The following examples provide practical examples of the use of BART and qualitative accounts or patient reported outcome measures (PROMs)
A patient had experienced numerous physical health problems culminating with diverticulitis and was at risk of developing peritonitis. My new intensive model of BART psychotherapy involved her attending for 15 hours of BART psychotherapy spaced out over 3 days. The feedback was so positive that she stated the detailed and in depth work had brought her more insight than the ten years of psychotherapy she had received previously. Her written feedback was as follows:
"In my session I was working on my recent traumatic experiences involving repeated infection, misdiagnosis and eventual development of septicemia on two occasions. The infections left damage to the bowel resulting in ongoing symptoms and in addition a recent diagnosis of diverticulitis. I was focusing on my experience of these events particularly the sense of not having a voice and not been heard throughout numerous assessments; I had felt very unsafe, helpless and uncared for throughout that time. I then focused specifically on the bowel symptoms, using the bilateral activation and was being guided through the "light stream” exercise by Art and had reached a stage in which I was imaging harnessing a source energy that provided a violet healing light; during this visualisation work I became aware of my father joining me to offer support and love - he died more than 30 years ago from peritonitis arising from a bowel rupture related to diverticulitis from which he had suffered for about 10 years. My eyes were closed but I "saw" him sitting to my left, slightly behind me with his right arm encompassing me. He emanated a powerful golden light from his upper and lower body and I could "see" a small section of his jacket around the righthand side pocket - a jacket I recall him sometimes wearing in the last couple of years of his life. The light was infinitely more powerful that the one I was visualising. . I "heard" him say, "that I did not need to suffer as he had done". My sense of his presence and communication from him was, as real as if I was seeing, feeling and hearing his presence but it did not involve any of the senses that relate to the outside world. It never occurred to me to open my eyes or to turn to my left to see him more clearly but the experience was absolutely as real. I could not answer the question as to how I knew it was he but I knew with the same certainty and recognition I would experience if my son or daughter suddenly joined me in a room in real life.
I experienced this and continue to experience it as a most ordinary event; my Dad just dropped by to help and yet my conscious mind sees it as an extraordinary event for which I have no rational explanation. I experienced a profound sense of safety in his presence; this is a novel feeling for me having grown up in a very insecure, unpredictable environment related to my father's alcoholism, which manifested in extreme binges every few months and my mother's untreated complex PTSD. The sense of safety has remained with me, not in the sense of a profound new experience as occurred when my father was with me but in an ordinary sense of it now being possible for me to live in the present in a way that was never previously possible. This has resulted in a new sense of vitality and pleasure in life."
This shows how BART psychotherapy is a therapeutic approach that taps into a powerful source of healing at the deepest level of connection the patient can achieve with their loved ones. I also treated her 21-year-old son who has dyslexia and severe social anxiety. He had failed to socialise during his first year of university abroad and mum was concerned for his future. He also tended to have difficulty with organization and completing assignments partly due to his dyslexia.
Recent feedback is as follows:
"He seems to be really making strides. He has been out a couple of times each week with various friends and it seems to be an 'ordinary' event for him rather than a major anxiety provoking possibility. His work seems to be going very well and he sounds much more organized than ever in the past. Also, he is trying new
things and has just been rock climbing, not easy with size 13 feet! But he was very pleased that he did well at it, which is interesting as his balance and coordination were extremely poor as a child but that seems to have shifted. He sounds very happy with life at present."
A heavy goods vehicle driver was referred to me following involvement in a fatal road traffic accident several years earlier. Since then he had attended more than 90 individual sessions of CBT. He spoke of how he dreaded these sessions as he was often asked to repeat the history. This became increasingly difficult because of his dysregulated affect. He was in a state of speechless terror and experienced continuous fear and hopelessness. This had led to severe depression with suicidal intent. During BART psychotherapy I used bilateral cerebellar stimulation to regulate his affect. I asked him to imagine the chair as the driving seat in his heavy goods vehicle. I asked him to hold the bilaterally activated buzzers in each hand as if holding onto the steering wheel. I used the freeze frame technique to slow the reprocessing into manageable images. His peripheral nervous system became reactivated as if he was reliving the event in vivo. His grip tightened on the tactile buzzers and as re revisualized the point of impact his right leg shot forward as he sat in the chair. My patient had his eyes closed and was unaware of this instinctive motor impulse. When I drew his attention to the sudden movement, he realised this was when he applied maximum pressure to the brakes of his heavy goods vehicle. Metaphorically it was as if his life had been put on hold since the accident as at a somatomotor level he was still applying the brakes to his life in an unconscious way. During the BART psychotherapy session he was encouraged to mindfully let go of these ‘brakes’ in order to let his life ‘get back on the road’. This stoic patient was able to relive the experience and grieve appropriately realising that the driver who swerved into his path was the guilty party and that the accident was not his fault. The physical injuries he suffered from the accident and the associated traumatic images of the driver of the other vehicle were readily dealt with during several further sessions of BART psychotherapy. His latest feedback was that he had recovered his previous zest for life and was well on the road to recovery. The key learning point from this case is that the stuckness in processing was due to an unconscious movement impulse that had literally put the brakes on this patient’s life preventing him from moving forward. Identification of this and then mindfully allowing the patient to become conscious of this movement helped to lift his foot of the
brakes and start to gently press on the accelerator pedal again.
- When age 8 she had to leave the family home with her mother to escape domestic violence by her father against her mother.
- Memories age 5 when she had a cough and was told to be quiet by her mother so as not to upset her father. Aware of the abuse her mother was likely to be on the receiving end she almost suffocated herself with a pillow in an effort to keep quiet and sleep.
- Multiple episodes of child sexual abuse from age 8 to 11 from a neighbour who used to babysit. The buzzers where used to activate a sense of healing and I user the metaphor of using the buzzers as a taser to force him away from her.