They didn’t…

..give me chemo. After a four hour wait I got to see the doctor, in between his clinic patients, for literally 5 mins. That’s all it took for him to decide not to give me the chemo. Honestly. money, time and energy could have been saved if he just asked me those questions over the phone, but never mind, I am a patient, patient.

A grading system is used when looking at side effects of the drugs I am being administered, and the doctors are particularly concerned about peripheral neuropathy. This is damage to the nervous system causing loss of sensation or pain and if you are not careful can be irreversible, so I am grateful for the doctors being so cautious.

It is graded in severity and a decision is then made whether to give the drug or at least reduce the dose.

Grade 1 Asymptomatic; loss of deep tendon reflexes or parathesia (including tingling) but not interfering with function No action

Grade 2 or Grade 1 with pain Sensory alteration or parathesia (including tingling) interfering with function but not with activities of daily living (ADL). Reduce bortezomib (Velcade, one of my chemo drugs) to 1.0 mg/m2 (25% dose reduction)

Grade 3 or Grade 2 with pain Sensory alteration or parathesia interfering with ADL Withhold bortezomib until toxicity resolves then restart at 0.7 mg/m2 (50% dose reduction)

Grade 4 Permanent sensory loss interfering with function (disabling) Discontinue bortezomib

As I was grade 2 with pain the drug has been withheld and I expect I will receive a reduced dose in cycle 4 of my chemo regime.

So I am chemo free and it feels good, I can even taste some foods!

I suppose there is a double edged sword to all this because although life without chemo is much more bearable I do realise it is doing some good and killing off those cancer cells. So I shall visualise the few little rats left behind hibernating, and them not getting rampant during this drug free rest period. Then on March 25th whilst they are still snoring away they will be zapped with the next dose of infertility gas making the males impotent and the females unable to reproduce. Sorry little rats but no more sexy times for you, I don’t want cancer babies chewing on MY bone marrow.

Hmm… rats in my bone marrow, I think I could have perhaps come up with a better metaphor than that!

Thinking about metaphors etc lets get back to which therapy?

Human Givens Psychotherapy

The theory of Human Givens is founded on the belief that every human has certain resources, such as creativity, imagination, memory, problem solving abilities and different thinking styles. Additionally, each person has specific core needs. these include physical needs such as warmth, shelter, food and water and emotional/psychological needs such as love , autonomy , attention, meaning and purpose, belonging, security, status. Remember the LAMBSS?

This theory suggests that it is only at times that these needs and resources are lacking that people fall victim to symptoms of addictions and other disorders such as depression.

The goal of this method of therapy is to identify and clear any obstacles that are preventing the realisation of these needs.

The human givens approach to psychotherapy was founded in 1998 by 2 British psychotherapists, Ivan Tyrrell and Joe Griffin, who decided that a larger “organizing idea” or foundation for psychotherapy was needed, based on these human needs or givens. These needs and resources, which are built into our biology, constitute the “human givens.”

Human Givens therapists focus on helping clients identify unmet emotional needs and empowering them to meet these needs by activating their own resources in new ways. The human givens approach, is increasing its evidence base and has proved effective for conditions such as depression, anxiety, addictions, trauma, obsessive-compulsive disorder and panic attacks.

It does not require the client to re-tell their story in minute detail, is more interested in the hear and now and is brief in its approach.

See below a case study taken from the Human Givens website. I have chosen this one as it is very similar to the work I have done and my own experiences.

SARAH, a single mother of two boys under five, shuffled dispiritedly into my [Ivan Tyrrell’s] consulting room. She was completely lacking in confidence and her voice was almost a hoarse whisper as a result of what she termed her nervous breakdown. She lived on a council estate in a flat too small for herself and her two children (one of whom had behaviour difficulties), and had had to let her children go to live with her parents because she couldn’t cope with them in her present circumstances.

A year previously, her ex-partner, the father of her sons, had thrown a brick through the window of her flat, broken in and assaulted her. A new relationship had just recently gone wrong because the man, himself depressed, was too possessive and overprotective of her. She was in despair, missing her children desperately, and, knowing she needed help, had accepted the chance of free sessions of therapy to be used for training purposes.

She told me she was unable to sleep properly and felt utterly exhausted. Since her parents had taken over responsibility for her sons, she rarely left her poky flat, had let herself get overweight and spent her time depressed about her life and the loss of her boys, or worried about her debts. In answer to my questions about her life, she told me she hated being on benefits and that, when she was 17, she had loved her work as a care assistant in an old people’s home. I also found out that she had used to enjoy going swimming and had joined a gym before her ‘breakdown’ but had rarely gone there.

When I asked her what, realistically, she would like to have happen in her life, she said she would like to move, and mentioned for the first time that she was now ‘priority’ on the council’s waiting list to be allocated a house and garden. She was actually expecting to hear about a move within a week or so. She also wished for a job, although she saw many obstacles to this.

As we talked, I countered her negative comments about herself, inviting her to see herself as caring, loving, independent, someone with initiative and so on, and explained how endless worrying turns one inwards. What would help her most, I suggested, was to direct her attention outwards, so that she could find solutions to her problems instead of just worrying about them, and regain her interest in things outside of herself. These ideas were new to her.

I suggested she close her eyes and relax while, one by one, we went through the things she had said she needed to sort out in her life and she imagined herself dealing with them. For instance, I asked her to imagine herself enjoying going swimming regularly again, and going to the gym; to imagine herself looking at local papers for possible jobs, perhaps in the care field, or finding out about courses she might want to take; and to imagine herself in a new house with her boys back living with her and feeling positive about the future. I conveyed my impression of her as a strong, ‘can-do’ person, who could do much to change her situation within the next few weeks before I saw her again.

I also asked her to start noticing the good things, however small, that happened over that period and make more good things happen. “All you can work with is now and the future. You can’t do anything about the past,” I said. “I think the changes will be fantastic.” “Okay,” said Sarah. “That sounds good.”

When she came back to see me a few weeks later Sarah was looking bright and alive. “I feel really well,” she said. “You gave me a lot to think about, a lot of positive things.” She told me she was swimming regularly and had already started losing weight. Although she hadn’t gone back to the gym, she was using an exercise bike at home in the mornings.

She now had her children back staying with her three or four nights a week and planned to have them home full time very shortly, as she had now been offered a three bedroom house. She was doing a parenting course, which she found really useful in helping her handle her sons’ behaviour, and had been in touch with an agency which helped single parents back into work. She was also “getting on top of” her bills and announced she had felt low only one day in the last month. “I actually feel in control of my life again,” she said. “I felt like it was being taken over by, I don’t know, I just felt like it was being taken over.”

Shifting her focus on to solving her problems had stopped her negative introspections, normalising her sleep patterns as a result. Her voice was also back to normal. When I commented that she seemed to have everything pretty much under control and probably didn’t need any further help from me, Sarah herself said, in amazement, “One session I think that’s probably all it took, really; it gave me a push in the right direction. Whereas if I’d gone to [a different kind of] counselling, I might still be back where I was.”

She told me she had had a couple of sessions with the counsellor at a college she had attended some years before. “The woman I had just sat there. She didn’t comment on anything, she just expected me to pour out all about my past history. Basically, you are stuck in that little world still, revolved round the past, which isn’t really a good idea because — you can’t change it! [That kind of] counselling doesn’t give you anything whatsoever to think about or to dwell on, whereas this therapy does. You’ve got a lot of positive things to think about that you can get on with in your life.”

© Joe Griffin and Ivan Tyrrell 2006

You will notice the use of visualisation. It would appear that the client went into a hypnotic, trance like state as various ideas were suggested to her.

I have used this way of working for many years now and have personally experienced excellent results. Young people are particularly open to this way of thinking and I believe it empowers people to participate in their therapeutic journey.

I love problem solving rather than ruminating over the whys and wherefore’s.

See below a simple exercise I often use:

Look around the room you are sitting in and notice all the red things in the room. Then close your eyes and make a mental list of all those things. Before you open your eyes list all the blue things you noticed in the room.

Because your mind wasn’t focusing on the blue things I don’t suppose you noticed many if any.

Now imagine if the red things were your problems if you focus on them you will see them in abundance but will you notice the blue things, the solutions?

Try focusing on the blue things and you will will soon start to notice more solutions than problems.

Have a good day.

Deborah x

PS. Thank you for all your comments and emails its good to know you are still out there, so I will carry on writing until I run out of things to say or you tell me to please shut up!

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