Healing Trauma and Post-Traumatic Stress

The experience of trauma can come from any event which stresses the nervous system or drains our emotional (psychological) resources. Being “traumatized” often refers to the symptoms a person might experience after the event. These can include:

  • anxiety and dysphoria (uneasiness, depression, restlessness)
  • emotionally-based problems (such as irritability and detachment from relationships)
  • intrusive re-experiencing (unwanted memories and reminders, “flashbacks”)
  • avoidance of the unwanted memories and reminders
  • hyperarousal (jumpiness, easy to startle)

Individuals experiencing a life-threatening (or perceived to be life-threatening) event sometimes experience post traumatic stress. Symptoms of post-traumatic stress include:

  • hypervigilance
  • flashbacks (reliving)
  • dissociation

Falling into the anxiety disorder category, post-traumatic stress is considered to be a psychological reaction to experiencing a life-threatening event. The traumatic event usually involves actual death or a sense of impending death/serious injury to one’s self or others.

Traumatic events leave the mind and body in shock. In the aftermath of the experience, we start to make sense of what happened and we begin to process our emotions and reactions. Individuals with post-traumatic stress remain in psychological shock. In order to move on from the experience, we need to look at the experience, and face those memories and emotions. As the famous poet Robert Frost said, “The only way out, is through it”. However, the way in which we look at it needs to be gentle and moderated. Contemplating the entirety of an upsetting situation will only leave us raw and emotionally flooded. We need to look at it in bits are pieces, while taking care to resource ourselves.

Click here to read more about post-traumatic stress and complex post-traumatic stress on my website.

I choose to believe that post-traumatic stress is not a life sentence. I believe that by working with the thwarted energy in the nervous system and creating regulation, we can process the traumatic material and start creating healing. The therapeutic approach I am speaking of is Mind-Body Attunement Therapy (MBAT). Developed by psychologist Kevin Miller, MBAT is based on the self-regulation therapy of research and therapist Peter Levine.

Some great books by Peter Levine include:

Waking the Tiger: Healing Trauma, The innate Capacity to Transform Over-whelming Expereinces (1997), by Peter Levine and Ann Frederick

In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness (2010), by Peter Levine and Gabor Mate

Trauma-Proofing your Kids: A Parent’s Guide for Instilling Confidence, Joy, and Resilience (2008), by Peter Levine and Maggie Kline

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Visualizing a Safe Place

flower gardenOur imagination is a powerful tool in our repertoire of resourcing strategies. An imaged safe place is one of these. Everyone needs a place where they can feel safe and each person’s safe place makes perfect sense just for them. It could be in the Swiss Alps, in a quiet country house, an beach beside the ocean, a peaceful garden, or a cozy room. While these lovely places of comfort aren’t usually physically available to us when we need them most – we can still create a mental haven,  accessible through imagery, and available to you whenever you need it. Having an inner safe place has proven effective in helping people cope with stress and increasing their sense of safety and comfort.

The use of an imagined safe place is especially helpful for people who have experienced trauma. When fear, panic, or self-destructive thoughts become over-whelming, you can use your imagination to go to a restful inner sanctuary – a personal haven from the effects of trauma and other life stresses – to regain a sense of safety, to restore strength, and to achieve a renewal of spirit. Once you have grounded yourself with your safe place, you will find yourself feeling more equipped to deal those tough emotions or memories.

Resources:

Cohen, B. M., Barns, M. M., & Rankin, A. B.  (1995). Managing Traumatic Stress Through Art: Drawing from the Centre.

Miller, K. (2012). Mind-body attunement therapy: Clinical Strategies. Mind-Body Attunement Training Centre

Use a Memory Cue

sticky dotsWhen it comes to behaviour changing, remember to use our techniques can be difficult. We can learn the greatest, life-changing technique, but if we can’t remember to use it in the moment we need it the most, well then, it is rendered quite useless. Try using a memory cue to start creating a pattern of use.

I call this strategy the “Sticky Dot Technique” because it involves the use of the small, circular sticky dots that can be purchased at any business supply store. Take approximately 10 sticky dots, and place them in places that will be visible to you (such as on your computer, cell phone, in the kitchen, on a coffee mug, on a mirror, and so forth). When you see a sticky dot, check in on how you are coping. What are you doing behaviourally? What sensations are you experiencing physiologically? What are you saying to yourself? You may want to remind yourself to “just breath”, or to honour your healing journey in another way.

I can not take credit for the genius behind this technique! It was taught to me in 2005 by a practicum supervisor (Derrick Doige), as part of my Master’s degree. Derrick Doige is a Counsellor with Okanagan College in Vernon BC, and also has a private practice.

Deepening the Breath

Anxiety and stress can affect the way you breathe. Holding your breath, as well as breathing rapidly or shallowly may be related to chronic anxiety, which can be a symptom of post-traumatic stress. Awareness and regulation of the quality of your breathing can have several positive effects:

  • Slowing and deepening your breathing allows for adequate intake of oxygen and output of carbon dioxide which is needed for physical well-being
  • Conscious breathing during times of distress allow you to release muscular and emotional tension, thus reducing levels of distress
  • Focusing awareness on breathing can shift thoughts away from flashbacks and non-productive or obsessive thinking, and bring your awareness back to the present moment

Get to know what your breathing patterns are like throughout the day. Take a quiet moment to tune in, and notice the following qualities of your breathing:

  • the depth of your breathing: is it shallow, deep, moderate
  • the rate of your breathing: is it fast, slow, moderate
  • the pause between the inhalation and exhalation of your breath
  • the expansion and contraction of your rib and abdominal areas
  • changes in the overall pattern of your breathing

Here is a simple breathing technique you can do anywhere:

  1. In a moment of calmness, inhale completely, and then count starting at 1 as you exhale
  2. When your exhale was complete (oxygen was completely out of your lungs) what number did you have?– This number now becomes your baseline. When you find yourself feeling anxious, stressed out, angry, etc. focus on slowing your breathing:
  3. Add 2 more numbers to your baseline

** This means slowing the rate of your exhale, not counting faster!

So, if during a moment of calm, your exhale takes you to the court of 6, during a moment of emotional upset, you will want to stretch that exhale to the count of 8.

Want to make that deep breathing more powerful? Add a Visualization to dandelionIncrease your Calm:

For some people, it is helpful to pair deep breathing with a calming vision. As you are learning this technique, it may be helpful to visualize a ship floating on the sea. As you breathe in, waves wash up onto the shore and the ship bobs closer. It bobs close enough to the shore that you can clearly see its details: lettering on the bow, the colour of the sails, people on the deck, etc. As you exhale, the waves pull away from the shore and the ship bobs farther out of view. Or you may want to visualize a feather floating in the air, a balloon, and so forth. Because deep breathing involves the pulling of oxygen into the lower lungs first, for some people it is helpful to visualize a jar being filled with water. As the water is poured in, it splashes into the bottom of the jar, then rises to the top, overflowing over the rim and out onto your hands. The jar symbolizes your torso, and the water the oxygen you breathe.

Resources:

Exhale-plus-2 Idea adapted from Carolyn Costin, MA, M.ED, MFT (2011)

Cohen, B. M., Barns, M. M., & Rankin, A. B.  (1995). Managing Traumatic Stress Through Art: Drawing from the Centre

Haskell, L. (2003). First Stage Trauma Treatment

Mate, G. (2003). When the Body Says No: The Cost of Hidden Stress

Sgt. Charles E. Humes (2003). Lowering Pursuit-Induced Adrenaline Overloads
http://www.pusuitwatchorg/stories/adrenaline.html

Focusing in the Present Moment

Taming your Monkeymonkey mind

Learning to be focused in the present moment can be challenging. I don’t believe this is just the case for those who have experienced trauma, of for those with anxiety. I believe it is a symptom of fast-paced society, where we are driven to do more and where flashy technology and advertising vies for our attention. Often when we try to concentrate, our minds have a tendency to wander. It just takes some focused attention (and patience with yourself) to learn to be present and in the moment.

A distracted mind has even been referred to as ‘monkey mind’. I imagine this as having a monkey contained in a room – he’d be jumping from one piece of furniture to another, climbing the ways and hanging on the curtain rod or blinds – and all the while chattering incessantly. It is in this way that our minds tend to do the same: engaging in an endless flow of dialogue, jumping from topic to topic. If you are trying to focus your attention in the present moment, please do not be discouraged if your mind wanders! It is natural. Everyone has ‘monkey mind’ from time to time!

Reassure yourself that iI takes practice to become mindful: to be in the moment and aware of your thoughts without judgment.  If you notice while you are doing any of containing and grounding strategies that your mind wanders, be patient with yourself. It’s hard to learn a new skill; do not put yourself down or call yourself names. Most likely there have been enough people across your lifespan who have done that. Simply notice that it happened, be kind to yourself, and return to where you left off.

Resources:

Tolle, E. (2003). Stillness Speaks.

Kabat-Zinn, J. (2005). Guided Mindfulness Meditation, Series 1.

What is Affect Regulation?

Affect regulation strategies include developing the tools and resources necessary to recognize, observe, modulate, and cope with affects you may be experiencing (affect is another word for emotion). In developing these tools and skills, you will be better able to cope with disturbing emotions as they arise (such as grief, anxiety, anger, fear, frustration, etc.).

Developing the ability to regulate affect begins with learning to identify emotional sensations within your body.

Containment strategies are useful techniques to regulate affect because they can be effectively used to control intrusive trauma memories and images (flashbacks), and disturbing physiological sensations. These overwhelming memories, images, sensations, feelings, or thoughts can sometimes lead to harmful behaviour, making it extremely difficult for you to focus on healing. Learning effective containment skills can empower you and reassure you during difficult times. The term containment is not used here to refer to “stuffing” or ignoring your experiencing. Just the opposite, in fact. It’s about acknowledging the incredible power the distressing memories have, and creating the safe internal place from which to work through them. In her book “Healing from Trauma”, Jasmine Lee Cori describes it as “to contain something is to hold it, to create a place for it, in some ways to protect it”.

“With containment… we learn to discriminate how much (emotion) we an handle at  any given moment without overload. We understand that the point is to keep the feelings from getting so intense that they burn us. We learn to contain a feeling so that it doesn’t run roughshod over us but instead is given a place and listened to” — Jasmine Lee Cori

Because every person is unique, there may be some affect regulation strategies that work well for you and others that do not. Try the strategies that sound interesting to you, approaching them with an open mind and a curious attitude. Try each strategy you select over a couple of days, and write in your journal what the strategy was like for you.

Resources:

Cori, J. L. (2008). Healing from Trauma, A Survivor’s Guide to Understanding your Symptoms and Reclaiming your Life.

Haskell, L. (2003). First Stage Trauma Treatment: A guide for mental health professionals working with women.

About Mind-Body Attunement Therapy

Mind-body attunement therapy (MBAT) is rooted in the science of neurobiology. This fundamental underpinning sets MBAT apart from other therapies, which tend to be rooted in theory. It is an attachment and trauma focused therapy. Mind-body attunement therapy addresses the essential role played by the body, and the experience of emotions in the body. Peter Levine, a pioneer in the field of trauma theory and self-regulation therapies, explains that an incredible imprint is left in the nervous system when a person experiences a traumatic event. When faced with life-threatening danger, our human tendency is to fight, flee, or freeze. Our bodies generate an amazing amount of life-preserving energy. If our physiological response to that danger is somehow thwarted, such as when the danger is over-whelming and we freeze, this energy remains “stuck” in the nervous system. 

Mind-body attunement therapy thus is a body therapy, which works with the experience of emotion in the body (the “stuck” energy in the nervous system). There are basically two “jobs” that we want to accomplish in therapy to create a healthy nervous system. The first is to resolve unprocessed emotional memories that remain locked in the nervous system. These tend to get activated frequently (you likely know they are activated because you react with a high level of emotion which doesn’t seem to fit the situation you are currently in). So these unprocessed emotional memories tend to negatively impact our emotions, behaviours, and thoughts. The second “job” we want to accomplish is to teach your nervous system to return to calm quickly once it has been activated. Research shows that when we are exposed to ordinary everyday stressors, it takes approximately 2 to 3 minutes to return to a sense of calm. Some individuals take significantly longer than that, with activated responses lasting from several hours to several days. Using mind-body attunement therapy, the focus is on resolving unprocessed emotions and teaching the nervous system to calm quickly. Thus, MBAT assists individuals to work through over-whelming experiences without causing them to be re-traumatized.

“Trauma is a fact of life. It does not, however, have to be a life sentence. Not only can trauma be healed, but with appropriate guidance and support, it can be transformative. Trauma has the potential to be one of the most significant forces for psychological, social, and spiritual awakening and evolution. How we handle trauma greatly influences the quality of our lives.”  — Peter Levine

Resources:
Levine, P. (1997). Waking the tiger: Healing trauma: The innate capacities to transform over-whelming experiences.

Miller, K. (2012). Mind-body attunement therapy: Clinical Strategies. Mind Body Attunement Training Centre.