Case Study TSW Holistic Health & Medicine (2006) 1, 42–70 ISSN 1749-494X; DOI 10.1100/tswhhm.2006.24 Clinical Holistic Medicine: The Case Story of Anna. II. Patient Diary as a Tool in Treatment Søren Ventegodt1,2,3,4,*, Birgitte Clausen5, and Joav Merrick6,7,8,9,10 1Nordic School of Holistic Medicine; 2Quality of Life Research Clinic; and the 3Quality of Life Research Center, Teglgårdstræde 4-8, DK-1452 Copenhagen K, Denmark; 4Scandinavian Foundation for Holistic Medicine, Sandvika, Norway; 5Vejlby Lokalcenter, Vejlby, Denmark; 6National Institute of Child Health and Human Development; 7Center for Multidisciplinary Research in Aging; 8Zusman Child Development Center; 9Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel; and 10Office of the Medical Director, Division for Mental Retardation, Ministry of Social Affairs, Jerusalem, Israel E-mail: [email protected] Received November 1, 2005; Revised December 27, 2005; Accepted December 28, 2005; Published February 10, 2006 In spite of extreme childhood sexual and violent abuse, a 22-year-old young woman, Anna, healed during holistic existential therapy. New and highly confrontational therapeutic tools were developed and used to help this patient (like acceptance through touch and acupressure through the vagina). Her vulva and introitus were scarred from repeated brutal rape, as was the interior of her mouth. During therapy, these scars were gently contacted and the negative emotional contents released. The healing was in accordance with the advanced holistic medical toolbox that uses (1) love, (2) trust, (3) holding, and (4) helping the patient to process and integrate old traumas. The case story clearly revealed the philosophical adjustments that Anna made during treatment in response to the severe childhood abuse. These adjustments are demonstrated by her diary, where sentences contain both the feelings and thoughts of the painful present (the gestalt) at the time of the abuse, thus containing the essence of the traumas, making the repression of the painful emotions possible through the change in the patient’s philosophical perspective. Anna’s case gives a unique insight into the process of traumatization (pathogenesis) and the process of healing (salutogenesis). At the end of the healing, Anna reconnected her existence to the outer world in a deep existential, suicidal crisis and faced her choice of life or death. She decided to live and, in this process, assumed existential responsibility, which made her able to step out of her mental disease. The advanced holistic toolbox seems to help patients heal even from the worst childhood abuse. In spite of the depth of the existential crisis, holistic existential therapy seems to support existential responsibility well and thus safe for the patients. KEYWORDS: quality of life, QOL, philosophy, human development, holistic medicine, public health, holistic health, holistic process theory, life mission theory, group therapy, incest, abuse, rape, sexual abuse, existential healing, existential (Antonovsky) coherence, Denmark *Corresponding author. 42 ©2006 with author. Published by TheScientificWorld, Ltd.; www.thescientificworld.com Ventegodt et al.: Clinical Holistic Medicine (32) TSW Holistic Health & Medicine (2006) 1, 42-70 INTRODUCTION Many forms of therapy have been tried with rape and incest victims, but the therapy has often been less than effective and sometimes even counterproductive[1]. The more severe the abuse, the more difficult it has been to re-establish a normal emotional range and a positive philosophy of life. Victims have been treated with cognitive-behavioral and existential therapy, reality therapy, group therapy, and also with family therapy, analytical psychotherapy, supportive group therapy, and couple therapy[2,3,4,5,6,7,8,9, 10,11,12,13,14,15]. Even with these methods, it still seems to be extremely difficult to facilitate a process of existential, emotional, mental, and sexual healing that takes the patient all the way back to a normal state of mind. Quite surprisingly, we have seen this process accomplished where the patient was fully healed with the help of holistic existential therapy. The patient was so severely abused, both physically and sexually, that such a recovery was highly unexpected. We, therefore, felt the patient’s story worthy of publication, even though the patient diary is long. Anna[16,17] was a 22-year-old patient who had been severely sexually abused most of her childhood by her father and two other men who blackmailed her father to let them have the girl for sexual exploitation by threatening to report him to the police if he refused. Her story is as terrible as they come and we have presented the case record[17], as well as her own patient diary, below to illustrate what it actually takes to get well again after such abuse. The most amazing thing about the story is Anna’s full recovery. She is now a successful university student with a boyfriend, today, several years after the treatment ended. It is suspected though that she recurrently will have to face philosophical, spiritual, emotional, and sexual problems in the years to come because of the abuse. We believe that her physical and mental problems have been solved. Only a strong and persistent relationship with her particular partner based on love, care, acceptance, and respect will give her the holding she will need in these difficult periods. Her challenge now is to use her knowledge from the therapy to build a satisfactory life. We render Anna’s story in its full length, as it is important to show the huge, persistent cleansing work that had to be done by the patient herself in order to recover, when adopting the medicine of consciousness. It is particularly interesting to notice how many negative decisions have to be found and released before a severely existentially and mentally ill patient does indeed recover. The story also shows how the traumas available for integration in the therapy contained still bigger and more unbearable existential pains, as the patient gradually got more strength and more resources to go deeper into the “inner refuse bin”, drawing still nearer to live her own purpose of life. This is a very important sign of the patient’s existential healing. Her story starts just before she had her first breakthrough, recalling the sexual abuse. The relationship is between the patient and her physician [SV], together with the principal nurse [BC], and other nurses of the Research Clinic of Holistic Medicine in Copenhagen who gave both individual therapy[18] and holistic group therapy[19,20,21] that the patient attended in the start of her diary. This therapy is very much like the relationship between a caring father and a little daughter around 4 years old, due to the fact that she had a long course of individual therapy (see the case report[17]) and the abuse started when she was at that age. Please be warned that some parts of the story are very gruesome indeed. As sexual assaults and rape are among the life events with the most dramatic negative effect on quality of life, the physician must take these traumas very seriously. In most of the world, sexual abuse of young woman is still very common and studies from different western countries indicate an incidence of about 15% of girls being assaulted sexually in childhood[2,22,23]. These patients are also more likely to be physically abused later by husbands and partners[22,24] and sometimes even the therapist who is supposed to heal and protect them. A reason for this is the sexual openness and the lack of normal sexual borders of these patients, making them easy targets for abuse, in combination with a high degree of suppressed emotional pain, making them highly projective. These high numbers are disputed though. A problem with the sexually abused patient is that it is so difficult for the physician to be the one opening the old painful wounds of abuse because he will inevitably be the projection screen for some the worst things that happened to the patient. As the patient cannot contain the overwhelming emotional pain of the earlier events, it will be projected out on the surrounding world, and the therapist/physician will be the one most likely to get these projections. Any impurity of this kind in the 43 Ventegodt et al.: Clinical Holistic Medicine (32) TSW Holistic Health & Medicine (2006) 1, 42-70 therapist himself will then be dramatically energized and brought into experiential focus and without the strict professional ethics in this situation, it is practically impossible not to be “a part of the game”. When this is happening, one reasonable theory for explaining the high occurrence of “professional incest” seems to be that many therapists themselves have a background as victims of abuse. The rationale for “professional incest” comes from an unconscious longing for healing of the therapist’s own painful wounds on body and soul. With a keen awareness of ethics and ethical behavior, allowing intimacy and not sexuality between the therapist and the patient with sufficient supervision, training, and therapeutic processing by the therapist, this problem can be handled[1,25,26,27,28]. In this case, a therapist who was abused him- or herself might be the most wise and helpful of therapists, as abuse fully integrated turns into a huge gift of understanding and acceptance of life in all aspects, even the darkest and most difficult. A therapist who does not know the evil side of mankind[29] is often not capable of helping patients treated as badly as Anna was. Only very few patients have an experience to the absurd degree of sexual violence that Anna had to recover from, and she did project very strongly, giving a good example of the above-mentioned problem. The principles of existential holistic therapy and the process of holistic healing have been presented elsewhere[18,19] as the use of it on mental and sexually abused patients[26,30] and all these strategies were used here. Most of the tools in the advanced holistic medical toolbox have been used to heal Anna[27] and the difficult (level 8) technique of acupressure through the vagina and anus was partly developed for use in this case[28]. The core tools of the following process are found at the group level (level 5)[20,21]. The patient’s diary is a very important tool in holistic existential therapy. It allows the patient to confront all the things that appeared in the therapy, including the medical consultations. It also allows the patient to place the emotionally charged material in a safe place until it can be processed in the therapy. It also gives an important record of the process, so that track is kept of the often very extensive process of healing hundreds of gestalts. Most importantly, it allows the patient and the physician to identify negative sentences, the life- denying decision, from the gestalt, to help the patient integrate and let go of all negative beliefs and attitudes accumulated though the painful life events. When reading the patient diary, it is important to understand that this text arises from a highly systematic and therapeutically well-supported exploration of the patient's subconscious material, with a strong focus on confronting the repressed negative feelings of the gestalt. The patient is encouraged to dive into these negative emotions and enhance them. As this is done, the old feelings of wanting to die, going insane or wanting to commit suicide appear in the patient's mind. These states of consciousness are not born out of the present moment, but out of the painful past, and thus they cannot and should not be avoided in the therapy. They must be understood as difficult, but necessary phases of the therapy. In the beginning we had the fear that the severe existential crisis described in the diary could actually some day lead to the suicide of the patient, which would make this kind of intense therapy unsafe for the patients. We have now closely observed hundreds of patients going though deep existential crisis, and quite remarkably, to our knowledge not a single one of these have ever tried to commit suicide, neither during nor after the therapy. This is in a way highly surprising, as psychiatric patients like Anna are known to often attempt suicide. The reason for the intensive holistic therapy being safe, in spite of the dark content of the stream of consciousness, seems to be that what really makes a person insane is not the content of the consciousness in the present now - we can dream the most horrible things and still be sane - but our level of existential responsibility. Choosing to confront the old traumas in existential holistic therapy in close contact with the therapist with the intent of healing, reflects this high degree of existential responsibility. So the patients can go really deep into their existential choices, and choose "to be or not to be", and still be completely sane, and therefore not at risk for committing suicide, because of the spontaneity of a psychosis. There seems to be three fundamental themes of the existential crisis in the course of deep existential healing: 1) The loss of the old ego - the identity crises: Who am I? 2) Confronting the nature of the real self: what am I? and 3) Choosing life: Why am I here? What is my purpose and mission? The metaphor of the personal transformation, so well illustrated by Anna diary, is the transformation of the butterfly's larva: first it must loose its old self, to go into the transforming pupae; second it must remember its true nature and transform though this remembrance; and finally it must choose to be the butterfly, to get out of the pupae into the world. Please notice that Anna became a student of holistic medicine, and her unique talents of 44 Ventegodt et al.: Clinical Holistic Medicine (32) TSW Holistic Health & Medicine (2006) 1, 42-70 understanding the process of healing and her own needs in the therapy was an important reason for the development and use of new tools like "acceptance through touch", and "acupressure through the vagina"[26,27,28]. DIARY OF ANNA Monday of the group course Yesterday evening Søren (SV) arrived when nearly all of us were sitting at the fireplace. I was very insecure. I was just thinking of how afraid of everything I was and how much I wanted to go home, as quickly as possible. Søren came over to me and was extremely considerate, most affectionate and nice to me. He hugged me a lot and said warm words. Evening. Already this first day I feel it as a hundred days. Søren appears to be at his best today, and I have been glad to be here. Today we should get to know each other further, shake hands, hugs and a few words; and I noticed all the other participants. Actually, there are many lovely people here, and even those whom yesterday I thought would tire me, I do contain. Afterwards we should choose a partner. A young man, Peter, came over to me and told he felt kindness towards me. At first he scared me; then Søren comes over to help me to sense, and yes, I felt kindness towards Peter too. So we became partners. Later we made exercises where we showed each other attention in turn, care and respect. I think Peter and I were doing some fine exercises – and now I am very glad that he is my partner. He seems very affectionate and nice. Later on that day my abdominal pains and shoulder pains worsened, and I got headache. Søren helped me and backed me in giving myself away to Peter and not being afraid to both give and receive physical care; thus we talked about trust. Peter and I talked about wanting to break through, finding out what we needed, and making sure to get our needs fulfilled. I am quite convinced this is the way it will turn out. I so fervently wanted that, although I try to hold back, to be the nice girl, and therefore I hide the fear in my abdomen. I want, indeed! Tuesday I work at finding negative resolutions: I trouble other people I am troublesome I am a burden I am impossible It’s my fault I am not good enough Wednesday It’s in the afternoon and I am sitting at the fireplace together with Søren. I tell him that I am frustrated and scared as well as that I don’t deserve to live and that I don’t deserve life. Søren takes me on his knee and let me nestle close to him like a little child. I tell him that I have timedout. We talk a little about containing the feelings, and what strikes me isn’t so much what Søren is telling, but it’s the nearness, his holding me close and containing me, while I didn’t thought I deserved to live; and there I was sitting on his knee and got slowly better. Later the same day, in the evening, we are a few from the center, who have gone to the beach. Last only Søren and I are left. I feel sad, as I have started remembering ever more difficult episodes from my childhood, all with the topics of abuse. A fire is lit, and I am lying on a rug, while Søren is sitting besides me. He asks me to go into my feelings. His presence and attention, which seem one hundred percent directed towards me, makes me calm, and I am not afraid to go into the feelings; I feel confident in his 45 Ventegodt et al.: Clinical Holistic Medicine (32) TSW Holistic Health & Medicine (2006) 1, 42-70 company. Furthermore, I feel such a trust in Søren, which I have never experienced in any person before, and therefore it is very important to me that we are alone as I am a very private person. So I was lying there on the rug near the fire and I experienced how my body began to shake, almost in jerks, and how these jerks increased in intensity and how the intervals between them became shorter and shorter. Along the way Søren is meta-communicating and tells me that I shake, because of the energies, which my gestalts have bound and now are in the process of releasing. I tell Søren in detail, which episodes are coming up from my sub-consciousness, and we have got many pauses en route, which I experience as most tactful by Søren. It should thereby be possible for me to come into something very profound and difficult. The sentence “this is unreal” comes up. Now I experienced, while telling Søren what I saw and sensed, that I spoke with a mechanic, strange voice, and I realized that the voice was not mine. Parallel to this, I experienced that I was standing at the end of the fire and was undergoing all those things, I was telling about mechanically while laying down. In other words, standing I sensed the feelings and the pain connected with the abuses and infringements, and laying down my framed body talked about them. This experience was real and very “physical”; I could distinctly feel that I was shifting between the two bodies. When life was hurting it got unreal to me and thereby I was able to hold on being alive again. Down on the beach I let go of the sentence “this is unreal”. It was like having received my first revelation. Søren told me, after we have worked, that previously I was borderline which makes me terribly sad. It aches so much inside myself; and to think that I should be psychically ill! His stressing that I am ex- borderline now helps. He holds me close, gives me some of his warmth, and I can feel that he cares for me although I am a strange one, and it feels indescribably nice and at the same time almost incomprehensible to me. Here are some episodes from the last few days I have come to think of. Spankings: My father often punished me by giving me a spanking on my naked behind. Once I was spanked, because I was eating too slowly (a dish with chops and tomatoes); as I was drawing with my green lettering pen outside the paper onto my blue velour track suit. Sometimes I got spanked if I did not eat quickly enough at supper and then again after having sat at the table for three hours. Actually, it was accidental whether I got spanked for not eating fast enough. I guess it depended on my father’s mood. Communication: For days my father could be angry and not say a single word to us, and we knew that in any case we should not say a word to him either, nor should we do anything wrong at all. However, the problem here was that I never did know what was wrong, because there was never something for sure. If he needed to beat or yell, he just did so. Beaten and yelled at, I was never told why. Therefore, there was never anything for sure because there was never an explanation why he did as he did. I dreaded by father, and was mortally afraid of him and his violent changes of mood. After being beaten I was always sent to my room and was only allowed to come out, when he told so. There I would cry, silently, so he should not hear me. Constipation: As a baby I ate the foam-rubber mattress in my cot, toilet paper in the bathroom and paper from the newspaper if accessible. Later on I very often got constipation and I remember that last I got it at the age of 7–8 years, when my mother had to “dig the shit out”. Thursday I have got a new life and a new face. I can easily sense how terrified I am. Talked with my partner Peter about it. We had become interdependent. I went into him because I am not able to be in myself; this is unreal. By going into Peter I get out of reality and so I am timed out. It was so tough for me when timing out as a little child. I am empty I am hollow I want to go away I want to live (14 days old: I fight for living, I am in trouble and through my will, I do survive) 46 Ventegodt et al.: Clinical Holistic Medicine (32) TSW Holistic Health & Medicine (2006) 1, 42-70 Friday Today I have had quite an experience. A real, beautiful and loving experience with Nete. All my kindness went to her and it was reciprocated tenfold by her. I was blissful. Never before have I experienced wanting to give love with so much devotion; it made my head swim. I am eternally grateful to Søren for having arranged this totally unique and fantastic love background, which I feel we have got here at the course, where we are giving and receiving love freely and without any restraint, either in the form of words, physical care or in the mind. It was during this totally fantastic and very beautiful experience that I got a full comprehension of many aspects of Søren’s holistic medicine. I was deeply moved and am indescribably happy I had testified that love can be the door to a genuine meeting between two persons, who were so far away from each other to start with. I can sense that love is constantly flowing here, and I myself have never believed that I should experience so much warmth and kindness by other people. I have started believing much more in love as a medicine, and I can feel this gets myself closer to the trustfulness, and actually this is a much greater gift to me. And how could it possibly be different? Søren is the first person that I have really trusted, i.e. pure trust, so of course he is also the one who opens me for that trust in other people as well. This is one of the greatest gifts I can get: to regain the trust in other people! Sunday At a time I choose to lie down as my stomach ached strongly, much more than usually, and Søren searched on my stomach for the place aching. He found the place, pressed at the spot, and then I felt the pain; a lot of pain. I cried violently and did really manifest myself. Søren asked me various things, while touching that place on my stomach, but I was not able to reply to his questions. The convulsions/jerks I had experienced on the beach together with Søren started again, and soon they turned worse than that night. I got cramps in my head and in my legs as well, and the cramps were more and more intense. Now Søren supported my head, and I began to feel a burning pain coming from the inside of my head. It ached so much that it felt like an imminent explosion. Søren told me that these were fever cramps from when I was a little baby and from which I almost died, my mother and father not being there for me. I liked that Søren was meta-communicating meanwhile. It reassured me in the situation. The cramps grow even more intense, and soon I am beating myself, exactly like at the time my brother and I played when we were younger (a play where I pretended to be mentally handicapped). It grew ever more intense, I shake all altogether, and it was completely wild. I suffer unresistingly. Then the sentence “I want to live” turned up, the sentence being thus connected with this situation, this gestalt. I almost screamed the sentence, and my voice reflected huge and intense pain. On having said the sentence, I got relieved. Soon bliss itself washed over me; never before had every single fibre been relaxed so much. Afterwards I released the sentence “I want to live”, and again I shivered a little. Harsh. Søren hugged me, and I can feel he is there for me; no matter what. I am so blissful! This is my second revelation. At the time I decided I wanted to live, I did very nearly die. I am surviving exclusively based on my will, and ever since have I been feeling as if I did nearly die. I have not been living, but did very nearly die. Release – bliss. One gestalt poorer. Monday In the evening I am manifesting myself again. I am in my room. Something big is underway. As many participants of the course are manifesting themselves, Søren has to leave me at regular intervals. This I am able to contain, and I am constantly feeling he is together with me in the mind; the mere idea of this preparing myself to pull through. The manifestation initiates where I am in my mother’s womb. I move a lot, but I have the impression that she does not want to feel me. So I move ever more. My body shivers; writhes and soon I fling body and head backwards and forwards. Søren back me all along and ask what is happening and what I am feeling. I feel his care for me, which makes me going direct into the pain. 47 Ventegodt et al.: Clinical Holistic Medicine (32) TSW Holistic Health & Medicine (2006) 1, 42-70 I manage to get all the way around my mother’s womb, I rotate, and soon I begin to feel a sort of rope round my arms and chest; I got wrapped up in the umbilical cord. I get the impression I should split; the umbilical cord feels like a straitjacket. I get water, amniotic fluid, in the throat, and I cannot swallow it. I get strangulation sensations. However, my mother still cannot feel me, she does not want to feel me, and I decide NEVER MIND. Soon afterwards my body become quiet and something else turns up. I am back lying with my baby brother. My mother and her new partner have sex, and I say “She does not want to.” Now I am on the track of the sexual assaults. After having said “She does not want to”, I now hear and see the arousal and say: I DON’T WANT TO HEAR IT – OVER. Then comes: I DON’T HEAR IT. I start saying THIS IS BAD, repeat it many times and do not really want to proceed. I am strongly maintaining that THIS IS BAD, and Søren tries in different ways to proceed. He is very tactful and extremely delicate in the situation and handles my situation so gently. Now comes the sentence I DON’T WANT TO KNOW IT, then I DON’T WANT TO SAY IT, and this while I am crying and incredibly frightened. Søren back me up and let me know that he is taking good care of me. Then comes the sentence IT’S NOT MY FAULT, and here I can sense that I mean it is not my fault that I am arousing him (the perpetrator) and that the event is taking place. Then comes the sentence THIS ISN’T OK, and here I am uncovering it, I guess. Then comes the sentence THIS IS SECRET and the sentence YOU SHOULD JUST KNOW THAT YOU WILL BE PUNISHED, HARDER THAN EVER, IF YOU TELL IT. Again Søren try to encourage me to proceed and to go deeper into the episode. I trust Søren one hundred percent, and I know he can help me and he wants to back me up through anything tough. Now I sense that the door is being opened, and I can hear the noise of somebody trying not to make a sound. It is my father coming in. He sits down on the edge of my bed, hold of my waist and place me, my back turned, onto his penis. He hives me up and down over him, has an orgasm, and lay me back in all the blood and sperm. While this take place and during most of the process, my body make twitching movements, in jolts, like during an intercourse. Then comes the sentence IT’S NOT ME, and I say this because here I go outside myself and fly, I jump from an aeroplane and float in the sky, but I know I will hit the soil again. I am floating painlessly and land on the soil with a crash. Then come the sentences I DON’T WANT TO and then IT IS MY FAULT, and then YOU WILL GET PUNISHED, and I DON’T WANT TO HEAR IT. While this happens I am back, 4 year old, talking with a very mechanical voice, almost in twitches, and the voice only disappear the following day in the afternoon. Several things come to me as memories the next day: How my father had punished me, because I tempted him. How my hair was cut, how I was dressed and brought up like a boy to reduce this temptation. How I carried on with this, when I myself started buying clothes: men’s clothes, businessman shoes and the like. I looked like a grown-up man in my clothes. How also my mother was feeling guilt; therefore she shut herself into the bedroom, unable to take care of me and love me, even when I tried to encourage her. How finally I had to leave the bedroom, because I could feel she hated me. Maybe she punished me by her ill treatment; maybe it was her payback? The food. How I was not allowed to eat what was supposed to be my father’s filling for his packed lunch. Therefore, I ate roasted onions, macaroons and raisins for lunch after school. I was hungry, but there was not any food for me. Tuesday I still talk mechanically, am a little 4 years old girl who is very scared of other people, whom I believe will punish me, every single one of them. I feel as if I am in day care now, where everyone will be after me. Søren is incredibly nice and endlessly affectionate towards me. He is like, often before, my father, however it is completely different this time. Now I feel he is the only one, who really can protect me from all the evil people, and I prefer to stay near him. At breakfast he makes funny puppet dances with his fingers, which make me laugh a lot. I feel how I am only 4 years old and I am really not older. Søren’s dancing like that with his fingers make me happy and warm inside; he meets me as the 4 years old girl I am, and he does it with consideration and affection. 48 Ventegodt et al.: Clinical Holistic Medicine (32) TSW Holistic Health & Medicine (2006) 1, 42-70 Later down in the hall I do not dare at all to look at any of the other participants, and I am sitting safely besides Søren. He asks them, at my request, to take good care of me and let me be alone for a while. After a short while the twitches, the intercourse movements reappear. I am sitting beside Søren, I am totally confident because of his presence and I just go into the feeling. I suffer unresistingly. Now I do not care whether the hall is full, whether everybody is watching; because the hall is full and yet it is empty. Only trust and care are here. I do dare, and therefore I suffer unresistingly. The movements become more hefty and powerful. I can feel it is happening/I am getting raped many times indeed. Just as I am sitting there I get ever younger, and at the end I have got no language. Am I 3 years? 2 years? The following sentences turn up: I CAN DO NOTHING, IT’S MY FAULT, I DON’T WANT TO, and I CAN’T STAY ANYWHERE. Together with Søren I return to the episode, where my dad had sex with me and afterwards he turns me round so he can spank my behind: everything is wet in the bed, and my whole body is aching, and I cannot be in the bed. I can stay nowhere and in the morning my mum clean up. Thursday Yesterday everyone from the male group found their purpose of life, and we had a wonderful evening together on the beach. We from the female group had arranged entertainment, including belly dance and songs, food including coffee, wine, chips and cake, and then we served them. Our mantra during this was: no control, no criticism and no claims. Well, I must admit that actually I enjoyed a lot just being allowed to do anything so they should feel comfortable. And they were much greater, when meeting us there at midnight; they were bloody men, indeed! So this morning we should find the female’s purpose of life. While meditating to music, the men went about whispering gifts to us women. At a point Søren come to me and whisper in my ear something basic about my purpose of life. I got so touched that I started weeping. It felt like so incredibly great words, and I can hardly believe that the words he told were about me. Friday I find my purpose of life: “I bring warmth and joy”. I find this as the finest and most valuable gift I have ever got. Tuesday Sunday I came home after two fantastic weeks at the summer course. Yesterday I was 11 years old and wished for a fancy pink school bag. I am in flow, it feels so nice. Today I have turned 12 and have got the first period. It was a mixture of relief (I am like the others), sadness (because I should have it for the next 40 years) as well as a dislike about growing up. Ironically, as at the age of 12 I was already a little adult. I played a lot with my doll I had bought and took it for an evening walk. I felt I was back to the time, when I played with my big dolls house, something I was completely crazy about. Today I wish for a doll’s house of my own. Again I think of the nice words Søren whispered in my ear about my purpose of life. It warms. Wednesday Today I am 13 years and wish for a dress. Thursday Good night 14 years and still without the dress. Sigh. Saturday I dream a lot for the time being, and Thursday night had a particular dream. I dreamed that I confronted my dad with the sexual assaults, that in the dream he got scared, and that the accusation was exact. He could not really answer back. Heavy artillery indeed I had been driving in position. I was at a really nice concert, and at long last I had bought a super fancy dress, which I was wearing, and I felt simply so dishy! I felt smashing indeed, and it was really a fantastic sensation. Hurray! 49 Ventegodt et al.: Clinical Holistic Medicine (32) TSW Holistic Health & Medicine (2006) 1, 42-70 Later I went dancing in the nightclub. It was divine and even a little better than usual. I did it to my heart’s content, and it was fantastic! Medical consultation at the clinic run by Søren (Quality of Life Research Clinic) Ever since the assaults I have regularly reverted to them by myself, on the hard bathroom floor, where I at the age of 7 years made quick and hard masturbating movements with three fingers, which took me back to the rape. I reverted because, although this was foolish, it was a form of contact between my father and me, the only contact we had besides when he hit/punished me. I also did revert when having sex with my boyfriend. The brutality/fierceness was nearly always part of it, as I would prefer to be taken from behind quickly and hard, be pinched and bitten on my nipples. Søren helped me to feel first the pain in my vagina aperture, my uterus, then my whole inner pelvis. He contacted the scars in my vulva and vagina; tactfully, balancing on a knife-edge. (The techniques of holistic pelvic examination, acceptance through touch and vaginal acupressure was partly invented to be able to heal the existential, mental, emotional and genital scars of this patient[26,27,28,31]). He brought me home to my uterus. He had been healing something inside me; this morning I saw my body as rounder, smoother and much more feminine. My psychosexual development is no longer like that of a four year old. I am on a fair way to become a woman. I got an enormous gift from him, and I am very grateful to him. Søren dealt with healing the scar on my right labia, which was continuously chapping. It got better while he was healing it and en route the pain was very close to unbearable. At first came the physical pain, which was almost unbearable and then I enter into the emotional pain. There is a huge and intense gestalt, and my hands are completely clenched. I feel an enormous rage and can also feel that I am not able to release the rage although the sentence “NOW IT’S DAMMED ENOUGH” is swimming in my head like a mantra. Afterwards I get in dialogue with my inner little girl after having found the sentence “I HIDE”; thus I have been hiding in my own hand, when getting abused. It prevents an adult life, where I can react and be present in myself. I let go of this sentence, and now the rage changes. By the way I had a splitting talk with that little girl. As Søren asked me to release the sentence she tells me: YOU DON’T KNOW WHAT YOU ARE DOING and IT’S DANGEROUS. Then I tell her that we cannot play hiding the rest of our lives and be lying under a blanket without saying anything and without moving the rest of our lives. We must live instead, I tell her; thus I am able to release. Afterwards the rage can get out, and at first I chat, then hit, then beat and hammer with clenched fists on two pillows, while I am saying: “Now it’s dammed enough!” That helps. It’s nice to let go of the rage, and that ease me a lot. Sunday New negative sentences: I am ugly I am afraid of men I feel sorry for myself She is too much I am getting punished Saturday Now I realize that my dad did often assault me in the morning before my mum was awake. Wednesday The sentences: I don’t need you I need nobody There is nothing to come after 50 Ventegodt et al.: Clinical Holistic Medicine (32) TSW Holistic Health & Medicine (2006) 1, 42-70 turned up in connection with my getting stock of something, a gestalt, in which I suffer and which makes me very sad. I am talking with Søren, and more than anything else I need affection and care, I distinctly feel that, and still I do not need anyone/you. It was so obvious that what I needed most was somebody. Then appeared the sentences. And the reason why I do not need anyone/you is that there is nothing to come after. Nevertheless, I am not able to get anything. Thursday Over the breakfast I phone and talk with Søren about how I am doing. We talk about my sentences, and he says to me that he is there for me if I should need him. I just have to tell him I am need him. This is a good and extremely important thing for me to learn; it is a way of letting other people in. It is a way of approaching others. Presence. This opening is primarily due to Søren, as I feel I may “practise” on him. I can practise needing him and then learn to contain either his being there that very moment or having to wait for a better opportunity. It is safe to practise with Søren. Tuesday The sentence I AM IMPOSSIBLE turns up. Wednesday Two sentences appear: IT’S ABSURD WHEN I COME, I AM DYING New memories came to the surface after that; about my aunt’s treatment of me during the summer holidays at her place. I did everything wrong. I was always in the way. And about my father: I am seven years. The night is a hell. I do not sleep at all. I remember how I simply did not dare to sleep on my back, when I was younger. When my dad came into my room at night to have sex with me, I was always sleeping on my stomach. And when he had finished with me, “his screw doll”, I would always return lying on my stomach, in the blood and sperm, and pull my arms completely under by body trying to give myself a little care. I almost see the whole episode like in a movie; how he sneaks up onto my room, gets hold of my waist, takes off my pyjamas trousers and briefs, and places me down over his stiff penis, my face turned off him. He moves me like it pleases him, all the while my small doll legs are kicking. He does not care whether I am completely dry, whether he gets crooked up inside me, whether I am suffering, whether skin may be trapped, whether I am bleeding, whether I get cuts and wounds. Sometimes he also laid me on his thighs taking me up and down over his penis. Medical consultation at the clinic run by Søren (Quality of Life Research Clinic) I have been bleeding a little from the intestines for a while. Søren examines my rectum. I have the impression of getting filled up two hundred percent and it is tremendously uncomfortable for me. It feels as if a refrigerator is crammed into me, and I say I CANNOT STAND HAVING IT INSIDE ME. I do not feel there is any room. It turns ever more unpleasant, worse and worse. I would like to run away screaming. I cannot be there at all; it gets worse and worse. I CANNOT FIND MY BEARINGS AT ALL, I said, and now I am in the space with planets passing and stars hanging and shining. And I want to go home. I feel there is something completely wrong and that I am not myself. Now the disorientation takes over completely, and I am totally gone on. I do not know at all where I am. I would like to say to Søren, he shall be careful not to become like them (my dad and mum), but I cannot get myself to tell it. I say, “This is the worst thing you have done to me”. Afterwards I apologize for my projection. I cannot accept him in any way at all. I think “HE IS A PIG, HE DISGUSTS ME” and at the same time I am awfully ashamed of myself. The dislike is too heavy, the shame too overwhelming; I am not in me, I am not at home. I can feel I am beside myself, and this scares me terribly. I cannot find my bearings at all. Shame and pain. HE SCARES ME, HE IS LIKE THEM, I think. Søren says that the pain I am experiencing now is too intense for me to contain, and 51