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I know people who have been told -- by therapists -- that their only hope is to medicate, prevent, and cope... because their amygdala is damaged and makes them afraid of every feeling they have, due to multiple chronic childhood traumas.

Figure 1a, so to speak, depicts the pathway my friends/family have been told to follow, which seems futile if one knows one is prone to regularly throwing oneself under the bus by not being perfect(ly capable) at maintaining self-care/preventative maintenance.

I believe that therapists more confident in the brain's ability to heal, would have mentioned healing as a prospective relief from suffering, and a prospective source of 'wiggle room' for not having to do perfect preventative maintenance ad infinitum.

Do you have experience helping people whose symptoms include terror/life-threatening frustration at having to do perfect maintenance just to continue to live with a ticking time-bomb of unresolved trauma they've spent more than a decade trying to address with therapy? (Not psychotopology.)

I have a few such clients, and they seem to be responding very well to psychotopology fieldwork. I just wanted to inquire how many case studies there might be, total, for psychotopology helping in these types of situations.

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Great questions, Briana. I've got a post lined up for sometime in the coming weeks which illustrates this exactly with the words of a former client. She speaks about having learned "some coping skills" around her feeling of terror that would paralyze her life from time to time. And she talks about how different it was to go into it, and "instead of trying to manage it... [we] asked it what it needed to heal." She describes how "that particular moment when we transformed that feeling was, I totally remember, that it was like, I just created a bridge to a higher power.**

Now, in this case, the terror was "an actual physical physiological reaction that was created during those times of abuse" rather than a "frustration at having to do perfect maintenance..." But the situation seems similar.

So, overall, I have two responses to your question. First, we want to find the pivot state, the underlying state that holds the anticipated failure. I call this the "nightmare scenario," and will discuss it in more advanced techniques at a later time. If you can find and access that, starting there will make transforming the pattern much, much easier.

Second, someone with these kinds of extensive patterns of trauma and compensation has a lot of work to do. Transforming the one that's at the surface is likely to open the way to others that are more deeply buried. But feeling the shift of one can give an overall sense of hope, that there is a way forward, and that every step brings us closer to the light.

The depth and extensiveness of the work required to completely heal from this kind of decades-long reinforcement of helplessness can take years, though. It's always good to carry that perspective in any work we do with ourselves and others. We are — all of us — way more compromised than we can know from where we stand right now. I wish your clients the best.

Oh, and to your question about how many case studies, that's hard to say. Most everyone I've ever worked with was not open to sharing their work, had limited funds to pursue longer-term work, and made liberating gains right from the beginning that enabled them to step forward with whatever was most important in their lives at that time after a few high-intensity sessions. I've not had the benefit of a) clients whose work was paid by insurance, or b) institutional support that would enable economics to be less of a factor. There is an immense amount of work to be done and learning to be achieved by future, more organized efforts applying fieldwork to the endless varieties of suffering.

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I love this article so, so much, because it's both humble and humungous.

You asked for feedback/improvements to the writing, and I feel inclined to point out how the IMAGES could make as much sense, and be as intriguing and inviting, as the, imho, fabulous text -- and get effectively shared online!

I see the brilliance of the images, and I want to attempt to help them make sense at *first* glance.

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FIVE COMMENTS ON IMAGES:

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I know you don't, but it would seem that you agree with the first image's limited options as depicted. I would hate to see anyone Restack the first image, or find it in a Google Images search and believe that it portrays your opinon. (This is currently true for both images, actually -- I explain why, further down.)

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TO REMEDY THIS, I sincerely hope a description can be depicted beneath/alongside each image, e.g. "Contemporary model of self-regulation without psychotopological options."

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The way I learned to publish in such journals as Nucleic Acid Research, figure 1 depicts the hook, the aha, the finding... not the model that the paper aims to disprove, displace, or question. These 2 images do that, but only if taken together.

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TO REMEDY THIS, I'd make a point of calling them 1a and 1b, since it is the *juxtaposition* of the two images that illustrates *your* finding.

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While the article invites curiosity in a very inviting way, I find figure 1b (my nomenclature) focuses my attention on multiple loose ends in a disturbing way. One factor in my confusion is the use of a "?" where, in the text, you emphasize that *curiosity* is key, and well-warranted...

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The size and singularity of the "?" comes off, to me, as if you, as the scientist presenting, wish you could transform emotional disstress directly, and have no idea how to do so -- when the whole point of the article is that you have discovered what goes in the "?" and you want the reader to get excited!

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TO REMEDY THIS, I might suggest focus the eye of the observer on the contents of the "=>" items by - replacing the "?" with an "!"

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- replacing the "?" with an asterix demarcated as

"*psychotopology fieldwork" in all 5 small-arrow examples,

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- associating the "?" with the more general

"Emotional Distress => Relief"

(rather than the specific example "Depression => Cheerful")

or

--and this is my favorite option--

- leave out the "?" altogether and make all 5 small arrows equal.

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Even with the remedies above, 1b seems unnecessarily disharmonious on multiple levels.

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TO REMEDY THIS at the level of the 5 small arrows, one might change the 5 small arrows to all go the same direction, not 2/5 one way, and 3/5 another.

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On another level, I would hope they would match the direction of the larger pattern/larger arrows.

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Now, even if

- the 2 images were near enough one another to be visually compared in a single glance,

- the small arrows all went the same direction, and

- there were no "?" distracting the viewer from the new/different words in the content,

your point would still be difficult to discern, and subliminally countered by the cognitive dissonance between the directionality of the small arrows relative to the large ones... and perhaps the inclusion of the rectangles in 1b at all.

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In other words: since I find the discovery of psychotopology to be a soothing discovery that aligns everything around it, I want this reflected in the images.

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Figure 1b looks more, and not less complex, than figure 1a, which is unsettling. Partly this may be because the rectangles aren't clearly *either* the same *or* different between 1a and 1b, but *both* similar *and* different.

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I believe the idea you are trying to convey, is that psychotopological awareness makes self-regulation more straight-forward. (Correct me if I'm wrong.)

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TO REMEDY THIS visual confusion and better illustrate your primary point, I might suggest

*one* of the following changes:

- put the 2 images together (e.g. repeat 1a when introducing 1b) for comparison.

- leave big arrows from 1a in 1b, but cross out the old direction (or make bi-directional.)

- put the rectangles in classic Western left-to-right order:

*on the left* in 1a (as is), but *to the right* of the Distress=>Relief portion in 1b.

- cross out "dys" in all 3 rectangles, as well as the big arrows.

- leave out the large arrows and the words "Causes" and "Power lies here" in 1b,

entirely, and perhaps even the rectangularly-boxed, psychoanalytical, abstractions.

- emphasize the transformation of the rectangular boxes

"Neurochemical Imbalance => Balance,"

"Nervous System Dysregulation => Regulation" and

"Cognitive Dysfunction => Functionality"

by using small arrows similar to the ones around "Emotional Distress => Relief."

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Wow, thank you for this deep dive, Briana. When I look at the images after reading your comments, I see exactly what you mean, and how confusing/misleading they can be.

They definitely need some rethinking/revising, and I will do that at some point. My guess is that I'll be going through all this material in a couple of months, after finishing the mapping series and laying out the first phase of the science, in order to assemble it into the first volume of the psychotopology book series. For now, I'm going to stay on track with writing what's next and trust that to actually feed back into this and enable me to simplify these images even further.

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