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Benjamin Fry's Story
One cold November morning in 2009 I woke, as usual, in the dark, shaking. I lay there, exhausted, trying in vain to talk myself out of my state of unmanageable anxiety. I hadn’t slept for a full night without drugs since the previous Christmas. I hadn’t been able to work properly. My family relationships were all but burnt out.
I had thought I could recover. Each day brought fresh evidence that I might not. This morning, though, I did something different. I turned a corner from trying to talk myself into a forgotten state of calm and drifted down a darker alley. I made plans to kill myself. These were careful, elaborate, detailed. It was important that I did not invalidate my life insurance policy, the only legacy I could leave my family; my wife and five young children. It was a luxury to think this way. It brought me joy. My suffering could end.
I spent the morning drifting deeper into this path of fatal relief. Then the other side of my brain spoke up. As a trained psychotherapist I knew the stages of suicidal ideation, growing from despair to the desire for death and to making specific plans. I was well advanced, I realised with a shock. I was angry, too, to find that I was trapped by my kids. I grew up with a dead parent and the thought of condemning them to the same fate wasunthinkable. And also, on some level, I just knew that I wasn’t supposed to go out like that. Eventually, the household woke up around me. I faced my Rubicon.
It had begun with the financial crash of 2008. Like so many other people, this threw a spanner in the works of my life plans. I work in psychotherapy, an industry that clings to the edge of starvation. So, to continue in the lifestyle to which I had become accustomed in my twenties as an entrepreneur, I remained active in business. I took bigger and bigger gambles to get by. I was nearly out of a complex prop-erty tangle when the crash hit. Oh, and my wife became pregnant with our fifth child. Over the next three to four months, I began to unravel. By her third trimester I was a walking zombie, unable to work, play or communicate. Five days after the birth of our baby boy, I begged my parents to help me and they admitted me to the Priory. That was when things started to go really wrong. I remember my 11-year-old daughter saying to me towards the end that I was just a ghost who lived in the same building as her. My wife was beginning to give up, too. We had to move house, city, schools, to try to accommodate a new financial reality. I couldn’t even help her to pack. Many times my fear, dread, pain, guilt, depression, anxiety, grief and terror had been so visceral, so overwhelming, that I had to live one minute at a time, ten seconds at a time, sometimes one second at a time. If I could survive that, I might recover. There were dozens of times when if someone had put a loaded gun in my hand I would have immediately blown my brains out.
I presented a BBC series, Spendaholics, about compulsive overspenders, on which I was the public face of therapy. I was good at it, well connected, well informed and I had resources. I may as well have been a blind, illiterate beggar for all the good it did me in getting the help I needed. In the palatial offices of the medical director at the clinic, I told him that I was generally very anxious and he diagnosed generalised anxiety disorder. I was horribly sensitive to medication. The only therapy I received was cognitive behavioural therapy (CBT), in groups. This was certain to be my lifeline back to sanity: they have evidence for it, and none for anything else, apparently. It was a hopeless mismatch for my symptoms.
My mother died when I was 11 months old from aplastic anemia triggered by a dangerous antibiotic. At 40 I was reliving that loss of security and my infantile panic at what followed. I needed a way out, not sideways, not back, but through. I didn’t know it yet, but CBT didn’t even correspond to the part of my brain that was malfunctioning. CBT starts with the idea that our thoughts create our emotions and, therefore, our behaviour. Trauma, however, affects the brain stem and is regulated by the limbic system, the lower two parts of the triune brain (the reptilian and mammalian ancestors of our cognitive cortex). One of the key symptoms of a trauma reaction is the activation of these systems, with the consequence of a cognitive shut down. (Imagine me trying to explain that last sentence to you while harpies shower you with bolts of fire; you get the picture.) The worst thing about CBT is that it relies on the idea that you are ill because you have the wrong thoughts; so if it doesn’t work, it’s your fault. Nice.
I tried another expensive psychiatrist, a leader in his field. He thought that I woke up early because in the Stone Age my weakness would have required me to get up before the other predators to find the easy kills. I began to realise that no one knew anything, yet everyone had an opinion. So I moved on. I received prayer, exhortation, salvation, even exorcism. Someone suggested acupuncture. It made me worse. I tried drugs again. They made me much worse. I went to the crisis unit at the local mental hospital. The man-child psychiatrist had seen me on TV and was sure that I’d be fine. He sent me home. I was in a living hell and there was no way out.
My life was saved at a place called Mellody House in Arizona. It was set up by Pia Mellody, a celebrated American therapist, with the help of Peter Levine, the world’s foremost expert on trauma reduction. A psychotherapist friend had been bugging me for some months to go to a psychiatric hospital in America, where, she promised, they would pull me through the trauma. I had reached the end and had nothing left to lose, except my life. I called for a quote. It cost two grand less than we had left in the world. So I, the walking infant who could hardly leave the bed without my wife, booked myself on a flight to Phoenix and told her to take me to the airport. I didn’t tell her why. I had no idea if I would be OK, or if I would ever return. I was leaving her with no money and five children in a new home, a new town, at the onset of winter. That was enough. She kicked me out of the car at Heathrow; my children with faces that I’ll never forget, faces that haunted me through the four months of my treatment. Mellody is a pioneer in the area of addiction treatment and set out an unerringly accurate matrix of human behaviour. The foundation of the model is that addiction is traumabased. Trauma, with a small “t”; the kind of thing that may not make the papers, but anchors in the limbic system, freezing emotions in a stand-off between the three parts of the brain.
When we perceive that we have a life-threatening condition, our lower brain tells the rest of the body to get ready for fight or flight. When we are overwhelmed by a powerful threat, we have the third option, which is to freeze or “play dead”. After the threat has passed, we need time to discharge this energy. The third part of our brain, which invented the computer on which I type, the language I use and the reason I use it, is non-accessible when energy is frozen into the limbic system during the third part of “fight, flight or freeze”. This means that talking about our trauma is pretty useless.
Without the discharge of this energy, we store the fight-or-flight energy, which starts to make our nervous system disreg-ulated. We don’t ride the highs and lows of life with moderation and ease; in fact, some of us go all the way to the threat response (anxiety) until we crash into the exhausted trough of stasis (depression). These frozen packets of energy are easily activated, by sight, sound, smell, touch or taste, a similar person, thought, situation or dialogue. This activation can be unbearable (do you ever find yourself going mad for almost no reason around certain people?). Multiply that by other events, people and situations and you may feel somewhat crazy. And if this happens often enough, it may be difficult to recover between episodes, resulting in the need for assistance; medication, even. Drugs, alcohol, sex, work, food, fantasy: they’ll all do. Welcome to the human race.
Dr Levine, an American academic who pioneered this model of trauma discharge, discovered this shared ability between human beings and animals to release frozen energy from threat in the late Sixties. He has brought his work through several phases, including work with Nasa’s space shuttle programme. The latest phase is the development of a technique to heal trauma, not merely manage it, as with CBT or medication, but to heal it like a wound; to discharge the frozen energy and to leave the past where it belongs. Mellody asked him to help her to set up a pilot facility to heal trauma for her addiction patients. The result was Mellody House, where I spent ten weeks after being medically
stabilised at the psychiatric hospital next to it.
The primary trauma reduction technique used there is Levine’s own method, Somatic Experiencing (SE). This is a very careful therapeutic intervention that guides the patient away from his or her mind and into what the nervous system is trying to complete. The set-up is conventional — two people sitting in chairs talking to each other — but then you will start to be aware of one part of your body more than the other parts. I might feel that there is a strong feeling in my neck, for example — tingling, or heat, or tightness. The idea is that this is a physical blockage of energy that has been frozen and not released. You then explore this together — the therapist may lay his or her hands against the spot — and see what happens next. They guide you into staying with the body’s process, with letting it get on with it, and emotions may be triggered — guilt, or sadness, or more positive ones.
Sometimes you can feel the energy moving. EMDR (eye movement, desensitisation and reprocessing), which is another methodology that intervenes in trauma, was also used, and we the clients were helped to reset our understanding of our histories and behaviours using Mellody’s cognitive model in groups and in individual sessions.
Once I was stable enough to leave, I carried on with Dr Levine’s SE method with a practitioner in London, who had miraculously moved there recently from Canada. It has been more than a year now and it is a process that is beginning to reach a conclusion. Unlike conventional talking therapy, this process has to end; it runs out of energy to discharge. And once you get there, the word most often used is freedom.
As a patient, my recovery was a miracle. As a practitioner, I saw the same miracle in the others who were with me. One friend reported when he left that this was the first time since he was 13 that he had not felt depressed. These were people like me — men and women of all ages — who had been failed everywhere else and were either going to get well or die. Anecdotally, outcomes appear to be astonishing.
I asked my nine-year old son as I began to write this piece what his reflections were on my time away. He said that it was terrible but that it was also great that I got better. He was clear that I wasn’t better only in the sense that I wasn’t ill any more, but better; a better father in ways that he could not define. My relationship with my wife started again from scratch and deepened in every possible way. She said that she married the man she always knew I could be, and now she had met him. She has started to have the same therapy with a local practitioner and, one by one, as we have started to mend, our children have begun to come forward with their problems, partly due to the normal problems of life and partly due to the recent trauma of my illness and absence. These are also being cured by the same technique. It’s amazing how a child can do in a few weeks what an adult might need a year to get through.
Coming back to life meant coming back to work. I am indelibly touched by the horror of suffering from a mental illness in the UK, an apparent desert of wellinformed treatment inhabited by a pompous cadre of professional delusion. Typical of this, for me, was the NHS’s talking therapy service, a CBT monoculture that has invalidated and decimated the broad church of other talking therapies; it was this variety that kept therapists humble to their clients’ needs and made innovation possible. Research shows that this service doesn’t reach what they define as recovery for about 90 per cent of the people referred to it, yet it costs the State about five times more per session than private psychotherapy.
To respond to this, I have set up an initiative called Stable (getstable.org), which provides volunteer therapists from any modality — as long as they are well-trained, insured and registered — for any government programme that will pay for results. This could be new academies, private-sector prisons, GPs, your local council, etc. The idea is that the individual therapists prove their worth case by case, and when the client reaches the desired outcome, the therapist gets paid. It’s getting a good reception in Whitehall (I was in Downing Street to talk about it this week), but the bureaucracy is overwhelming. If you want state-funded access to private psychotherapy, your best bet may be to ask your local GP to Get Stable.
But the project that is closest to my heart, inevitably, is the idea of re-creating for sufferers in the UK the access to treatment that saved my life. This means a carefully managed path into a facility such as Mellody House and an equally carefully managed return into wellstructured aftercare in the UK. It is very expensive, but if we can make it work for enough people, we will have powerful friends to help us to bring this work to the nation, perhaps even one day through the NHS. Please join me at getstable.org to start getting people well again.
Benjamin Fry is a psychotherapist with a private practice in Harley Street, London.