Relational and Body-Centered Practices for Healing Trauma

Lifting the Burdens of the Past

Sharon Stanley

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781317432890
• Edition: 1
• Topic: Psicología
• Subtopic: Psicología clínica

Relational and Body-Centered Practices for Healing Trauma provides psychotherapists and other helping professionals with a new body-based clinical model for the treatment of trauma. This model synthesizes emerging neurobiological and attachment research with somatic, embodied healing practices. Tested with hundreds of practitioners in coursesfor more than a decade, the principles and practices presented here empower helping professionals to effectively treat people with trauma while experiencing a sense of mutuality and personal growth themselves.

1 Trauma and Embodied Relational Therapy

DOI: 10.4324/9781315692364-2

What is necessary is not that the initiated should learn something, but a transformation should come about in them, which makes them capable of receiving the teaching.

(Simone Weil 1952, 83)

The Healer Within

“What do you think actually helps people heal from trauma?”

The question came from an insightful woman named Karolyn during a community dialogue on Somatic Transformation.

In response, I described a somatic—bodily—form of empathy that can emerge in interpersonal relationships that fosters transformation from one state of being to another. Somatic empathy communicates to people suffering from trauma that they are seen, felt, and understood just as they are, allowing them to feel felt. With somatic empathy the practitioner is receptive to another’s suffering while offering containment, aliveness, and vitality in the moment, despite darkness and confusion. In an authentic relationship based on a somatic sense of empathy, practitioners are committed to knowing the other in the other’s own internal terms.

“So interactions can become healing experiences for both,” I concluded.

“Then we are all healers!” Karolyn replied, a smile on her face.

She is right: We each hold the human capacity to offer healing through our interactions. Yet without intentional empathy and mindful attention to the bodily-based cues that reveal our own subjectivity and that of other people, our innate power to heal others remains underdeveloped. We miss ordinary moments of possible restoration. An essential aspect of adult maturity, somatic empathy is achieved through a personal and communal struggle with the internal dynamics from trauma that threaten to separate and isolate us. Somatic ways of knowing and relating have formed the epistemology of diverse, flourishing cultures around the world and have been used to restore connection, vitality, and innate growth processes to trauma victims throughout history (Berman 1989).

What Is Somatic Transformation?

Soma is a Greek word that describes a unity of the body and mind. Somatic Transformation is a healing modality that incorporates bodily ways of knowing—our own as well as that of others—into consciousness, an ancient path for changing the imprint of trauma. The professional expertise necessary for somatic practice includes a left-hemispheric knowledge of neurobiology and a right-hemispheric development of embodiment, empathy, and intuition. Schore (2005) writes, “It is certainly true that the clinician’s left brain conscious mind is an important contributor to the treatment process” and that current treatment is “now focusing intensely on implicit nonverbal communications, bodily-based affective states, and interactive regulation as essential change mechanisms within the therapeutic relationship” (25–27). As we explore the development of embodiment, empathy, and intuition, we will focus on the development of helping relationships where people can communicate with their bodies as well as words, resolve the emotional reaction of past trauma, and regulate current experiences of adversity, pain, sorrow, and joy.

The principles and practices of Somatic Transformation draw from a number of areas including the neuroscience of human development; interpersonal neurobiology (Cozolino 2014; Schore 2003a, 2003b, 2012; Siegel 1999, 2010; Kalsched 2013); phenomenological philosophy and methodology (Merleau-Ponty 1962); and somatic healing practices from traditional societies (Diamond 2012; Atleo 2004, 2011).

An emergent model, Somatic Transformation practices expand clinical expertise in six areas: embodiment, somatic awareness, somatic empathy, somatic inquiry, somatic intervention, and somatic reflection. These therapeutic practices engage mindful awareness of subtle changes in the inner worlds of clinicians as well as clients. Our inner world is shaped by our own subjective lived experience and coming to know the inner subjective world of another opens new ways of perceiving for both. Somatic practices attend to the suffering that endures from trauma and provides creative ways to resolve the conscious and hidden memories that can overwhelm one’s inner subjective world.

The foundation for helping people suffering from trauma lies in the development of an empathic embodied relationship, a connection that provides the intuitive wisdom to respond to the person in the moment with resonance and contingency. Research in interpersonal neurobiology has revealed that injuries from trauma lie in the brain and body, not just the mind. We now know what traditional societies have always known: the brain changes through empathic relational experiences between individuals within caring communities and, particularly, in the repair of breaches in those relationships. Numerous studies confirm the value of empathic relationships in healing even the most difficult trauma (The Boston Change Process Study Group 2010).

The goal of Somatic Transformation is to create relationships of unusual safety, attunement, resonance, and coherence that can identify and creatively resolve the obstacles to right-hemispheric processing of lived experience that come with trauma. Mindful attention to the shifting, sensory-based inner world in the context of a trusted relationship initiates the transformation of trauma. Before we take a closer look at what trauma is, take a moment to explore your own somatic experience in Exercise 1.1: Embodiment—Sensory-Motor Awareness and Regulation on page 199 of the appendix. This exercise will give you a felt sense of the concepts discussed in this book.

What Is Trauma?

Since the Vietnam War, the word trauma has been used to describe a variety of aversive, overwhelming experiences with long-term, destructive effects on individuals and communities. People who have experienced war, terrorism, disaster, assault, poverty, and other forms of violence often communicate their distress through confusing behavior. Some may withdraw when it seems they should engage, or engage aggressively when it seems that a gentle approach would suffice. Posttraumatic behavior seems disconnected from present day reality, and it is. Time does not move on for people with unresolved trauma; they remain locked in the moment of impact and injury when development was interrupted. Traumatic memories remain active, even if they are not conscious, and live on in the body as implicit memories even if the mind has forgotten or intentionally forgiven the event.

Traumatic events fall into two overlapping categories: Shocking aversive events include abuse, assault, injury, disaster, and massive loss. The subtler, yet profoundly debilitating, losses in human connection are known as relational-developmental trauma. This type of trauma refers to the emotional neglect an infant or young child experiences in interpersonal interactions with caregivers, as well as the failures in human connection and attachment throughout the life span. Incidences of relational-developmental trauma are far more profound than is obvious, and as Philip Bromberg (2011) claims, we all carry relational trauma deep within our inner worlds. We have all suffered emotional neglect in significant relationships from the absence of attunement, resonance, and feeling felt, some more devastating than others that may be traced back several generations. Symptoms of relational-developmental trauma can be similar to those suffering from aversive events and can include stress, anxiety, anger, aggression, dissociation, depression, addiction, and medical illness.

When relational-developmental trauma and aversive events occur simultaneously or in accumulative experiences that link together in dysfunctional neural patterns, complex trauma is the result. As a way of protecting the inner self, people who have experienced complex trauma tend to be either chronically highly vigilant or drop into flaccid, collapsed defenses. These defenses are unconscious and remain impervious to attempts of logical reasoning, willpower, and other cognitive strategies to effect permanent change until the underlying dysfunctional neural patterns have been shifted. In other words, the disruptions from trauma result in disturbing bodily-based symptoms and endless suffering. Unable to end the suffering or find it meaningful or redemptive, people who have experienced complex trauma develop survival strategies, including personality adaptations and addictions to avoid their inner anguish.

Dan Siegel synthesizes the concept of trauma: “When the negative impacts of a life-threatening or mind-disabling experience are long lasting, when the psychological wounds of such an experience persist and do not heal well, we call this unresolved trauma” (2012, 39–1). The psychological wounds of trauma result in the inability to emotionally self-regulate, particularly in stressful situations. Allan Schore writes that relational trauma leaves an enduring imprint with “an impaired capacity to regulate stressful affect and an overreliance on the affect-deadening defense of pathological dissociation.… Highs and lows are too extreme, too prolonged, or too rapidly cycle and are unpredictable” (2012, 164).

Stressful affect, the emotional remnant of complex trauma, can involve very high-energy reactions such as terror, anger, rage, and aggression, as well as very low-energy reactions such as despair, depression, and dissociation—each exhibiting a lack of embodied awareness of the present moment. People who have experienced trauma can cycle up and down between these states of “aggressive terror,” known as hyperarousal, and “frozen terror,” known as hypoarousal, in ways that are difficult to predict (Schore, personal communication). People suffering from these dysregulated nervous system patterns commonly experience disembodiment and disassociation—survival defenses that can leave them vulnerable to a lifetime of further trauma.

Trauma Survival Defenses: Disembodiment and Disassociation

We know ourselves fundamentally and most vividly through relational bodily-based experiences (Damasio 2011). Disembodiment and dissociation cause us to miss out on these experiences—cutting off our connection to our essential self and the essential self of others. Perpetuating the long-lasting symptoms of trauma, disembodiment involves a loss of connection with bodily-based sensations, movements, and primitive emotions. The innate feelings that arise in response to danger and life threat, primitive emotions arise from disrupted neural perceptions and are held in the body after an overwhelming experience, becoming disruptive emotions and physical symptoms throughout the life span (Panksepp and Biven 2011). The neural perception of danger can fuel primitive emotions of rage, while the neural perception of safety opens one to care for another. The neural perception of life threat results in a profound sense of powerlessness (Porges 2011).

While disembodiment acts as a protective device, numbing unbearable sensory information from terrifying neural states and primitive emotions in the moment of trauma, people who are disembodied lack authentic vitality and a sense of aliveness. Disembodiment can lead to dissociation of the mind and altered mental states. To dissociate, people unconsciously dull their ability to perceive and respond to their own bodies’ sensory cues. As attention is withdrawn from bodily-based processes, awareness of the present moment is diverted. A person who dissociates loses track of sensations in his body and unconsciously alters awareness to avoid sensory or emotional reminders of trauma. In dissociated left-hemispheric dominant states, people can ruminate on their “issues,” confabulate stories and alternative realities that provide protection and escape from suffering, rather than endure the intense feelings and meaning of the actual lived experience.

The spiritual effect of dissociation in traumatic moments is intriguing. The Jungian psychoanalyst Donald Kalsched (2013) describes how a radical disconnection of the mind from the body during a traumatic event becomes an opening, a breaking through, which allows spiritual energy to enter the internal world for protection and solace. Kalsched (2013) describes the spiritual forces available to people who have entered into dissociated states as both numinous—bringing help, protection, wonder, and beauty—and demonic—bringing dark, frightening, and chaotic energies. For Kalsched, people who experience trauma have access to spiritual powers that both protect and persecute the soul.

These overwhelming neural states, intense emotions, and spiritual energy from traumatic events can emerge in authentic helping relationships—and are then accessible for healing. Helping professionals need to create containment and safety for the overwhelming sensations and feelings that come from dissociated memories. In the processes of disembodiment and dissociation, we lose connection with the truth of our lived experience and the actual environment as it exists in the present moment; however, the truth of the lived experience continues to exist hidden in our bodies and can be met, known, and integrated in relationship with an empathic other. When people suffering from trauma are able to stay embodied and regulate their affective states, they can tolerate small doses of suffering and pain while processing traumatic memories. In the following section, we’ll explore some of the effects of trauma that extend beyond dissociation and disembodiment.

Pervasiveness, Risk Factors, and the Toll of Trauma

The psychological effects of trauma are emotional, physical, behavioral, social, and spiritual with a wide variety of symptoms, and recent studies indicate that far more people are suffering from trauma than has been previously acknowledged. An ongoing epidemiological study of early childhood trauma, the National Comorbidity Survey (NCS), was first conducted in the United States in 1990. It was replicated with new participants between 2000 and 2004 in an attempt to predict mental health and substance abuse disorders. In an analysis of the data from a national probability sample, Koenen et al. (2010) found that 40 percent of the U.S. population has experienced at least one event of trauma before the age of thirteen, children of color have more violence in the home than Cau...