Levine Trauma
This is an introduction to the ideas
of Peter Levine around trauma. It is good to keep in mind
that he has a particular way of defining trauma operationally, and
he then presents a theory of how trauma happens ... basically that
the animal/person goes into freeze state after fight or flight,
but that instead of having a normal process of emmerging back into
motion, the animal's neo-cortex in effect circumvents the normal
hindbrain processes and causes the animal to come back into motion.
This then has the effect of leaving certain hindbrain directed processes
and coordinations still dysfunctionally frozen, manifesting in what
we observe in someone as "trauma". (This dovetails very well,
by the way, with Julian Jaynes late 70's sketch of the emergence
of consciousness as a trauma responce ... The
Origin of Consciousness in the Breakdown of the Bicameral Mind.)
He then describes a purely physical process of reintegrating the
frozen hindbrain coordinations through attempting "completion" of
the movement... not a unique idea to his work, but something that
he spends a great deal of energy reseraching and coming to understandings
of. A great advantage to this work is that it is not based
on verbalized story... one doesn't have to dredge up memories of
what caused the problem, and thus avoids all of the pitfalls of
this approach, including restimulating and reinforcing the trauma
pattern, fabrication of false memories (1980s Recovered Memory Movement
as well as certain aspects of the current resergence of "Encounter"
practices), and difficulties dealing with people who can't remember
(like with amnesia nbased in brain trauma).
I think his framework for understanding trauma is at the very least
an excellent starting place. The twitches and fear responces
revealed in the passive sequencing work are basically revealed trauma
in this Levine sense of the term. I also think that the inhibition
techniques that we use in passive sequencing study, which are perhaps
more closely linked to Alexander technique, represent a totally
different approach to get to the same or at least a very similar
end result of renitegration of the hind brain and destimulation
of trauma responces. I think that the two practices compliment
each other well...
Memory,
Trauma & Healing
by Peter Levine, Ph.D.
The
brain's function is to choose from the past, to diminish it, to
simplify it, but not to preserve it.
--
Henri Bergson
from The Creative Mind, 1911
For therapists,
the current controversy surrounding so-called false ''recovered''
traumatic memories raises a number of compelling questions. Where
do these 'false' memories come from and what is their function?
More importantly, what role does memory play in the understanding
and treatment of trauma?
Around 1900, the
French philosopher Henri Bergson gleaned deep insights into the
nature of memory that are just now being appreciated by contemporary
researchers and clinicians. Bergson theorized that there are two
fundamentally different forms of memory; one conscious, the other
unconscious. Neuroscientist Daniel Schacter (1996), in a readable
volume entitled Searching for Memory, describes his examination
of a patient with a serious head injury. This man (called Mickey)
had little memory of his recent experiences. Schacter asked Mickey
a series of obscure questions such as ''Who holds the worlds record
for shaking hands'' and ''Where was the first baseball game played?''
Not surprisingly, Mickey did not know the answers to these questions.
Schacter then gave them to him. When asked the same questions twenty
minutes later in another room, Mickey correctly answered Teddy Roosevelt
and Hoboken, New Jersey, etc., to the trivia questions. However,
he had no recollection of how he got this information and thought
that perhaps it might have been from his sister. Although he had
an implicit memory of his meeting with Schacter twenty minutes earlier,
he had no explicit memory of it.
Similar observations
and extensive experiments have been carried out by experimental
psychologists, cognitive neuroscientists and clinicians, confirming
that we humans have two distinctly different forms of memory; one
explicit and conscious, the other implicit and unconscious. The
description by Schacter of Mickey's strange behavior illustrates
the curious ''dissociation'' between the conscious and unconscious
aspects of memory.
Of particular
significance in working with and understanding trauma, is a form
of implicit memory that is profoundly unconscious, and forms the
basis for the imprint trauma leaves on the body/mind. The relationship
between implicit and explicit aspects of an experience is an important
dynamic in the resolution of trauma and in the question of false
memory.
Memory as Procedure
The type of memory
utilized in learning most physical activities (walking, riding a
bike, skiing, etc.) is a form of implicit memory called ''procedural
memory.'' Procedural or ''body memories'' are learned sequences
of coordinated ''motor acts'' chained together into meaningful actions.
You may not remember explicitly how and when you learned them, but,
at the appropriate moment (like Mickey's trivia knowledge), they
are (implicitly) ''recalled'' and mobilized (acted out) simultaneously.
These ''motoric memories'' (action patterns) are formed and orchestrated
largely by involuntary structures in the cerebellum and basal ganglia.
Procedures are
primarily non-conscious, and attempts at conscious learning are
generally counter-productive. Imagine trying to learn how to ride
a bicycle, ski or have sex from written instructions. It cannot
be done. A book may point you in the direction of where to begin,
but the learning occurs through instinct, trial and error.
Trauma is about
procedures the organism executes when exposed to overwhelming stress,
threat and injury. The failure to neutralize these implicit procedures
and restore homeostasis is at the basis for the maladaptive and
debilitating symptoms of trauma.
Completion and
Remembering
Acts must be carried out to their completion. Whatever their point
of departure, the end will be beautiful. It is (only) because an
action has not been completed that it is vile.
--
Jean Genet, from Thief's Journal
In response to
threat and injury, animals, including humans, execute biologically
based, non-conscious action patterns that prepare them to meet the
threat and defend themselves. The very structure of trauma, including
activation, dissociation, and freezing are based on the evolution
of reptilian, mammalian and primate predator/prey survival behaviors.
When threatened or injured, organisms draw from a ''library'' of
possible motoric responses supported by adjustments in the autonomic
and visceral nervous systems. In response to threat and injury we
orient, dodge, duck, stiffen, brace, retract, fight, flee, freeze,
collapse, etc. All of these coordinated responses are somatically
based-they are things that the body does to protect and defend itself.
It is when these orienting and defending responses are overwhelmed
that we see trauma.
The bodies of
traumatized people portray ''snapshots'' of their unsuccessful attempts
to defend themselves in the face of threat and injury. It is because
they have been overwhelmed that the execution of their normally
continuous responses to threat have become truncated. Trauma is
fundamentally a highly activated incomplete biological response
to threat, frozen in time. For example, when our full neuromuscular
and metabolic machinery prepares us to fight or to flee, muscles
throughout the entire body are tensed in specific patterns of high
energy readiness. When we are unable to complete the appropriate
actions and discharge the tremendous energy generated by our survival
preparations, this energy becomes fixated into specific patterns
of neuromuscular readiness. Afferent feedback to the brain stem
generated from these incomplete neuromuscular/ autonomic responses
maintains a state of acute and then chronic arousal and dysfunction
in the central nervous system. Traumatized people are not suffering
from a disease in the normal sense of the word. They have become
fixated in an aroused state. It is difficult (if not impossible)
to function normally under these circumstances.
Residual incomplete
responses (the ''snapshots'' of unsuccessful attempts at defense)
are the basis of (implicit) traumatic memory. Just as Mickey was
unable to remember the source of his trivia information, trauma
is not ''remembered'' in an explicit, conscious form. It is coded
as implicit procedures based on biological survival reactions. These
incomplete procedures seek completion and integration, not (explicit)
remembering. The compulsion that so many trauma survivors have to
''remember'' is often a misinterpretation of the profound urge to
complete the highly charged survival responses that were aborted
or truncated at the time they were overwhelmed. This is a significant
factor in the genesis of spurious memory.
In an attempt
to rationalize their highly activated (incomplete) survival responses,
traumatized people will often create explicit stories that energetically
match their internal experience . These ''memories'' may be accurate
only in the sense that they are metaphors for what is stored implicitly.
Many survivors of trauma need an ''explanation'' for their disturbing
internal states. For example, I have worked with numerous people
who came to me fairly certain that they had been molested or raped
as children. In many cases the people were correct, but not in all
of them. Several clients had created interpretations that seemed
to explain their symptoms, but, in fact, they had been traumatized
by early childhood surgical procedures. To a child, a frightening
surgical procedure can be experienced very much like a rape.
Whether you can
remember a traumatic event explicitly is not highly significant
for healing to take place. Trauma is implicit. What is significant
in the resolution of trauma is the completion of incomplete responses
to threat and the ensuing discharge of the energy that was mobilized
for survival. When the implicit (procedural) memory is activated
and completed somatically, an explicit narrative can be constructed;
not the other way around. In this way, survivors can begin to re-member,
i.e., to associate the dissociated aspects of their body experience
and thaw the frozen energy that is at the core of their trauma.
In doing this, they begin to integrate implicit experience into
coherent conscious narratives. These stories are neither true nor
false. They contain a balance of elements, some of which are historically
accurate, some are symbolic of feeling states, while the primary
function of others is to promote the healing process.
Jody
Twenty-five years
ago Jody's life was shattered. While walking in the woods near her
boy friend's house, a hunter came up to her and began a conversation.
It was mid-September. There was a chill in the air--her boyfriend
and others thought nothing when they saw someone apparently chopping
wood. A madman, however, was smashing Jody's head again and again
with his rifle. The police found Jody unconscious. Chips from the
butt of the rifle lay nearby where they had broken off in the violent
attack.
When I first saw
Jody two years ago, the only recollection she had of the event was
scant and confused. She vaguely remembered meeting the man and then
waking up in the hospital some days later. Jody had been suffering
from anxiety, migraines, concentration and memory problems, depression,
chronic fatigue and chronic pain of the head, back and neck regions
(diagnosed as fibromyalgia). She had been treated by physical therapists,
chiropractors, and various physicians. The year before I saw her
she had slipped and fallen on her back while ice skating. After
this event she was barely able to function.
Jody, like so
many head-injured and traumatized individuals, grasped desperately
and obsessively in an attempt to retrieve memories of her trauma.
She seemed driven by the unconscious belief that if she could only
capture the memory, she would somehow be released from the shattering
grip of her experience. In our first session Jody struggled to remember,
to piece together vague images from the hospital and the faint recollection
of talking with the hunter; but nothing would come; only intense
frustration....grasping, grasping....trying to go back to the scene
and return with the whole self she knew before the injury.
When I suggested
to Jody that it was possible to experience healing without having
to remember the event, I saw a flicker of hope and a momentary look
of relief pass across her face. We talked for a while, reviewing
her history and struggle to function. After traumas such as Jody
experienced, previously normal people often feel that they are pushed
to the edge of insanity. Jody was haunted by the unthinkable fear
that she was damaged forever.
Focusing on body
sensations, Jody slowly became aware of various tension patterns
in her head and neck region. With this focus on the ''felt sense,''
she began to notice a particular (internal-kinesthetic) urge to
turn and retract her neck. In allowing this ''intention'' to execute
as slow gradual ''micro movements'' she experienced a momentary
fear, followed by a strong tingling sensation.
By allowing these
involuntary ''intentional movements'' to emerge and ''gradually''
to complete, Jody began a journey into and beyond the deeply unconscious
implicit ''memory traces'' of her traumatic assault. In learning
to move within a dynamic tension between flexible control and surrender
to these involuntary movements, she began to experience gentle shaking
and trembling throughout her body. Thus began, ever so gently, the
discharge of her truncated energy (not from explicit memory-she
had none at this time). Jody's implicit memory was leading her home.
In later sessions,
her head would turn away, while her arms and hands moved slowly
upward and outward in a protective stance. These spontaneous movements
were sometimes accompanied by brief animal-like shrieks almost identical
to the distress calls recorded in species as diverse as birds and
monkeys. She then felt the impulse in her legs to run, followed
by more aggressive postures. She bared her teeth slowly, and, using
her hands as if they were claws, experienced the urge to strike
back at her assailant. Jody then became aware of (vestibular) sensations
of falling. She felt the impact of the fall, followed by sensations
of pain and bruising on the front and back of her head.
By completing
these various defensive, distress and orienting responses, Jody
was able to construct a sense of how she (her body) prepared to
react in that fraction of a second when she was attacked. She became
aware of head pulling back and away, a flash of the rifle butt coming
toward her, her hands and arms moving upwards, the frozen impulse
to run and the sense of running, the deep sense of fighting (trembling),
the smash on her head, a quick whiff of the assailant's peculiar
odor-then, the fall forward onto her face and the repeated blows
to the back of her head. In being able to stretch out, in time,
this highly impacted shock imprint, she not only implicitly ''remembered''
the event, but began to experience deep organic discharge and her
body's innate capacity to defend and protect itself. In moving ahead
in time from where it had been arrested twenty-five years ago, Jody
proceeded gradually toward the restoration of her shattered self.
In the Theater
of the Body
While explicit
memory is accessed primarily through cognition, implicit memory
must be reached through the body. The ''felt sense,'' as Gendlin
calls it, (though we use it daily) is relatively undeveloped in
most ''post-industrial'' adults. This ''felt sense'' is made up
of kinesthetic, proprioceptive, vestibular and visceral (autonomic)
information channels. Afferent flow enters the brain stem as non-conscious
(instinctual) information, and is then elaborated upon by the limbic
(emotional) and neo-cortical (cognitive) brain structures. Through
the felt sense, interoceptive information (which forms the unconscious
background of all experience), can be integrated and brought into
a conscious figure.
Jody, through
her felt sense, was able to extract the ''intention'' signal to
move her head from the background noise of random tension. To reiterate;
intentional movement is non-conscious -- it is experienced as if
the body was moving on its own volition, not by conscious effort.
By following these intentional impulses, various spontaneous (but
organized) micro-movements were initiated. This was accomplished
by the discharge of the incomplete survival response in the form
of gentle shaking and trembling movements, along with beads of cold,
then warm perspiration.
Jody was becoming
deeply resourced by her biological capacity to defend herself, as
well as by the discharge of energy and her new-found ability to
move between conscious control and surrender to the realm of involuntary
sensation. In that fraction of a second, when the madman raised
his rifle, Jody's primitive body/mind oriented and sorted hastily
through the possible defensive procedures available to her. Although
she did not get to execute most of these implicit procedures at
that time, her body had been energetically prepared to do so. In
completing these life preserving actions twenty-five years later,
she released that bound energy and added to her resources the felt
realization that she had, in fact, attempted to defend herself.
Out of Africa
I recently described
the particular type of spontaneous shaking, trembling and breathing
that Jody and other clients exhibit in their sessions, to Andrew
Bwanali, park biologist of the Mzuzu Environmental Center in Malawi,
Central Africa. He nodded excitedly, then burst out;
''Yes.....yes.....yes!
That is true. Before we release captured animals back into the wild,
we make absolutely sure that they have done just what you have described.''
He looked down at the ground, then added softly; ''If they have
not trembled and breathed that way before they are released, they
will not survive.... they will die.'' Although humans rarely die
from trauma, their lives are severely diminished by its effects.
Fortunately, trauma does not have to be a life sentence.
Renegotiation
- Somatic Experiencing
''Renegotiation''
is a word I termed to describe the process of healing or resolving
trauma. It is the gradual, resourced discharge of the highly compressed
survival energies, accompanied by a ''retrospective'' completion
of biological defensive and orienting responses that were frozen
at the time of overwhelm. It is not a cathartic reliving of the
traumatic event, a method that can lead to re-traumatization.
Somatic Experiencing
(SE) is the name I have given to this work. It is a naturalistic
approach to the healing of trauma developed over the last twenty-five
years. SE is based on the understanding of why animals in the wild,
though their lives are threatened routinely, are rarely traumatized.
Their ability to discharge fully the highly activated energies mobilized
for survival and then reorient (resume normal functioning) points
to an innate, instinctual capacity for the resolution of trauma.
This innate capacity is shared by humans, and is a potent resource
when appropriately utilized.
The foundation
of Somatic Experiencing is built upon a tradition of somatic education
and body-oriented psychotherapy. It draws upon the neurobiological
study of the multi-directional interconnection between the body,
brain and mind. Post traumatic stress is viewed not as a permanent
neuropsychological disease, but as a functional and largely reversible
distortion in the multi-dimensional somatic and autonomic pathways
that meld the mind and body. SE examines the critical pathways whereby
afferent information from muscles, joints and viscera is fed back
sequentially to primitive portions of the brain to regulate survival
behaviors.
This approach
uses education about and awareness of body sensations as a primary
tool to alter these pathways. When appropriate, gentle manipulation
of the muscles, joints and viscera is employed. The biological strategies
that enable animals to restore homeostasis after being aroused by
threat are learned by traumatized individuals. Empowered with these
innate resources, people can transform trauma. This healing journey
occurs primarily biologically and archetypally, not cognitively
and biographically.
The Physiology
of Trauma
When Jody began
to gradually access and discharge the activation bound in the muscles
of her head, neck and shoulders, allowing the completion of truncated
protective and defensive responses, her nervous system was able
to alter its regulatory ''set point'' for arousal. Most psychiatric
researchers believe that the brain chemistry is permanently altered
as a result of trauma. For example, it is thought that neurons in
the Nucleus Locus Coerulius (NLC), (part of the Reticular Activating
System-RAS), become stuck in a fully activated state. As a result,
this nucleus sends adrenergic (adrenaline-like) fibers into both
the limbic and neocortical brain systems, maintaining high arousal
levels throughout the brain. In order to combat this phenomenon,
medical research is looking for potential drugs that would specifically
block NLC-RAS activity.
What is being
overlooked, however, is that the NLC receives a major portion of
its input from sensory receptors in the head, face, neck and visceral
organs. When a person perceives threat through primitive brain structures,
muscles in the head, neck and viscera are activated in readiness
to initiate the appropriate survival responses. At the same time,
fibers from the NLC are busy arousing the entire brain through the
RAS. Simultaneously, fibers from the brain stem and limbic system
further activate muscles in the head, face, neck and viscera-which,
in turn, send more impulses back inward to the NLC,...etc., etc.
If an organism
is unable to completely discharge the escalating nervous system
activation through life preserving action (i.e., fight or flight),
then that mobilized energy will become locked in the somatic (head,
face, neck, viscera) -- NLC loop. A classic ''snowball rolling down
the hill'' positive feedback system is created that will reverberate
until the survival responses are completed and the energy discharged.
If not, the activation will develop into the complex symptoms of
trauma. For this reason, preventative measures are vital after overwhelming
events. Without them, somatic and dissociative symptoms will form
to bind the highly activated, but undischarged survival responses.
The formation of trauma symptoms is a non-conscious adaptation whose
purpose is to prevent the organism from being further overwhelmed.
Though it is much easier to prevent trauma, it is still possible
to resolve many of the effects of even deeply entrenched traumatic
symptoms.
Each time Jody
was able to complete the truncated defensive and protective actions
locked in her head and neck and discharge the energy bound there,
she was able to remove ''fuel'' from the NLC/RAS-neuromuscular feedback
loop. This resulted in a gradual, progressive deactivation of the
global arousal system governing her brain and body.
Memory and Healing
Jody's essential
experience of herself began to change as she completed and integrated
the truncated implicit procedures. The question of whether she remembered
what actually happened is largely irrelevant. In completing the
implicit survival procedures, she began to form a fresh narrative.
This new story incorporated archetypal imagery, sensations, feelings
of death, renewal and rebirth, as well as images from the event.
As she gently trembled and quivered, visions of quaking aspens replaced
the fearful images of her assault.
One of the paradoxical
and transformative aspects of implicit traumatic memory is, that
once it is accessed in a resourced way (through the felt sense),
it, by its very nature, changes. Out of the shattered fragments
of her deeply injured psyche, Jody discovered and nurtured a nascent,
emergent self. From the ashes of the frantically activated, hypervigilant,
frozen, traumatized girl of twenty-five years ago, Jody began to
reorient to a new, less threatening world. Gradually she shaped
into a more fluid, resilient, woman, coming to terms with the felt
capacity to fiercely defend herself when necessary, and to surrender
in quiet ecstasy
Nature's
Lessons in Healing Trauma
by Peter Levine, Ph.D.
Trauma is a Fact
of Life
A single brief
exposure to an overwhelming event can throw a normally functioning
individual into an abyss of emotional and physical suffering. Whether
or not a person rebounds from this dark edge of near insanity or
tumbles more deeply into the ''black hole'' of trauma remains a
mystery. Modern psychiatry has little understanding of why one individual
helplessly succumbs to a traumatic circumstance, while another remains
unscathed or even fortified from the same event.
Because human
responses to potential threat vary so greatly, it is difficult to
identify or classify sources of trauma. Most people (both lay and
professional) associate trauma with events like war, extremes of
physical, emotional or sexual abuse, crippling accidents, or natural
disasters. However, many ''ordinary'' or seemingly benign events
can be equally traumatic. For example, so-called minor ''whiplash''
automobile accidents frequently lead to bewildering and debilitating
physical, emotional, and psychological symptoms. Common invasive
medical procedures and surgeries (particularly those performed on
frightened children who are restrained while being anesthetized),
can be profoundly traumatizing. Children often become fearful, hyperactive,
clinging, withdrawn, ''bed-wetters'', or impulsively aggressive
after such ''routine'' events. Sometimes the effects from these
experiences do not show up for months or even years. They may appear
in the form of ''psychosomatic'' complaints (such as head and tummy
aches) or as inexplicable anxiety or depression.
Many people express
their symptoms by compulsively ''acting them out''. The parents
of convicted mass murderer Jeffrey Dahmer and Ted Kaczinski (the
alleged ''Unabomber'') have given poignant and sobering descriptions
of the formative effects that childhood medical procedures had on
their sons. Dahmer's father and Kaczinski's mother both describe
the profound disconnection, despair, isolation, and bizarre behaviors
that their children began to exhibit after being terrified by medical
procedures. Following a hernia operation at age four, young Jeffrey
Dahmer seemed to ''snap.'' He later began to repeatedly cut and
remove the intestines from dead animals. This behavior can be viewed
as an attempt by the boy to overcome and master the helpless terror
induced by the surgical procedure that he experienced as an evisceration.
At the tender age of nine months, a terrified Kaczinski was strapped
to a table after resisting a physical examination. Years later,
the sight of an immobilized tree shrew captured by his father drove
Kaczinski into fits of hysterical rage and terror. The perplexed
parents of these two men have spent anguished hours contemplating
what effect these events may have had on their sons lives.
In a more ''ordinary''
story from the pages of Reader's Digest entitled Everything is not
Okay, a father describes his son Robbie's ''minor'' knee surgery:
The doctor tells me that everything is okay. The knee is fine, but
everything is not okay for the boy waking up in a drug induced nightmare,
thrashing around on his hospital bed-- a sweet boy who never hurt
anybody, staring out from his anesthetic haze with the eyes of a
wild animal, striking the nurse, screaming 'Am I alive?' and forcing
me to grab his arms....staring right into my eyes and not knowing
who I am.
Unfortunately,
stories like this are commonplace events often leading to the formation
of tragic psychic scars. I am not attempting here to excuse or even
explain the violent and abhorrent actions of anyone. Whether ''ordinary''
events can account for the extreme behaviors of some people is a
question that needs to be addressed, but it is not the point I am
making. What is vitally important for us to understand is that events
which hardly seem traumatic can be as traumatizing as the horrors
of war. Dr. David Levy (writing in 1946) found that children in
hospitals for routine reasons often experienced the same kinds of
severe symptoms as ''shell-shocked'' soldiers that had to be brought
back from the front lines in Africa and Europe. Sadly, our medical
establishment has been slow to acknowledge and incorporate this
extremely vital information, which, if implemented, could prevent
unnecessary suffering from the debilitating effects of trauma. It
is evident that what makes an event potentially traumatizing is
the perception (conscious or unconscious) that it is life-threatening.
It has only been
in the past ten to twenty years that trauma has been widely recognized,
although its essence was long ago powerfully captured by the Homeric
Greeks, the ancient Sumerians, and through the eyes of Shamans from
many indigenous cultures. Recent scientific research has been instrumental
in helping to reframe trauma in a modern context, thus removing
some of the stigma attached to it. New studies and medical treatment
have inspired a modicum of hope for the alleviation of this particular
kind of suffering. Psychiatry has not, however, captured the essential
nature of trauma, nor has it uncovered if, or by what means, it
can be healed.
The leading edge
of theoretical and clinical work on Post Traumatic Stress Disorder
(PTSD) takes a disturbingly mechanical view of human trauma, and
is, I believe, fundamentally misleading. For example, there has
been a recent attempt to find a causal link between trauma and brain
pathology. Vietnam veterans with long standing PTSD, when autopsied
after death, showed ''shrinkage'' in the hippoccampus ( a region
of the limbic/emotional brain involved in learning). This phenomenon
has been corroborated by laboratory research that detected significant
hippocampal shrinkage in the brains of animals who had been subjected
to extreme and protracted stress. The pessimistic implication drawn
from these studies is that the symptoms of PTSD, including memory
lapses, anxiety, the inability to modulate emotion and control violence,
are all due to brain damage--in short, that PTSD is an irreversible
(incurable) form of brain disease. Though the evidence appears compelling,
I am convinced that the aforementioned ''brain damage'' and other
bio-chemical changes are secondary effects that are not only preventable,
but in many cases reversible.
When faced with
threat, the body and mind mobilizes a vast amount of energy in preparation
for the ''fight or flight'' response. This preparedness is supported
by an increase and diversion of blood flow and release of ''stress
hormones'' like adrenaline and cortisol. It seems probable that
the prolonged excess of cortisol (or even a deficit which may be
characteristic of depression in chronic PTSD), is what leads eventually
to the hippocampal brain damage. The shrinkage does not happen suddenly.
It is the long term, i.e., unresolved chronic trauma and stress
that alters the cortisol levels which, in all likelihood, leads
(over time) to the brain shrinkage. Even with long-term (chronic)
trauma, there is a strong possibility that the hippocampal degeneration
may be reversible. The shrinkage appears to be due to dendrite loss
which may be (at least partially) restored if the chemical stressors
are de-activated and returned to normal levels. Therefore, it is
essential to help support and guide individuals in the aftermath
of overwhelming life events in order to preventuntold tragedy.
A positive aspect
of recent medical research on trauma is that it raises critical
questions concerning the damage that is being inflicted upon a generation
of children ravaged by wars throughout the world, and by violence
in our inner cities. Unless we can learn to resolve the effects
of trauma, we may be creating a generation of hyperactive, learning
impaired, violence-prone, brain-damaged ''citizens'', whose actions
will pale Hollywood's wildest nihilistic fantasies. This tendency
is by no means limited to war and violence torn areas of the globe.
Many middle class children and adults suffer from anxiety, depression,
and psychosomatic disorders. Some of them are prone to violence
or are functioning at greatly reduced potentials due to the effects
of what we have termed ''common everyday occurrences.'' Unresolved
trauma leads to re-enactment, and is a major factor in the escalation
and perpetuation of violent behavior. Solving this threat to local
and global social stability is and will be one of our greatest challenges.
Another positive
aspect of the aforementioned generally limited and pessimistic line
of trauma research is that it affords 'legitimacy' to the very real
suffering of people with PTSD. Rather than being told ''It's all
in your head'', some people may be (arguably) comforted by being
told that ''It's all in your (damaged) brain.'' The research also
points to the far-reaching social consequences of trauma, and raises
the question that we, as a culture, must answer: how do we as individuals,
as a people, as a nation, and as a global community, plan to care
about our collective traumatic experiences? It is obvious that we
have not adequately addressed this question: one needs to look no
further than the unconscionable percentage of homeless people (at
least forty percent) that are Vietnam veterans.
Some of the negative
implications of the disease-oriented view of trauma are: 1) It is
scientifically misleading by confusing cause and effect. A disturbance
in the natural biological process does not necessarily lead to incurable
pathology. 2) It obscures (or ignores) the innate resiliency of
the human organism (when supported and guided appropriately) to
rebound and heal in the aftermath of overwhelming life events 3)
It fails to recognize our capacity as human beings to support and
empower each other in the process of transforming trauma. In summary,
the over-emphasis on pathology (on what is wrong) impedes the healing
process by diverting attention from our innate capacities to self-regulate
and restore balance and vitality. In short, we are dis-empowered
by the absence of regard for what is right with our organisms.
Nature's Lessons
It is through
the study of the natural world and mythology that we may begin to
understand the critical role of biology and instinct in the formation
and resolution of trauma. We are living, breathing, pulsing, self-regulating,
intelligent organisms, not merely complex chemistry sets. We need
to identify with our animal roots and dare to inhabit the Serengeti
plain that dwells in our collective soul. There, we will become
aware of many things. Our senses will rise from their slumber, and
we will behold the crouching cheetah as it readies itself to attack
the swift, darting, impala. Track your own responses as you watch
the fleet cheetah in a seventy mile an hour surge, overtake its
prey. You notice that the impala falls to the ground an instant
before the cheetah makes contact. It is almost as if the animal
has surrendered to its pending demise.
It's Physiology
- Not Pathology
The fallen Impala
is not dead. Although on the 'outside' it appears limp and motionless,
on the 'inside' its nervous system is still activated from the seventy-mile-an-hour
chase. Though barely breathing, the Impala's heart is pumping at
extreme rates. Its brain and body are being flooded by the same
chemicals (e.g. adrenaline and cortisol) that helped fuel its attempted
escape.
It is possible
that the impala will not be devoured immediately. The mother cheetah
may drag its fallen (apparently dead) prey behind a bush and seek
out its cubs, who are hiding at a safe distance. Herein lies a short
window of opportunity. The temporarily ''frozen'' impala has a chance
to awaken from its state of shock, shake and tremble in order to
discharge the vast amount of energy stored in its nervous system,
then, as if nothing had happened, bound away in search of the herd.
Another function of the frozen (immobility) state is its analgesic
nature. If the impala is killed, it will be spared the pain of its
own demise.
Three little girls
(described in US News and World Report, Nov. 11, 1996) are sitting
in plastic molded chairs in the hospital waiting room. They seem
calm, betraying nothing of the horror they experienced the night
before. The children were tied up, the three year old threatened
with a gun, and then they watched as their teenage sister was shot
in the head (though not killed). They appear ''calm'' on the outside,
but their physiology's tell a very different story. Hearts still
racing at one hundred beats per minute, their blood pressure remains
high. Inside their heads, the biological stress chemicals are saturating
their brains. Like the fallen Impala, these ''frozen'' kids, while
appearing calm (if not unresponsive), are still internally prepared
for the extremes of activation necessary to initiate the flight
or fight procedures they never had a chance to execute. Those chemicals
are now turning against their very futures. The increased heart
rate is associated with the hair-trigger fight/flight response,
and is played out in the hostile/withdrawing behaviors that will
characterize their bleak and agitated days at school and sleepless
nights at home. Bruce Perry of Children's Hospital at Bayhn College
of Medicine gives teachers and parents of traumatized children devices
that allow them to monitor the child's heart rate at a distance.
This way they can refrain from making demands that are likely to
cause the children to explode in rage or withdraw in fear. He also
prescribes clonidine, a drug that seems to help block the fight
or flight response.
I believe both
of these approaches can be of some use. Unfortunately, by focusing
on pathology and the suppression of symptoms, the essential biological
ingredient of resolving trauma is missed-that is, completion of
the thwarted fight or flight defensive procedures and the close
human contact that is required to support this completion. Without
completion and resolution, people remain frightened, isolated and
hopeless. When completion occurs, like the impala, a person can
be transformed and rejoin the herd.
Completion
Acts must be carried
through to their completion. Whatever their point of departure,
the end will be beautiful. It is (only) because an action has not
been completed that it is vile.
--
Jean Genet, from Thief's Journal
Though it appears
that we have separated ourselves from animals, like the impala and
cheetah, human responses to threat are biologically formed. They
are innate and instinctual functions of our organisms. For the impala,
life-threatening situations are an everyday occurrence, so it makes
sense that the ability to resolve and complete these episodes is
built into their biological systems. Threat is a relatively common
phenomenon for humans as well. Though we are rarely aware of it,
we also possess the innate ability to complete and resolve these
experiences. From our biology comes our responses to threat, and
it is also in our biology that the resolution of trauma dwells.
In order to remain
healthy, all animals (including humans) must discharge the vast
energies mobilized for survival. This discharge completes our activated
responses to threat, and allows us to return to normal functioning.
In biology, this process is called homeostasis: it is the ability
of an organism to respond appropriately to any given circumstance,
and then return to a base line of what could be called ''normal''
functioning.
In the National
Geographic video ''Polar Bear Alert'' (available at video stores),
a frightened bear is run down by a pursuing airplane, shot with
a tranquilizer dart, surrounded by wildlife biologists, and then
tagged. As the massive animal comes out of its shock state it begins
to tremble, peaking with an almost convulsive shaking--its limbs
flailing (seemingly) at random. The shaking subsides and the animal
takes three spontaneous breaths which seem to spread through its
entire body. The (biologist) narrator of the film comments that
the behavior of the bear is necessary because it ''blows off stress''
accumulated during the capture. If this sequence is viewed in slow
motion it becomes apparent that the ''random'' leg gyrations are
actually coordinated running movements - it is as though the animal
completes its running movements (truncated at the moment it was
trapped), discharges the ''frozen energy,'' then surrenders in a
full bodied ''orgiastic'' breath.
I was first made
aware of the profound significance of these kinds of physiological
reactions in the healing of trauma quite by accident. In 1969, a
psychiatrist referred a patient to me who was suffering from acute
anxiety and panic attacks. The attacks had become so severe that
the woman (Nancy) was unable to leave her home unaccompanied. The
psychiatrist, who knew of my interest in mind/body healing (a fledgling
field at that time), thought that perhaps she would benefit from
techniques I had developed that utilized sensory awareness as a
way to deep relaxation.
Relaxation was
not the answer. In our first session, as I naively and with the
best of intentions attempted to help her relax, Nancy went into
a full-blown anxiety attack. She appeared paralyzed and unable to
breathe. Her heart was pounding wildly, and then it slowed to almost
a stop. I became quite frightened as we entered together into her
nightmarish attack.
Surrendering to
my own intense fear, yet somehow managing to remain present, I had
a fleeting vision of a tiger jumping toward us. Swept along by the
experience, I exclaimed loudly, ''You are being attacked by a large
tiger. See the tiger as it comes at you. Run toward that tree; climb
it and escape!'' To my surprise, her legs started trembling in running
movements. She let out a bloodcurdling scream that brought in a
passing police officer (fortunately my office partner somehow managed
to explain the situation). She began to tremble, shake, and sob
in waves of full-bodied convulsions.
Nancy continued
to shake for almost an hour. She recalled a terrifying childhood
memory. At the age of three, she had been strapped to a table for
a tonsillectomy. The anesthetic was ether. Unable to move, feeling
suffocated (common reactions to ether), she had terrifying hallucinations.
This early experience had a deep impact on her. Nancy was threatened,
overwhelmed, and as a result, had become physiologically frozen
in what biologists call the ''immobility response''. In other words,
her body had literally resigned itself to defeat, and the act of
escaping could not exist. In this pervasive state of ''core anxiety,''
Nancy lost her real and vital self, as well as a secure and spontaneous
personality. Though she hadn't literally died, parts of herself
had suffered a kind of death.
After the breakthrough
that occurred in our initial visit, Nancy left my office feeling,
in her words, ''Like she had herself again.'' Although we continued
working together for a few more sessions, where she gently trembled
and shook, the anxiety attack she experienced that day was her last.
Out of Africa
I recently described
the particular type of spontaneous shaking, trembling and breathing
that Nancy and other clients exhibit in therapy sessions to Andrew
Bwanali, park biologist of the Mzuzu Environmental Center in Malawi,
Central Africa. He nodded excitedly, then burst out;
''Yes.....yes.....yes!
That is true. Before we release captured animals back into the wild,
we make absolutely sure that they have done just what you have described.''
He looked down at the ground, then added softly; ''If they have
not trembled and breathed that way before they are released, they
will not survive.... they will die.'' Although humans rarely die
from trauma, if we do not resolve it, our lives can be severely
diminished by its effects. The result for many of us is often described
as a ''living death.''
Waking the Tiger
The DSM Four (the
diagnostic manual used by psychiatrists and psychologists) defines
''panic anxiety reactions'' as follows: The attack has a sudden
onset and builds to a peak rapidly (usually within ten minutes),
and is often accompanied by a sense of imminent danger or impending
doom and with an urge to escape. Symptoms include palpitations,
sweating, trembling (which sufferers usually try to suppress), sensations
of shortness of breath, a feeling of choking, chest pain or discomfort,
nausea or abdominal stress, dizziness or lightheadedness, fear of
losing control or ''going crazy.
Over three million
Americans suffer from regular panic attacks, a majority being women--the
more likely prey when it comes to our species. We see in the definition
of panic anxiety-the sense of imminent danger or impending doom
associated with an urge to escape. This is the essence of trauma;
the urge to escape coupled with the perception of not being able
to.
At the time I
met Nancy, I was studying animal predator-prey behaviors. I was
intrigued by the similarity between Nancy's paralysis when her panic
attack began, and what happened to the impala discussed previously.
Most prey animals use the immobility response when attacked by a
larger, more powerful predator from which they can't escape. I am
quite certain that these studies strongly influenced the fortuitous
vision of the imaginary tiger. For several years after that I worked
to understand the significance of Nancy's anxiety attack and her
response to the image of the tiger. I now know that it was not the
dramatic emotional catharsis and reliving of her childhood tonsillectomy
that was catalytic in her recovery, but the discharge of energy
she experienced when she flowed out of her passive, frozen immobility
response into an active, successful escape. The image of the tiger
awoke her instinctual, responsive self. The other insight I reaped
from Nancy's experience was that the resources which enable a person
to succeed in the face of a threat can be used for healing. This
is true not just at the time of the experience, but even years after
the event.
I learned that
to heal trauma it was unnecessary to dredge up and relive memories.
In fact, severe emotional pain can be re-traumatizing. What we need
to do to be freed from our symptoms and fears is to arouse our deep
physiological resources and consciously utilize them. If we remain
ignorant of our power to change the course of our instinctual responses
in a proactive rather than reactive way, we will continue being
frozen, imprisoned, and in pain.
As I continued
to work with people suffering from anxiety reactions and so-called
''psychosomatic'' conditions like migraines, muscular syndromes
(e.g., fibromyalgia, back and neck pain), functional gastrointestinal
disorders, severe PMS, asthma and even some epileptic seizures,
the more I became convinced that these symptoms are the nervous
system's attempt to bind (or contain) the intense survival energies
that remain in the body/mind as the result of unresolved trauma.
When these energies could be gradually discharged, physiologically,
in gentle trembling (often accompanied by mounting chills of apprehension,
readiness, and an experience of ''breaking through'' expansively
into warm beads of moist perspiration), the symptoms would often
be dramatically reduced or even eliminated. Sometimes, though not
always, images of the event(s) would appear indicating possible
source(s). They were not necessary for healing to occur. The images
were often, but not always accurate depictions of an event. This
led me to conclude that so-called ''traumatic memories'' are not
necessarily the actual story of what happened. They are accurate
in the sense that the images match the ''energetic intensity'' of
an experience. They also satisfy the deep yearning we humans have
to know what happened to us. This is an important key to unlocking
the mystery of traumatic memories, and avoiding the pitfalls created
by ''false memories.'' For example, it is critical that we understand
that many peoples' (unconscious) experience of medical procedures
is quite similar to the experience of rape. Any suggestion of rape
or molestation by a therapist (or by media exposure) can influence
traumatized people to create ''false memories'' in order to explain
any ''rape-like'' experience.
The Root of Many
Disorders
It is estimated
that as many as thirty to forty million Americans (twelve to fifteen
percent of the population) have experienced persistent anxiety.
Another twelve million have been troubled by a milder form of anxiety
known as ''restless leg syndrome'' (an explanation for this jitteriness
of the legs due to incomplete survival responses can be gleaned
from the image of Nancy as she escapes from the tiger). Add to this
figure twelve and a half million people who suffer from obsessive-compulsive
disorder (a condition that keeps people in a constant alert state
known as hyper-vigilance), ceaselessly searching for threat even
when none exists.
Stress-related
illness (mental and physical), may account for the vast majority
of symptoms for which people seek medical help. Serious psychiatric
disorders (involving anxiety, depression, sleep disturbances, and
substance abuse) are on the rise in America and in other industrialized
nations. In 1994, the conservative Archives of General Psychiatry
reported that half of the entire American adult population meets
the formal diagnostic criteria that denote serious psychiatric illness.
Since World War Two, the rates of adolescent depression and suicide
have both tripled. As startling as these statistics are, even more
alarming is the sharp rise in violence among our youth. Concurrently,
hyperactivity and Attention Deficit Disorder (ADD) are approaching
epidemic proportions. Various school districts are reporting that
as high as ten to twenty percent of their elementary school population
is regularly using Ritalin (a type of amphetamine prescribed by
doctors to counteract hyperactivity and ADD). The trouble with Ritalin
(and other drugs used for similar purposes), is that not only are
they potentially addictive and dangerous, they fail to get to the
root of the problem. I believe that a substantial percentage of
violence-prone children (as well as many of those diagnosed as hyperactive
or having ADD) are actually suffering from the effects of unresolved
trauma. The behaviors they exhibit (which we term disorders) are
often manifestations of hyper-arousal and hyper-vigilance, both
which are core symptoms of trauma.
The tacit acceptance
of drugs as the answer to this epidemic is frightening as well as
misleading. These so-called disorders are not diseases like pneumonia
or juvenile diabetes. Why are we not profoundly disturbed by the
creation of future generations of chemically-dependent citizens?
Will America become known as the ''Prozac Nation,'' unable to function
without mood elevators and anti-depressants? Perhaps this situation
already exists. When viewed in the context of this increasing chemical
dependence, our government's purported ''War on Drugs'' appears
ludicrous at best. With a significant proportion of children and
adults hooked on powerful (legal) ''mind-altering'' substances (not
to mention alcohol and illegal drugs), it forces us to ask the question:
what has gone wrong?
The prevailing
psychiatric view of these disorders is that they are ''biological
diseases.'' The standard treatment is pharmacological. Drugs can
certainly be a useful component in treating these afflictions, however,
the prevalent confusion between biological maladaption and ''brain
disease'' obscures the global affect that unresolved stress and
trauma have on our organisms.
When we overwhelmed
by threat, our bodies and nervous systems activate life-preserving
survival responses. If we are unable to complete these innate ''action
plans,'' then we cannot discharge the vast amount of energy mobilized
to do so. When this occurs (like Nancy), we retain in our bodies
and minds undischarged residual energy, which, in turn, manifests
itself as the symptoms of trauma. Most symptoms of trauma are found
in the descriptions of many psychiatric and so-called ''psycho-somatic
diseases'' and syndromes. Why we humans have become so vulnerable
to trauma is a complex question that I have addressed in depth in
a recent book, Waking the Tiger--Healing Trauma. What I want to
emphasize here is not only can much untold suffering be prevented,
but the expenditure of billions of dollars a year (over forty-four
billion on depression alone) can be reduced significantly.
The longer traumatic
activation has been unresolved, the more difficult or more time
consuming it is to resolve it. Many people know something about
basic first aid: how to stop bleeding, what to do if someone is
burned, or how to help choking victims, and how to do CPR. Very
few of us know how to be present and offer the energetic and emotional
support necessary to ensure that stressful or overwhelming events
will not lead to the debilitating and chronic symptoms of trauma.
These are skills we must all develop if we yearn to be ''thrivers''
(not victims or merely survivors) of trauma. Trauma ''first aid''
must be applied on a societal level as well if we are serious about
stemming the rising tsunami of violence that threatens our survival
as a species. If we are to continue evolving, we must first learn
to master our innate resources, those that empower us to be fully
human.
Medusa
Mythology teaches
us about courageously meeting challenges. Myths are stories that
simply and directly touch the core of our being. They remind us
about our deepest longings, and reveal to us our hidden strengths
and resources. They are also maps of our essential nature, pathways
that connect us to each other, to nature, and to the cosmos. If
we let them, they can lead us home. The Greek myth of Medusa (the
Gorgon), captures the very essence of trauma and describes its transformation.
It is the weaving together of myth and biology (''Mytho-biology'')
that will help us solve the mystery of trauma.
In the Greek myth,
those who looked directly into Medusa's eyes were promptly turned
to stone....frozen in time. Before setting out to vanquish this
snake-haired demon, Perseus sought council from Athena. Her advice
to him was simple; under no circumstances look directly at the Gorgon.
Taking Athena's advise to heart, Perseus used the shield on his
arm to reflect the image of Medusa and was then able to cut off
her head without being turned to stone.
If trauma is to
be healed, we must learn not to confront it directly. This can be
a hard lesson to learn. If we make the mistake of confronting trauma
head on, then Medusa will do to us what Medusas do. True to her
nature, she will turn us to stone. Like the Chinese finger traps
we all played with as kids, the more we struggle with trauma, the
greater will be her grip upon us....... There is more to this myth:
Out of Medusa's wound, two entities emerged. Pegasus, the Winged Horse and Chrysaur, the Warrior with the golden sword. The horse is a symbol of the body and instinctual knowledge; the wings symbolize
transformation.
The golden sword represents penetrating truth and clarity. Together,
these aspects form the archetypal qualities and resources that a
human being must mobilize in order to heal the Medusa called trauma.
The reflection
of Medusa we must perceive and respond to in order to vanquish and
transform her vast energies is mirrored in our instinctual natures.
Once in touch with this primordial wisdom, we will be able to be
present in our own organisms as well as with those of another. This
innate wisdom allows us to not only master trauma, but to experience
ourselves and others fully. Without it, confusion or over-control
will rule all of our relationships.
In another version
of this same myth, Perseus stores the drops of blood from Medusa's
wound in two vials. Those from one vial have the power to kill,
the other, to raise the dead and restore life. What is revealed
here is the dual nature of trauma: first, its destructive ability
to rob victims of their full capacity to live and enjoy life. Second,
the paradox of trauma--its power to transform and resurrect. Whether
trauma will be a cruel and punishing Gorgon, or a vehicle for soaring
to the heights of transformation and mastery depends upon how we
approach it.
Because we are
human animals, trauma is a fact of life. It does not, however, have
to be a life sentence. It is possible to learn from the animal experience,
and rather than brace against our instincts, embrace them. With
guidance and support, we are capable of emulating the impala, and
learning to shake and tremble our way back to the herd. In being
able to harness these primordial and intelligent instinctual energies
we can move through trauma and transform it.
Compassionate
Presence
Eight-year-old
Anna has enormous brown eyes. She could have been a model for one
of David Keane's popular paintings of almond-eyed children. The
school nurse has just brought her in to see me. Pale, head hanging
in defeat, barely breathing--she is like a fawn frozen by the bright
lights of an oncoming car. Her frail face is expressionless, and
her right arm hangs limply, as if it was on the verge of detaching
itself from her shoulder.
Two days earlier,
Anna went on a school outing to the beach. She and a dozen of her
classmates were frolicking in the water when a sudden riptide swept
them swiftly out to sea. Anna was rescued, but Mary (one of the
mothers who volunteered for the outing) drowned after courageously
saving several of the children. Mary had been a surrogate mom to
many of the neighborhood kids, including Anna, and the entire community
was in shock from her tragic death. We had asked the nurse to be
on the lookout for children who displayed a sudden onset of symptoms
(e.g., pain, head and tummy aches, and colds). Anna had already
been to see the nurse three times that morning, reporting severe
pain in her right arm and shoulder.
One of the mistakes
often made by ''trauma responders'' is to try to get children to
talk about their feelings immediately following an event. Although
it is rarely healthy to suppress feelings, this practice can be
re-traumatizing, because in these vulnerable moments children (and
adults as well) can be easily overwhelmed. Previous traumas can
re-surface in the aftermath of ''overwhelm'', creating a complex
situation that may involve ''deep secrets'', untold shame, guilt
feelings, rage, and pain. For this reason, we sought out and learned
some of Anna's history from several helpful elementary school teachers
prior to seeing the child. The following information was revealed:
At age two, Anna
was present when her father shot her mother in the shoulder and
then took his own life. More recently, Anna had been infuriated
when Mary's sixteen-year-old son Robert had bullied her twelve-year-old
brother. There was a strong possibility that Anna harbored ill will
towards Robert, and sought retribution. This raised the likelihood
that Anna might feel profound guilt about Mary's death-perhaps even
responsible for it.
I ask the nurse
to gently cradle and support Anna's injured arm. This will help
Anna contain the frozen ''shock energy'' locked in her arm, as well
as heighten the child's inner awareness. With this containment and
support, like the impala, Anna will be able to slowly, gradually,
thaw, and access the feelings and responses that will help her come
back to life.
''How does it
feel to be inside of your arm, Anna?'' I ask her softly.
''It hurts so
much'' she answers faintly. Her eyes are downcast, and I say,
''It hurts bad,
huh?''
''Yeah.''
''Where does it
hurt? Can you show me with your finger?'' She points to a place
on her upper arm and says, ''Everywhere, too.'' There's a little
shudder in her right shoulder followed by a slight sigh of breath.
Momentarily, her drawn face takes on a rosy hue.
''That's good,
sweetheart-does that feel a little better?' She nods slightly, then
takes another breath. After this slight relaxation, she immediately
stiffens, pulling her arm protectively towards her body. I seize
the moment.
''Where did your
mommy get hurt?' She points to the same place on her arm, and begins
to tremble. Nothing more is said. The trembling intensifies, then
moves down her arm and into her neck. ''Yes, Anna, just let that
shaking happen-just like a bowl of jello-would it be red, or green,
or even bright yellow? Can you let it shake? Can you feel it tremble?''
''It's yellow,''
she says, ''like the sun in the sky.'' She takes an almost full
breath, then looks at me for the first time. I smile and nod. Her
eyes grasp mine for a moment, then turn away.
''How does your
arm feel now?''
''The pain is
moving down to my fingers.'' Her fingers are trembling gently. I
speak to her quietly, softly, rhythmically.
''You know, Anna
sweetheart....I don't think there is anybody in this whole town
that doesn't feel like that in some way it was their fault that
Mary died.'' She glances at me briefly, and I continue-''Now, of
course that's not true...but that's how everybody feels...and that's
because they all love her so much.'' She turns now and looks at
me. There is a sense of self-recognition in her demeanor. With her
eyes now glued on me, I continue...''Sometimes, the more we love
someone, the more we think it was our fault.'' Two tears spill slowly
from the outside corners of each eye before she slowly turns her
head away from me.
''And sometimes
if we're really angry at someone when something bad happens to them,
then we also think that it happened because we wanted it to happen.''
Anna looks me straight in the eye, and I say, ''And you know, when
a bad thing happens to someone we love or hate, it doesn't happen
because of our feelings. Sometimes bad things just happen...and
feelings, no matter how big they are, are only feelings.'' Anna's
gaze is penetrating and grateful. I feel myself welling with tears.
I ask her if she wants to go back to her class now. She nods, looks
once more at the three of us, then walks out the door, her arms
swinging freely.
Alex (like several
of the children who witnessed the tragedy from the beach), was having
trouble sleeping and eating. His father brought him to us because
the youngster had barely eaten in the last two days.
As we sit together,
I ask him if he can feel the inside of his tummy. He places his
hand gently on his belly, and, with a sniffle, says ''Yes.''
''What does it
feel like in there?''
''It's all tight
like a knot.''
''Is there anything
inside that knot?''
''Yeah. It's black....and
red....I don't like it.''
''It hurts, huh?''
''Yeah.''
''You know, Alex,
it's supposed to hurt...but it won't hurt forever.'' Tears cascade
down the boy's cheeks, and color returns to his face and fingers.
That evening, Alex ate a full meal. At Mary's funeral Alex wept
openly, smiled warmly, and hugged his friends.
Because trauma
is ''locked'' in the body, it is in the body that it must be accessed
and healed. With proper support, the body will discharge the locked-in
energy as surely as a stream flows to the sea. Words are used as
compassionate reflections, not as explanations. We don't need to
help each other ''get our feelings out,'' we need to be compassionately
present for one another. This kind of acknowledgment creates the
ambiance that will allow the frozen sensations and feelings to soften
and flow at their natural pace. Don't Push the River.
In healing trauma,
the body's ''felt sense'' is the equivalent of Perseus' shield.
Through the reflection of our own body awareness, we can master
the innate resources that transform trauma. Everything we need waits
inside...we must learn to be the heroes of our own healing...not
just heroes that say ''no'' to being victimized and seek vindication,
but Heroes that say ''yes'' to Pegasus, and soar to new heights
of evolutionary freedom. Medusa is fear...fear turns us to stone.
It is time for human beings to leave the ''Stone Age.'' behind.
Trauma is something we all share. Like the blood from Medusa's wound,
it is a potential gift....a natural vehicle for personal, societal
and global transformation.
Connection
Live not in separation
--
E.M. Forster
Trauma is about
broken connections. Connection is broken with the body/self, family,
friends, community, nature, and spirit, perpetuating the downward
spiral of traumatic dislocation. Healing trauma is about restoring
these connections.
Some years ago,
I had the privilege of teaching at the Hopi Guidance Center located
at Second Mesa, Arizona. I teach my work by using direct personal
experience. Initially, I became aware that there seemed to be a
strong resistance among tribal members to participate experientially.
I knew that the people were shy, and that they have strong cultural
taboos regarding self-disclosure (especially to outsiders). What
I didn't know was that they have a world-view so different from
mine that I nearly missed it entirely.
I discovered that
it was the use of ''I'' that troubled and perhaps even confused
the Hopi. When I framed an experiential demonstration in the third
person (indicating the healing needs of others), people participated
more freely. In Anglo-European cultures, it is the needs of the
autonomous ego that dominate perception. In the Hopi culture, it
is the needs of the tribal community that are primary. The Hopi
are not alone in this world view. In many aboriginal cultures, the
entire group shares the pain of an injured individual. Because of
this felt connection, the healing of a single person naturally becomes
the responsibility of the entire group. Specific rituals are performed
involving the whole community. The Hopi say that if (trauma) is
not dealt with quickly by the whole group, then its negative consequences
will affect the tribe for seven generations.
When it comes
to healing trauma, the ''limitations'' I experienced among the Hopi
turned out to be vital strengths. I realized that the participation
of an entire community is a fundamental resource in the process
of healing a traumatized individual. What happens to cultures whose
sole focus is self-involvement and autonomy? What lies in store
for countries made up of isolated individuals who have little feeling
for being a ''people?'' They become, as we have, particularly vulnerable
to the disconnection that results from traumatic experiences. I
mention again these facts: forty percent of America's homeless are
Vietnam veterans-perhaps half of our population is suffering from
major mental illness-we are entrenched in an explosion of violence
among our youth that may result in the dissolution of many urban
areas-we grow increasingly dependent on legal and illegal drugs
in an attempt to cope with this situation. These disturbing statistics
all speak, at least in part, to our inability as a culture to heal
trauma.
How much of our
present dilemma is a result of our own free choice as expanding
human beings wishing to evolve toward autonomy, individuality, and
pentium-paced technology? How much is a result of the constricting
downward spiral of fewer and fewer choices created by traumatic
disconnection? I don't know the answer to these ''chicken or the
egg'' questions, but I believe that the future of the human species
may be predicated upon the unification of tribal connection with
individual freedom and autonomy. Our strength and adaptability as
human beings lies in the integration of instinct, emotion, and rational
thought. If we choose to abandon our instincts, we limit our evolutionary
choices--we distance ourselves from the innate resources necessary
to experience our connection to others and to the natural world.
Without this connection we are choosing to live in a spiritual void.
Without this connection we cannot heal trauma--we can only build
tenuous superstructures around it in a feeble attempt to protect
ourselves from its devastation.
There is much
we can do to heal trauma and create a pathway towards connection.
As individuals, families, and professionals, we can be present for
our children in the aftermath of potentially traumatic experiences.
Automobile accidents, injuries, serious illness, emergency and necessary
medical procedures, violence, natural disasters, and loss (from
death or separation) do not have to leave children frozen. Children
possess an innate and vibrant resiliency that can enable them to
rebound from ''overwhelm'' and injury. In a 1994 article published
in Mothering Magazine called Understanding Childhood Trauma, and
in a forthcoming book, It Won't Hurt Forever, I discuss first-aid
for trauma--how to provide the support and guidance necessary to
help children resolve and prevent traumatic reactions. It is possible
for all of us to learn a few simple (compassionate) guidelines that
can be employed to help children (and adults) move through the intense
fear often associated with injuries and medical procedures. If this
information is incorporated into our existing medical and paramedical
model, it could prevent much unnecessary suffering and reduce health
care costs dramatically.
On the societal
and global levels, the cycle of war, violence, and trauma repeats
itself, escalating into an ever-increasing threat to civilized existence.
The Foundation for Human Enrichment is involved in the formative
stages of several projects whose goal is to work with the traumatic
roots of violence (see We Are All Neighbors: Healing the Roots of
Violence). By addressing trauma in infants and children, we hope
to transform the generational cycle of traumatic re-enactment. By
bringing together the parents and infants of both recent and historical
adversaries (ethnic, racial, religious, economic, geographic, inner-city),
it may be possible to re-establish the broken connections that exist
between alienated groups. Once the connections are made, the likelihood
that the perpetual cycle of violence and suffering can be resolved
will be greatly enhanced. If anyone can help us overcome the horrors
of violence and war, it is our children.
''Give me a place
to put my lever,'' decried Archimedes, ''and I will move the world.''
Dominated by conflict, destruction, and trauma, we may find this
fulcrum, this focal point, in the tender, physical, rhythmic pulsation
between a mother and her infant. When the primary connection is
strong and vital, the world outside becomes a less threatening,
more hospitable place. When the broken connection between the body,
mind, and spirit is restored, when the severed bonds between people
and nature have been re-woven, we can begin, as a species, to feel
at home on this beautiful planet Earth.











