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Tuesday, October 1, 2019

How & Why Somatic Experiencing Works

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Last week I received a call from a potential client, typical of the ones I receive from those seeking help after spending years in and out of talk therapy yet still finding themselves anxious, depressed, or dealing with maladaptive behaviors such as addiction, gambling, or eating disorders. “Why will this treatment be different from what I’ve had in the past?” asked the caller. 

The short answer: because it will likely be the first time you bring your body into the healing process. 

Our bodies hold memories and imprints of our past experiences. The trauma at the root of our anxiety, depression, and maladaptive behaviors can’t be resolved without our body finding a way to release these memories and imprints. Sustained healing only happens when our nervous system regains equilibrium. Somatic Experiencing (SE) helps us move beyond the cognitive process of understanding our trauma. It’s a process that reprograms the body’s primitive survival instincts, allowing one to feel a greater sense of connection, safety, and ease in one’s body. 

What Is “Trauma Brain”?

To understand why SE is such an effective treatment for trauma, let’s begin by exploring a new way of looking at trauma. 

When we think about trauma in our lives, we often refer to an event: a burglary, the unexpected death of a parent, an accident that left us injured. But Peter Levine, Ph.D., the founder of SE, has a different perspective. He maintains that trauma is not an event, but the energy that gets locked in your body around real or perceived threat. 

The extent to which a person experiences trauma is directly related to their ability to restore a sense of safety in the aftermath of the threatening event. If they’re unable to effectively do that, their nervous system gets stuck in the survival states of fight, flight, or freeze. 

These survival states are only useful for acute states of threat. When an individual gets stuck in a trauma reaction because they cannot restore their sense of safety, the individual will continually sense danger when danger is not present, or completely shut down and lose capacity to live in the present. 

Think about your own experiences, have you ever found yourself over- or underreacting to a situation for no obvious reason? This is often due to the unresolved trauma from the past that is locked in your nervous system.

To illustrate this, let’s think of our brains always acting in two ways: “survival brain” or “safe brain.” In a safe brain state, we are open to learning new information and can see the big picture of a situation. We feel calm, peaceful, curious, and unafraid of making mistakes. 

When the survival brain is turned on, we are hyper-focused, we feel a sense of threat and cannot tolerate ambiguity. Fear dominates our decision-making skills, and we often lose our sense of competence. The longer survival brain stays on, the harder it is to turn it off. 

Safe brain is expansive and life feels vital and joyful. Survival brain creates misperception, ambiguity, and threat. The better we can manage our stress reaction, the easier we can keep out of survival brain. This takes time and effort and requires that we develop a tolerance of uncomfortable sensation in the body. If we are unable to tolerate the uncomfortable sensations, we try to numb them or distract ourselves from them with maladaptive behaviors. By growing our ability to tolerate discomfort, we gain the capacity to move through our challenges and the knowledge that we can safely come through the other side of a difficult experience. 

Why Somatic Experiencing Is Different

When trauma strikes, the nervous system loses its ability to maintain a state of balance. The trapped energy from the traumatic experience causes the nervous system to rush to a state of fight, flight, or freeze — the “over” or “underreaction” that we discussed earlier. SE works to help bring the nervous system back on line by helping the individual restore their sense of safety. This can only happen when the body has a “biological completion” and the trauma energy has the opportunity to reintegrate back into the body. 

SE uses a clinical map to access the physiological states of survival known as fight, flight, and freeze and helps release the self-protective and defensive responses we hold in our body. When an event happens too fast and we do not have the time or ability for self-protection or defense, this survival energy gets stuck in our body as an incomplete biological reaction. This stuck energy is what causes trauma symptoms. 

In this way, humans are no different than animals in the wild. When an animal has been under threat they will reset their nervous system by shaking off the trauma. This shaking is a “biological completion” for the animal that allows its nervous system to restore its sense of well-being.

Often in talk therapy, an individual continues to relive the story of the past experience. And while it is important for the story to be heard, the retelling of it alone does not enable the body to create a new and more empowered relationship with the past experience. 

SE is different. SE includes talking, but the talking is used to track body sensation and meaning attached to experiences, rather than bring the individual back into the event of the trauma. When we bring the body into the therapy process and facilitate a way for the individual to physically move through the experience with a sense of safety, the relationship to the experience changes and the stuck energy will discharge.

This all sounds well and good, but how does it actually happen? 

Sensation, Imagery, Behavior, Affect and Meaning (SIBAM)

An SE practitioner helps the client navigate through traumatic sensations using the framework of SIBAM (Sensation, Imagery, Behavior, Affect and Meaning) to incorporate the body and its experience into the process. 

Unlike most therapy modalities which are considered “top down,” meaning they use our highest form of cognition, SE begins with a “bottom up” approach of sensorimotor processing aimed at guiding the client through the most primitive to the most complex brain systems. The therapist begins by guiding the client to track sensation and movements, helping a patient develop a felt sense of his internal states of tension, relaxation and respiration cycles. This is a powerful mechanism to regulate the autonomic nervous system. 

Cultivating the awareness of these sensations is the foundation of healing the psychological effects of trauma because it allows us to tolerate and complete the physiological impulses that are trapped in the body. For example: if a patient is experiencing intense sensation or tension in their neck, the therapist may ask the patient to observe the tension but also pay attention to other parts of the body that feel more neutral. Through this process, the patient learns to tolerate the experience and begins to develop a sense of being in charge of their physiology. The patient gains confidence and the capacity to feel sensation and emotions without a sense of overwhelm. Just like the animal in the wild, the SE patient will feel a desire to discharge the traumatic energy through shaking, tears or intense heat from the body. 

A client name Pam who came to see me several years after having a stroke. Pam’s nervous system was very activated, especially when she began to tell me about the stroke. Her narrative became fragmented, and her sentences began to fall apart. Her eyes widened; she looked like a deer in headlights. Pam was not safe in her body and used the story of the events before and after the stroke to avoid being with the experience. When I was able to slow Pam down and build a sense of safety between us, we began to move through the events of the stroke in a more cohesive and organized manner. Through the use of SIBAM, Pam began to shake and tremble and discharge the energy that was remaining in her body. Even more interesting was that the shaking happened on the right side of her body and arm, where she had been impacted by the stroke. This was the biological completion of the unresolved trauma from her stroke; soon she felt a greater sense of overall safety throughout her life. 

Leaving the Past Where It Belongs

While the nervous system is designed to be self-regulating, it has its limitations around trauma. Unresolved trauma, especially when trauma is chronic and accumulated, can lead to more extensive mental and physical health symptoms. The long term effect of SE treatment is a restored sense of healthy functioning, which includes reduction in maladaptive coping skills, resolved sleep issues, and mood stabilization — to name a few. When the body gains the capacity to self-regulate, it restores its sense of safety and balance. In turn, stress hormones lower and the body can produce more “feel good” hormones such as serotonin and oxytocin.

As an SE practitioner, I have the privilege of helping individuals restore their sense of safety and gaining a new lease on life. I witness clients experience a renewed sense of safety and ability to experience a more joyful and connected life filled with deep, meaningful relationships. I see incredible openings of creativity and productivity, all of which are possible when one is able to change their relationship with their traumas and leave them in the past where they belong. 



from Psych Central https://ift.tt/2p4Aksm

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