Quotes and Definitions of Trauma

"Trauma again is not what happened to you. It is what happened inside you as a result of what happened to you. And that's the good news, because if trauma was what happened to you, that somebody sexually abused you or that your parents died in a war, if that was the trauma, there's nothing you can do to change that. That happened. It was never not going to have happened. But if trauma was the wound that you occurred inwardly, you can heal that wound at any time. So actually the recognizing what trauma is as an internal psychological wound with manifestations in your body actually allows you to heal it." 

- Gabor Mate

“Preventing people from moving when something terrible happens is what makes trauma a trauma.” 

- Bessel Van der Kolk

My Approach to Nervous System-Informed Therapy 

Informed primarily by Stephen Porges' Polyvagal Theory and Dr. Daniel Siegel's Window of Tolerance

In a hyperarousal state, you may also experience buzzy, go-go-go energy, feel edgy, irritable, and restless. Brene Brown calls this overproducing.  In a hypoarousal state, you may experience procastination, a lack of motivation, inertia, feeling lazy, doing little to nothing to change. Brene Brown calls this underproduction. 

In sessions with a Nervous-System aware and mindful therapist, sessions will focus on increasing your Window of Tolerance over time, by pendulating (moving or swinging) between titratated (small bites at a time) amounts of processing the hurt, with, strengthening resources. 

Therapy may focus on one traumatic event and we may end our therapeutic relationship after you feel it is no longer impacting your day-to-day life. However, therapy can also be a place to process a lifetime of 'small t' traumatic events, generally relational or self-esteem related. In which case, we too can choose multiple paths. Two of which include: working efficiently and effectively to reduce the 'sting' of each of the traumas until you feel you are ready to move away from therapy. Or, may take a slower approach, giving more space for working through what is happening in life currently along the way, and giving space to really feel into the relief, the celebration following a completed processing of a memory. 

The duration of treatment really depends on the current state of your nervous system, the support system you have, your goals for therapy, your trauma history, and your preference in approach. I do have my own biases, and, will always name them as such to ensure I am not influencing your decisions in a way that feels blindly led to you. We will be collaborative all the way through. After all, one of the main keys in healing childhood trauma is getting to a place where your Inner Child can truly see and trust that things are different now: that you have a voice to advocate for yourself, the means to take care of yourself, and the commitment to only let those who see you for you and respect you as you to have any influence in the way you see yourself or live your life.

The 5 Steps in the Body's Trauma Response

from Peter Levine's Waking the Tiger

(1) Startle Response 

a state of hypervigilance, sensing a potential threat

(ex. hearing a tiger walking in nearby brush)

⬇️

(2) Stress Response

a state of a high energy and action

(ex. thinking "What do I do? I got to get out of here!" and vigilantly looking for an immediate way to protect yourself or get away)

⬇️  

(3) Thwarted Movement 

a moment where self-defense is useless  

(ex. seeing that there is no opening to run away, and no branch to climb a tree fast enough)

⬇️ 

(4) Freeze Response

a state of panic quickly met by powerlessness and immobilization

(ex. feeling stuck, perhaps wide-eyed and staring in the tiger's direction)

⬇️  

(5) Shut-Down 

a state of heaviness and hopelessness

(ex. feeling like there is no way to survive, nothing to be done but surrender to the inevitable suffering)

Wordens Tasks of Mourning

Task I: To accept the reality of the loss

Task II: To process the pain of grief

Task III: To adjust to a world without the deceased

• External: How has the death affected everyday life?

• Internal: How has the death affected feelings about self and abilities?

• Spiritual: How has the death affected spiritual beliefs and views of the world?

Task IV: To find an enduring connection with the deceased in the midst of embarking on a new life.

Caroline Leaf's Possibility Mindset for Uncomfortable Emotion(s) 

1. Embrace: Gather awareness and allow yourself to feel whatever is there

2. Process: Reflect and Write

3. Recheck: Look at what you've written and worked through, see how it can be looked at differently. What is the solution? What did you learn? How can you move forward?

4. Action

Our Nervous Systems are Working Overtime to Keep Us Safe in the Midst of Uncertainty

May 7, 2020

There is so much being written, said, and spread about Coronavirus, COVID-19, and life in quarantine presently. I’ve withheld myself from adding to the noise.

Here’s the thing though: there is a LOT of contradictory information out there. Contradictions said between people in authority and between people speaking from their expertise. It’s confusing.

Our bodies interpret these contradictions as chaos. The chaos translates as a threat to our survival. Our amygdalas (as seen as the thumb in the picture below) are the alarm bell system of the brain. They are all presently hyper-alert, screaming “Give me back my independence,” “Give me back my freedoms,” “Give me back my financial security,” “Give me back my sense of immortality,” and “Give me back my connection with others.” It’s a lot of loss, a lot of grief that we don’t like and don’t want.

All of this protest, whether fight-or-flight energy, has gotten locked within us. Fight can be either a physical or verbal attempt of overcoming danger and flight is our attempt of getting away from danger. Picture Usain Bolt caught and restrained mid-flight. Picture Jackie Chan getting his arms and legs tied to his body mid-fight. Picture Martin Luther King Jr. presenting his “I have a dream” speech, and mid-sentence, his lips are glued shut and he’s unable to speak.

All that fight-flight energy pushed back inside the body without a way out throws the nervous system off balance.

Science has shown that the lasting impact of difficult events on the brain and body is related to how we make sense of the event and our experience rather than the event itself. Consider how two people may both be told at a ticket office for a new movie “Sorry, we’re all sold out.” One person might say “Bummer! Well, can I have a ticket for the next movie then please?” While the other person may seemingly overreact with, “This always happens to me. I came 20 minutes early! Is this for real? There has to be some way!” Both people were told the exact same thing. Their reactions to the event are quite different. The first person maintained Upstairs Brain capabilities, while the second person slid down quickly into Downstairs Brain reactivity.

Similarly, some people in quarantine are having a very difficult time, while others are able to utilize the time to accomplish projects around the house and complete To-Do List items that had been on hold in the busy day-to-day pre-quarantine life. Personality type (ex.introversion vs. extroversion), trauma history of unfortunate incidents, general felt-sense with structure vs. unpredictability, the safety of the quarantine environment, and the familiarity and likability of the people in the quarantine environment are only a handful of variables that allow each person’s experience within the collective experience to be unique to them.

Anxiety is one of the most contagious emotions.

The picture named “Figure 2.1” identifies what happens in our bodies when we move from our Parasympathetic Nervous System—our rest and digest or tend and befriend state—into a Sympathetic Nervous System response.

The Autonomic Nervous System Ladder below is a part of Stephen Porges’ Polyvagal Theory. Porges found that the vagus nerve that moves through the torso up into our face connects our body and brain, sometimes called our gut-brain and our head-brain. It’s quite fascinating all the places we can influence our felt-sense of social safety through informed movement practices with sound and breath, specifically.

When we’re thriving, we’re in a Ventral Vagal activation state, our Upstairs Brain. For most people, when the threat of quarantine and illness first came, we jumped into Sympathetic Activation, sliding down into Downstairs Brain with fight-or-flight reactivity. No matter how many times we hear “We’re all in this together” there can still be an overriding sense of “There’s no way out” or “Nobody is looking out for me and there’s nothing I can do.”

That’s the Dorsal Vagal shut down response. We freeze when we don’t have the option to fight or flee. Think of a possum—pretending to be dead so that any predator would lose interest. We collapse when we truly feel “There is nothing I can do,” when we’ve lost all energy and belief in the ability to keep burning energy and resources: Usain Bolt caught and restrained, Jackie Chan all tied up, or Martin Luther King Jr. with glued lips after some time of trying to get loose. It too is a survival response—a conserving energy response.

If you’re experiencing a greater amount of exhaustion and nightmares, as many people are, chances are that fight-flight energy hasn’t had a way to get out and sunk down into an involuntary freeze or collapse Dorsal Vagal state. Nightmares occur when we have too much sympathetic activation. Deep REM sleep is the only time our bodies process information without the emotional charge of cortisol and adrenaline rushing the brain. Disney Pixar’s Inside Out has a pretty good representation of disturbed REM Cycle sleep in “Dream Productions.” Our brains attempt to make sense of any unprocessed material from the previous day through dreams. When life feels un-make-sense-able, our dreams are left chaotic and charged with fear.

Awake and asleep, our nervous systems are trying desperately to keep us safe and alive. In the process of making sense, we filter through what information will be stored for future retrieval and what will be discarded. Richard Miller offers two guided meditations on iRest.org for deeper rest that may be quite helpful for getting settled in your own nervous system as you lay down to sleep.

When we begin to move down the Ladder, we’re more jumpy, more reactive than reflective.

We’ve probably all been told to take a calm, deep breath. Sometimes even being told ‘calm down, take a breath’ can be unsettling.

When we inhale we tap the vagus nerve in our gut and as we continue to exhale, then inhale and repeat, key information is sent up into our brain saying: “You’re okay. You are going to be okay.”

There are so many methods of breathing. Below is a menu of soothing options. As you read through the practices, consider if it feels like a “Yes,” “Maybe,” or “No” for your nervous system. Goal: Try to slow down your breaths from 10-14 breaths per a minute to 5-7 breaths per a minute. All of the practices can be repeated until your heart rate feels calm to you, then repeat one more time noticing how it feels to feel calm.

Regulatory Practice Name & Description

Box Breath

Inhale for 4, hold for 4, exhale for 4, hold for 4.

Daily Minimums

Set an achievable activity/practice goal for each of the 6 parts of being a whole person: Spiritual, Emotional, Social, Physical, Mental, Play/Creative. These are commitments that are doable even on your lowest days. Ex. I will have 5 minutes of meditation/prayer/spiritual reading when I get out of bed (spiritual), name my emotions when I notice them (emotional), reach out to 1 person outside of my home with a “thinking about you” message (social), go for a walk around my neighborhood (physical), read for 15 minutes (mental), and do something artistic for 15 minutes (play/creative). Choose what works for you and is honoring, healthy and helpful to your nervous system.

Grounding

Stepping outside, whether on grass, dirt, or pavement, begin to notice the felt-sense of being supported. Notice the temperature and texture of the ground beneath your bare feet. With a natural, deep inhale, allow the sense of being supported to rise into your body. With your exhale, allow yourself to sink deeper into the support of the ground beneath your feet.

Parasympathetic Extended Exhale

Inhale 5, exhale 6; or, inhale 4, exhale 8.

Sympathetic Extended Inhale

Inhale 5, exhale 4; or, inhale 9, exhale 8.

"Hmm” Breaths

Inhale 6 counts, then with your lips closed make the sound “Hmmmmm” vibrating your lips, jaw, and eardrums for a 6 count exhale. This practice also strengthens the vagal nerve located near the ear.

Emphasizing Sense of Choice and Witness

• Example 1: “For snack, I want fruit. I can choose an apple, orange, banana, or mango. I choose mango.” Inhale. Exhale. “I have choice.” Inhale. Exhale.

• Example 2: “For my meditation, I’ll sit...Observing my body, I want to lay down…My arms want to open out to the side.” With each movement, however small, highlighting the sense of choice with a deep inhale and exhale.

• Example 3: “For my connection outside of my house today, I will call/text/FaceTime/Zoom/message with ___.” Inhale. Exhale. "I am a witness to their grief and struggle, joy and triumph, as they are a witness to mine." Inhale. Exhale.

Emphasizing Ability to Move

Ex. Perhaps hanging your torso over your legs with loose monkey arms or willow tree branches dancing in the wind. After some time, inhale and rise up.  Exhale, and further your hang.

Fear Melters movement 

• Flight? Root. Lowering into a deep Buddha squat, image your toes rooting you down deep into the earth where the earth is able to energize you right here in this moment. 

• Fight? Ooze. Imagine yourself as oozing chocolate as you slow down your words, softening and oozing your arms, jaw, shoulders, and hips. I also think of this as turning limp like an octopus letting my tentacles sway. 

• Freeze? Wiggle. Starting with your fingers and toes, moving to your hips, knees, and shoulders, and finally feeling the wiggles move through your whole body, energizing you all the way to the core.

• Faint? Love scoops. Reaching your arms out and scooping
  up all the energetic resources around you. Bringing your hands full of love towards your heart, stomach, mind, or wherever you would like to receive loving touch.

Emphasizing a Moment of Awe

Scanning your environment, identify a point of interest to savor. Moments of awe help us recognize our smallness, while also feeling connected to something vast. Once dentified, naturally deepen your breath as you let the felt sense of awe fill your body.

Embracing Hug

Inhale deeply and slowly as you stretch your arms to the sides as far as they’ll reach. Exhale as you bring them in, hugging yourself. Inhale deeply and slowly. And, as you exhale wrapping your hands a bit further, deepening your hug.

“Name it to Tame It.”

Within your natural deep breathing, gently bring nonjudgmental observation to your emotional and sensory experience. As something arises, practice naming the emotion or felt-sense aloud to yourself.

Radical Acceptance

Within your natural deep breathing, gently greet whatever emotion, thought, or felt-sense arises with a friendly, slight smile and compassionate “this too.”

Organized Movement

Organized movement such as yoga, riding bikes, walking, running, or dancing allows the fight-flight energy to move within the parameter of predictability.

SIFTing Through  

As you allow natural deep breaths to rise and fall, begin to observe your inner state with non-judgement. What bodily sensations do you notice? What images appear in your mind’s eye? What emotional feelings come up? And, what are your thoughts? You could choose to journal your observations.

In any practice, you’re growing awareness of what feels good or helpful to your nervous system, and, adding the Yes’ and Maybe’s to your toolbox. When we practice regularly, we build a habit of knowing the tool works. Then when something happens, we can rely on the tool to be there. If we don’t practice, when we flip our lid, we likely will forget there’s a toolbox all together.

With current circumstances intensifying the reality of uncertainty, I believe our primary responsibility is doing what we can—as individuals and as community—to protect and settle our own nervous systems and when we are settled lend our balance to another. Just as anxiety is contagious, calm is contagious too.

Our world is flooded with stress hormones right now. We’re actually in a collective trauma state. Trauma being a word used to express “life is too overwhelming for me to process and cope through with the tools I know.” When we are able to find some sense of calm, we have activated soothing hormones. We can then reach out to those whom we’re living with or through technology with others outside our places of shelter and share a sense of calm through eye contact or other gestures that increase our sense of connectedness hormones.

To do this, you can start by scanning how you’re spending your days. Where are you when you feel most activated? Who are you around? What are you doing? For example, I generally appreciate movies most when I cannot predict the ending. However, in the midst of global uncertainty, I’m choosing only to watch movies or television with my spouse, and all of our movies are predictable. If something begins to rush my system with stress or heightened anticipation, we choose together to turn the movie off. It’s one thing I can do to help my system feel a little more settled.

Just as we want to add helpful practices, we also need to scan our lives for habits or current behaviors that are adding to the noise and unsettledness of life. It's about grieving what normal rituals and rhythm have been lost as Coronavirus came into the scene, and, finding the rhythm that best suits you and the people you love at this time.

Perhaps this commitment to building habits around taking responsibility to settle our own nervous systems and lend our settled systems to others more effectively can be our answer to the purpose of this suffering, as written about by Viktor Frankl in Man’s Search for Meaning (1946). Will you imagine, with me, a more compassionate world filled with a greater sense of relational safety?

_____________________________

References

Brach, T. (2004). Radical acceptance: embracing your life with the heart of a Buddha. New York: Bantam Books.

Brown, B. “Comparative Suffering, the 50/50 Myth, and Settling the Ball.” Unlocking Us. (2020, April 2).

Dana, D. (2020). “How to Help Our Nervous Systems During a Pandemic.” Psychotherapy Networker.

Kolacz, J., Kovacic, K. K., & Porges, S. W. (2019). Traumatic stress and the autonomic brain‐gut connection in development: Polyvagal Theory as an integrative framework for psychosocial and gastrointestinal pathology. Developmental Psychobiology. doi: 10.1002/dev.21852

Porges, S. W. (2011). Polyvagal theory: neurophysiological foundations of emotions, attachment, communication, and self-regulation. W. W. Norton & Company.

Siegel, D. J. (2011). Mindsight: Transform your brain with the new science of kindness. London, England: Oneworld Publications.

Siegel, D. J., & Bryson, T. P. (2016). The whole-brain child: 12 revolutionary strategies to nurture your childs developing mind. Vancouver, B.C.: Langara College.