What Trauma Resolution Through Somatic Experiencing?


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What Trauma Resolution Through Somatic Experiencing?

by Content Manager

26May

Somatic Experiencing is unlike other therapies for recovery from trauma, such as “talk therapy” or analysis to get to root causes, Cognitive Behavioural Therapy (CBT)  (which works with the relationship between thoughts, feelings, symptoms and behaviours), or Critical Incident Debriefing* which is not to say that any of these are not helpful.  Somatic Experiencing is based in hard science (anatomy, physiology, and the New Brain Science that has been emerging over the past 20 years or so), and also seems to transcend the science.  It works with the conscious mind, the physical body (through sensation and movement) and with conscious and unconscious memory.   Somatic Experiencing helps the body of the trauma victim to complete the defensive responses that were engaged during the experience, but did not get to complete because the defensive responses were overwhelmed or over ridden (with our conscious will).

*Critical incident stress management (CISM) is an adaptive, short-term psychological helping-process that focuses solely on an immediate and identifiable problem. It can include pre-incident preparedness to acute crisis management to post-crisis follow-up. Its purpose is to enable people to return to their daily routine more quickly and with less likelihood of experiencing post-traumatic stress disorder (PTSD).[1] Evidence-based reviews, however, have concluded that CISM is ineffective for primary trauma victims, and should only be used for secondary victims, such as responding emergency services personnel. CISM was never intended to treat primary victims of trauma. (From Wikipedia)

In somatic experiencing, there is a very important relationship between emotions, physical sensations and movement impulses related to traumatic or overwhelming experiences.  By paying attention to and following sensations that are noticed in the body and how the sensations shift and change relative to thoughts and feelings associated with the traumatic experiences in a very carefully guided way, the huge survival energies and emotions related to the traumatic experience that have gotten stuck in the body/mind can be gradually discharged out of the body and nervous system.  The experience then becomes a memory without the emotional charge and emotional triggers any more.  It becomes history and is no longer constantly present to the individual once the trauma(s) are fully processed.

The normal sequence of events in the body when there is a threat to survival is as follows: there is a sudden pause in activity; visual and auditory acuity are suddenly heightened; and there are movements of the body, like turning the head and body to try to locate the source of the threat.  Blood is diverted away from the thinking/problem solving part of the brain (our prefrontal cortex) and our internal organs to the large muscles of the body.  The subconscious/instinctual or pre-programmed strategies for dealing with threat will automatically kick in (i.e. whatever strategies that were used in past experiences for dealing with threat whether they worked or not, and/or well practiced/rehearsed strategies for dealing with dangerous situations such as training of first responders) and there is a huge surge in adrenaline and physical strength as the body prepares to fight or flee

If the physical measures to escape or subdue the threat have been successful, what happens with prey animals in the wild is that they will shiver and shake and discharge the excess energy that is in the nervous system out of the body, and there will be no emotional residue from the experience.  Life returns to normal.  Humans are also designed to discharge excess survival energy this way.   But this process is often interrupted by well meaning helpers or even by the conscious mind of the trauma victim who may be fearful of these natural body responses.  They can even be regarded as socially inappropriate and therefore suppressed.

If fight or flight are not possible or are unsuccessful, it’s as if a switch in the brain gets flipped (it’s involuntary) and the mind and body go into a state of freeze/dissociation where the individual may lose consciousness, experience an “out of body state”, or feel an unnatural state of peace without pain, even with serious injury to the body.  The person may look as if they are limp, or dead, but this state is akin to having both the gas pedal and brake pedal to the floor at the same time in your car.  The huge survival energies that have been mobilized are still present but just not visible to the observer.

If the threat has passed and the state of freeze/dissociation is allowed to proceed to completion without interruption, there will be the same kind of discharge of energy as described above.  The body will twitch, shake and tremble.  There will be changes in breathing patterns and circulation as the body as the body discharges the excess energy.  If the individual was in full flight, or engaged in fight or was experiencing violence at the time of the freeze, then running or fighting movements and emotions will likely occur as the individual comes out of freeze.  There is a saying: “as they go in, so they come out”.   Our paramedic and hospital emergency procedures do not take this into account.  If a person is tranquilized or restrained during such an experience, the energy will not be discharged, and the sensory impressions of the environment at that time will be stored in procedural (subconscious) memory, to get triggered during future experiences and often interfering with the person’s ability to function well in their life.  

When the normal sequence above is interrupted and the body is unable to complete the survival strategies and discharge the excess survival energies, it is like the survival part of the brain thinks that the emergency is still happening even when it is long past.  Ongoing.  For years even.  This can cause constant anxiety, hypervigilance, irritability, anger, rage, hypersensitivity to light and sound, feeling constantly in a fog, confusion, physical awkwardness or being accident prone, easily disoriented, disorganized, intrusive memories, panic attacks, nightmares, difficulty with focus and concentration, difficulty with new learning, and more.

A very interesting thing happens with memory too when one has experienced unresolved trauma.  We have two kinds of memory.  The kind of memory we are mostly aware of is our autobiographical memory or conscious memory. It is consciously retrievable.  The associated part of the brain is called the hippocampus.   This functions best when we are in a generally relaxed, neutral or happy state of mind.  We use this kind of memory when we are learning, studying, recalling what we had for breakfast yesterday, our grocery list, and important events in our lives for example.  The other kind of memory is called procedural memory.  It is where we store procedures that we have practiced so much that they become automatic, so that we don’t have to think about all the steps involved in the specific activity.  Examples of procedural memory could be driving a car, riding a bike, playing a musical instrument at a high level of proficiency, or having a high degree of proficiency in dance or a martial art.  This subconscious (procedural) memory is also where memories associated with traumatic events are stored.  The brain structure associated with this is the amygdala.  It is part of our survival system.  Everything that we see, hear, feel, do, experience in an overwhelming traumatic event gets stored here for the body/mind’s future reference and use if a similar situation should arise in the future.  For example:  a trauma survivor may not remember the event but every time they see a red car or hear a siren, they experience rage, anxiety, or a panic attack and don’t know why.  And they have no conscious memory of the red car that hit them or the siren they heard as 1st responders arrived on the scene.  For the body/mind, it’s like the emergency is still happening.

In Somatic Experiencing one’s life is seen as analogous to a river.  Our life flows like a river.  There are rocks and rapids from time to time.  Sometimes it is flat and calm.  Sometimes it flows fast.   As long as we can navigate the rapids and around the rocks, we can manage quite well.  However, sometimes there is an overwhelming event or trauma that breaches the bank of the river and creates a whirlpool that can catch us and suck us down.  This is called the TRAUMA VORTEX.  This includes all the experiences and emotions associated with the specific trauma.  Contact with the Trauma Vortex could be as simple as just mentioning the event.  A deeper contact would be giving a headline version of all of the associated events.  The deeper into recalling the trauma associated memories and sensations that one goes, the more activated or aroused the nervous system becomes and the more intense will be the emotions and physical sensations and memories that are experienced related to the event.  There is also what is called the HEALING VORTEX.  This flows in an opposite direction, metaphorically, to the Trauma Vortex.  This is made up of the individual’s resources, which can be memories or actual things that feel neutral, or less bad, or positive and uplifting to the person.  It can include positive memories, sensations and experiences that the person has had in their life.  It can be as simple and transient as the hearing the gentle rustle of leaves or recalling a great conversation with a friend.  It can be the presence or memory of a person who unconditionally loves and supports you, or an important accomplishment that felt wonderful.   By moving our attention between the Trauma Vortex and the resources associated with the Healing Vortex, the energy that has been stuck in the nervous system can be gradually discharged, so that triggers are neutralized and no longer have the effect of taking us back to the event as if it is still in the present.  This is done by tracking sensations in the body within the limits of tolerance (i.e. not going into overwhelm).

To track sensations in the body means to notice and follow sensations in one’s body with curiosity, suspending any judgment of good or bad, no matter how uncomfortable they may feel, at the same time paying attention to such qualities as intensity, sized, shape, direction, hardness/softness, contraction/expansion, texture (eg. Smooth or prickly), and even colour which can be associated with the physical sensation.  When we focus our attention on, and follow a sensation, it usually changes, shifts or moves somehow, and if it doesn’t, another sensation usually arises somewhere else which can then be followed.  

The Somatic Experiencing practitioner guides the client’s experience back and forth  between the memories, feelings, sensations, and/or movements related to the Trauma Vortex, and the memories, thoughts, feelings, and experiences related to the Healing Vortex in a safe and manageable way such that the bound survival energy is gradually and safely discharged from the body and nervous system.  As this bound energy is discharged and survival responses are completed, the Trauma Vortex gets smaller and smaller until it disappears, and what is left are the memories of the experience without any emotional charge or attachments.  What this looks like is that a person is able to talk about what happened to them without feeling like a victim any more, from a place of neutrality, or even empowerment, no longer mysteriously triggered by thoughts or sensations, or movements or people or things in the environment.

The difference between managing symptoms of trauma, and trauma resolution is something like the following metaphor:  consider a swimming pool, which is full of inner-tubes floating on the surface.  The pool represents the person and the inner-tubes represent unresolved traumas.  Managing symptoms (as in Cognitive Behavioural Therapy (CBT), talk therapy, or blowing off steam by doing strenuous physical activity like working out or running for example) is like letting air out of the inner tubes, which is not to say that these are not important or unhelpful – they can be very helpful.  Taking medication or supplements to manage symptoms such as anxiety or depression can also be very helpful, but it’s like lassoing the inner tube from the bottom of the pool and pulling it down under the surface, so that the individual can perhaps function better in their life while taking the medication or supplement, or applying the management strategies.  But the inner-tubes are still there, in the pool, under the surface, only to rise again to the surface when triggered by something in the environment or even an internal experience such as a sensation, thought , or feeling.  Trauma resolution through Somatic Experiencing is like dissolving the inner tubes.

by Melody Lynden, B.Sc. OT, OT Reg. (Ont.)