From Complex Trauma to Collective Trauma: Restoring the Healing Cycle

The events that result in a diagnosis of complex trauma may include prenatal injuries as well as childhood adversity. Whatever the nature of the events or the impact of distressing relationships, the autonomic nervous system reacts with alarm and then defenses. When in a state of alarm and defense, cells throughout the body alter their purpose of maintaining health and change their inner course toward defense.  If safety is reestablished within moments and relationships repaired, the healing cycle of the cells are naturally restored and resilience develops in the person’s body and mind.

Without relational safety and connection for an immediate repair, the cells continue their course of defense resulting in chronic mental and physical illnesses. Robert Naviaux calls this reaction the chronic defense response in an article on the metabolic regulation of the healing cycle (Naviaux, 2018).  Naviaux identifies the changes that occur to the endocrine systems such as the thyroid and adrenal cortical throughout the body and the power of vagal nervous system to restore the endocrine systems.  Stephen Porges, an innovative neuroscientist, continues to offer possibilities for healing through activation of the vagal nervous system, often known as the parasympathetic system.  From Allan Schore, a prolific research neuropsychologist, we have learned that relational connection with awareness of our inner selves and with others is the short path to a healing cycle.

What does this have to do with healing trauma for the individual as well as a culture?  As psychotherapists have observed, people with complex trauma often have other chronic illnesses that stem from dysregulation of the metabolic endocrine systems that affect the function of cells.  In order to stimulate the healing cycle, we have learned to regulate the autonomic nervous system so that the vagal nervous system is not compromised and frozen by unnecessary activation of the sympathetic nervous system.  But is that enough?  What is necessary to restore the healing cycle so that resilience grows and the optimal window of arousal expands to tolerate increased stress and adversity? 

Antonio Damasio, an inspiring neuroscientist and writer, points out that the cellular health of the body is reflected in the health of the culture. In his book, The Strange Order of Things, Damasio describes the sequence of a healing cycle through the right hemisphere of the brain, moving from cells to feelings and images that create new meaning.  If just a few individuals suffer from complex trauma or a chronic defense response, the culture is able to respond with knowledge, compassion and empathy to restore the healing cycle in those people.  However, when a chronic defensive response expands throughout a culture through misinformation, poverty, food shortages, injustice toward particular individuals due to gender, sexual orientation, color of skin, religion and other issues of diversity, the culture is no longer able to maintain mental and physical health. We call this collective trauma.

That does not need to be the end of the story or the breakdown of a nation.  The higher cortical processes of humans differ from other animals in their ability to be conscious and aware. In a culture with increased stress and adversity, it is essential that each individual become aware of their ability to restore health and wellness through a surrender to the healing cycle in a relational context.  A time of crisis requires a change in lifestyle to optimal health through nurturing food, optimal activity, restful sleep and relational connectivity so that we can care for the more wounded and the young with authentic empathy and compassion. A change in lifestyle at a time of crisis, requires a personal and collective rebirth of courage, meaning and purpose rather than a submission to overwhelming fear and the deepening of a chronic defense response.

The renewal of courage, meaning and purpose begins in the renewal of a healing cycle to our very cells.   How can we rise up to our ability to extend wisdom, empathy and compassion to the people  who are suffering when we have become exhausted, stuck in a chronic defensive pattern and our very cells are resistant to an innate course of healing?  We need to stay in contact with intimate relationships, know our  bodily-based feelings, nurture our creative images and reflect on the meaning of our lived experience.

Perhaps we can learn from the indigenous people of our land. Richard Atleo, a UBC scholar of NuuChahNulth people of Vancouver Island describes the season of winter as a deeply restful and restorative time. His people took time remember their identify through storytelling and creatively recalling the teachings of their ancestors. 

Each of us does have a mission, a purpose and meaning for this time.  We are each needed.

What if we took this winter to deeply rest, restore our very metabolic health, live simply, eat wisely, love passionately and forgive ourselves and others for all the hurt we have caused.  What if this dark winter could become a time a deep reflection and re-membering?

Those of us with a past of  immigrant ancestors who came to this land with their hopes, vision and courage could take time to reflect on our own lived experience, our legacy from our past and who we are becoming for the future.  Perhaps we could reflect on the suffering of those with ancestors who did not chose to come here but were forced into slavery from which we have profited.  We could remember the indigenous peoples whose land we appropriated and continue to occupy without even an apology.  What if we each came to a larger, more expansive perspective of who we were, are and can become to create new ways to live together in the healing cycle of our culture.

Coming Alive and Opening to Vitality

An exciting new paradigm in mental health professions has begun. Psychotherapy is integrating evidence-based theories from neuroscience relevant to the human quest for a healthy and meaningful life. Knowledge from neuroscience reveals principles that lead to creative, innovative healing practices for the transformation of physical, emotional and spiritual trauma.

When traumatic events occur, major systems in the body shift from states of alive vitality to defensive states of contraction and immobility. Danger and life threat is unconsciously detected by the autonomic nervous system (Porges & Dana, 2018), signaling sympathetic arousal to cells, organs and muscles throughout the body. Within a few moments, the mitochondria, the “powerhouse” of every cell,  shifts from wellness to defense (Naviaux, 2018). With this switch, oxygen needed by the cell is now used to defend and the body is bathed in adrenalines and cortisol. Trauma becomes a whole system disability, not just a physical or emotional disorder.

Traumatic reactions are caused by the biological reaction to an injury and not the original injury. (Naviaux, 2018). Unless a traumatic event is met in the first one to three days with healing practices, the biological reaction deepens and becomes a chronic illness, including anxiety and depression. This enduring reaction requires different treatment than the original injury. In fact, we do not need to know the origin of the injury, we need to attend to present moment reactions and work toward regulation of the autonomic nervous system to restore health, vitality and wellness.

The biological reaction of a defensive state, whether it is withdrawal, fight or ‘immobilization with fear’ (Porges & Dana, 2018) has a number of serious consequences. We lose our awareness of our inner world and defend, disembody, dissociate from present moment experiences and intimate relationships. With this biological reaction, we become vulnerable to protracted illnesses (Navaiux, 2018).

Disembodiment results in a loss of awareness of present moment reality. Unresolved emotions from traumatic memories are buried, hidden even from ourselves. The concealed emotion can emerge without warning in panic, chronic illness, anxiety, addiction and inappropriate behavior. When disembodied, perceptions are distorted and we become oblivious to much of what is actually happening. Perception narrows to obsessions as we try to analyze or reason our way to clarity and peace. The ancient wisdom and information from the body, our gut knowledge and heart resonance, vanishes.

Interoception, the ability to read the meaning of internal sensation, lies at the core of embodiment.  With interoception, psychotherapists can offer mindful, non-judgmental presence to sensations and, with relational, body-based practices, assist people with trauma to regulate intense emotions. Emotional regulation is not about controlling affect, but about listening for the meaning of the intense biological reactions we call emotions. With interoception, an awakening of body awareness, people with trauma can inquire into their present moment sensations and dissipate unneeded defensive reactions. Embodiment is necessary for a practitioner in order to accurately observe, listen and discern the unconscious dynamics of trauma.  Slowly, but surely, people with trauma respond to gentle invitations to gradually embody their lived experience and relinquish defensive reactions.

Embodiment is characterized by a felt sense of grounded aliveness, calm and active presence in the moment with a growing awareness of subtle shifts within the body and from the environment. The fundamental human need for belonging rests on our ability to feels one’s own physical presence. Embodiment allows us to unconsciously process information from our bodies into meaningful knowledge. When people are embodied they express authentic emotion through facial expression, voice, gesture, touch and posture and can receive similar nonverbal communication from another. Their perceptions are marked by open curiosity and interest rather than ruminations and obsessions.  

Embodiment offers abundant knowledge and wisdom about our own inner world and the subjective world of others. People living in traditional societies stay embodied and connected to each other for survival, without chronic defensive reactions, providing a baseline for human growth and development (Narvaez, 2014).  Ancient practices of embodiment are associated with enhanced emotional and physical health, prosocial relationships and low interpersonal violence.  Narvaez (2014) points out that “Western brains are not developing optimally”…without a fundamental sense of embodiment. With embodiment we can enter into somatic ways of knowing and engage the right hemisphere of our brain. Somatic psychotherapy begins with embodied empathy, intuition and expertise in relevant neuroscience.

Embodiment involves an awareness of the felt sense in the present moment and requires a direct encounter with the inner world. This subjective way of knowing can be communicated with the eyes, the tone of voice and subtle movements of the face and body. Embodiment is characterized by a freshness and vitality that generates interest in the listener, allowing words to flow from perception to expression and carry an inherent sense of value and the vital spark of life – an inner sense of spirit.

Habits of disembodiment can be challenging.  When therapists encounter resistance to invitations to attend to the inner world, it may be due to the intensity of unresolved emotion in the unconscious realms.  The shared, mutual therapeutic work of healing trauma requires deep respect for resistance to embodiment. As we slowly and mutually approach and uncover intense hidden affect with unbearable sensations, our intersubjective relationship makes them bearable. With this opening, embodiment and healing become possible, restoring the fundamental human sense of aliveness and vitality.  

Exercises for embodiment are in the appendix of my book:

• Stanley, S. (2016) Relational and Body-Based Practices for Healing Trauma: Lifting the Burdens of the Past. Routledge.  

• Narvaez, D. & Schore, A.N. (2014) Neurobiology and the Development of Human Morality: Evolution, Culture, and Wisdom (Norton Series on Interpersonal Neurobiology) 1st Edition

• Naviaux, R K (2018)  Metabolic features and regulation of the healing cycle – A new model for chronic disease pathogenesis and treatment. Mitochondrion – on-line 9 August 2018  (In press)

• Porges, S. & Dana, D. (2018). Clinical Applications of the Polyvagal Theory: The Emergence of Polyvagal-Informed Therapies (Norton Series on Interpersonal Neurobiology) 1st Edition

Autonomic Neural States

This graphic is illustrated by Sharon Stanley.

Getting Out of “Stuck” and Processing Those Old Emotions

I recently picked up a book called Hillbilly Elegy by J.D. Vance. In this memoir a young Yale-educated lawyer exposes a disheartening legacy of relational and multi-generational trauma. As a child of the “white working poor”, J.D. was able to break out of emotional “stuckness”, but as he insists, only with the loving support of his grandparents and others.

To clarify these dynamics, J.D. turns to research called Adverse Childhood Events or ACE’s.  The ACE’s studies from the National Institute of Health document the effects of relational multi-generational trauma on thousands of individuals and offers a startling glimpse into the effects of trauma, including emotional dysregulation, relationship difficulties and serious physical illnesses. When we combine ACE’s research with the study of epigenetics we can trace epigenetics how what happens to us can change how our genes function and leave us with emotional wounds from poverty, loss, discrimination, immigration, war and insecure and frightening relationships with caregivers.

J.D. brings a new perspective to the intense suffering of people who seem to be “apparently normal” (van der Hart, Nienjuis and Steele).  The “apparently normal” among us are the ones that suffer deep emotional and physical pain but have learned to hide it with addictions, the drama of troubled relationships and a competitive, consumer culture.  We are now seeing that the suffering of the “apparently normal” people with unprocessed emotional trauma affects our political and social environment, not just the individual or family. Under the thin façade of “normal” lies profound anguish and growing accumulation of a crushing health issue.

As research indicates, our central nervous system is formed in and through relationship and is the foundation for our emotional well-being. Neuroscience calls us to move from a cognitive approach to bodily-based relational ways to process emotion. So many of us have endured a legacy of historical trauma from immigration, wars, famine, genocide and other experiences of the past.  How do we learn to process emotion rather than ruminate on it while increasing blame, shame and immobility?    

The memories of reactions to both historical and personal trauma lie in the body, in organs, muscles, bones and fluids. These unprocessed emotions form a vast organizational structure that connects the systems of the brain and the body such as the nervous, immune, endocrine, digestive, circulatory and respiratory functions.

Somatic Meditation for Emotional Processing

Somatic meditations offer resources for health and development as well as creative interventions for their work with people with unprocessed emotions.  The following meditation is one that is inspired by the work of Reggie Ray, allows us to gradually integrate generational emotional trauma. This meditation is best done in relationship as both parties work to co-regulate vague, somatic symptoms that seem to relate to early childhood trauma and/or historical trauma. Deep unprocessed emotions lie in the viscera of the belly, the abdomen, chest, throat, face and brain—as well as the voluntary limbs and skeletal system.  Be prepared for the emergence of feelings that have been out of awareness as you enter into this meditation.

1. Take time to lie down on a solid surface, a rug or mat under your body, and a pillow under your knees.  Gently notice the felt sense in your body, slowly sweeping your awareness over your toes, feet, ankles, legs, pelvis, back shoulders, elbows and head.  

   • Encourage your bones, muscles and tissues to feel gravity and begin to let go of any tension and holding.  Imagine the earth beneath you in its texture, form and presence.  

   • Bring your awareness into a surrender into gravity, trusting the earth to receive any discomfort that has been in your body.  You may notice the subtle vibrations of the earth that can begin to move into your body.  

   • As you witness your own body, observe and acknowledge the inner movements and feelings.  You are entering into your fundamental birthright, your ability to fully live as an embodied human being.  From the perspective of embodiment, your awareness becomes a potent internal dynamic for healing.
     

2. As your awareness moves from observing from a distance to a sense of being in your body, that embodied awareness becomes a potent healing dynamic, gently shifting the organization structures of trauma.  From an inside perspective and embodied awareness, bring your attention to your belly.

   • Gently place your hands on your belly and notice from the inside what sensations, movements and feelings are present.  Simply notice, don’t try to change anything or interpret anything.  Simply be with, in and joined with whatever appears.  Here we are. Embodied. Together.

   • As you notice the sensations, your brain is listening and, in its infinite wisdom, can implicitly do whatever it needs to do for healing. A neural connection here, a release of hormones there, or perhaps a non-voluntary movement.

   • You can trust your innate wisdom to do what is needed. If you move back into rumination—just readjust and come back to embodied awareness.
     

3. Next bring your attention to your midsection.  Place your hands on your ribs and observe from the perspective of your hands what you might sense going on inside the abdomen.  

   • Now shift your awareness to embodiment and enter into the felt sense of the chest, lungs and solar plexus.  Simply notice with great compassion any sensation, movement or lack of movement.  

   • Emotional processing through bodily-based awareness needs accompaniment. Take your time to be with the sensations and movements, join your awareness with them and it will lead to where it needs to go.  Notice color, tightness, heaviness, density, space, vibration, pulsation or numbness.  

   • Don’t try to fix anything—simply hold awareness so the unconscious brain can take note and devise its own strategy for healing. 
     

4. Continue this exploration into the throat, embody the sensations, movements, tightness, space, color and any other phenomena that may emerge. Trust this journey into the core of emotional processing in the throat and neck.  

   • Take a few moments now to shift to the face, bring a little movement into the eyebrows and then embody any sensations, movements or numbness.  

   • Attend next to the jaw, allowing it to drop down into gravity and notice how that shifts any sensations in the face or viscera.  Follow the tracks of the somatic phenomena as it moves through the body.  

   • Allowing your inner wisdom to guide you with subtle, “barely perceptible cues”, into the unknown and hidden places of old historical trauma or more current holding of overwhelming emotions.  Engage your awareness and follow deep into embodiment.  
     

As you complete this inquiry through your embodied awareness, let go of this focus and simply breathe and relax, preparing to enter into your day.  As you come into a more external, yet embodied awareness, you may want to jot down some notes that come to you as you allow your reflective abilities to integrate this inquiry.  

Gradually, over time, your body will re-organize to allow new responses to emotional experiences that are different from the reactions of the past.  Continue to be intentional about your emotions, let go of the endless attempt to solve them through rumination and enter into a somatic inquiry within the memories as they live in the body.  And then offer to guide another through this labyrinth of human transformation.

When Our Bodies Betray Us

Last night as I gathered with a small group at a local yoga center, I listened to several participants describe how they have felt betrayed by their own body.  Injury, illness and severe emotional loss had combined to overwhelm their usual self-care practices of thoughtful nutrition, yoga and insight-based meditation.  The result for these caring and conscious people was a profound loss of trust in the innate wisdom of the body to recover physical, emotional and spiritual health.  They wondered, “Where do we go next?”  They were interested in how the knowledge and practices of Somatic Transformation could help them access their diminished vitality and restore trust in the innate healing processes of their own bodies.  

Somatic Transformation has lately been going through a renewal.  Since the publication of my book, “Relational and Body-Centered Practices for Healing Trauma: Lifting the Burdens of the Past”, I have discovered a new depth of knowledge through the regular practice of somatic meditations.  Each day, after a personal stretching and gentle yoga practice, I enter into a somatic meditation, guided by ancient Buddhist wisdom.  My personal practice of meditation  has been integrated with the research insights from neurobiologist Stephen Porges and his Polyvagal Theory and with the knowledge of right hemisphere emotional processing from the research of neuroscientist Allan Schore.  

For the past two years, I have been intrigued with an innate urgency to personally incorporate somatic mediations into my daily life.  This daily practice, under the guidance of a five-month retreat called Meditating With the Body from DharmaOcean has awakened in me a renewed interest in the development of somatic meditations that respect the bodies and souls of people who have been wounded by physical, emotional and spiritual trauma.  People who feel betrayed by their bodies.  The healing process of neurologically and empathically based somatic meditations are finding their way into my private psychotherapy practice with people with trauma as well as into the educational work of Somatic Transformation.     

The roots of somatic meditation lie deeply in ancient Tibetan spiritual practices, as well as the practices of other traditional societies, and have been the focus of the profound work of Reggie Ray.  Reggie, known more formally as Dr. Reginald Ray, is a former historian of Buddhism, and founder of DharmaOcean, a world-wide organization for the advancement of somatic meditation.  In his radical life work, Reggie is bringing the vast healing resources of ancient generations into a healing modality that is most needed and appreciated by people who are interested in exploring the innate intelligence of the body.  In “The Training and the Path”, Reggie synthesizes his trust in the organic wisdom of the human body:

“(The body is) a coherent intelligence with a point of view, a process with direction, a source of wisdom, and a limitless benevolence… (It) constantly communicates information about life.”

When I ponder the above statement, I am affirmed in the trust I have placed in the body to reveal and transform “all that is not yet love”.  The historical legacy of trauma has resulting in the suffering of millions in our world and often a deep sense of cynicism, dissociation, and despair that comes with a feeling we have been betrayed from the inside—from within our own essential being.  

I am excited to incorporate the new knowledge from the practice of somatic meditations in our training program for helping professionals, the consultations with practitioners of Somatic Meditation and now in community based groups of people interested in how to restore an innate aliveness of the body, soul and spirit in our wounded world.  I will be posting new practices for somatic meditation on this blog.  Please feel free to participate in this exploration and let us know in the comments or on our Facebook page what is clinically helpful.