Suicide has been in the news recently, with the deaths of two high profile people and a series of deaths at the University of Bristol. Those who lose someone close through suicide often ask “why?”; “why now?”; “ “what signs were missed?”. Some feel guilty or angry, and all feel the empathetic pain of someone dying alone in such a way.
While some who commit suicide may have mental health diagnoses, many don’t. Few of us have not been touched by suicide by a family member or within our social or community circles; while writing this I have counted 6 suicides in my circles.
The data from the Samaritans tells us there were 6188 suicides in the UK in 2015; the group with the greatest suicide rate is men aged 40 – 44; the rate by men being three times greater than for women. A recent publication analysing suicides in doctors under investigation found that medical practitioners carry a high suicide risk. The number of suicides annually is significant, affecting many people.
So why are two celebrity suicides given so much publicity and what does it have to do with coaching?
There is a myth that success in terms of achievement and making money protects people from the inner pain of trauma associated with an intense sense of aloneness, emptiness, abandonment, lack of close attachments, and feeling unsafe. However hard we work to be successful professionally will not override our early history and our emotional vulnerability to these feelings. It is an illusion that is held by many and when we see the news, this illusion is challenged.
It is rare but can happen that our clients imply they ‘have had enough’ or ‘it is better if they just leave the world’; often this might be said as a throw-away line so that we are not always sure we have heard what we think has been said. It is not true that those who talk of it never do it, that it is ‘just a cry for help’. Suicide can bring great judgements from others and can be felt as a passive-aggressive attack on those who care for the person. But to refer to someone’s suffering as ‘just a cry for help’ is to miss the point. Anyone implying that they are thinking of ‘ending it all’ is in emotional pain.
Through his clinical work, Professor Franz Ruppert has developed a simple way to understand the deeply complex matter of psychological trauma. This is the lasting impact on our psyche and body systems from early attachment dysfunctions and levels of unbearable stress; from conception onwards. When we have grown up without the feeling of being safe, or of being helped to regulate our unbearable stress and distress, or been subject to abusive relationships, or been emotionally abandoned, we are left with scars that we bury deeply within us.
Ruppert’s model (left) describes the trauma as being the lasting splits in the psyche. To survive traumatising experience emotionally, the trauma feelings are deeply buried (within the trauma ‘self’) and instead a ‘survival self’ emerges to ‘press on regardless’; to override the pain and to cover up the psychological wound (which doesn’t heal).
While a healthy self remains, the extent to which its resources can be accessed depends on the level of trauma experienced. The survival self uses various strategies, one of which is illusion “If I work hard I will be safe” or “If I work hard I will be loved” or “If I have lots of money I will be safe” or “if I climb this ladder high enough I will be okay” (only to find, after all the hardship, ‘the ladder has been up against the wrong wall’ - Joseph Campbell). Another survival strategy is addiction to work, alcohol, drugs, sex, shopping. Like all addictions the initial hit feels good, but then it feels much worse, until the next hit. The trauma may become somatised, that is expressed in the body through intense pain or auto-immune disease; from which addictions to pain killers may result.
According to Ruppert, suicide is a survival strategy. It is the attempt, by the survival self, to ‘kill off’ the internal pain and distress that is associated with the trauma self – the intense loneliness, abandonment, lack of safety, terror and rage. These are the feelings of a child from a traumatising situation. It is the ‘end of the road’ for trying to manage that pain by any other means whether professionally successful or not. The idea can bring a sense of relief that the battle could be over.
Some who consider suicide, and may act on it, may feel they are a burden on others and it would be better if they just left the world. This is the survival self’s response to the pain of the very young child who wasn’t wanted or whose parents were unable to welcome the child as he or she is.
If clients make such comments about ‘opting out of life’, take it seriously and check if you are hearing them correctly. Tell them you take it seriously and can only imagine (if you can) what emotional pain they must be for that to seem like a solution.
As coaches, our function is then to facilitate a conversation about who else the clients have told (this helps us know if a partner or GP knows), and what help they are getting. Our aim should be to encourage them, being directive if we need to, to talk to a partner and tell the GP. We cannot make clients do either, but we can offer our support to their thinking through how they might do that.
One of our clients might commit suicide as if ‘from nowhere’. This is a shock and common responses are to feel we should have seen the signs. However, often the signs are so deeply hidden that they are not there for others to see. People develop very effective masks. If clients talk of or commit suicide, we need to get our own professional support through supervision.
While it is rare for a client during coaching to talk of or commit suicide, it is helpful to understand what psyche-trauma really is, and how it presents in adults. From that theoretical understanding we can then evolve coaching responses that are appropriate and be clear about the boundaries between coaching and therapy in working with trauma.
In our Masterclass on 26th July, ‘Coaching to Change Lives’, Jenny Rogers and I will talk about this way of understanding trauma and what it means for transformational coaching. For information and booking www.coachingandtrauma.com.
Julia Vaughan Smith 17th June 2018
 Professor Franz Ruppert, Professor of Psychology, University of Applied Sciences, Munich, Germany. www.franz-ruppert.de
I’ve been engaged in several things this week. I am preparing for our two day workshop in June (www.coachingandtrauma.com), writing a book chapter on Coaching/Therapy boundaries in relation to working with trauma, and writing up my notes from reading ‘In the Realm of Hungry Ghosts’ by Dr Gabor Maté. They are all interweaving in my mind.
Often when we talk of trauma, there is a lot of misunderstanding about what trauma is and how it presents. The anxiety levels of practitioners can go up as they contemplate being confronted with a disturbing narrative. As coaches, I do think we have to be able to hear such accounts or we will have all kinds of strategies for making sure we never have to. It is knowing what we do next that matters. More commonly though, in coaching, what we need to recognise and be able to work effectively with, is the shadows of the past in the present
Dr Maté’s book is about addiction and comes from his work with drug addicts in Canada. He talks widely abut addiction though, including work addiction, consumer addiction and all the other things many of us realise we are compelled to do. I think of the number of clients I have worked with, and myself, who were desperate for a better ‘work:life’ balance, and yet seemed a victim to the forces that kept them in that place unable to make changes needed to give them the outcomes they wanted. The theme of developmental trauma underlies this behaviour, as addiction, like denial (I am fine, nothing is the problem) are ways we survive internal pain. A typical statement he gives is: “I love whatever I am doing so much I never want to stop”, and”‘so where is all this pain and grief I am supposed to feel?”. Such behaviour is a way of numbing or soothing that pain, but it doesn’t go away and if unaddressed can escalate.
He asks a good question: “Could it be that X or Y is serving a function in your life that is helping you endure a situation that would otherwise be making you very unhappy?”
Now, jumping back to the chapter on boundaries, is this a coaching question or a therapy question? I think it is both. If we take a premise that coaching is about facilitating the client’s resourcefulness this question seems an entirely valid coaching intervention in raising a possibility which the client can answer or not. It leaves the decision with the client, where it should be.
How about this one, from Nancy Kline’s ‘Time to Think’: “What is in your face that you are not facing?” A good question about denial, challenging the ‘everything is fine’ defence. The nature of denial is to make us think that the addiction is actually enhancing our life or making us a ‘good person’. Rescuing is a good example of that too. The other factor about denial is that is prevents us facing the truth of our current situation.
The issue for both questions is what do you do next? And are you up to being with what might be said? And if not, what is getting in your way?
We need to be able to recognise the shadow of the past and have some appropriate coaching interventions at hand. “A trigger in the present will set off emotions that were programmed perhaps decades ago at a much more vulnerable time in a person’s life. What seems like a reaction to some present circumstance is, in fact, a reliving of past emotional experience” (Dr Maté). We cannot change the past, but we can become aware of how it is triggered and affecting us in the present; for clients and for ourselves.
The coaching frame gives us a sound basis on which to shape our responses. The nature of the spaces between sessions, often a month or more; the short term-ness of the contract means that we cannot ‘hold’ someone through a reliving experience of the past. Our focus is the present. Our role is not to diagnose. However, many of the things clients bring to coaching are signs of the past being activated in the present. So often clients in survival behaviour such as denial or addiction or avoidance, pull us out of shape. We talk more, become more directive maybe, bring in more tools and techniques. Or we coach that survival behaviour itself supporting someone to get really good at their work addiction, without fully checking that that is what the client really wants.
The questions for us, and which we will engage with over the two days are: “What do we do with a disturbing narrative?” “What are shadows?” “How should we respond?” and “How is my past being retrigged in the present with this client at this time?”.
Jules Vaughan Smith
8th May 2017
Maté, G (2008) In the Realm of Hungry Ghosts. Vintage Canada
Kline,N (1999) Time to Think.Ward Lock
Dr Maté is running a two day workshop in London in May as part of the www.breathoflifeconference.co.uk. The conference is bringing leading trauma therapy practitioners and researchers together.
A sample of my trauma reading list:
I have been thinking a lot about grief; 2016 having bought several doses to me reminding me of the waves of intense feelings that loss brings. I experienced loss repeatedly in my childhood as close family members died seemingly in quick succession, from natural causes. Then, I had no idea what was happening to me emotionally but this last year has felt like a reawakening of that time, as well as a response to current circumstances. I imagine I locked away much of the feeling, including the fear that comes from people suddenly disappearing from a child’s life. I was a child in England in the 1950s, when children were kept away from death in the belief that it was better for them and that ‘children aren’t that affected’ or ‘children get over things quickly if it isn’t indulged’. It was the post war generation who had seen so much death and already carried grief by the bucket load.
I came across this wonderful memorial in the Protestant Cemetery in Rome, where John Keats (the poet) is also buried. It is the ‘Angel of Grief’ (1840) by William X Story, an American, and ishis wife’s memorial. He is now also buried there.
It touched me deeply, the collapse of the angel, one imagines sobbing or just defeated by the loss. It must have touched others at the time too as it is replicated many times across memorials in north America. It is that inner sense of collapse of part of self, that part that was attached, and maybe identified with, the person who has died. It can crush the spirit until it finds the energy to regenerate. It is so powerful it can fragment the ‘self’ we have constructed, that ego that believed it had control over life and the future.
I felt this was expressed so valuably by David Grossman (an Israeli author in an interview with Jonathan Freedland of the Guardian) on the death of his son: “Yet, in order to do almost anything, you have to act against the gravity of grief. It is heavy, it pulls you down, and you have to make a deliberate effort to overcome it. You have to decide you won’t fall”. He said that it required a conscious decision on his part not to immerse himself in grief; that he had to decide ‘how much to insist on life’.
Clearly, each person experiences loss differently, and each loss may bring about a different grief response. We share the capacity for grief with elephants, apes, monkeys and for sure, many other species. Many of us have seen the film of elephants mourning a member of their group in a way that looks very familiar.
Dictionary definitions carry the metaphors of the heaviness of grief. Interesting to note that, according to these definitions, only women appear to experience these deep feelings. Patrick Harpur in ‘A complete guide to the soul’ (2010), talks of the ‘soul’ being expressed in metaphors of descent, depth and darkness. He implies that moving through grief is ‘soul work’ whatever that means for each of us.
Mourning (noun): the expression of sorrow for someone's death. "she's still in mourning after the death of her husband". Synonyms: grief, grieving, sorrowing, lamentation, lament, keening, wailing, weeping
Grief (noun): intense sorrow, especially caused by someone's death. "she was overcome with grief”. Synonyms: sorrow, misery, sadness, anguish, pain, distress, agony, torment, affliction, suffering, heartache, heartbreak, broken-heartedness, heaviness of heart, woe, desolation, despondency, dejection, despair, angst, mortification.
With all that is known about grief and mourning it is extraordinary that the Diagnostic and Statistical Manual of Psychiatric Disorders (DRGs) for mental illness, used for diagnosis and prescription by psychiatrists and others, calls any grief feelings like the above, lasting longer than 2 months, to be an abnormal/chronic grief response requiring pharmaceutical intervention. The message is ‘hurry up’ don’t make your grief too visible or deep.
The loss caused by the death of someone close can be complex. It may be that there was a deeply loving and close relationship, or it could be that the relationship was a difficult and entangled one. Part of the work is to reclaim ourselves from the entanglement and to take the essence of loving and being loved. We have to let go of the ‘what might have been’ and ‘what the future held’ and remind ourselves that we only really have now, this moment.
One of the causes of grief for me this year was my own health, a loss of the certainty of immortality, which, while a delusion, is still one that helps many of us engage in life. This is a different kind of grief, but takes us into the same dark places. Loss of this certainty, and the loss of others, takes us into the territory of death anxiety. So eloquently talked about by Irvin Yalom in ‘Staring at the sun’ (2008. He says choosing life without illusion is being able both to ‘know that we all die, while living as if we will live for ever’.
David Grossman’s point about choosing life, is echoed by Miriam Greenspan in her account of her own grief in ‘Healing through dark emotions’ (2003). She talks of coming to know two ‘selves’ following the death of her infant son, “the one that urged her to follow the ghost and the other that, despite everything, was alive in a new way”. She talks of the ‘simultaneous shattering of ego and expansion of consciousness’ that comes for many through grief.
Greenspan talks of grief’s alchemy, through which there are no short cuts if we are to regenerate ourselves and chose life. It took me a long time for the penny to drop, that it wasn’t about getting back to where I was in myself and my life, ‘getting back to normal’ but of letting go and moving through a transition to a new and different, and maybe unfamiliar, place being made possible because of the grief.
25TH FEBRUARY 2016 LONDON
As I sit here, in the light of bigger skies in the south of France, where I have come to focus on a number of writing commitments, I am thinking of February and beyond. Imagining what might be helpful and interesting for the APECS session and how best to form a bridge between the world of traumatology and the world of coaching.
I think the connecting point is identity; how it gets compromised and expressed. To some extent all roles require an internalisation of role identity, a fusion with our self-identity. However, if our self-identity is a constructed one it becomes more friable as pressures mount, or in a hostile or challenging environment and as we get older. We rely on defensive strategies (avoidance, control, denial, distraction, dissociation, illusion, compensation) to distract ourselves from this inner pain. Surviving in this way can be exhausting, leading to burnout in some cases.
So how do our identities become compromised and constructed? This is the link with the traumatised self/psyche. Does it matter if we coach the constructed identity in support of defensive strategies? That is the link with coaching.
First things first. It is probably that traumatised psyches are widely spread and common. It is not something restricted to some very unfortunate few, or to those whose emotional suffering means they are unable to hold a professional career. It could be seen as part of the human condition. However, that doesn’t mean that it is less likely to affect adversely the quality of one’s life, relationships and vitality. It can derail us; it can drive us in punitive directions (think compulsive over work/self-sacrifice). People can be highly successful professionally and carry psycho-emotional distress.
The word trauma has so many meanings and associations that it can become confusing. Is it an event/experience; is that the trauma? Or is it the impact on the psyche? I see it as is the latter – experience which is beyond what can be coped with, causes high stress, then dissociation. In the dissociation (a psychological withdrawal from reality), the pain, terror and helplessness caused by the experience is repressed deep into the unconscious. What emerges is a survival self/care-taker self/self-care system which acts as if that hasn’t happened but whose whole existence is to create a series of defensive behaviours and a constructed self. We still have a healthy self/core self that remains but is limited by the survival strategies. There are neuroscience and endocrine explanations for what happens, too, but I find the idea of ‘the split psyche’ , as described by Professor Franz Ruppert, a useful metaphor for understanding the impact of traumatising experience.