som hittills inte lett så värst mycket matnyttigt… Men jag tror jag kan överleva det. Hoppas så i alla fall.

---

Need to pour out things (now in the end of a school-year and thus a bit tired and reacting stronger than usual?).

Something struck me apropos the evaluation we did with the group I am responsible for, about that we leaders could work even more for making the group a group, but the students seem to think the people in the group are very nice people and that the group is fairly nice anyway. But it could be even better. Especially could the new students get even better introduced.

I really appreciated the ideas we got from all who answered this evaluation.

I came to think about the organization on a higher level… A boss that is capable (and who want, and I am not sure she always want this honestly) to encourage integration and cooperation. But if you do this you are at risk of losing control over the group/the work-place! You can’t steer it in the same way as if you hold groups separated and maybe even some individuals for yourself.

And that’s what I think my boss does and has tendencies to do! Almost like we are still school-children and need to compete about other mates/comrades favor!!! And as if she is still a school-girl too!?

Because I think it was like this (not to go into details) when we started with dance-activity in our school a little more than 15 years ago… She then became the responsible for that education and I felt already then that she held the dance-teacher for herself even, or not least, towards us accompanists!!! Strange! Or not?

The result is, from my view-point that the dance and not least the dance-teachers aren’t integrated in the school-activity today either in a way I think would have been possible, and I think it would be difficult to change this as long as we have the boss we have (the responsible for the dance-activity then became our boss 1998! And her husband was our boss 1985-90!!! So how come we got the boss we now have?)…

If she had encouraged and worked for integration and cooperation (and how was the original introduction in the first place really?) it would perhaps have created creative processes that would have reached over her head!!?? Even far over it too, and in a way, more or less consciously, she was aware of that?? That it was risky to allow brain-storming and ideas to be articulated and to flower. And let ideas come up that didn’t come from her???

And in the end; was this even beneficial for the dance-activity either?

And today there is as we have not only one music-school but three or four…

The work-place isn’t better than its boss I think… And our boss doesn’t in my opinion neither have artistic, pedagogical nor organizational qualities (as if I have!?)… She is good at talking and very “social”, she likes parties and thinks that’s the solution in creating a good work environment!!! Phew I just say! This awakes the obstinacy in me really (the obstinate child!?). Because I really don’t think it is so easy!!

But if things are functioning at the work-place then parties and social things can work and be nice… But you can’t take it from that angle or solve everything with that (isn't that by the way "a bit", or very much, humiliating? What are we; grown up or?). The reaction/result can be the opposite instead I think! Some, the cleverest and most ambitious teachers, gets angry instead to be forced together and being forced to pretend things are different than they are!?? And you definitely can’t force folks to have nice parties! To pretend things… Falsely, hypocritically… But, yes, sometimes you have to play the game… And smile even if you don’t really feel for it?? But nobody can hinder you from feeling and thinking inside and quietly, or? (and how is my poker face? A person standing me fairly near said smiling and a bit teasingly when we were playing cards that I have no poker face! And yes, I am afraid I don’t have…).

Hmmm, I don’t say I am neither one nor the other and I think I can cope with this… But I needed to pour this out?

Our former boss (1991-1998) also lacked interest in pedagogical and artistically issues (had hardly worked as teacher) and he was also completely uninterested in care about the employees (had enormous own problems)... Then we had the steel-bath in economy so a strong (but also in other ways weak!?) leader had been recruited? The ceiling at work became very low... It was fairly easy to take over after him!!?? He lay the ground for the boss we now have. Everything would be better than what we had had...

I joined a gestalt-group where one of the women had worked for a longer time than I and frankly said that she had hardly seen any real good boss... That was very relieving for me... So it was maybe allowed to feel and react as one did!? :-) As if you need to get permission for that!? You react as you react!? And you can try to understand why you are reacting or not try to understand it... And on what you are reacting... But all reactions are worth to take seriously!? And respect, as long as one doesn't cause real harm to anyone or oneself?

And, yes, I think that unfortunately it has been and still is harder to recruit bosses that would be the best!? C. Maslach&M.P. Leiter wrote in "The truth about burnout. How organizations cause personal stress and what to do about it" which came already 1997 in English, "Sanningen om utbrändhet. Hur jobbet förorsakar personlig stress och vad man kan göra åt det" which came 2000 in Swedish, that they feared the work-places and companies would be drained on their best folks with the work environment we have... (And how is this for the societal economy? And for work-places and companies?)

In psycho-history they talk about backward psycho-classes and the ones needing power probably comes from that "category"!? Even if one maybe shall be careful about labeling people???

And, yes, I am daughter to a boss (one that was formal and another that was informal?)... So what do I have to come with and say, so I can just keep quiet!??? (a bit ironically).

-//-

Addition at 11.00: Oh, I am about to explode over all stupid people!!?? :-)

Our boss said carelessly and dispatching about a colleague of mine who was fairly angry at work and meetings (he was exhausted?) that he had boss-problems, i.e., problems with all bosses. She has that “style”? To push things away, completely!? Nothing has with her to do (or her in her way of being boss, her husband also had "problems" with this man when he was boss), but is only a question about others!? She has nothing to learn!? I reacted very angrily when she said this (and she has said other similar things that I have also reacted against). The big-sister in me: protecting my siblings (and myself through them?). Even if the colleague above was 11 years older than I and even if I was actually younger.

And he got retired already at age 57!!! A problem the bosses had swept under the carpet/rug I think because of their lack of competence and ability to handle things!!! And lack of will too!!?? And no interest in developing those skills either or developing hardly anything else to make a radically better job!? Oh, how do I sound now??

Oh, I am rather angry???

And I think she is also the one that even less than anyone else on this work-place has educated herself further neither in work-things (neither artistically nor pedagogically) nor personally!? She doesn’t need to? Because if you can and know you just can and know, no education in the world can change that!? And in a way that’s true too, you can’t be taught to be empathic for instance… OR to become a good teachers or boss, but education can’t make it worse at least, so? Or? Then the education must be very bad!?

Or some have the quality to learn from life exclusively (yes true, I think some can really learn from life, but then you see it and sense it, this is obvious for the environment!? This person radiates this?)? Or something?

By the way the Swedish religion psychologist professor Owe Wikström writes about existential crisis; crisis that come for all human beings sooner or less... And those crisis are sound... And a sign you are a living human being... To cite him shortly.

Tiredness and tension and stress and nerves lying on the surface here? :-) But I use to be able to handle them... Even in the worse mess standing there with both feet on the ground - extremely clever!! Phew!!! I should be a little less clever???

It's raining cats and dogs :-) which is contributing to my mood, but is not the whole explanation to it!? A relief is that the dog Eskil also reacts when it is bad weather - reacts very much. He doesn't even have to put his nose out to sense a bad weather!!! So after all, I am not totally insensitive??? Hopefully! :-) Oh, I wish I had his company, on walks and here at home... I am so fond of him.

In case anyone run out of things to read...

In the middle of practicing piano:
Bob sent this in case I run out of something to read and write about :-). Things on the same topic as the last blog-posts about Kirkengen and Getz!? I haven't read them yet, but will. Thank you for the tip, Bob!! :-)

"I found this report, by Dr. Cathy Zimmerman, of the The London School of Hygiene & Tropical Medicine, which also speaks of the medical consequences of sexual abuse, and thought you might find it interesting.
I found the pointer to that report in this powerful article.
In it the author mentions:
'And those children quickly learn that the ultimate betrayal of their trust doesn't much matter to the rest of us.'
Bob"

-//-

Addition at 17.58: Now I have read the first essay (no, it was the second I had read!!)… Yes, it was very powerful, and it boiled under the surface in the man writing it!? yes, I recommend a reading. Something came for me: ”The Holy Family”!!?? Absolutely forbidden to break up the family unit!?

Quotation from the essay:

“This in-your-face hypocrisy is the real message of the law. The perpetrators quickly realize that they have been granted a ‘Get Out of Jail Free’ card… so long as they have the good taste to sexually abuse only their children.”

Adults other than the parents that sexually abuse children are harsher punished…

Our new government consists of four parties of which the Christ Democrats are holding the family very high!!! Yes, very hypocritically I think. And probably got voters on that… Even if this party still is fairly small (I wouldn't miss it at all if it disappeared!!!)… And I think there has blown neo-conservative winds here… No, I don’t like this… Shouts for “harder grips” have been raised. If harder grips should be needed and necessary why are they needed? Out of the blue? Is the solution to be tougher, harder etc.? What does that learn young people instead?

-//-

Wednesday May 30, at 17.29: Changing the title again!! Thank you again, Bob, for this tip! :-) I wanted to forward it, hope that's ok?

But the risk I wouldn't have anything to read is minimal :-) which I think you know!?? On the contrary, I have a lot here to read still... Phew!

Ingeborg Bosch about burn-out...

The Dutch therapist Ingeborg Bosch writes in her book "Rediscovering The True Self" at page 249 about burn-out:

"These symptoms much resemble what could be the result of false hope; to keep on trying to accomplish something that cannot be accomplished."

-//-

Översatt till svenska blir det något i stil med

"Dessa symptom liknar mycket det som skulle kunna bli resultatet av falskt hopp; att fortsätta försöka åstadkomma något som inte kan åstadkommas".

Det vill säga man ägnar sig åt något som är hopplöst att utföra!? Man försöker ändra något då som inte går att ändra nu...

-//-

Addition at 15.23, see the case histories:
Arthur's story, Christine's story, Danielle's story, Juliette's story and Marlies story.

Spring feelings/vårkänslor…

Found this on my refrigerator, a sender in I tore out from the paper some month ago , a little freely translated :-) in my spontaneous style:

Spring feelings…

I saw your car, knew you were in the neighbourhood, felt the happiness of seeing you and maybe hearing your voice.

My eyes sought out the surrounding, there you were, you attracted me.

I don’t know how to behave not to reveal what I feel; therefore I often get a bit stiff when you are in the surrounding. But the feeling is nice, think such a feeling can be there in spite of my age.

“Pensioner”.

Yes, it is incredible, and quite wonderful!?

-//-

Vårkänslor…

Jag såg din bil, visste att du var i närheten, kände glädjen av att se dig och eventuellt höra din röst.

Mina blickar sökte av omgivningen, där var du ju, du tilltalade mig.

Jag vet inte hur jag ska bete mig för att inte röja vad jag känner, därför blir jag ofta litet stel när du finns i min närhet. Men känslan är skön, tänk att den finns där trots min ålder.

”Pensionär”.

Linn Getz about Kirkengen/Linn Getz om Kirkengen...

Linn Getz writes:

”In an attempt to make an ultra-short summary of the findings, I again emphasis the rich flora of somatic complaints that finally find a ’logical’ explanation when the patient is allowed to reveal – and reflect upon- a history pf sexual abuse [but do all patients remember such events?]. Some of the symptoms may be classified as ‘traditional’ in the sense that they do occur in textbooks and could well have had a defined pathological origin (e.g. pelvic pain). Other symptoms immediately strike one as ‘odd’ and far from textbook-like (i.e. an intermittent inability to see colors /…/ the thesis presents seven categories that in a broader sense reflect different aspects of long-term imprint of sexual trauma. Many of the phenomena may occur together.”

“In general practice and, to an increasing extent, even in psychiatry, the history taken from patient tends to be brief and symptom orientated, in some instances including standard formulas to ‘objectify’ the status of the patient /…/ uncritically referring ‘diffuse’ patients to further investigation of organ systems and body parts /…/ the most relevant investigation to set up for the enigmatic patient is an extended consultation giving room for complete history taking /…/ one need to know the setting in which the suffering emerged. This includes facts about childhood and upbringing, close relationships, education, the timing of illness and disease in relation to life events /…/ the doctor’s question leaves an understanding in the patient that trauma matters to the professional who tries to understand the origins of suffering. This focus may generate new ways of thinking both for the patient and the doctor. Even though it may not open the mystery box on the spot, it may contribute to a healthy solution in the long run.”

She also writes that

“The main conclusion of Kirkengen’s study is that ‘incomprehensible’ suffering may contain logic.”

And

“The gestalt reflects the fact that at one time in life this person was overwhelmed. Human integrity was violated and last resort coping strategy was activated. These strategies helped the individual survive in the storm but are disabling when preserved or repeated in the calm waters.”

Yes, events that never became processed then or not processed to a certain degree (and many events aren’t processed for human beings) causes problems; in social relations, in life, in health (psychological and somatic)… To be able to articulate things lessens the pressure, tension and stress? And can improve the health. Improves the health for many. Getz also writes that violations of other kinds than sexual also can cause health-problems… Which the ACE-study also has revealed, with its categorisation of adverse childhood experiences (skadliga barndomserfarenheter in Swedish) where for instance physical and emotional abuse (disrespect, whose importance and effects by no means should be minimized or belittled) also are mentioned, together with emotional and physical neglect (that the child wasn't seen or mirrored for example, or not seen or mirrored for its own sake and not mirrored in a deep rooted belief in the child, my silent reflection, all these things are much more traumatic and painful and humiliating for a child than we are aware of I think, and successful therapy has actually proved this recently).

Felitti believes in giving people the opportunity to talk about what one has experienced and mean that this has healing effects.

See also his essay "Turning gold into lead."

//

Linn Getz skriver:

”I ett försök att göra en ultrakort summering av fynden, vill jag starkt betona den rika floran av somatiska åkommor som slutligen hittar sin logiska förklaring när patienten tillåts avslöja – och reflektera över – en historia av sexuella övergrepp [men kommer alla patienter ihåg sådana händelser?]. Några av symtomen kan klassificeras som ’traditionella’ [dvs. kan organiskt konstateras!?] i så måtto att de förekommer i medicinsk litteratur och kan ha haft ett väldefinierat patologiskt ursprung (t.ex. bäckensmärta). Andra symtom slår en omedelbart som ’udda’ och långt ifrån textbokslika (som t.ex. en periodiskt återkommande oförmåga att se färger) /…/ tesen presenterar sju kategorier som på ett bredare sätt reflekterar de långsiktiga märkena av sexuellt trauma. Många av dessa fenomen kan uppträda tillsammans”.

”I allmänpraktik, och i ökande utsträckning även i psykiatri, tenderar historien som man inhämtar från patienten att bli kortfattad och symtomorienterad, i vissa fall inkluderande standardformulär för att ’objektifiera’ patientens status /…/ okritiskt remitterande ’diffusa’ patienter till fortsatta undersökningar av organsystem och kroppsdelar /…/ den mest relevanta undersökningen av gåtfulla patienter är en utökad konsultation som ger rum för komplett tagande av dennes historia /…/ man behöver veta förhållandet i vilket lidandet uppstod. Detta inkluderar fakta om barndom och uppväxt, nära relationer, utbildning, timingen av det dåliga måendet och sjukdomen i relation till livshändelser /…/ doktorns frågor lämnar en förståelse hos patienten att trauma har betydelse för den professionella som försöker förstå lidandets ursprung. Detta fokus kan generera nya sätt att tänka både för patienten och doktorn. Även om det inte öppnar Pandoras ask direkt, kan det bidra till en hälsosam lösning på sikt.”

Hon skriver också:

” Kirkengens studies huvudslutsats är att ’ obegripligt’ lidande kan vara logiskt.”

Och

”Gestalten reflekterar det faktum att en gång i livet blev denna person ’överväldigad’. Mänsklig integritet blev kränkt och den sista tillflykten var att copingstrategier aktiverades. Dessa strategier hjälpte individen att överleva stormen men är invalidiserande/handikappande när dessa bevaras och upprepas i lugna vatten."

English word of today "disabling" which means handikappande or invalidiserande in Swedish.

Utgjutelse/outburts...

Utbrott: Det är bara en massa prat! Om det sen leder till något... På jobbet. Hur utnyttjas vår dyrbara tid?
//

An outburst: There is only a damn lot of talk at work! Does it lead to something? To anything? To something constructively? It sounds so fine, but… How is our precious time used???

Inskrivet i kroppen/Inscribed in the body...

Artikel i "Tidskrift for Den norske legeforening" av Anna Luise Kirkengen: "Innskrevet i kroppen".

//

Article by Kirkengen herself about her findings.
//
Addition at 20.30:

Kirkengen writes in the chapter

”Discussion – violation of boundaries” ("Diskusjon – Grensekrenkelser" in the article) in the referred article, that on background of her interviews with sexually abused human beings she dare to maintain (hävda in Swedish) that violations of the bodily, psychological, sexual and social integrity all represents devastating experiences. Her study gives a ground to maintain that to arrange these violations according to their devastating effect is of subordinate (underordnad in Swedish) meaning seen from the experience-perspective. It is the violation of boundaries itself that is the central thing. To be made light, looked down upon, despised (ringaktad in Swedish) is what causes harm – my conclusion and comment. And which have harmful affects; on health, the whole life, ones self-respect...

And the ACE-study reveals the long-term effects on health. A study on 18, 000 grown up people with an average of 58 years, coming from middle-class! Thus not the lowest classes either!!

And it is shown that the earlier these violations are “committed” makes the violated and abused extra exposed for new violations later in life. As if the boundaries have been made more brittle, fragile, and easier to look down upon and easier to step over! So abusing and violating a child, especially by a care-giver (a grown up standing near, and mostly the ones standing nearest), is to play the child in later abusers and violators hands! By showing disrespect for the child’s emotional, physical and sexual integrity… And one can’t really rank those violations if I understood Kirkengen right (see above). They are all bad and causes harm. And they often exist together all of them more or less but in different degrees, but all are harmful.

It is of utter importance to show the child (even the newborn, and the fetus already) the deepest respect! For its feelings, reactions, needs, boundaries and integrity etc.

There is much more to add, and I will probably come back to that. Spontaneously writing... But that's my style? :-) (and this is after all my blog, so...).