Sunday, 10 June 2012

Reversal Therapy, Crohn's and the Seasick

Some of you may have noticed that I got exiled just off the coast of Dover on Friday. Due to hurricane winds (oh yes my friends, my appalling luck is not limited to matters of health) we were stuck at Calais for three hours, then couldn't dock at Dover for another two.

The water was a little choppy and one by one, most of the other passengers succumbed to seasickness. I'm afraid it was too much for my black humour to resist, and I lit up twitter with my hilarity at being the only person NOT being sick on a boatful of vommers. 

Simon, a twitter friend (@SilverCat) wrote this fascinating post about something called "Reversal Therapy. He's a gestalt therapist who blogs at' and has given me permission to re-post it here :

Reversal experiments: @suey2y vs the seasick

An illustrative example of accessing disowned/underused aspects of self, spontaneously enacted, and viewed from the perspective of gestalt therapy theory. This post is published with @suey2y's permission.
  1. In an effort to return to first principles, I've started re-reading Gestalt Therapy: Excitement and growth in the human personality, the original and still most effective statement of gestalt therapy theory. If, like many others, your exposure to gestalt therapy has been through Gestalt Therapy Verbatim, then I highly recommend you read the earlier, more theory-oriented GT.

    The first half of GT consists of a series of experiments that allow the curious reader to test out gestalt theory. I'd just come to the part about exploring polarities and imagining being in the reverse of my current life-situation, when I saw a highly appropriate series of tweets.
  2. suey2y
    Definition of irony : I am stuck on a ferry, 6 HOURS late docking due to hurricane gales. Am only person on board NOT feeling sick! #crohnie
  3. Sue Marsh, aka @suey2y, is a well known campaigner for disability rights, who first came into my awareness through the Spartacus Report. The irony of her situation as the only person not to be seasick is intense seeing as nausea and sickness is part of the daily grind for someone with Crohn's disease.

    The stage is set for a living, breathing reversal experiment. In terms of a polarity, we could say that Sue is more used to being identified with sickness when it comes to issues of general health and well-being. In terms of gestalt theory, this is seen as a continuum; we could work with this as the sickness-wellness continuum and ask where on that scale Sue would habitually see herself.

    Now, the statement 'I am sick' or 'that person is sick' carries with it the unspoken 'I am not well' or 'that person is not well'. Wellness is denied to the person identified as sick. What gestalt therapy has to say about polarities is roughly that the whole of the continuum exists within the person. By identifying someone as sick and not well, we are accepting one aspect of their self and denying another. Sickness and wellness only exist in contrast with each other; one cannot be sick without having a well-being with which to contrast being sick.

    As a consequence, when we identify with one side of a polarity, and deny that part of ourselves that must embody the other side in order for us to occupy the side we do, we lose access to that part of our self. It's a bit like only hanging out in the parts of a city that feel most reflective of who we are; we immediately lose access to sights and sounds and experiences further removed from our habitual sense of who we are. And the more aspects of our self we lose (read: deny ourselves) access to, the less vitality we have to draw on.

    In gestalt, the way to regain access to these parts of ourselves is to re-identify with them, hence the reversal experiment. It's mind-bogglingly simple, yet often very difficult to do in practice. It goes like this: having identified an aspect of your personality that is disowned (experienced as not-me), identify with that aspect by acting it out. This can be as elaborate as standing up, walking around, and getting fully into character. As a lighter touch, it can be thinking of I-statements to make from that perspective. The stronger the dis-identification with that aspect of personality, the stronger the resistance to the experiment; boredom steps in, you become tired, or shame blossoms up in the form of embarrassment and feeling silly.

    But if we manage to get into some creative play with what it would be like to occupy that reversed perspective, we will quickly tap into some potent energy:
  4. suey2y
    Who dares me to high jack tannoy, and tell every vommy lightweight passenger to go to work NOW you lazy bastards?
  5. suey2y
    They would look at me with horror, incomprehension. Welcome to my world. Sorry, but I think it's hysterical#crohnie #fitforwork
  6. suey2y
    It's like the world has suddenly reversed. I am the smug, thoughtless bastard eating the sausages, they are the imploring.
  7. BAM! Now this is powerful stuff; having reversed position, we get a cathartic release that expands the ego boundary to re-include a part of self that is usually denied. This is particularly valuable for me as a therapist, because I then get to experience first hand what it is that the person I'm working with is keeping at bay. Sure, we can talk about it, and makea lot of headway, but nothing is as valuable as direct here and now experience, of inviting the subject under discussion into the room.
  8. suey2y
    It's their illness behaviour. They aren't actually seasick
  9. Ouch! Ever had seasickness? Imagine being told, to your face, that you don't. Excellent, you now have some inkling of what happens in a fitness to work interview.
  10. suey2y
    I even have anti-emetics in my bag, but I'm not sharing cos you have to do, like, 10 yrs NVQ in vomming B4 docs allow you any RELIEF
  11. suey2y
    Ooh, I cld go round saying "Well of COURSE you were sick you ate that scone/drank that beer/smoked that fag .Aching with evil revenge urges
  12. suey2y
    Oh this gets better!! We're delayed AGAIN! It's like they're all in patients waiting for the nurse with the anti-sickness that never comes!
  13. Hopefully, you get the point. Somehow, the reversal experiment is more effective at getting across how someone experiences themselves than them explaining that experience. This is for two reasons: 1) the switch of positions allows for greater contrast, and 2) the reversal releases more energy than exploring the familiar.

    Essentially, the reversed position is a part of self, and so seeks expression. However, it is a denied part of self, so its expression is resisted. In order to resist expression effectively, that resistance must be at least equal in energy to the desire to express the denied part. Hence the energy released by a reversal experiment.

    There are many different reasons for introducing a reversal experiment in therapy. The aim is pretty much always the same though: to bring the disowned material into awareness, and promote a greater integration of the whole of the person. And in the context of public attitudes towards and between different social groups, the empathy generating power of this reversal becomes not only apt but urgently needed. After all, as one person tweeted:
  14. davidjwalsh
    if you don't follow @suey2y please read her tweets from about 1hr ago, and then hope you never get ill in the uk#itcouldbeyou
  15. Maybe if people who identified themselves as being generally in good health, in contrast to 'the sick' or 'the disabled', or if people who are 'employed' in contrast to being 'unemployed', played this reversal game for themselves, our society as a whole might be less willing to stomach the NHS and welfare state being shredded before our eyes.


  1. I'm reminded of a story I read about a Blind Canadian lawyer. A courtroom was plunged into total darkness because of a power cut(one of those ingenious central rooms with no windows I guess) and the law stated clearly that no one could be expected to work in an environment that was dangerous to them. So proceedings were suspended and as people were heading out the Blind lawyer said "What? Can't you people work in the dark?"

    It highlights something about disability equality which often seems to be deliberately misunderstood by non-disabled people. Disabled people are expected to adapt and meet the expectations of others often in circumstances which are dangerous to them specifically. This is a standard of ethics which almost no developed western nation tolerates for long when applied to non-disabled people. Yet attempts to redress this balance are disingenuously characterised as 'special treatment' and supposedly at odds with principles of equality.

    The real special treatment goes almost unquestioned.

    1. Amusing story! And very revealing.

      Like when I was working at Somerset County Council and a couple of people in wheelchairs attended a meeting of Full Council. A guy in a wheelchair joked about how they were causing trouble, and I pointed out that, really, it was the building causing trouble for them.

  2. Interesting read as ever, Sue. As one in the same boat (yes, we haven't finished) albeit not to the same degree, I'd also point out that I do this all the time, as I imagine most do. The retweeting and favouriting that happened on this evening was as rapid and widespread as I have ever seen and unlike certain mainstream stand-upss, we had an awful lot of malice-free fun with this. I'm @OstendGudgeon on Twitter if that doesn't show on here.

    Reading between the lines there is a clear indication that we use it as a coping mechanism because we have to cope. You have to find humour in the horror because we always have the horror. That it brings home an awful reality to non-affected or disaffected viewers is a bonus that long ago I learned to exploit. Any stand-up speaker needs a hook, an attention grabber, and the deeper the hook, the less it dislodges.

    I enjoyed that evening and personally, having had a ropy day or two, felt better for it. There is a cathartic element to it and I don't disagree it's for the reasons above. Again, good piece.

  3. Oh, the irony :)

    Sure I get the point. Do that, been there in my own way. Gave me a wry smile. Nicely written, bitter sweet, and very much welcome. Thank you xx

  4. It is interesting (not always fun) to watch a non disabled person struggle with something simple that a disabled person has to deal with everyday.

    as a child i was told: If we swap even part of our medical problems with a non ill person for 5mins it would drive them insane.

    and as you watch non disabled people struggle with simple things that we have to put up with everyday it proves true.

  5. It's true. Two ppl very close to me have told me that salmonella was without doubt the worst pain/illness they've ever experienced.

    They told me with the horror still fresh in their voices, shaking their heads at the memory. Not quite able to believe they'd really felt so awful. Both said "I honestly thought I was dying"

    I looked at them in wonder - cld they really not know I feel like that every single day of my life? Really? I learned in the end we're not designed to believe or recognise that stuff. We think our suffering is unique, worse than any other.

    1. Having experienced both a bad case of Salmonella and autoimmune disease related inflammation of the bowel, I can confirm that they really do feel very similar.

    2. I think feeling nauseas 24/7 along with being sick is the most demanding of any illness and you never ever get use to it despite myself suffering with it for 30 odd years everyday is a struggle and everyone I've ever mat who has had Chemotherapy agrees with me