The Munyer Method - Trigger Point Release & Esalen® Bodywork

Somatic Bodywork vs. Psychological Talk/Story

Therapy in the Resolution of Traumatic Events

Introduction

I am concerned about how trauma and Posttraumatic Stress Disorder (PTSD) are defined and treated in the world today. I would like to inspire the heart and mind of the reader to bring compassion and curiosity into the discussion of PTSD. This paper will contain information for inviting inquiry about how we understand traditional psychological “story/talk” therapy and somatic experiencing bodywork “non-talk/story” therapy in the resolution of PTSD. I will demonstrate the magnitude of PTSD, and define the two therapeutic approaches used in the resolution of PTSD. I would like to offer my opinions with facts of some real life experiences, woven through my summation and conclusion.

A survey of 1,245 American adolescents showed that 23% had experienced physical or sexual assault, or witnessed violence against others. One out of five developed signs of PTSD. This could possibly mean that 1.07 million U.S teenagers currently suffer from PTSD. (Kilpatrick, Saunders, Resnick, & Smith, 1995, p.46)

The paper will focus a critical lens on two existing approaches to PTSD: somatic experiencing bodywork therapy and traditional psychological story/talk therapy. Here, story/talk therapy is an alternate name for the various forms of psychotherapy that emphasize the importance of the client or patient speaking with a therapist as the main means of expressing and resolving issues of PTSD. The other method of approach is Somatic Experiencing® (SE) or other somatic based therapies, which works with the physiological systems in the resolution of PTSD. I am interested in how these two approaches define and work with trauma. I am using trauma and PTSD in the same contexts; trauma is a deeply distressing experience, medicine physical injury or an emotional shock following a stressful event. PTSD is an anxiety disorder that can develop after exposure to one or more terrifying events that threatened or caused grave physical harm. For the purposes of clarity and ease of writing, I will address trauma and PTSD as the same. I am interested in how these two approaches define and work with PTSD. How is story/talk therapy effective in the resolution of PTSD? How is story/talk bodywork therapy effective in the resolution of PTSD? How can we combine these two methodologies in to one approach in the resolution of PTSD? In asking these bigger questions, I am also interested in embedding questions about the potential for psychological story/talk therapy to re-traumatize clients.

Curiosity and excitement graces the way into the jungle of empirical knowledge and I will question those very gifted and accepted methodologies for the treatments and resolution of PTSD. I hope by writing the approaches and treatments to PTSD that we may find some new ways to combine the two therapies as one in the treatment and resolution of PTSD.

Psychological definitions of PTSD

Trauma and PTSD are different diagnosis and yet they are similar in their fundamental origins. We have come to link the terms in part due to the importance of medical language in the practice of psychology. Therefore, in order to understand how psychological talk therapy defines trauma, we must understand how it defines PTSD.

The Mayo Foundation for medical education and research define PTSD:

Post-traumatic stress disorder is a type of anxiety disorder that’s triggered by an extremely traumatic event. You can develop post-traumatic stress disorder (PTSD) when a traumatic event happens to you or when you see a traumatic event happen to someone else. (Mayo Foundation for Medical Education and Research (MFMER). 1998-2008)

After reading the Mayo’s definition it lead me to the Oxford Dictionary as a resource, because of the many technical medical references that are used with its definition as a way of defining trauma:

A deeply distressing or disturbing experience: they were reluctant to “talk” about trauma. An emotional shock following a stressful event or a physical injury, which may be associated with physical shock and sometimes leads to long-term neurosis. (The Oxford Dictionary of Current English | Date: 2008)

Here, according a general understanding represented by the Oxford dictionary, trauma can develop into a “long term neurosis”. That is to say, somehow a traumatic experience can become a trauma disorder. These disorders are most frequently labeled as PTSD. The following classifications describe the evolution of PTSD and the language used to articulate its meaning. It was helpful to understand how The International Statistical Classification of Diseases, Injuries, and Causes of Death define and treat PTSD. I am offering some cited information for clarification of PTSD.

The International Statistical Classification of Diseases, Injuries, and Causes of Death (ICD-6) 1948 diagnoses PTSD as an “acute situational maladjustment:”

“ Acute (characterizing a rapid onset of signs or symptoms of short duration) situational (the place in which something is situated; a location) maladjustments (inadequately adjusted to the demands or stresses of daily living).”

The DSM-I (APA, 1969) used the term “transient situation personality disturbance.” The ICD-9 (WHO, 1977) diagnoses PTSD as “acute reaction to stress.” The most current definition in the DSM-IV (1994) is as an “acute stress disorder and post traumatic stress disorder.” The National Institute of Mental Health stated; “PTSD is an “anxiety disorder” that can develop after exposure to one or more terrifying events in which grave physical harm occurred or was threatened.”

The ICD and DSM suggest a focus on the subjective information concerning PTSD and does not really address any objective concerns in the resolution of PTSD.

Dr. Jon Allen, a psychologist at the Menninger Clinic in Houston, Texas and author of Coping with Trauma: A Guide to Self-Understanding (1995) suggests and defines two components to a traumatic event: the objective and the subjective.

It is the subjective experience of the objective events that constitutes the trauma...The more you believe you are endangered, the more traumatized you will be...Psychologically, the bottom line of trauma is overwhelming emotion and a feeling of utter helplessness. There may or may not be bodily injury, but psychological trauma is coupled with physiological upheaval that plays a leading role in the long-range effects. (Allen, J. G., 1995. Coping with Trauma, p.21).

The American Psychiatric Association echoes this theme of objective / subjective experience, which this is reflected in its DSM-IV definition of PTSD:

The entry criterion (Criterion A) for the diagnoses of PTSD (DSM-IV; American Psychiatric Association, 1994) defines traumatic stressors (as opposed to ordinarily unpleasant stressors) as the witnessing of, or experiencing, threat to life or severe injury to the self, or to a significant other. This objective aspect of Criterion A reflects the established finding that a threat to life is a potent predictor of PTSD, which distinguishes PTSD from other types of stress-induced illness. The other specifically traumatic aspect of stressors is the subjective experience of “intense fear and helplessness. (2004, Vol. 72, No. 1, 31– 40).

The American Psychiatric Association’s stated criterion bases its definition on the mental process of the subjective mind. It claims trauma is a mental disorder and is treatable through psychological approaches. The criterion is lengthy in content and empirically supports psychotherapy as the vehicle of intervention with resolution of PTSD. Here we continue to see that a psychological understanding of PTSD disorders is organized around this second category - the subjective experience of trauma as opposed to its objective events.

While an objective trauma is necessary for diagnosis, it is these subjective experiences – explained by Dr. John Allen in terms of belief and emotion, and in the DSM as a feeling of helplessness – that become the vehicle that drives psychotherapy treatments. Joseph Weiss describes his theory of how psychotherapy works,

Psychopathology is rooted in pathogenic beliefs; these are compelling, grim and maladaptive. A person develops pathogenic beliefs in childhood by inferring them from traumatic experiences. The therapist’s basic task is to offer the patient the help he seeks in his struggle to change his pathogenic beliefs. The therapist, by his overall approach, his attitude, his reactions to the patient’s tests, and his interpretations, helps the patient to feel safe and secure, to face the dangers predicted by his pathogenic beliefs, and to work at the task of disconfirming them. (Weiss, Joseph. How Psychotherapy Works: Process and Technique. New York: Guilford Press.1993, pages 5-6)

This orientation toward “beliefs” fails to address the whole body as an envelope of containment of residual trauma. Moreover, this orientation permeates most of the styles of psychotherapy or also known as “talk therapy”.

Psychological Modalities in the treatment of PTSD

The following are a few suggested story/talk treatment therapies offered for working with PTSD to consider.

Classical talk therapy consists of a patient sitting in a chair or lying down on a couch and a psychologist subjectively talking, making interpretations and taking notes as (s) he gives a treatment to his patient. Some approaches do utilize this method of the resolution of PTSD.

Exposure Therapy (ET) creates a container for thoughts and feelings in the security of psychotherapy. This reduces the belief that thoughts and feelings are dangerous.

ET is a type of behavior therapy in which the patient confronts a feared situation, object, thought, or memory. Sometimes, ET involves reliving a traumatic experience in a controlled therapeutic environment. The goal of ET is to reduce the distress, physical or emotional, felt in certain situations. ET addresses anxiety, phobias, and post-traumatic stress. During ET, a therapist helps the patient remember a disturbing thought, traumatic situation, or feared object. The therapist also helps the patient deal with the unpleasant emotions or physical symptoms that may arise from this exposure. Through confronting the situations and thoughts that cause stress, patients are often able to learn coping skills, eventually reducing or even eliminating symptoms. Patients are usually encouraged to “talk” about their feelings during exposure therapy and to learn ways to face fears and stressful emotions. They are also encouraged to learn new ways of viewing fears and distressing situations. This is a quick synopsis of ET, which gives us a glimpse of some overall theory and methodology. After reading through the information offered, it becomes clear that the focus and direction of ET utilizes the story/talk approach in its resolution of PTSD. ET does not supply any connections to the rest of the human body. There were no references of any neuro-physiological information or treatment of the organic physical messages/clues by the therapist from the client’s activation (The over-arousal or high activation of both branches of the autonomic nervous system.) with PTSD.

Psychological Debriefing (CISD)

A debriefing or psychological debriefing is a one-time, semi-structured conversation with an individual who has just experienced a stressful or traumatic event. In most cases, the purpose of debriefing is to reduce any possibility of psychological harm by informing people about their experience or allowing them to “talk” about it. (Raphael, Beverley, 2000, p.5)

This approach is a widely accepted practice of normalizing the traumatized individual and warding off any PTSD repercussions. After reading the available information on the methods and techniques of CISD, I found references to the physiological repercussions in the rest of the body. The focus was completely orientated to the subjective mind.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR helps a person “reprocess” the traumatic memory through “rapid learning” creating positive re-framing. EMDR integrates elements of many effective psychotherapies in structured protocols designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies. EMDR is an information processing therapy and uses an eight-phase approach. During EMDR, the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session. (Shapiro, 2001, p.5)

I have experienced EMDR personally and would like to record my evaluation that EMDR does not address many references to clues and cues of the physiological systems. It does address the physiological system of the mind and the limbic messages to the frontal cortex. EMDR performs its methods of deactivating traumatic stresses in many sessions. I have seen and experienced that EMDR does not bring me in connection with the inner trauma messages of my physiological body. The main vehicle for the therapist is guiding the client in subjective directions of re-framing their event. EMDR facilitates the mind extensively for guiding the client around in their landscape of the traumatic event.

In summation, these practices and definitions lead into some reflections and questions on how the current ways address the resolution of PTSD. Most of the practices rarely address the entire physiological body as an envelope of contained trauma. I rarely read of any references to the unconscious body messages being addressed in the talk/story session. The traditional therapist appears to be extremely passionate and somewhat fixed in pursing the “story or event” as the primary focus of resolution to trauma and PTSD. My overall concerns revolve around the recognition and expression of the client’s objective physiological responses through talk/story therapy, while ignoring the reality of their subjective experience.

Somatic definitions of Trauma/PTSD

The word Somatic comes from the Greek root soma, which means “the living body in its wholeness.” (Hanna, T., 1980, p.19) This definition helps us to understand human beings as an integrated mind/body/spirit, or a psychobiology. Somatic bodywork defines and articulates its approaches in the field of traumatology in a way that intentionally challenges the mainstream view of PTSD. Rothschild (1994) suggests:

“One only has to read the most basic of the literature on the function of the brain, the nervous system and the physiology of stress to understand that the mind and the body are undeniably linked.” (Babette Rothschild, M.S.W. & Erik Jarlnaes. 1994, p.5)

Rothschild’s views and opinions are supported by noted authors, traumatologists and therapists, including: Robert Scaer, Bessel A van der Kolk, Alexander McFarlane, Lars Weisaeth, Pat Ogden, Kekumi Minton, Claire Painand Dr. Peter Levine. In Dr. Peter Levine’s book Waking the Tiger; he explains his methodologies and definition of trauma:

Trauma is an internal straitjacket created when a devastating moment is frozen in time. It stifles the unfolding of being, and strangles our attempts to move forward with our lives. It disconnects us from ourselves, others, nature and spirit. When overwhelmed by threat, we are frozen in fear, as though our instinctive survival energies were ‘all dressed up with no place to go. ( Levine, Peter A. 1997, Back Cover)

Levine’s concepts derive from his observations and studies of the organic instinctual world of animals in their natural habitat. He believes that we have an instinctual capacity innately built into our physiology to self regulate and to intellectually and objectively understand the mechanism of our physiological experiences. Levine asks and answers an intriguing question:

“Why are animals in the wild, though routinely threatened, rarely traumatized? By understanding the dynamics that make wild animals virtually “immune” to traumatic symptoms, the mystery of human trauma is unveiled.” (Levine, Peter A. 1997, Back Cover)

Levine’s observations and research suggest that an animal’s reaction to trauma involves primarily the reptilian response and self-regulation. Animals do not organize their response around the “story” as we as humans tend to respond. We use our already instilled pathogenic beliefs to resolve the trauma event.

Levine, and many others, gives us a landscape and a variety of information on how to contact and work with neurological responses that we congruently share with animals. The neurobiological responses are activated when working physically or in social engagement with the human body. These responses are stored in the interwoven collagen fabric of our physiological systems. Dr. Levine’s book is an important resource for working with defining PTSD.

Van der Kolk states that trauma experiences are not just about the event, but are also about the inability of the traumatized person to cope with overwhelmed “sensations” in their physiological systems. Given that trauma is primarily about sensations (and not about their secondary interpretation using intellectual systems) Van der Kolk suggests,

...[trauma] therapy needs to consist of helping people to be in their bodies and to understand their bodily sensations. And this is certainly not something that any of the traditional psychotherapies, that we have all been taught, help people to do very well. (Van der Kolk, McFarlane, and Weisaeth. 1996, p.201)

This quote supports the somatic component of objective bodily “sensations and feelings” in the resolution of trauma. The operative words here are “sensation and feeling” and thus, for van der Kolk, the core issue in trauma is “reality.” Van der Kolk cites Caruth as a support to his contentions;

“It is indeed the truth of the traumatic experience that forms the center of its psychopathology; it is not pathology of falsehood or displacement of meaning, but of history itself.” (Caruth, 1995, p.5).

This “reality based” definition of trauma interlaces or dovetails with a growing interest in the diagnosis of PTSD.

While Van der Kolk recognizes the limitations of the psychotherapy (talk/story) model, he nevertheless looks for some bridges between the two treatments. Van der Kolk contends that studying somatic physiology and psychology together would effectively create bridges in treating and resolving trauma and PTSD. However, this does not mean that everyone can actively move through stress related traumas without feeling signs of PTSD.

In his book, Traumatic Stress, Van der Kolk acknowledges PTSD and its ability to give validation to the people suffering from trauma, instead of imagining them “crazy” and sent away believing there is no truth in what they are sensing or feeling. Van der Kolk and others (myself included) realize the importance of acceptance/support of what a PTSD person is going through is real and extremely treatable.

Thus, for many reasons, PTSD has become a dominant lens for understanding trauma. It has been a core part of the diagnostic nomenclature since 1980. The legitimacy of PTSD has created an emergence of scientific studies to examine the information and notions of the effects of PTSD. This gives access to some reliable scientific instruments to measure effects of trauma evaluation and diagnoses.

Understanding the pathways of a Trauma/PTSD

The information gathered from the official studies Bremner et al. (1995) illustrates a model of arousal pathways organized around limbic brain functions. This model supports the activity of the neurological systems in the activation of a trauma, which affects the whole physiological system. The pathway of arousal starts with the thalamus ? amygdala ? hippocampus ? pre-frontal cortex. They all work at the same time to integrate the sensory information. If the arousal is at high levels then the integration will be disrupted and stopped. If the amygdala gets high levels of activation it will produce, long term affects on the declarative memory. It is important to maintain a safe coherence (the feeling that life is manageable, comprehensible, and meaningful) in the body system when working with over activation. Information from the amygdala is sent to the brainstem, which controls the autonomic, behavioral and neurohormonal response systems.

Then the amygdala transforms the transmission into emotional and hormonal information, which controls emotional responses (LeDoux, 1992). LeDoux’s research with rats who where induced with fear studies the neural pathways that create emotional memories. The work centers within the amygdala’s assimilation of fear in rats. This information on the mechanisms of fear in rats supports an understanding of fear in the human brain system.

These factual MRI are extremely important, because the information tells us of responses from the amygdala and how it sends the information to the neo-cortex. The amygdala and neo cortex demonstrate direct working relationships between “body” responses and story/talk responses. This information aids us in an understanding of arousal and where it is stored in working with people with trauma and PTSD. The declarative memory of the neo-cortex is the event, which can assist in the access to the Autonomic Nervous System (ANS) and self-regulation of the physiological systems. These substantiated studies and research support key points relevant to the objective physiological landscape and the psycho-physiological integration.

The observations and information related to the thalamus ?amygdala ? hippocampus ? pre-frontal cortex relationship is imperative for anyone working with people suffering from trauma and PTSD. Sometimes explaining these relationships to a client/sufferer can be very helpful for their ANS self-regulation and coherence (coherence is the quality of being logically integrated, consistent and intelligible, congruity or agreement). Some clients have a need to know what is going on physically in their body, as well as to understand their traumatizing event. This gives balance and understanding with their pain and suffering. The information of the ANS process supplies the declarative memory in supporting the release and discharge of their traumas and resulting in a self-regulation of the physiological systems.

The movement through time is an important aspect in working with any trauma. The traumatized client is not present and usually has no hope for the future. Instead, they form a fear around the reoccurrence of the event happening repeatedly. The resolution of trauma involves re-establishing grounding and presence in their physiological systems. Establishing a way the client can move and feel safe within his trauma event, will create coherence in their trauma experience. Assisting the client to establishing an updated version of their event helps with resiliency, coherence, safety and transformation. Creating a safe place inside the traumatized body facilitates and supports the client’s empowerment, coherence, resiliency and trust activations.

Figure 1-1

The above illustration demonstrates the effects and pathways of emotional arousal on declarative memory.

Declarative memory is an aspect of human memory that stores facts. It is so called because it refers to memories that can be consciously discussed, or declared. It applies to standard textbook learning and knowledge, as well as memories that can be ‘traveled back to’ in one’s ‘mind’s eye.

The definition and function of declarative memory is important, because it shows that the brain can also be used as a “bookmark” of information in tracking and resolving trauma. The bookmark gives us a resource to understand how the entire physical body is involved in a trauma. The illustration shows us that declarative memory is also stored in the amygdala, which is not about the story/talk information. The information is about our stored traumas in our other limbic systems were the amygdala, contains our arousal memories of the event. The area that somatic regulation and discharge take place is in the resolution of our ANS. The declarative memory stores the objective event, which can assist in the access to the ANS, which leads to the discharge and self-regulation of the physiological systems.

Summation and Conclusion

The substantiated studies and research support key points of the objective physiological landscape of trauma and further the integration of psychology and physiology. This leads further into the summation and conclusion of my critical paper. The significance of the somatic bodywork methods of the deactivation of a trauma and the psychological methods of deactivation of trauma are in some ways diametrically different in their approaches of the self-regulation of a trauma. I have experience in others and myself that talking about the event creates more hyper arousal and activation of the ANS. Current Science and technology support ANS stimulation with scans of the brain (PET, CAT, SPECT) and neuron-feedback machines showing the reactions and interactions between reflective memory, words, feelings, images and actions with animals. The animal studies conclude that long-term effects of stress affect the brain circuits and systems (ANS). The areas of stress response come from the hippocampus, amygdala, and then pre-frontal cortex.

The scan below offers a look at the mechanisms of the hippocampus when under the activation of a threat.

Pasted Graphic 2

The MRIis a documentation of neurological activity, which demonstrates graphic activity of trauma inside the brain. The graphic activity is a workable component of somatic bodywork experiencing in the resolution and dysregulation of the physiological systems.

Methodologies of Somatic Bodywork Experience

When the methodologies of somatic bodywork experience are applied, there is a decrease in the arousal to the hippocampus activation. The neurohormonal and physiological methods focus on the autonomic responses, using the event or story as a bookmark for inquiry into the behavioral reactions and the physiological systems. The physiological somatic bodywork therapist works with the event and story to create a safety and dysregulation of the ANS. Thus creating an organic homeostasis (regulation of the internal environment and maintaining a stable, constant environment) and gives light to the wisdom of the internal neurobiological and neurological functions of the human body. Our internal neurobiological and neurological function educates us in our organic synaptic responses of our internal systems. This supports the importance of working with acknowledgment of the activations of our natural neurological expressions.

One way that our bodies educate us is through the transmission of impulses from the limbic system to the neo-cortex. This transmission creates an organic space that is rarely noticed or felt in humanity. That “space” before the mind reflects a liquid space of grace without thought. With this information and knowledge, we are able to practice responding with reverence to our internal autonomic responses. This is the space where somatic trauma base therapy begins. We can slowly becoming more aware of the ANS process and activations, when we communicate with our external environment. We can learn to feel before we act. There is a saying by Rene Descartes: “I think, therefore, I am”. Well, from the information, it might be more appropriate to say, “I am, therefore, I think”. All responses start in the body (ANS) and not in the declarative (mind) reactions.

Figure 3-3

The above illustration indicates one axon transmitting its synaptic informational response to another. This happens with millions of axons before it even gets to the neo-cortex. Knowing this information actually creates a sense of calmness in the mind and body, because it allows a quantum space of time before declarative expressions, which gives time to respond to what is actually happening with in the physiological systems first.

Stories and Sessions

This brings me to some stories to help substantiate how working with the body and story can deactivate the trauma. These stories are actual occurrence of a trauma in the resolution and self-regulation of our neurological systems.

A client, who was diagnosed with PTSD, came to see me for a session. She was very frightened and extremely upset, confused and panicked. I explained to her about Somatic Experiencing (SE) methodologies and about the physiological systems of information and functions that assist in the resolution of PTSD. She showed an interest in the mechanism of the body and seemed to calm down with some dialogue and information. I have found that people want to know how the body functions. It also adds a component of knowledge and comfort to what they are going through in conjunction to their event. I noticed during our conversation that her body showed signs and gestures of becoming more relaxed and safe. She started to ask questions and I answered her the best I could. We conversed about where she lived and her working situation. I explained and practiced ways of resourcing to objects that felt safe and comforting (trees, objects, things in the external and internal environments). I would ask her, “where does she feel this external objects in her body. Then I would like you to notice, when your comfortable, the sensations (tingling, heat, cold, itchy etc) she experiences happening inside her body. During the inquiry, she revealed a location of something in her heart. I replied, “Tell me more about the sensation in your heart?” She replied, “Calming and safe.” I replied, “I am curious, what is the sensation of calming feel like?” She replied, “Like a river moving” (we made contact with her ANS system of the internal body. This would be a place of grounding for her when we would work with her arousals). After awhile we titrated (moving slowly) to some talk about her life in New York. In our conversation, I noticed her legs were moving in an abrupt pattern (legs started to move which is an indication of flight) that indicated ANS arousal. I asked her about her experience in New York and she reflected a story about 9/11. I noticed an immediate response to her physiological body (her body shifted and facial expressions of fear lined her face). I asked, “Are you feeling any sensation in your body when you mentioned the 9/11?” She replied, “Yes, a tightness in my throat”. I replied, “Would you put your hand on your throat and describe the sensation that you feel and take your time.” She replied, “Heat and tightness.” I replied, “I am curious, tell me about the heat does it move?” She replied, “The heat moves up and it’s getting hotter” (she begins to move her feet which are an indication of flight). I replied, “Follow your feet” and she got up and started to move around the room. I said , “Look around and tell me what you notice?” She replied, “the trees outside.” I replied, “How does that feel?” She replied, “Calming” (working the technique of pendulation, to something she felt grounded, would give her an external sense of safety and presence). When she felt safe, I asked her, “feel the sensation of your throat again and tell me what is happening. She replied, “Heat and I want to say No. I replied, “Say no.” With a loud “No,” she began to move faster in the room. I replied, “How are you doing? She replied, “I feel really itchy and tingly.” She began wiping her hands down her arms and legs claiming that it felt like ants (these are signs of discharges of the ANS system). She moved around for about 10 minutes wiping the ants off and moving around the room. She began to move slowly and the wiping of the ants had subsided. She then sat down. I asked, “How are you doing?” She replied, “I feel a total buzzing all over my body” (with a great sense of relief and calmness in her voice and body and her body was discharging the trauma effects of years ago with 9/11). I waited awhile for the discharge, self-regulation and organization to settle in her fibers of her physiology. I asked her “How are you feeling?” she replied, “I feel so calm and clear, I have never felt like this before, I feel empowered and happy.” I replied, “Where do you feel your calmness and clarity?” She replied, “In my belly.” I replied, “Spend some time there and tell me about your sensations”. She replied, “I feel warm and safe.” After some time had elapsed, I asked her about how she felt about the event of 9/11. She paused, and then replied, “Wow, I don’t have that uncomfortable feeling anymore.” (Expressing amazement in her voice and body)

The next session story I would like to share demonstrates the simplicity of ease by which trauma begins to move in its organic objective environmental element. Observing the unconscious movements and gestures of the physiological systems that my clients share with me, gives me clues about the direction and movement of their trauma dance. To reflect these clues to the client in such a way that illuminates the trauma safely is truly a profound moment in the resolution of PTSD. When I watch how nature and physiology teaches us organic ways to relieve, our discomfort’s is profound and healing.

This brings me to a very organically driven session with a new friend of mine named Gabe, he is just about to turn 6 years old. The picture below is of Gabe. Gabe was born with his umbilical cord wrapped around his neck, which suffocated him as a newborn infant. The doctors revived Gabe. I felt so honored in sharing somatic bodywork with Gabe, so he could possibly have the chance to feel freedom and safety in relation to himself and his trauma. I played games of colors, sounds and nature to help create feelings of safety, trust and coherence. We played a star wars game with a light saber sword from my Apple’s iphone, which gave out different colors and sounds when moved. We played with experiencing the colors and sounds of the iphones light saber sword and where we felt these colors and sounds in our bodies. We spent time noticing what kind of sensations we felt in our bodies with these colors and sounds. We experienced a few colors and sounds and began to feel safe in parts of our body. Gabe was learning about feeling his sensations in his body and resourcing to his external environment for support and coherence, which will guide Gabe to his trust and safety. When Gabe chose the red color, I immediately noticed a neurological change in his body, he suddenly became deeply fearful and sad. When I asked how he was feeling with the red he said softly “Sad.” I noticed he became overwhelmed and frozen in his body. I watched the straight-jacketed (immobility) effect of his fear and sadness take over his whole body. Just at the moment, Gabe was feeling a neurological change a huge wise old yellow bumblebee came flying and buzzing into our space. I noticed that Gabe’s sensory receptors picked up on the wise old yellow bumblebee, but he was too frozen in his fear and sadness to respond. I said: "Gabe, did you see that huge yellow bumble bee flying and buzzing in the room?” He immediately yelled out, "YES" and I said, “Do you want to chase it?” With lighted passion in his eyes and excitement vibrating in his body, he jumped up like a newborn sprout just out of the ground and he started to chase passionately after this huge wise old yellow bumble bee. I could see and experience his freedom flowing like ocean waves into and out of his physiological systems. Joy illuminated through his eyes and heart. I felt a sense in myself that Gabe was realizing something huge had shifted in himself. (I noticed how freely he moved in his body and laughed while he was chasing the bee, which demonstrated the discharge and self-regulation of the ANS). I experienced a young boy awakened onto himself. The photo below was taken after Gabe experienced his first organic discharge and self-regulation. I feel so humble and so very thankful for that huge wise old yellow bumblebee.

“Nature is such a teacher, I am blown away again.”

Figure 4-4

This experience with Gabe demonstrates the techniques and approaches, which could be added in working with PTSD/trauma in the traditional psychological therapies. Gabe’s experience emphasizes the importance in objectivity and coherence in self-regulating forms of immobility and freeze of the physiological systems.

Reflections and Conclusion

The following are some reflections and conclusion of my critical inquiry. I have given hundreds of sessions like the ones above in Somatic Experiencing® and the results of resolution to traumas are usually the same. The person is released from the effects of their event or story and move on to feeling a great sense of calmness, coherence, resiliency and spaciousness inside their physiological body.

The body is a huge container of wisdom and knowledge that is without limits. The body knows organically how to regulate itself, when given the space and support to express its inner truth. Our human evolution shows us that our bodies have been functioning physiologically for thousands of years without any help from our conscious mind. The physiological systems know how to breath, circulate, produce, regulate and so on…all the time without any support from us taking over its functions.

The story/talk part of a session is just a way to tap into “headlines or bookmarks” of the event and not to explore the specifics details of the event. Tapping in too deeply in the details of the event can over arouse (re-traumatize) the ANS and the person will shut down in defense to protect himself or herself from perceived threat. The story needs to be acknowledged, but only as a caveat to the activation of a traumatic event. I have found out how to use the story as a bookmark and to be aware of the arousal affects the bookmark has on the physiological system. In somatic bodywork therapy I want to strongly emphasize that talking is only used to enter the event and is not being used as the only way to resolve the trauma. I am mainly interested in using talk/story as a portal to revealing how the body shows signs of activation, coherence and self-regulation.

I believe and have experienced the importance of working with the “whole body” as a way of approaching and working with PTSD. I believe that the scientific world would benefit greatly in understanding the traumatic pathways of information and acknowledging the cues and clues of the physiological systems in the resolution and self-regulation of PTSD. Finding new ways to completely treat PTSD events in a safe and compassionate procedure would greatly increase the continued coherence and resiliency of the traumatized individual.

The time has come, for all of us to start looking at the human body more objectively and to learn from its innate empirical wisdom. To begin expanding our knowledge and treatments on how we address PTSD and trauma in its resolution. Learning how to approach PTSD organically could resolve our psychological and physiological traumas that occur in the routines of our daily life’s experiences. I hope that this will bring forth a new paradigm of connection with the physiological and psychological aspects of treating PTSD.

Images

Figure 1 Van der Kolk, McFarlane, and Weisaeth. 1996. Traumatic Stress. New York, NY; Guilford Press.

Figure 2 Bremner, J., Randall, R., Scott, T., Bronen, R., Seibyl, J., Southwick, S., Delaney, R., McCarthy, G., Charney, D., Innis, R. (1995). MRI-based measurement of hippocampal volume in patients with combat-related posttraumatic stress disorder. American Journal of Psychiatry, 152:973-981.

Figure 3 Somatic Experiencing Manuals, The Human Enrichment, Boulder, CO

Figure 4 Photo and Bee designed by Arthur Munyer

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³ The Oxford Dictionary of Current English | Date: 2008.

A deeply distressing or disturbing experience: they were reluctant to “talk” about the traumas of the revolution. An emotional shock following a stressful event or a physical injury, which may be associated with physical shock and sometimes leads to long-term neurosis.

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The entry criterion (Criterion A) for the diagnosis of PTSD (DSM-IV; American Psychiatric Association, 1994) defines traumatic stressors (as opposed to ordinarily unpleasant stressors) as the witnessing of, or experiencing, threat to life or severe injury to the self, or to a significant other. This objective aspect of Criterion A reflects the established finding that a threat to life is a potent predictor of PTSD, which distinguishes PTSD from other types of stress-induced illness. The other specifically traumatic aspect of stressors is the subjective experience of “intense fear and helplessness. (2004, Vol. 72, No. 1, 31– 40).

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¹³ Shapiro, F. 2001. Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures (2^nd ed.). New York: Guilford Press.¹³ Raphael, Beverley , 2000. Psychological Debriefing: Theory, Practice and Evidence. Cambridge: Cambridge University Press.

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¹⁵ Babette Rothschild, M.S.W. & Erik Jarlnaes. 1994. Nervous system imbalances and post-traumatic stress: a psycho-physical approach. Members: European Association of Body-Psychotherapy and European Society for Traumatic.

One only has to read the most basic of the literature on the function of the brain, the nervous system and the physiology of stress to understand that the mind and the body are undeniably linked.

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¹⁷ Van der Kolk, Bessel A., McFarlane, Alexander, Weisaeth, Lars. 1996. Traumatic Stress. New York, N.Y.: The Goliard Press.

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²²Van der Kolk, McFarlane, and Weisaeth. 1996. Traumatic Stress. New York, NY; Guilford Press.

²³ Caruth, C. (1995) (ed.) Trauma: Explorations in Memory, London: John Hopkins U.P.

“It is indeed the truth of the traumatic experience that forms the center of its psychopathology; it is not pathology of falsehood or displacement of meaning, but of history itself.” (Caruth, 1995, p.5).

²⁴Bremner, J.D.; Randall, P.R.; Capelli, S.; Scott, T.M.; McCarthy, G.; Charney, D.S. Psychiatry Res., 1995, 59, 97.

²⁵Center for Neural Science, New York University, 6 Washington Place, 10003 New York, NY, USA

²⁶ LeDoux, J. E., (2000). Emotion circuits in the brain. Annu Rev Neurosci. 23, 155-184.

²⁷ Van der Kolk, McFarlane, and Weisaeth. 1996. Traumatic Stress. New York, NY; Guilford Press.

²⁸ Kulka, R.A.; Schlenger, W.E.; Fairbank, J.A.; Hough, R.L.; Jordan, B.K.; Marmar, C.R.; Weiss, D.S. Trauma and the Vietnam War Generation: Report of Findings from the National Vietnam Veterans Readjustment Study. (Brunner/Mazel, New York, 1990.

²⁹ Bremner, J., Randall, R., Scott, T., Bronen, R., Seibyl, J., Southwick, S., Delaney, R., McCarthy, G., Charney, D., Innis, R. (1995). MRI-based measurement of hippocampal volume in patients with combat-related posttraumatic stress disorder. American Journal of Psychiatry, 152:973-981.

World health Organization (WHO). 1948 Manual of the international statistical classification of diseases, injuries, and causes of death (6th revision). Geneva Author.

World health Organization (WHO). 1969 Manual of the international statistical classification of diseases, injuries, and causes of death (8th revision). Geneva Author.

⁶World health Organization (WHO). 1977 Manual of the international statistical classification of diseases, injuries, and causes of death (9th revision). Geneva Author.

⁷ World health Organization (WHO). 1994 Manual of the international statistical classification of diseases, injuries, and causes of death (10th revision). Geneva Author.

National Institute of Mental Health, US National Institutes of Health

2004, Vol. 72, No. 1, 31– 40 0022-006X/04/$12.00 DOI: 10.1037/0022-006X.72.1.31

Caruth, C. (1995) (ed.) Trauma: Explorations in Memory, London: John Hopkins U.P.

Bremner, J.D.; Randall, P.R.; Capelli, S.; Scott, T.M.; McCarthy, G.; Charney, D.S. Psychiatry Res., 1995, 59, 97.

Center for Neural Science, New York University, 6 Washington Place, 10003 New York, NY, USA

LeDoux, J. E., (2000). Emotion circuits in the brain. Annu Rev Neurosci. 23, 155-184.

Van der Kolk, McFarlane, and Weisaeth. 1996. Traumatic Stress. New York, NY; Guilford Press.