Bevis Nathan DO (Hons)
MA, Dip Paed Ost, SEP

I’ve been working in health care for thirty four years; first as a clinical chemist and phlebotomist, then joining the British School of Osteopathy in 1982, graduating in 1986 with honours and prizes, and finally reinventing myself as a trauma therapist in 2009, using the technique known as Somatic Experiencing. I’ll tell you why I did that later…..

I’ve lectured at home and abroad in various under-graduate and post-graduate subjects, my favourite being the psychological effects of osteopathic and therapeutic touch. I now teach occasional post-grad courses in traumatology to osteopaths. My MA was in health care philosophy and medical ethics, I studied paediatric osteopathy as a post-grad diploma, and I taught medical ethics for Bristol University’s adult education programme. That’s the boring stuff.

Soon after qualifying as an osteopath I realised that no-one was talking about – let alone teaching – the more mysterious, maybe psychological and emotional effects of osteopathic treatment. So I researched the subject and after a few preparatory articles the end result was ‘Touch and Emotion in Manual Therapy’ (Churchill Livingstone 1999), a textbook for manual therapists. In it I set out firstly to explore the philosophical basis of osteopathy, and explain what’s missing from it, and secondly to reveal all the evidence indicating that when people get touched as part of any therapy, there is always – and I mean always – a psychological effect. I was interested in what this effect could be. I still am. Of course, it’s different for everyone. For some it might appear trivial; for some it’s massively important.

 

Mind-Body Medicine

This leads us inevitably into the field of so-called ‘mind-body medicine’ – that is, addressing people’s health problems and concerns as problems of people – not of mechanical bodies. Bodies are not mechanical. Ok, they’re partly mechanical, obviously, but an upbeat, positive, honest, grateful and loving person with good relationships and sense of meaning and purpose in life is going to have a healthier body, that’s for sure.

Anyway, to continue this ramble, I was, and am still, deeply interested in the wider, broader contexts of why people get ill, and what makes them get better. ‘Holistic’ medicine, you might call it. Sadly, the word ‘holism’ seems to have had a bad press and has been hijacked and misunderstood by the new age movement, so I prefer ‘whole person medicine’, or ‘medicine as if people matter’, or something like that.

I wondered if I might combine some sort of psychotherapy with osteopathy, and so I researched and trained a little in Gestalt, Transactional Analysis, Biosynthesis, Biodynamic Massage and Bioenergetics (look them up – most are biologically-based psychotherapies (not TA), using models that attempt to bring together, in some way, mental functioning and the anatomical and physiological organisation of the body). All are interesting and useful, but all are speculative – speculative in terms of truly integrating behaviour, feeling and thought with bodily health.

So I decided to specialise in the treatment of children and took a post-grad diploma at the Osteopathic Centre for Children in London. Now children are very interesting because little ones have not yet learned to separate mind and body in the way adults have, and you cannot treat them as if their bodies had somehow ‘gone wrong’. Children need to be loved and held and – here’s the important bit – made to feel safe, in order to get the most out of medicine in general and osteopathy in particular. And children love to be touched. Actually, it turns out adults need all this too, but sometimes being grown up means we pretend we don’t.

I learned a lot about honesty and presence from treating kids and continued looking for a satisfying way to integrate osteopathy with the more psychological and emotional stuff.

My Traumatic Experience

And then we all nearly died – in the tsunami of Boxing Day 2004. My wife and I and three kids were in Sri Lanka, in our beach huts, a few metres from the water, and the sea came into our bedrooms. Now the sea is not supposed to come into your bedroom, as my daughter astutely  pointed out, but it did. And it swept us off our feet and swirled us around and pushed us against the roof of the hut. I had managed to get into the kids’ hut and tried to grab them. But you can only grab two children when you’ve got two arms, and my daughter, who was furthest away, couldn’t get to me, and I couldn’t get to her. She disappeared out the door of the hut and out to sea (as it turned out, at the same time as my wife was washed out of her hut). Her screams were drowned out by the noise of the water.

The first thing I learned about life-threat and trauma that day is that there is absolutely no room for sentiment when you are fighting with every fibre of your strength to save your life and the lives of your loved ones. There is no space or time for it. You fight, you make split second decisions that are not decisions because they are instinctive reflex behaviours reacting to what is happening now. My daughter had gone and I and my sons were being pushed up against the roof of the hut by the water, and we were all going to die because there was no air left. I remember thinking, in an instant, that I could not cope watching my boys die, and so I straightened my arms and pushed the boys up against the roof of the hut so they could grab the last remaining air bubble, while I submerged myself and prepared to drown.

Five seconds later, the hut broke apart. Good timing, huh? We surfaced in the torrent, surrounded by roof debris, but able to breathe and hold on to a joist. One minute later, the water got bored of being where it shouldn’t and decided to go somewhere else – it left the beach and the town and retreated hundreds of metres out, dumping us on a moonscape of flapping fish, rocks and huge long-spined sea-urchins. Some friends grabbed the boys and only then did the overwhelming terror and grief of realising my daughter and wife were probably dead suddenly visit me. I became unhinged and, yelling and crying, started running out over the sea bed to search for them. But without my specs I couldn’t see, and at the point when I collapsed, unable to run or even walk due to feet filled with sea urchin spines, I heard Bill shout ‘I can see them’. (Bless you, Bill.) And there were Rachel and Charis walking languidly in from the sea, wide-eyed, covered in scratches, but very much alive.

I’ll stop the story there (with difficulty, cos it’s a good story). Suffice it to say that, thanks to fate, or whatever it is, whereas several people died on our beach, a few miles down the road at the next town, thousands died. We were still alive, probably because of a geological quirk at the headland of our beach that refracted the wave into three separate smaller ones.

I learned two more important lessons that day. One – and this is the vital thing – if you utilise, in the moment, the incredible fight-and-flight adrenalised energy generated by life-threatening events, and you triumph; you will not suffer from post traumatic stress disorder (PTSD). If you are helpless and overwhelmed, you are vulnerable to it. Two, you can be overwhelmed in different ways; my inability to save my daughter was a form of helplessness, leaving me – for a short while only – with unutterable terror and grief. So even though I ran and screamed to try to find her, using up masses of energy, the knowledge that she was gone was overwhelming in its impact, and I suffered a small PTSD from that process – even though she survived.

I’ll cut the rest of this short, and I apologise for having gone on for so long. A few months later, I read about the post-trauma work being done with the tsunami survivors in southern India using a technique called ‘Somatic Experiencing’. It was extraordinarily effective in bringing people out of the extreme shut-down and shocked states that threatened their subsequent well-being. I attended a conference on the subject of trauma, booked myself on a workshop and subsequently took the three year Somatic Experiencing training programme – the first of its kind in the UK. I qualified in 2009 and have been using it and teaching it ever since.

Somatic Experiencing

Here’s why it’s so good; Somatic Experiencing addresses those aspects of the nervous system that deal with survival energy and survival behaviour. But it turns out that this ‘autonomic’ nervous system, together with certain more primitive parts of the brain, is also involved in organising all unconscious functions, from digestion, hormone metabolism and immune system function, to muscle tone and tension, emotional expression and interpersonal behaviour. The upshot of this is that it’s a brilliant tool for dealing with all sorts of situations where the problem is that the nervous system has become dysregulated in some way. I had found my ideal ‘link’ between bodily disorders and emotions and thoughts.

On that note, there is increasing recognition of medically unexplained physical symptoms (MUPS). Looking at a list of them, they tend to fall into three recognisable categories. One, disorders which modern medicine simply does not recognise or is only just beginning to. Two, so-called psychosomatic illness. Three, post-traumatic disorders. My current thinking is that patients in all these categories have probably suffered some kind of trauma – it’s the thing that messes up our psychological, biochemical and mechanical functioning the most. I would say that my expertise lies in the diagnosis of problems in these areas. If I think I have the right skills to help, I’ll use a combination of Somatic Experiencing, Osteopathy, breathing pattern re-training and other exercises. If not, I’ll refer you to one of my colleagues who has more appropriate skills.

(I write more about trauma and SE under the section on trauma,  PTSD and SE on this site. If you’re interested, read Peter Levine’s ‘In an Unspoken Voice’, and look on Utube for professor Stephen Porges’ lectures on Polyvagal theory.)

So, there we are. I use Somatic Experiencing and Osteopathy – sometimes both, sometimes one or the other – to help patients who are having problems with pain syndromes of all sorts – from headaches and back injuries to fibromyalgia and full blown Post Traumatic Stress Disorder – with its impressive array of symptoms. I suppose you could say my special interests are trauma and shock resolution, psychosomatic illnesses and the osteopathic treatment of children. Pain is the thing that brings half of my patients to me. Symptoms caused by shock (panic attacks, feeling disconnected, over-alert, fearful states – to name but a very few) make up the other half. Perhaps my principal talent (apart from playing the guitar, at which I’m improving slowly but surely) is as a diagnostician of as yet unexplained symptoms. I will build a thoroughly honest and frank relationship with you as we figure out how to get you well, devoid of power games and psychobabble (life’s too short).

Therapies I offer

 

“I live in Nigeria, and on my errand-packed trips to London I tried to squeeze in as many sessions as possible with Bevis. Helping me with my lower back pain, and relieving me from the effects of poor posture are only side benefits of these treatments. For me the real healing was in entering a room that has not even the slightest trace of judgment, not even when I argued the damming effect of towering stilettos on my back were negated by my altitude slickness, or when I admitted to not doing any of my exercises for months at a stretch. The only time I felt judged was upon uttering any unnecessary “sorries”. He once made me count how many times I said sorry in a session; it has since become one of my least used words, and for that I am grateful. This may sound strange but I must confess, I am not sure if I ever wanted the health of my back to improve. During an extremely emotional and challenging journey, laying in the care of a confidant, friend, and certainly a healer: that practitioner’s table holds a spot as one of only two places in the world where I felt safe and supported. Bevis helped me with many obstacles, and steered me to start overcoming my fears with compassion, understanding, and more often than not, witty banter. Even when we do not communicate for months at a stretch I know I can reach out to Bevis. Every time I am stressed or afraid, I hold on to his voice telling me not to be so hard on myself, drop my shoulders, and not to brace and store all my emotions. I also hold on to his words of support and belief in my abilities to make certain changes in my life.

 

Thank you Bevis; you have played a larger role in my journey than you know!”

-Madhu Hemnani