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Psychosomatic Trauma WorkMartin 1

Psychosomatic Trauma Work

Monica R. Martin

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John F. Kennedy University

Spring 2012

Trauma exists in our society at a large scale, greatly effecting every person within the community; it touches those who suffer from it and those who come into contact with the sufferers. Trying to function without healing the trauma proves to be a significant challenge, especially when the larger ramifications are not always fully understood nor recognized. When a person experiences trauma, he or she has experienced a stressful event and then enters into a state of shock, whether this initially is emotional, mental, physical; it infiltrates all of the above. This traumatic experience now filters the person's perceptions, emotions, and bodily functions. Entering into a healing process takes a outstanding deal of courage, strength, and vulnerability. The obstacle in working with trauma is the pertinent need to deal with the body, mind, and emotions simultaneously. Working with one and neither of the others leaves shrapnel in the individual. With so many methods, listening to the body and the self is optimal to find the key the fits to unlocking the traumatic patterning. The key remains that no one singular is the precise key to unlock the trauma patterning. I want to propose the use of elements of Peter Levine's Somatic Experiencing combined with a yoga practice and including elements of touch therapy as one possibility to work with a trauma client.

Early Attachment Trauma (a basis for a understanding trauma development)

During the initial stages of life, an infant experiences crucial stages of development as she learns to interact with its external world while simultaneously developing its own sense of self and mastery over her own self. This development depends on the stability of the consistent presence of the caregiver to guide the child through her growth. When the baby is hungry, the stomach signals through the nerves to the brain to be fed, but she does not understand what this sensation and translate as discomfort and agitation. At these initial stages, the baby does not understand all the various stimulation occurring within and with out.

The mother's role is to assure the baby this feeling is not fearful and that the sensation will pass. As Ogden describes in Trauma and the body: a sensorimotor approach to psychotherapy“Born with limited capacities for self-regulation, human infants are dependent on the externally mediated interactive regulation of their primary attachment figures to maintain their arousal within the window of tolerance.” (p. 41) When the baby cries, the mom holds the child and with a reassuring touch and soothing voice, aids the baby with calming the nervous system down. The reassurance let the baby know that the signals from the body can be slowed down and controlled. The mom's touch, skin to skin, slowly bring the baby's awareness to security of the touch. In addition, the child learns how to use her breathing to put itself at ease.

Through relationship with another, the child develops an understanding of not only the external world, but more importantly of herself. This cannot be discovered without the mirroring of another person to provide feedback for the child. Without this education, the child does not learn how to work with its own body signals. Frighten and agitated, the infant's system elevates to overdrive and overwhelm. Ogden continues to point out that “Early disruptions in attachment have enduring detrimental effects, diminishing the capacity to modulate arousal, develop healthy relationships, and cope with stress.” (p. 41) The role of the mother is not only to teach the child to self-soothe, but also to provide the baby with consistency. With neglect increased agitation from the mother as a response to the baby, the baby grows confused and does not feel the external world nor others in the outside world are safe. Rather than coping and being able to ebb and flow with the constant shifts and changes in life.

So how one works with this state which has been ingrained in the person's being for years comes to question. How does one tap into both the psyche and the body?

Somatic Experiencing

Peter Levine's Somatic Experiencing (SE) treatment of trauma revolves around the nervous system and manages to return the system to a stabilized balance. When an individual is confronted with an experience which threatens the being's survival, the nervous system is activated to preserve life. The person experiences dilated pupils; increased heart rate; increased circulation to the muscles; decreased circulation to the digestive system; increased adrenaline; and so on. The senses are heightened so the person can scan for the most appropriate course of action, whether to fight, flight, or freeze. In doing so, the energy level is elevated to carry out said activity. After the threat is no longer present, discharging the energy and completing the cycle is necessary so the nervous system can return to a normal state of equilibrium. The discharge can take various forms such as shaking, vibrating, or even playful role enactment (Tiger 174).Basically, Levine explains the discharge as staying with the process all the way through to completion.

Without the discharge the individual remains in a constant overly heightened state. The nervous system does not know that the threat no longer exists, so it stays activated. Levine points out that

If we can discharge this energy while actively and effectively defending against threat (or shortly after the threatening event), the nervous system will move back toward a normal level of functioning. … If the threat has not been dealt with successfully, the energy stays in our bodies. We have now created a self-perpetuating dilemma. (Tiger 146)

The full process is an energetic wave which builds momentum; serves to protect; and eventually dispels; however, common practice for humans does not include the last piece of the sequence. Instead, the energy remains at the built up level of increased hyper-awareness. This new state of functioning becomes the re-established norm; and in order for the system to maintain, the person gravitates to situations which will continually stimulate the individual into hyper-vigilance. “When the energy of this highly activated state is not discharged, the organism concludes that it is still in danger. The effect of that perception on the organism is that it continues to re-stimulate the nervous system in order to maintain and augment that level of preparedness and arousal” (Tiger 147). Any fluctuation, increase or decrease, in the system can be a threat and can seem as dangerous. The self-perpetuating cycle sustains the symptoms and helps the nervous system keep the situation under control because in order to release the traumatic energy, the person would re-experience pieces of the trauma.

Through SE, Levine describes the healing process of “renegotiation” in terms of vortices. He describes the trauma creates a vortex, disrupting the nervous system. The body reacts and creates an opposing healing vortex to counter the trauma. The challenge is to carefully navigate between the two vortices, continually moving from one to the other until the energy at each core is dispelled. “We move slowly and rhythmically, back and forth, from one to the other. By beginning with the healing vortex, we pick up the support and resources needed to successfully negotiate the trauma vortex. By moving between these vortices, we release the tightly bound energies at their cores” (Tiger 199). The foundation of this healing resides in staying the felt sense; remaining present with the body; focusing on what the body is trying to tell the individual. Feeling into the sensation of the reactivated trauma, the both then renegotiates into the healing vortex to gather resources. In small adjustments, the body fluctuates back and forth to support a slow unwinding.

During an SE process, the therapist sits with the client as a vigilant guide in a way. The client begins with the healing vortex to gain awareness of his own resources to use if and when necessary. As he slowly enters into the traumatic vortex, the therapist watches the client's nervous system, and when the client appears to be unraveling too much, the therapist reconnects the client with the healing resources. As the client toggles back and forth between the two energy sources; images, thoughts, feelings, words my come up. However, to Levine, these play secondary roles to the primary role of the body's felt sense and the nervous system.

In addition, Levine stresses that memory is not a tool to work with. The images and thoughts that surface are not to be entangled with memories. He views memories as not reliable, and they re-traumatizes the individual and reactivates the nervous system feeding the trauma vortex. He claims that trying to resolve the trauma by means of a clear, concise answer as to what and why things happen merely moves the person away from the present felt sense experience and into a cerebral center. “In learning to define trauma by its symptoms, rather than by the event that caused it, we can develop perspectives that will help us recognize trauma when it occurs. This will enable us to flow with our natural responses rather than blocking in the innate healing process” (Tiger 152). Trying to think and analyze the trauma still leaves the nervous system and trauma vortex untouched and unhealed. The way out is the way through.

Once the trauma and the healing vortices have dispelled by staying with the flow through to the completion, the trauma no longer holds a charge for the individual. Not until then can the person reach the transformed state of potential wisdom.

In a transformation between a traumatic state and a peaceful state, there are fundamental changes in our nervous systems, feelings, and perceptions that are experienced through the felt sense. The nervous system swings between immobility and fluidity, emotions fluctuate between fear and courage, and perceptions shift between narrow-mindedness and receptivity. (Tiger 193)

The pendulum swings between yin and yang until the center is reached and release. The key is allowing the system to guide the individual through to the other side of healing, and once the individual passes through the renegotiation, new information can be received and wisdom is there to be gained.

Careful navigation between both states, trauma and healing, is a fragile experience. I personally experienced a SE session, and the guidance did not successfully navigate between the two vortices of trauma and healing. I was lead into re-activating the nervous system in order to release the trauma energy; however, I did not experience the trauma in small intermittent doses, between the healing energy. Instead, I was lead into the trauma and the energy was in fact intense and deep. Since I had not experienced this before and had not studied the method prior, I thought this was how SE worked with releasing the energy, to dive in deep and sit with what is coming up. Immediately after the episode, the therapist continually apologized, explaining that it was too deep, too fast, and too much. At the moment when I was in her office, I did not share the concern; I felt the intensity of the experience but not the overwhelming factor. Throughout the next few days for almost a week, I felt out of sorts, uncomfortable, “something wasn't right,” edgy, sick, and the like. In hindsight, I now understand why I encountered this as my body struggled to integrate. This all manifested because I did not allow for my body and being to slowly acclimated to each release of energy. The idea is to go into a little bit of the trauma, then swing into the healing to help the nervous system incrementally readjust to its new flow and increase the person's resourcing to increase function. With the first-hand experiencing of the overly enthusiastic release of the trauma without assimilation, I understand the importance of the slow navigation between the trauma and the resources when working with clients.

Yoga to a Practice to Reconnect to the Body

Yoga adds another layer into working with the trauma in addition to the somatic experiencing. The breath is the foundation of any type of yoga practice. Basic, yet profound, mindfulness can cultivate with simply following the breath to notice all the subtle nuances in the tissues, cells, energetic bodies. A solid yoga practice has to potential the work though the subtle layers of the trauma wounding. Individuals scarred with trauma have a strong tendency to disconnect from their body. Following the breath into the body begins the reconnection with the body and helps the person learn how to safely move through the somatic experience. Particularly in a Hatha Yoga practice, the poses are held through a few breaths, and allows space for the practitioner to really settle into her body through subtle micro-movements. Also, the individual can move through waves of sensations by following the breath. If the position is too much, alternative poses are always offered so that the yogi can find what best suits her, in her own body.

On a physiological note, yoga physically aids the body regain balance and homeostasis through the main body systems: respiratory, circulation, digestive, and nervous. The practice works with the breath and helps the individual deepen the breath with mindfulness; with the breath the heart rate and the blood also flow into sequence. Utilizing the breath aids in calming the heart-rate and helps the practitioner regulate their own breath. Accordingly, with the slow, mindful breath, the nervous system communicates with the rest of the body to decrease stimulation.

What works well for trauma individuals is the invitation from the teacher, as guides the individuals in the class to follow the breath, to breathe in to his or her own comfort level; to listen to the body; and to just notice where the breath goes and where it wants to move. A simple invitation allows the person to stay in control and have authority over his or her actions and experience.

Yoga practice centers on staying with the present moment, this is a significant piece of work as the trauma individual has difficulty focusing on the present and no differentiation between past and present do not exist. As Maryanna Eckberg points out in Victims of cruelty: somatic psychotherapy in the treatment of posttraumatic stress disorder (2000), “In shock trauma the organism is overwhelmed beyond its capacity to cope and enters a state of shock. Its organization is profoundly altered. The entire system of perceiving, thinking, and behaving changes. There is no continuity between past and present.” (p. 2) The perceived threat constantly exists for the individual, regardless if the actual threat is not actually present, and the person system is stuck in the paralysis of hopelessness from the past. Yoga slows time down and works with each and every moment. The directive is to notice the body, follow the breath, reclaim connection and power with one's own system.

Again, the process of the trauma returns to the important relationship with another. In this case, the relationship is between the yoga teacher and the practitioner. Yoga in general can assist with helping the client regain a sense of self; however, if working with a teacher who specifically has studied and heightened his or her own awareness about how trauma runs through the system, a beautiful connection can be established. The teacher is there to support; to guide; to hold space; to witness the process of the trauma client.

In combining the modalities of Somatic Experiencing and yoga, the therapist can truly integrate the mindfulness, breath work, bodywork, and psyche to complete the process of fear locked in the individual. Both emphasize the teaching of resourcing tools and elevating awareness of the individual's being. The slowly work back and forth between the two, the subtle micro-movements and micro-processes do not miss the hidden moments of stuckness and edges to unravel.

Necessity for Touch with CranioSacral Therapy

As discussed at the beginning of the paper, the touch is a crucial element initial learning process of regulating the body system. With that in mind, including a touch element facilitates the continual healing process of trauma. At present, touch is a highly controversial topic in the therapeutic world legal vs. illegal; ethical vs. unethical; allowance vs. manipulation. As a bodywork, I cannot resist the desire to integrate touch in the therapeutic setting. With a heavy side note, the proper training, skill, and awareness are necessities to integrate this into practice.