Part of a psychotherapist’s toolbox is psychoeducation. This is helping therapy clients to understand themselves better and access tools to effect the change they desire. There are a few books that I recommend to my therapy clients and this is one of them. Their reaction is usually positive so here is a book review: How to do the work (recognise your patterns, heal from your past and create your self) by Dr Nicole LePera.
How could this book help you?
I had previously suggested to one of my counselling clients that he read a book called “Adult Children of Emotionally Immature Parents – How to Heal from Distant, Rejecting, or Self-Involved Parents” by Lindsay C. Gibson. My client found that book extremely useful in understanding why he felt, thought and behaved the way he did. And its impact on his life and relationships. His next question was “What do I do about it?”. As well as therapy, it was this book that I recommended to help overcome the childhood challenges and to transition into the person he wanted to be.
The book will also be useful for people who don’t feel the need for therapy but want to understand themselves better and improve their mental health. It’s a powerful tool to help improve self-awareness and emotional maturity. It also provides an insight into some therapy approaches and tools.
The author of “How to do the work” is a clinical psychologist who has become a holistic psychologist – looking at the complex interconnectedness of mind, body and soul. So it’s an integrated approach (drawing on traditions such as psychodynamic, CBT, mindfulness etc) to change. The Holistic Psychologist – The Power To Heal Yourself
Published in 2021, her rationale for writing the book was – even though a therapist – she felt burnt out, stuck, lacking purpose, anxious and emotionally alone. The book contains numerous tools to help you help yourself within a self-directed learning model.
She starts the book with her own story. Key phrases include:
“To truly actualise change, you have to engage in the work of making new choices every day”
“Our relationships are modelled on our earliest bonds with parent-figures”
“Unfortunately, Western medicine is constrained by the belief that the mind and body are separate entities”
“The placebo effect provides proof that when we believe we are going to get better or feel better, we often do”
She talks of a client who manifested her problems in high-achieving perfectionism: “You are not your thoughts”.
“Even though consciousness makes us human, most of us are so immersed in our inner world, so unconscious, even asleep, that we aren’t aware that there’s a script continually running through our minds”. Attentional control helps us take a breath before reacting.
There’s a report of an interesting experiment on the power of belief and its effect on aging. Yet 70% of the time we are fixated on negative thoughts.
Tools mentioned: Future self-journaling with a daily intention to change. Consciousness-building to prompt a daily reminder of your intention to change.
New theory of trauma
Starting with a story of a woman who hates her belly fat, the author explains how we can experience a state of dissociation – a coping mechanism of physical and mental disconnection from our environment in response to consistent stress or overwhelm. “Dissociation is a very common stress response for those who are living with childhood trauma. Psychiatrist Pierre Janet, who coined the term, described it as a ‘splitting off’ of the self”.
There’s an explanation of trauma (a deeply catastrophic event, like severe abuse or neglect). The Adverse Childhood Experiences (ACE) test is mentioned which “maps out how traumas sustained in childhood leave lasting imprints on our bodies and minds”.
Some people have no memories of their childhood for this reason. Although they can remember memories, they can’t connect them to concrete experiences. Aloofness can be one strategy adopted to deal with living in a constantly fearful state. (There’s mention of the book “The body keeps the score: Brain, Mind and Body in the healing of trauma” by Dr Bessell van der Kolk – which is an excellent if challenging book to read about trauma).
Many people who suffered childhood trauma become functional perfectionists, overachievers or addicted to different substances or behaviours. The author touches on childhood conditioning and the role of a parent-figure to provide a loving, non-judgemental and secure base to whom a child can return when venturing out into the world. It’s common for parent-figures to project their own unresolved traumas onto their children.
Various archetypes of childhood trauma are described from having a parent who:
denies your reality (so the child ignores their intuition)
does not see or hear you (so the child is emotionally-disconnected)
vicariously lives through or moulds and shapes you (resulting in pressure to succeed)
does not model boundaries (so children believe that crossing boundaries is part of closeness and love)
overly focused on appearance (so the child needs outside validation and thinks love is conditional on outward appearance)
The author describes a negative family reaction to her gay relationship and how she realised she was in a push-pull dynamic of emotional reactivity and emotional withdrawal. She describes Lazarus and Folkman’s theory of adaptive coping (to help return us to feelings of safety). Maladaptive coping strategies (like people pleasing, anger or rage and dissociation), often learned from parent-figures, give us a brief distraction or reprieve but end up with more disconnection from the authentic Self. Self-preservation leads to self-betrayal.
Trauma is part of life and unavoidable. The first step towards healing in mind and body is knowing what you’re dealing with – identifying the unresolved trauma.
Tools: Exercises to help you identify different types of childhood wounds
The author describes various physical reactions including fainting, headaches, brain fog and constipation. “Trauma makes us more likely to develop a host of physical and psychological conditions, from depression and anxiety to heart attacks, cancer, obesity and stroke”. And mentions another great book “When the Body Says No: The Cost of Hidden Stress” by Dr Gabor Mate (an addiction and stress expert).
Problems arise when the stress response – referred to as our fight-or-flight mechanism – becomes chronic and harms every system in our body. Hypervigilance and constant stress chemicals cause inflammation of the body. As well as impacting our ability for emotional resilience, form meaningful connections, concentration and higher cognitive tasks.
She introduces Dr Stephen Porges’s polyvagal theory. Many people use breathing techniques to encourage the vagus nerve to return us to a sense of calm (rest and digest system) and social engagement mode where we are primed to feel safe, secure and able to easily connect with others.
Immobilisation or “freezing” is another stress response. Another dissociative mode which explains lack of memory of past experience. Another common response is “I just can’t seem to connect with anyone. I want friends, but I can’t seem to cultivate any emotional depth. No one knows the real me. I can’t find love”. This can be caused by your subconscious perceiving a threat – even in safe social situations – and putting you in a state of fight, flight or freeze. Yet “We are interpersonal creatures. We require communication to survive”.
There’s also reference to emotional addiction – where we come to crave the hit or our usual emotional rollercoaster (perhaps subconsciously reminding us of patterns in our childhood). And this can draw us into relationships with people who are unpredictable and unreliable who recreate the relationship dynamics that create those emotional highs and lows.
Tools: Asses your nervous system dysregulation and restore balance to your nervous system through grounding, visualisation meditation, consciousness of your consumption of information and witness nature.
Mind-Body healing practices
The author talks about shame. And if your body can learn dysregulated ways of coping, it can learn healthy routes to recovering. Whether this is fighting against a fierce inner critic, learning again how to play and create, practising yoga, singing (which activates the vagus nerve) or using Wahls programme (food programme for those struggling with autoimmune disorders).
She argues that healing starts with learning how to tap into the needs of our body and reconnecting with our intuitive Self. Asking ourselves regularly: “How is my body reacting?” and “What does my body need?”.
She describes the 500 million neurons in our gut and explains how our emotional state can make us feel sick to our stomachs. Studies are mentioned that show links between mental illnesses and gut bacteria – and the emerging area of medicine exploring gut-immune system – neuroimmunology). And the value of fasting is mentioned.
“Inadequate sleep is incredibly damaging”. There are reports about the impact of poor sleep on Alzheimer’s, heart attacks, strokes and other conditions. “Studies have shown a link between daily breathwork practice and increased longevity”. The work of Wim Hof (“The Iceman”) is mentioned. Exercise helps us widen the window of stress tolerance. Even dancing can enable us to enter a “flow state” of pure enjoyment of the doing.
The power of belief
This chapter discusses the stories we tell ourselves. When a belief is repeatedly validated, it can become what is called a core belief. These are often generated in childhood and can become the framework of our personality. Once a core belief is formed, you engage in what’s called a confirmation bias (information that doesn’t conform to your beliefs is discarded). I often talk of the dangers of labelling which can become self-fulfilling prophesies (see Two big guns of communication – face-time and reframing (kimtasso.com)).
Negativity bias is where we tend to prioritise negative information over positive. This bias is evolutionarily hardwired – in the early days of our species, we were more likely to survive if we focused on the things that could kill us rather than the things that made us happy.
One theory of depression is that people who are depressed filter the world through a negative lens. When children’s emotional needs are not adequately met, they often develop a subconscious core belief that they are of worthy of having their needs met. This can lead to a belief that “I need to care for others in order to be loved”.
Tools: Core beliefs inventory and Creating a new belief
Meet your inner child
There’s a story about abuse which led to guilt, shame and self-loathing and overcoming this with a trauma therapist. This is followed with a brief review of John Bowlby’s attachment theory – how early relationships lead to: secure attachment, anxious-resistant, avoidant and disorganised- disoriented attachment. There’s also mention of family systems theory by Dr Murray Bowen.
The work of John Bradshaw on inner child work in people with substance abuse issues. And the suggestion that even those we call narcissist are reacting to an inner child wound that is deeply painful. Many of us act like children when we are threatened or upset. Seven inner child archetypes are explored: caretaker, overachiever, underachiever, rescuer/protector, life of the party, yes-person and hero worshipper.
A common defence is idealisation where people block out negative memories and consider themselves to have had a happy and perfect childhood. With suggestions that mid-life crises could be generated when they have achieved goals such as get a great job, buy a house or have children.
Our real long-term goal is to find security inside ourselves. There’s another story about a client’s inner child – and a true shift only occurring when you accept that the inner child will always be there and cultivate a dialogue between the inner child and present self.
Tools: Write an inner child letter to yourself and guided mediation
Th author talks of minor things that can trigger a strong reaction and notes that it is hard to regulate your emotions when something you are unaware of deep inside is touched. It can trigger a hidden narrative. The ego is defensive and fear-based – and judges things as good or bad.
She notes that the more shame we carry, the more the ego wants to avoid future situations where we could experience more shame or any deeper pain. The ego is hypervigilant and threats can manifest in many ways (see, for example, leadership conversation skills: SCARF model of neuroscience (kimtasso.com)). The ego works to defend is perception of who we are. The more we deny parts of our shadow self, the more shame we feel and the more disconnected we become from our intuition. There’s a four-step exercise to work with your ego.
Tools: Meet your shadow and changing to empowerment consciousness.
People who often complain of being bored may be chasing the intoxicating high of cortisol roller coaster. And this can be reflected in relationship patterns of emotional distance followed by resentment at attempts at intimacy by a partner and then panic when your partner moves away. Which is perceived as confirmation that “I will always be alone”.
The author goes on to explain how these patterns of behaviour are laid down in childhood – and relates to attachment style developed. She mentions the work of Dr Cindy Hazan and Dr Philip Shaver whose research showed that early infant attachment provides the basis for romantic relationships in adulthood.
Dr Patrick Carnes (who studied extreme cases including domestic violence, child abuse and “Stockholm syndrome”) described the relationship between two people as traumatic bonding – where we seek comfort from the source of our trauma.
The author suggests these dynamics do not support the expression of your authentic self. She goes on to suggest that some confuse signals of threat and stress for sexual attraction and chemistry. And this can lead to a pattern of attraction and shame (“I should know better”).
Trauma bond archetypes are described resulting from parents who deny your reality, do not see or hear you, moulds and shapes you, does not model boundaries or is overly focused on appearance or cannot regulate their emotions. She argues that once you are aware of the impact of trauma bonds the process of change can begin and authentic love can develop.
Tools: Identify your trauma bonds
She starts with a story about how a family can be overbearing, controlling and not observe typical boundaries. Some parents look to their children to get their own needs met which can lead to enmeshment. This in turn can lead to being unable to connect with others whilst also being a victim of other people “emotional dumping” on you and oversharing. And people can become “people pleasers” as a result. “True closeness involves mutual sharing together with the implementation of clear boundaries”.
Learning how to say “No” is a first step. And observing whether your boundaries are rigid, loose or flexible. Different types of boundaries are explored: physical (personal space and what you will/won’t discuss), resources (overly generous, predetermined schedules) and mental/emotional (feeling we are responsible for the mental/emotional states of those around us).
Emotional dumping and oversharing can occur in times of stress or discomfort – perhaps when people rush to fill silences with their own stream of consciousness. There’s guidance on how to set boundaries which is useful for those who wish to become more assertive. She includes sample scripts to help you communicate your new boundaries and how to deal with your inner voice “feel bads” when you try to enforce them.
Tool: Create a new boundary
The work of psychologist Dr Steve Taylor on awakenings is described. These experiences usually involve: a state of inner turmoil, within a natural setting and often connect us to some kind of spiritual practice. She observes that these can be seen as depression and anxiety or as messengers not to be repressed or avoided. And reflects that sometimes we are so focused on what others want that we don’t really know what we want ourselves.
She introduces the concept of reparenting as a result of having lived with emotionally immature parent-figures (I highly recommend the book “Adult Children of Emotionally Immature Parents – How to Heal from Distant, Rejecting, or Self-Involved Parents” by Lindsay C. Gibson if you wish to learn more about this).
And explains that a secure relationship with a therapist can provide a grounding for healthier relationships in life. Psychoanalysis is built upon this framework with the concept of transference – where we transfer feelings from our childhood onto the therapist.
Reparenting involves learning how to identify our physical, emotional and spiritual needs – to quieten our inner critic and embrace self-respect and self-compassion. The four pillars of reparenting are described: emotional regulation, loving discipline, self-care and rediscover our childhood sense of wonder.
She warns that reparenting can cause loneliness, disappointment and anger. But it forces us to come into close contact with our authentic self. She comments that we might have to “speak our truth” to our parents – to express our own reality – even if it is unlikely to change the parents. (I’ve seen how powerful this can be when I have encouraged my clients to speak to an empty chair where they imagine their parent sitting).
She describes her own experience of finally distancing herself from her family after realising she was codependent (her needs were always defined by others). And says that the joyful part of reparenting is letting go of the fear of what others think.
Tool: Develop a reparenting menu
Emotional immaturity revolves around the inability to tolerate. For example, people may cope with anger by slamming a door or with disappointment by deploying the silent treatment. This can also be seen in their inability to witness another person’s discomfort. It can result in a feeling of emptiness which the author believes is a disconnection from our authentic self.
She notes that most of us spend loads of mental energy trying to be understood. “The evolutionary drive towards social acceptance makes it impossible for us to connect with the people around us when we are in a fear state” (see leadership conversation skills: SCARF model of neuroscience (kimtasso.com)). One of the major achievements of emotional maturity is learning how to be at peace with such misunderstandings or with being misunderstood.
She mentions the 90 second rule of emotions – as physiological events they last for only a minute and a half. And that during moments of emotional intensity, our sense of time is skewed. She talks about taking the time to connect with your body and notice the difference, for example, between stress and excitement.
She talks of reframing negative into more positive emotions (Two big guns of communication – face-time and reframing (kimtasso.com)). And adds that walking may be one way to discharge physiological energy. There’s guidance for parents on how to help children recognise and name emotions and to model stress tolerance. The overarching key as parent-figures is to be okay with being imperfect.
Tools: Develop emotional maturity. Future Self Journal (FSJ): Emotional body check in
“You are never done with your development of emotional maturity”. She recounts a story of feeling criticised and a friend suggesting a walk which she declines. And then felt upset when the friend went for a walk alone. Her outraged ego was angry that she had been left alone when upset. She realised this ego story was a projection from the inner child wound and core belief that “I am not considered”. Instead in such situations she asks “What can I do for myself in this moment? How can I cope with these feel-bads?”
She goes on to talk about finding the self healer community and notes that research shows that three of every five Americans feel alone. And often there is an underlying core belief of “I am unloved because I am unlovable”. Loneliness increases the rates of autoimmune diseases and chronic illness. There is more material on connecting in Lost connections – Why you’re depressed by Johann Hari (kimtasso.com)
She explores authentic friendship, the need to feel safe and the process of co-regulation. And I love that she uses a quote from Native Americans:
Chief Black Elk of the Oglala Sioux Nation “The first peace, which is most important, is that which comes from the souls of people when they realise their relationship, their Oneness, with the universe and all its powers, and when they realise that at the centre of the universe dwells the Great Spirit , and that this centre is really everywhere, it is within each of us”.
Tools: Assess your interdependent relationship. FSJ: Creating interdependence.
Her epilogue contains a couple of nuggets: “We don’t remember days, we remember moments” (Cesare Pavese) and “Every moment, we make a choice: we can live in the past or we can look forward and envision a future that is different”.
You are your own best healer
The Conscious Self: Becoming aware
A new theory of trauma
Mind-Body healing practices
The power of belief
Meet your inner child
Other books I sometimes suggest to therapy clients:
Dr Julie Smith (Mental Health Guidance) (kimtasso.com) “Why has nobody told me this before?” July 2023. Straightforward explanation and simple tools to help you maintain good mental health. Topics include: low mood, motivation, emotional pain, grief, self-doubt, fear, anxiety, stress and a meaningful life.
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