Abstract from Katarina Gadjanski's Post-Diploma Psychotherapy Thesis
(The whole document could be emailed on request)
Contents
Abstract
Introduction & Context
Methodology
Part One: Body and Trauma
What do we mean by ‘Trauma’?
Understanding the neurophysiology of trauma
Normal response to traumatic threat
PTSD response to traumatic threat
Polyvagal theory
Part Two: Animal Trauma/ Human Trauma
How do animal bodies release trauma and what prevents this process in humans
Peter Levine's methodology
SIBAM & Somatic Experiencing
Part Three: Reflections
Case vignette and reflection on animal imagery in trauma work
Reflection on my writing and conclusion
References
Appendix I - Symptoms of trauma, PTSD and PTS
Appendix II - What factors contribute to developing of trauma symptoms in humans
Appendix III - SIBAM Model (continued)
Case vignette and reflection on animal imagery in trauma work
Abstract
‘Trauma is the fact of life – it doesn't have to be the life sentence.’ - Peter Levine*
Trauma is a complex psycho-physical experience which can emerge following a traumatic encounter/event, in which psychological and somatic stress responses persist long after the event has passed. Over the past ten years there has been much research in the area of neuroscience, looking specifically into the neurophysiology of trauma. These studies show us that the persistent symptoms of increased arousal that are often found in trauma victims result from disregulation of the nervous system. Neurobiology is demonstrating that mind, brain, and body are inextricably linked, so no one who works with any one of these can afford to ignore the other two (Wilkinson in Sieff, 2010).
The Polyvagal theory and the studies of default hierarchies show us that the instinctual and involuntary parts of the brain (that process trauma) are the same in humans as in any other mammalian animal. However, animals in the wild seem to be able to easily ‘shake-off’ and recover from the experience of tonic immobility/freeze response (which is one of the instinctual responses to life-threatening situations) and to return to normal functioning, while humans experiencing the same immobility response are often not able to do so, and develop the symptoms of post-traumatic stress disorder (PTSD). Levine (1997, p18-19) points out that traumatic symptoms in humans are caused by the 'frozen' residue of trauma energy and that the key to healing these symptoms lies in being able to 'mirror' the fluid adaptation of animals as they shake out and pass through the immobility response and return to being fully mobile and functional again. Levine's trauma-work methodology models this process.
Levine’s Somatic Experiencing model gives us gradual steps to assist trauma- clients to discharge the residue of ‘freeze’ energy and move through and complete these natural responses, in the same way that animals do. My research attempts to explore a possible link between this model of trauma processing (based on the natural ‘animal-body’ instinctual trauma processing) and the way that shamanic traditions use animal guides in healing rituals by embodying them and following the guidance and wisdom of the instinctual animal within.
* Levine, P. (2010) In an Unspoken Voice – How the Body Releases Trauma and Restores Goodness
Introduction: Setting things into context
I didn't choose trauma as the subject for my dissertation – it chose me. The traumatic incident that happened in the course of my psychotherapy training (please see Note 1 below) set me on this journey. It was my own trauma that changed the direction of my psychotherapy training and that kindled my interest in trauma work. In search for a safe place to continue my training after I left The Centre for Counselling and Psychotherapy Education (CCPE) following a violent attack, I transferred my studies to Re-Vision, Centre for Integrative Psychosynthesis. Ever since leaving CCPE I've been in the process of trying to work through this traumatic event and the profound effect it has had on me.
Over the past two years I have become increasingly frustrated with the limitations of talking therapy in trauma work. This frustration has sprung from my personal experience of therapy, the fact that despite months and years of working on my trauma I was still not healing from the tight grip it had on me. I didn't understand why I was not recovering; I knew this was not due to lack of expertise from my Transpersonal/Humanistic psychotherapist, nor due to unwillingness on my part to engage with my trauma. I felt similar frustration in my clinical work with trauma clients. I noticed that talking about their trauma (whether this was a recent event or a childhood trauma) would frequently cause feelings of re-traumatisation. This was very prominent in the case of P (please refer to my case study, 'The Frozen Boy'), who would experience severe feelings of panic, shaking and hyper-ventilation every time our dialogue moved even slightly in the direction of his early trauma. I personally also experienced these intense bodily sensations whenever I thought of, or talked about, the traumatic incident that happened at CCPE. I also experienced these symptoms whenever I was in an environment which reminded me even slightly of the place or circumstances in which I was attacked. I wanted to understand why my body was reacting in such a way that was completely beyond my conscious control. I also wanted to find out how to approach trauma in talking psychotherapy without causing re-traumatisation.
Van der Kolk (1994) explains that at the core of traumatised clients' disorganisation is an inability to analyse what is occurring whilst re-experiencing the physical sensations of past trauma. These sensations produce intense emotions in the individual which (s)he is unable to modulate. Van der Kolk suggests that therapy needs to help clients to stay in their bodies and to understand and regulate these bodily sensations. This wasn't my experience of psychotherapy (both through my personal experience of being a trauma client and as a psychotherapy trainee) and I wanted to find a new way of working that included these bodily sensations and the effect that the trauma had on the body.
It was only by ‘chance’ (not through my therapy) that I discovered at Re-Vision's Winter Residential Conference: ‘Embodying Soul – Ensouling Body’ that it was actually my body that was not healing from the trauma, not my psyche. At one of the workshops (please see Note 2) I started to experience a release from the grip of trauma that was ‘stuck’ in my body. At this point I didn't have an understanding or explanation of what was happening, but on the 'felt' level I knew that I was starting to experience healing. It was at this moment that my heuristic research (the initial engagement with this dissertation) actually began. I wanted to find out how trauma affects the body and what lay behind my healing experience at the workshop. I also wanted to know if this could somehow be integrated into 'talking therapies' trauma work. In the course of my research and looking for the answers to my questions I became deeply immersed in exploring the neurophysiology of trauma and a body-oriented approach to trauma work. I also started working with a body-psychotherapist. This dissertation is the product of my enquiries.
Kalsched (2010, p66) explains that in traumatised clients the psyche's self-care system can't allow all the elements of the traumatic experience to be present at once so this often results in a split between the mental and bodily components of trauma. Since starting this research I often wondered if this mind-body split that we see in trauma is equal to the split from the body that is found in many traditional talking psychotherapies (as it's the traumatised psyche that we normally give attention to, not the body).
Wilkinson (interview with Seiff, 2010) points out that modern neuroscience is finally enabling us to see that the brain/mind cannot be separated from the body. During the course of my research I found that body-oriented therapists do give attention to healing of the mind, although the body is their primary concern. In contrast, talking psychotherapists often give very little (or no) attention to the trauma that is in the body. Rothschild (2000, p xii) urges us to bridge this gap between traditional verbal psychotherapies and body-psychotherapy, which is also a gap between the theory developed by neuroscientists on the neurophysiology of trauma and the clinical practice of therapists working directly with traumatized individuals. She points out that trauma and post-traumatic stress disorder (PTSD) is forcing us to bridge these gaps as even the most conservative of therapists and researchers do acknowledge that trauma is not just a psychological condition, but also a 'disorder' (dis-regulation) of the nervous system, which has important somatic components.
Looking specifically at trauma-work models within my therapeutic background (Transpersonal Psychotherapy and Integrative Psychosynthesis) I noticed that trauma in the body is almost never mentioned. In my research over the past few months, I have explored neuroscience (neurophysiology of trauma) in order to understand what happens in the body during and after traumatic experience. I wanted to understand how to treat a traumatised body without separating it from (or giving priority to) the traumatised psyche. What was driving my research was my longing to heal the mind-body ‘gap’, both my personal mind-body split and the split from the body that I experienced in talking psychotherapy. In Integrative Psychosynthesis we already have a soulful and well-crafted practice and understanding of how to work with a traumatised psyche and perhaps this thesis could be a proposal to add another dimension to our trauma-work.
In the first part of my dissertation I am going to look into neuroscience and explore relationship between trauma and the body. Firstly I will define what is a 'trauma' and ‘post-traumatic stress disorder’ (PTSD), and what are 'trauma symptoms'. I will then look into the neurophysiology of trauma and explore what happens in the brain and body during a traumatic incident. I will examine what is the 'normal' response in the brain/body during a traumatic incident and what is the PTSD response. Drawing from neuroscience I will also explore the neurobiological factors that lie behind the development of PTSD.
In the second part of my thesis I am going to look into how the body naturally releases trauma, drawing from examples in the animal kingdom. I will also examine Peter Levine's trauma-work, which is based on assisting the body's innate ability to heal trauma. I was fascinated by the connection between the subject of Levine's first book ‘Waking the Tiger’ and the tiger ‘within’ me that I was trying to protect during my attack. Levine's methodology particularly intrigued me because it was developed from observation of how animals naturally release trauma. He (2010, p24) points out that animals in the wild are able (following a frightening encounter with the predator) to literally ‘shake off’ the induced state of high physiological arousal and return to natural movement, whereas humans frequently remain stuck in the aroused state. Levine (1997, p34) points out that post-traumatic symptoms are incomplete physiological responses suspended in fear and that those symptoms will remain until these responses are discharged and completed. In the second part of my dissertation I will also explore what factors contribute to development of trauma in humans and will examine Levine's ‘bottom up processing’ trauma model, which is designed to help discharge and complete these natural physiological responses.
In the last part of my dissertation I will reflect on my ‘findings’ and explore the unexpected turn of direction that my research took (which happened while I was trying to implement some of Levine's ‘bottom-up’ trauma processing into the work with one of my clients). This ‘incident’ made me realise that there might be a link between animal imagery work (that we often use in Transpersonal Psychotherapy & Integrative Psychosynthesis) and Levine's model of trauma processing (based on natural animal-body trauma processing).
*(The whole thesis could be emailed on request).