As I specialise in trauma management, I am often asked about how treatment works. The short answer is that often we do not know!
There are many leading therapists who get good results and this seems to arise because they are well informed and skilful (one reason why I have written the commentary on Person-centred therapy).
I’ve mentioned a few already, but I will focus here on Peter Levine having revised some of his material recently. As with Bessel van der Kolk, Peter looks at the responses of our body and he asks how we can work therapeutically with the body in different ways.
One thing of particular importance is the idea of the flight/fight response. The responses of the lower brain, and the amygdala in particular, can help us run or fight in a threatening situation. We can recover and escape, possibly without long-term physical or emotional damage.
However, if we do not run, the primitive circuits of our older and not so smart sibling can persist and take over. Our ability to function will deteriorate. The potential for post-trauma starts to be set up.
If you can’t fight or flee – you may end up frozen and helpless. You have to work through that unpleasant experience if the trauma is not to to be retained in your body. Therapy can help us to find a place for the experience that makes sense – to place it at the ‘back of our mind’ – rather than pre-occupying us by obstructing the front!
In his writings, Peter talks about the body as a container that embodies all our experiences – everything we think and feel. Simply appreciating that we live in a body, and not in our heads, starts to give us therapeutic opportunities to build a safe environment.
The bodily events happening one after another provide both the story about what is happening and the visceral exponent that ‘glues’ the event in our matrix memory. The story we tell rather depends on the workings of our younger and smarter sibling, This may provide one part of our recovery but only if the way in which we once felt inside is ‘unglued’ – that is, experienced, not avoided.
Once we regard the body as a source of information, and tune into what is happening in the body at any given moment, we may be able to release ourselves from some of the trauma held in the body.
Another way to view this Flight, Fight and Freeze response is to study Stephen Porges’ account of the Polyvagal system.
Polyvagal theory is a large and complex subject to research. It does demonstrate how modern therapy and modern neurology appear to be coming together. It is not a study to take on lightly!
How can we use these ideas in a practice?
When body scanning, just notice the thoughts, feelings and sensations, as described in the main body of my blog. When it feels right, focus on the sensations and stay with the body experience. Start to just notice the intense sensations and feelings as moment-to-moment experiences. Do not divert or distract yourself with starting something different. To do so would take you into a different set of experiments.
Just noticing these responses in the present can become very freeing, even if they seem to invite freezing as well. However, those feelings can transform themselves on their own – without action or the need to play them out.
Compare this with the mid-20th century approach of Alexander Lowen and Wilhem Reich. They recommended that therapy work with feelings by discharging them in some fashion; by acting them out. Today, we are aware that we are able to stay with the feeling and not necessarily express it outwardly. Feelings can still transform; indeed, the neurology of how feelings grow and subside rather require them to transform.
This leaves the issue: when might acting out work or, indeed, leave us stuck with more to come. When is this acting out, or cartharsis, as it is known, not required for healing to take place?
The general answer is that acting out will work in the here-and-now. When it is ‘situationally appropriate’. That is, when the threat is present and immediate. If I find myself in a circumstance that is potentially overwhelming, then it is usually better to act. The alternative to fight or flight is to freeze. It is this state of freeze that can foster stuckness – like the bunny caught in the headlights. Freeze works best when we need to be anaethesised or prepared for death.
I do some work in the area of domestic abuse. Here I notice how angry people do act and may do damage. Often they will speak remorsefully afterwards, but most often, this belated apology appear non-genuine. Furthermore, they are likely not to feel their anger after the event. They have acted; their feelings are dispersed. That action, anti-social though it may be, is defensive. Instead of just feeling the anger, it is enacted and minimal residual feelings are left. It would be handy if some genuine shame could survive, but with some people this does not happen.
So, in brief, how do you develop a sense of the body as a source of safety, rather than a repository of threat? Everything keeps changing but the body is still here; awareness is still here. We can tap into that. The body is a source of information – by tuning into what is happening in the body by body scanning we can look our fear in the eye – not as our best friend, maybe, but as a powerful tutor.