By Theresa L. Cangelosi
As a somatic psychotherapist, I have always used a body- based approach in my practice. When working with clients who have experienced trauma I have learned that a mind-body approach is crucial. Freud defined trauma as a break in the barrier that protects from over stimulation and leads to a feeling of helplessness.
When an event is too stimulating to be contained, we become overwhelmed, our lower brain structures organize our survival responses and our nervous system becomes disorganized. Our nervous systems can get stuck and we could look manic and hypervigilant, we can feel numb and vacant, or we can switch back-and forth between those extremes, which can look like bi-polar disorder.
This extreme range of symptoms is indicative of a disregulated nervous system in need of stabilization. When we experience a shock, there can be a break from earth, self, and others. In stabilization we look for re-reconnection to our natural self and our community.
The "break" that Freud mentioned could be any incident that we perceive as life threatening, such as a car accident or a rupture in attachment with our caregivers. Early developmental shock or trauma can underlie acute and chronic trauma, and be an indicator of who will develop PTSD.
Whether it is developmental or shock trauma, the approach is the same. A bodymind approach to trauma is necessary to address the disregulation in the brain regions that have been overwhelmed and are struggling to regain balance and stability. It is helpful for practitioners to understand the neuro-physiology of this disregulation, and in turn educate and empower clients to be aware of their natural ability to regain integrity.
Fortunately, most of the ways we help our fellow humans who have experienced a traumatic event comes naturally to us. We have all experienced how a hand on our back can comfort us when we are grief stricken, how speaking to someone who has been injured and letting them know we are going to stay with them can do wonders. Helping someone stay present, aware of self and eventually connected with others can be the difference in someone developing PTSD or coming out of the acute stress and recovering.
Current neuro-physiology teaches us about the sympathetic and parasympathetic nervous systems, so we don't have to wonder why what we do naturally works. Knowing how the nervous system is affected by trauma helps us to respond with an intention to stabilize. It is important to know where the nervous system is stuck, so we know what would bring it into a natural rhythm, and how the nervous system will respond.
In her course called Trauma First Aide(TM) Training, Geneie Everett, Ph.D. says, "you have to know what you're looking at, to know what you're looking for". Learning the symptoms of the sympathetic and parasympathetic nervous systems is a very helpful skill set in preventing and treating trauma.
When our life or bodily integrity is threatened, it is a normal and adaptive response to fight or flee to protect ourselves. This natural stress response allows us to use our sympathetic nervous system to respond in the most successful way possible and then to return to a normal level of functioning once the threat is gone. About 80% of the population can experience high levels of activation, acute trauma, and not develop PTSD, chronic trauma. Of course it is best to help anyone stabilize soon after a trauma, so the chances of developing the wide array of symptoms, associated with PTSD, both emotional and physiological, will be greatly diminished.
After an overwhelming event, clients could be in an acute or chronic stage of trauma and find that they are stuck in any combination of the stress responses: flight, fight or freeze. Our presence and voice engaging them can help the client become self aware and grounded . As we help the client find a place in their body where they tolerate feeling sensation, they experience the natural rhythm of their reciprocal nervous system The fragmentation can come together and give a sense of integrity. The manic energy of a fiercely wagging foot can slow down with guidance from a practitioner who knows the nervous system, and the client can experience their motion attempting regulation. Once their motion is slowed to a tolerable range of experience, they could feel the internal rhythmic rocking and then a full breath. Knowing the nervous system helps us all to listen to the body calling us back to the present where we are connected, whole and safe.
Learning about the nervous system gives both client and therapist another way to understand the language of the instinctive part of us that knows how to protect us and return us to our natural integrity and resilience. It is our sensory brain that is organized for survival during and after a traumatic experience. Since the cognitive functions of the neocortex are the areas of our brains that become disorganized by the overwhelm of trauma, we as therapists who treat traumatized clients need to know how to read the sensory messages of our lower brain structures related to breathing, circulation, digestion, reproduction, flight/fight response and unconscious control. When these life sustaining functions are stable, our nervous systems can return to their inherent wisdom and natural rhythm.
Theresa L. Cangelosi, M.A., SEP is a Somatic Psychotherapist and Somatic Experiencing ™ Therapist in private practice for 18 years in San Francisco. She was part of the team that taught Trauma First Aide ™ to first responders in New Orleans after Hurricane Katrina and currently is a teacher with Trauma First Aide Associates. Find Theresa online at www.tlcangelosi.com.
This article first appeared in the January February 2011 edition of the Newsletter of San Francisco CAMFT.
