What Does a Slinky Have to do with Trauma?

What if the traumatic event wasn’t the cause of trauma? It’s time to rethink trauma by looking to the body’s memory of the event, not the mind’s interpretation of the story. In this short video, Peter Levine explains how the body holds the energy of trauma and why we can’t begin to process the emotional suffering until we first resolve trauma on the physiological level.

One of the conundrums in trauma therapy is that as therapists, we are trained and usually very good at being empathic. And for many of our clients, we see great success with this.

But what do we do when our clients struggling with trauma and classic symptoms like flashbacks, nightmares, chronic pain and stiffness don’t respond to kindness and soothing?

In this short video, Peter Levine, Ph.D., explains how the body holds the energy of trauma and why we can’t begin to process the emotional suffering until we first resolve trauma on the physiological level.

Peter A. Levine, Ph.D., holds doctorates in both medical biophysics and psychology. The developer of Somatic Experiencing®, a body-awareness approach to healing trauma, and founder of the Somatic Experiencing Trauma Institute, which conducts trainings in this work around the world. Levine’s original contribution to the field of Body-Psychotherapy was honored in 2010 when he received the Life Time Achievement award from the United States Association for Body Psychotherapy (USABP).


Bessel van der Kolk’s Trauma Treatment Discovery

For 40 years, as both a researcher and a clinician, Bessel van der Kolk, M.D., has studied those living with trauma. Among them were soldiers, torture victims, child abuse survivors, and many others. What has he determined after years of research?

Trauma is a fact of life.

  • One in five Americans has been molested.
  • One in four grew up with alcoholics.
  • One in three couples have engaged in physical violence.
  • Millions of Veterans and their families deal with the painful aftermath of combat.

Such experiences inevitably leave traces on minds, emotions, and even on biology. Trauma disturbs people’s relationships with themselves, with others, and with their environment.

But trauma isn’t something we’ve always talked about. When leading trauma expert Bessel van der Kolk, M.D., entered the field, PTSD didn’t exist, and trauma wasn’t even whispered about in the halls.

For 40 years, as both a researcher and a clinician, Dr. van der Kolk has studied those living with trauma. Among them were soldiers, torture victims, and child abuse survivors, and many others. What has he determined after years of research?

There is not a one size fits all approach to trauma.

As clinicians, we can no longer be just a psychoanalyst, an EMDR expert, or a CBT practitioner. Instead, we must be exposed to a large number of different treatments and know when to use the tools of each method to best help our patients overcome the challenge of trauma—reestablishing ownership of their body, mind and self.

In his book, The Body Keeps the Score, Bessel van der Kolk outlines 8 paths to recovery. They include: owning your self, language,  EMDR, yoga, self-leadership, creating structures, neurofeedback, and communal rhythms and theater.

Do any of these paths to recovery surprise you? We think it’s important for clinicians like yourself to understand how these paths to recovery came to be. That’s why we’re providing a free video from Bessel van der Kolk discussing The Body Keeps the Score.

As a bonus, we’re providing a free hour of CE just for watching. Get started instantly (seriously, it’s free—don’t wait).


Putting the Pieces Together: Janina Fisher’s perspective on the history of trauma treatment

Twenty-five years ago, who would have thought that the experience of joy had a place in trauma treatment? We began with the belief that excavating dark and unspeakable horrors would set trauma survivors free. But in this new age of trauma treatment, we aim to help our clients find the light-or at least to find their bodies, their resources, and their resilience.

The following is an excerpt by Janina Fisher, Ph.D.
In 1989, trauma was still defined as “an event outside the range of normal human experience.” As descendants of Freud, we believed that the therapist’s role was to remain neutral and say as little as possible, often using the question, “How do you feel about that?”

By the early 1990s, however, The Courage to Heal, a self-help book by Ellen Bass and Laura Davis, introduced the main task of trauma work as retrieving the missing pieces of the abuse narrative and encouraging victims to confront their perpetrators with “their truth.”

I was troubled by what the The Courage to Heal model required of my clients. At the hospital where I worked, we were seeing some dangerous effects of this approach. Many clients became overwhelmed by the flood of memories that came once Pandora’s box was opened, and others began to doubt themselves when they couldn’t access memories. Worse yet, family confrontations frequently ended in retraumatization for the victim. Rather than finding support, our clients often found themselves becoming family outcasts.

During this paradigm shift in the trauma-treatment world, Judith Herman, who’d published Father-Daughter Incest in 1980, was convinced that there was something deeply amiss and destabilizing about the confrontational tactics recommended by Bass and Davis. She believed that good trauma treatment required delaying the focus on traumatic memories until survivors felt safe in their daily lives and had sufficient affect regulation to tolerate the stress of remembering dark episodes in their histories.

Herman believed that therapists must become educators, providing information that made sense of the client’s symptoms and helping them understand their intense reactions as survival adaptations to a dangerous and coercive childhood environment.

Just how revolutionary the idea of stabilization was in the early 1990s is illustrated by my meeting with a young client named Ariana. Despite a long history of childhood sexual abuse and many attempts to get help, she hadn’t been able to tolerate therapy for more than a few months. “What told you in each of your experiences with therapy that it was time to leave?” I asked.

“Either the therapists wanted to make me cry-or they wanted to move in for the kill when they say, ‘Next week, we can begin to address the trauma.’”

She’s right, I thought. In those days, most trauma therapists would’ve wanted a client like Ariana to cry as evidence that she was “in touch” with her emotions.

It seemed to me, however, that stabilization gave clients their lives back, offered them a meaningful present as an alternative to reliving the past, and was invaluable in their learning to tolerate their often volatile emotions.

Busting the Monopoly of Talk Therapy
Neuroscience was brought into the field of trauma by psychiatrist Bessel van der Kolk. His curiosity and crusading spirit led him to explore trauma in ways that more cognitively focused researchers tended to ignore.

When I started working on van der Kolk’s clinical team in 1996, he’d been arguing for years that traumatic memory included not just images and narratives, but also intrusive emotions, sensory phenomena, autonomic arousal, and physical actions and reactions. In 1994, when his paper The Body Keeps the Score was published in the American Journal of Psychiatry, the message that trauma often lives non-verbally in the body and brain was a source of tremendous discomfort in a field that didn’t yet recognize body-based treatments as reputable. However, the advent of brain-scan technology allowed him to conduct the research needed to support his arguments. His findings laid the groundwork for an alliance between traumatologists and neurobiologists, one that challenged the reign of talk therapy.

In van der Kolk’s 1994 study, 10 subjects volunteered to remember a traumatic event while undergoing a PET scan of their brain. As they began to recall these events, the cortical areas associated with narrative memory and verbal expression became inactive or inhibited, and instead there was increased activation of the right hemisphere amygdala, a tiny structure in the limbic system thought to be associated with storage of emotional memories without words. These volunteers had begun the scan with a memory they could put into words, but they quickly lost their ability to put language to their intense emotions, body sensations, and movements.

Retraumatization now made sense: if we purposefully or inadvertently trigger old traumatic responses, brain areas responsible for witnessing and verbalizing experience decrease activity or shut down, and the events are reexperienced in body sensations, impulses, images, and intense emotions without words.

This changes everything. Accustomed to using words as the primary treatment tool, talk therapists had to find other approaches, ones that weren’t so dependent on language and narrative and could therefore address the brain and body shutdown demonstrated in van der Kolk’s study.

Van der Kolk has been instrumental in bringing greater visibility and credibility to nontalk treatments. EMDR, in particular, expanded our notions of what constitutes effective psychotherapy in those early years.
Developed and extensively researched by psychologist Francine Shapiro in the late 1980s, it uses bilateral stimulation to help clients process traumatic experiences. However, because of EMDR’s unconventional, finger-waving method and a lack of support from other researchers at the time, it seemed more snake oil than legitimate therapy to many skeptics in the field.

But by the early 2000s, news of EMDR’s success was commonly being noted in popular newspapers and magazines in print and online. EMDR spurred another revolution for therapists. It suddenly seemed like a logical next step to learn other approaches that involved something more than sitting in a chair, listening, and talking.

How Neuroscience Changed Psychotherapy
With the publication of works such as Allan Schore’s Affect Regulation and the Origin of the Self in 1994, Joseph LeDoux’s The Emotional Brain in 1996, and Daniel Siegel’s The Developing Mind in 1999, the world of science began to inspire new growth in psychotherapy. Each argued that not just social-emotional development, but the slowly maturing brain and nervous system, could be dramatically and perhaps permanently affected by early attachment relationships, neglect, and trauma.

The case of Jessie illustrates my own education into how neuroscience came to guide more and more of my clinical work. Jessie’s long history of suicide attempts, hospitalizations, and dramatic deteriorations in functioning challenged everything I thought I knew about treating trauma up to this point.

As I pieced together sessions of contradictory conversations, I realized that although she may not consistently have remembered being traumatized, her body and nervous system were constantly being activated by the simple challenge of maintaining a consistent sense of selfhood from day to day.

According to LeDoux, Jessie’s amygdala-the part of the brain that scans for danger and initiates the stress-response system-had undoubtedly become irritable in the context of growing up with a frightening mother, a nonprotective father, and equally helpless siblings. Schore’s work helped me think about Jessie’s suicidality as a problem in affect regulation, rather than a wish to die. With a dysregulated nervous system and a coping toolbox limited by her childhood, her ability to soothe and regulate emotions was minimal. The affect associated with even acknowledging her traumatic experiences dysregulated her nervous system and set off false alarms in her amygdala, shutting down or hyperactivating autonomic arousal, and interfering with her ability to self-observe and think clearly.

My reading of Schore encouraged me to become more of a right-brain-to-right-brain interactive neurobiological regulator. Instead of using words, logic, or interpretation of the connections between emotions and triggers, I’d base my response on her response.

I concentrated on just two goals: not activating her amygdala in session and using my voice and body language to soothe and regulate her nervous system. That year, she made no suicide attempts and was more stable in sessions.

The Contribution of Somatic Psychotherapy
In 1999, van der Kolk’s motto became “Go to the body!” Personally, I resisted undergoing any body-centered psychotherapy training.

In spite of myself, I signed up for Pat Ogden’s training on sensorimotor psychotherapy after watching videotapes of her help clients resolve trauma. Slowly, I came to understand that a body-centered psychotherapy was less about touch and more about how to work effectively and sensitively with emotions and cognitive schemas.

This new understanding enhanced my work with Jessie. I chuckled when she said she had nothing to talk about, and I went on to ask her, “When you say, ‘I have nothing to talk about’ what happens inside? Do you feel more open or closed? Do you pull back a little? Shut down?”

“It’s more like a wall all the way down my front,” she said.

“And is it a familiar feeling?” I continued gently.

“Oh, yes! I get it with anyone who gets close to me. When I’m wishing to get to know them or wanting them to like me, it’s not there. But when they get closer, when they want something from me, the wall goes up.”

“How clever!” I said. “So your body created the wall to protect you from people who want things. That’s brilliant! Let’s just be curious about how it works, how your body knows when people want things.” I noticed that as I reframed the wall as a helpful tool, she looked more relaxed-and eager to keep talking. She was no longer that person who had “nothing to talk about.”

The Mindfulness Revolution
Mindfulness is inherently about relationships: how we relate to our bodies, beliefs, and emotions. In contrast, the hallmark of PTSD is being trapped in the past. While the neuroscientific world gave us the beginning of a science-based explanation for understanding PTSD, mindfulness offers a way for clients to change their relationship to the darkness of their pasts.

I now ask clients to avoid their usual habits of attachment or aversion and discover how to build new habits of nonjudgment, which, with sufficient repetition, evolve into increasing self-compassion, or at least neutrality. In this way, the mindfulness movement has been a practical extension of the neuroscience revolution, which has shown us that mindful concentration activates the medial prefrontal cortex and decreases activity in the amygdala-which, in turn, eases regulation of the autonomic nervous system.

Helping clients heighten curiosity and interest while not automatically descending into shame and self-blame is a slower process than helping them tell a story, describe a problem, or even devise solutions.

Mindfulness has also introduced the psychotherapy community to the idea that, instead of looking to painful, dark emotional states, we can look to positive states of mind and body as the source and essence of healing.

As neuropsychologist and therapist Rick Hanson explains in his bestseller Hardwiring Happiness, we need to be aware of “the negativity bias”-the human brain’s tendency to attend preferentially to negative stimuli, scan for danger rather than pleasure, and encode negative experiences more rapidly and permanently than positive ones. Hanson warns that if we don’t attend to and install positive experiences in psychotherapy, “the brain’s net will automatically keep catching negative experiences.”

In contrast with 25 years ago, the trauma treatment of today focuses survivors not primarily on pain, but on accessing new, more expansive feelings, the kinds of feelings they would have experienced if they’d never been traumatized. Listening to and witnessing the clients’ experiences remains central to the treatment process, but we’ve learned to give weight to our clients’ attachment experiences, to how their brains and nervous systems work, their ability to notice rather than judge, their appreciation of what it took of them to survive life’s setbacks, and increasing their capacity for noticing what’s happening in their bodies as the primary pathway for staying in tune with the present moment.

As I often say to my clients…

The goal of therapy is simply helping them reclaim their birthright, the basics to which all children are entitled: a sense of safety, welcome, and well-being.

This post is based on an article originally brought to life by our partner, Psychotherapy Networker.

Click here to read the full article, “Putting the Pieces Together,” written by Janina Fisher.

Psychotherapy deal4

There are thousands of victims. Will you help them heal?

A message from Bessel van der Kolk.

Traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from their selves.

For those struggling to heal from traumatic experiences, there is new hope: Neurofeedback.

Neurofeedback is a technique in which we train the brain to help improve its ability to take care of itself. By challenging the brain, much as you challenge your body in physical exercise, nuerofeedback can help your brain learn to function better.

But for so many traumatized children and adults, neurofeedback remains out of reach…

For this reason I have created a free CE video giving an in-depth discussion of the promising way to rewire the brain – through neurofeedback.

You’ll learn what neurofeedback is, how we study it, and see the remarkable results that we’ve obtained thus far.

I’ll also tell you why right now, neurofeedback is not eligible for insurance reimbursement and what you and I, together, can do about that.

I appreciate your dedication to improving trauma treatment and committing yourself so much to the mental health profession.

Please, enjoy my free CE seminar – and share with your colleagues to help me get the word out.

Bessel van der Kolk

P.S. Here’s that link again, and please take a moment to share this post on social media with your friends and colleagues! Sharing is easy, just click the icons below.

SongwritingWith:Soldiers—Rebuilding lives shattered by PTSD

Flashbacks, nightmares, intrusive thoughts…lingering symptoms that plague combat veterans struggling with PTSD. Now there is an innovative treatment for those looking to heal. Check it out…

Whether they have been wounded, shot at, or tragically witnessed death, thousands of military service members are struggling to cope after returning home from war. Posttraumatic stress disorder (PTSD) can occur after any person, civilian or service member, experiences trauma.

While there are many treatment options for service members struggling with PTSD, there is now a unique program helping soldiers rebuild trust, release pain, and forge new bonds through song. It’s called SongwritingWith:Soldiers.

SongwritingWith:Soldiers (SW:S) uses songwriting as a catalyst for positive change. In SW:S workshops, service members are paired with award-winning, professional songwriters to craft songs about their experiences, often about combat and their return home.

Want to learn more about this unique program?

Join Bessel A. van der Kolk, M.D., world-renowned trauma expert, as he presents the 26th Annual International Trauma Conference. This year’s conference will feature SongwritingWith:Soldiers in the Experiential Interventions track.

What do you think about this innovative program? 

Tell us what you think in the comments below!

SongwritingWith:Soldiers, Scott TRAILER from Mercy Lamp Productions on Vimeo.

Reserve your spot today! The 26th Annual International Trauma Conference presents current research findings on how people’s brains, minds, and bodies respond to traumatic experiences; how they regulate emotional and behavioral responses; and the role of relationships in protecting and restoring safety and regulation.

Interested in educational opportunities with Bessel A. van der Kolk? Click here.

Stop Reinforcing Shame with this Body Posture

If you’re going to get any joy out of being depressed, you’ve got to stand like this…

Why does shame ‘stick like glue’ for decades after the trauma?

Shame can be harder to shake than fear because we attach meaning to shame. Our bodies use shame as a survival response, and it also evokes other powerful feelings and responses such as:

  • Accompanying meaning-making that exacerbates the body responses and creates a ‘vicious circle’ of shame.
  • Feeling personal: it’s about “me.”
  • Being reinforced by other trauma-related schemas, such as “It’s not safe to succeed…to be self-assertive…to have needs…to be happy.”

In Shame and Self-Loathing in the Treatment of Trauma, Janina Fisher, Ph.D. explains how persistent shame responses reflect procedural learning, allowing the trauma survivor to respond instinctively, automatically, and non-consciously.

How can you help your patients break these automatic shame responses?

One way to do this is by combating shame through the body. Watch as Janina Fisher, Ph.D., shows you how to stop reinforcing shame with body posture.

What do you think of Fisher’s technique for combating shame through the body?

Tell us in the comments below.

Like what you see? Watch the full version of Shame and Self-Loathing in the Treatment of Trauma.

Emotional Freedom Technique: Tapping to better emotional health

Can you tap yourself to better emotional health? Watch and learn as Linda Curran, LPC and president of Integrative Trauma Treatment, LLC, demonstrates EFT.

The Emotional Freedom Technique (EFT) is an emotional version of acupuncture where patients will tap themselves to better emotional health.

Watch Linda A. Curran walk through EFT in this short video. Curran uses EFT to provide clients an integrative approach to trauma and treats PTSD in adolescents and adults, including those suffering from eating disorders, sexual trauma and self-injury.

Want to learn more? Check out Linda Curran’s book 101 Trauma-Informed Interventions: Activities, Exercises and Assignments to Move the Client and Therapy Forward.