Posts from the ‘Trauma Recovery’ Category

Apr 13

Healing Past Relational Trauma with Wholehearted Presence

The swirling busyness and restless energy settled and a profound stillness permeated the room, enveloping the group like a soft feather blanket. Sitting in silence and sensing the body was unfamiliar territory for most of the two-dozen workshop participants. After all, for many of them, the body had long-been associated with shame, self-judgment, discomfort, and trauma. Yet, there they were, courageously bringing compassionate awareness to their embodied experience, one moment at a time. Opening to the life that had been refused, again and again, until that moment.¹

This is a description of the first day of the first REAC²H workshop, which was conducted with a group of female survivors of childhood maltreatment. REAC²H is an acronym that stands for Restoring Embodied Awareness, Compassionate Connection, and Hope. It is an innovative approach to healing past relational trauma by cultivating present-moment awareness and self-compassion. The workshop was designed by Dr. Jon G. Caldwell, DO, PhD after years of research and clinical work in the fields of traumatology, attachment theory, affective neuroscience, and contemplative practices.

The REAC²H workshop was specifically designed to help individuals who have experienced “relational trauma”, which encompasses various kinds of emotional, physical, and sexual abuse that occur in the context of close relationships. Relational trauma has meaningful effects on the attachment system – an innate, biological system that facilitates interpersonal connection to adaptively shape human development. Thus, relational trauma and the resulting disturbances in attachment can have profound effects on a person’s developmental trajectory across the lifespan.

Aug 5

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Opening to the Shadow Self

Call it suppression or repression or whatever… the point is that we have a tendency to avoid pain. Not because we are wimpy – quite the opposite actually – much of the time we avoid pain as a way to “stay strong”. We avoid pain because it feels overwhelmingly huge and there just doesn’t seem to be enough “space” to deal with it. We think that we have to stay strong, for our partner, our kids, our job, or our quivering sanity. After all, life just keeps moving, and for most of us, at a pretty quick pace. So, what do we do? We stuff it down… we tuck it and run. We sequester the shadow parts of our self and we keep moving. We survive.

Once the unwanted parts get tucked or stuffed, we don’t really want to dredge them up. We convince ourselves that the unpleasantries of our past are better left in the dark recesses of our minds; “I mean, what good would it do to bring it all up now”, we might say to ourselves. In fact, over time we may not consciously remember what we pushed into to the shadowy corners of our psyche. We may develop nifty habits to keep the threatening information from bubbling to the surface, like addictive behaviors, unhealthy ways of thinking, or maladaptive emotional patterns. These aversive measures do keep the blackness at bay, at least for awhile, but they don’t hold.

Life has a way of reminding us of those things we don’t want to think about: The weight of an old betrayal that we relegated to the attic of our mind threatens to break through the sagging ceiling and drop into the living room of life each time someone threatens to leave us; a shot of fear rips through our body when we pass by the craggy door of our psyche’s cellar where long-ago we banished our unwanted shame related to hurting a friend or family member; we pull the emotional curtains tight to shield us from seeing the characterological garbage we threw over the back fence of feeling. It’s all tucked and stuffed… but not necessarily gone.

Jun 4

Practicing Boundaries without Armoring the Heart

Life seems to offer plenty of opportunities to practice boundaries! Whether it is in our relationships with family and friends or at the grocery store check-out line, we have many chances to decide if, when and in what ways information and people can be part of our lives. Maintaining healthy boundaries is widely considered a fundamental aspect of the recovery process and an important practice for general well-being. However, without a measure of thoughtful awareness, boundaries can inadvertently create walls around our heart, keeping us from connecting wholeheartedly with ourselves and others.

At The Meadows we often talk about two kinds of personal boundaries: external and internal. An external boundary has to do with monitoring and regulating the quantity and quality of other people’s interactions with us. An external boundary is sometimes considered a physical boundary because it deals with how much closeness we allow between ourselves and others. This degree of space between us and others can be related to actual physical proximity and contact or it can be related to emotional closeness and intimacy. Read more

Mar 22

From Islands to Landmasses: Gradually Increasing a Sense of Safety within the Body

As I try to understand the effects of psychological trauma, often it’s the body that tells the story. This was certainly the case with Jennifer (as I will call her). During our first meeting, she entered my office with a veneer of aloofness, but her eyes told a different story; they were darting about, quickly scanning me and my office for any signs of threat. She sat lightly and uprightly on her chair, legs ready to spring into action. Her breathing was shallow and quick, and was probably matched by her racing heart. Her eyes hungrily snatched-up any movement inside and outside my office – always on the prowl for signs of danger. Hers was the body of someone who didn’t know safety and probably hadn’t known safety for a long time.

During our second meeting, Jennifer and I talked about what it was like for her to always feel as though she was on “red-alert”. We talked about her constant scanning of the environment and what that felt like in her body. She described a wad of tightness in her belly that was almost always there – a persistent bodily reminder that she must never let her guard down. Her body was constantly ready to attack or to escape. Read more

Aug 6

Facing the Truth Behind the Mask

“Recovery is about living more in truth than in lies… it’s about facing reality and growing up.”

– Pia Mellody

Over 2,500 years ago, in Athens Greece, playwrights like Sophocles introduced a form of theatrical art known as the tragedy. Greek tragedies typically dealt with weighty themes such as betrayal, loss, pride, jealousy, rage, love, courage, honor, life and death. Often these dance-dramas also explored man’s relationship with God and the existential challenges that are part the human condition. Actors wore elaborate masks with exaggerated facial expressions so that their character’s role, emotional state, and intentions might be accessible to the audience. Commonly, one actor played several characters during the course of the theatrical performance, changing masks for each character and sometimes for each scene.

Fast-forward to our lives today and the Greek tragedy might be used as a metaphor for some of the key aspects of recovery from trauma and addiction. Like an actor in a play, often we are reacting to life’s existential challenges according to a script. This script can influence how we move about on the stage of life; it can spell out our roles in relation to others, how we think and feel, and how we act in various situations. From the first moments of conception and throughout development, by way of ongoing interactions between ourselves, others, and the environment, this narrative is written into our psychobiology – it becomes an implicit script in the mind-body system.

Moreover, similar to actors in Greek tragedies, our implicit scripts encourage the use of certain masks or personas. In many ways, this is completely natural and necessary for a life in which we play many different roles. For most of us, the scenes on life’s stage are constantly changing; we may transition from a family mask to a work mask, then to a friend mask, and back to a family mask, all within the course of one day. However, unlike the actors in a Greek tragedy, for us these personas are not distinct, separate people – they are aspects of a single being, linked together by the person behind the masks.

For some of us, our own life resembles a Greek tragedy, with painful experiences of betrayal, loss, abandonment, and trauma. These experiences are written into the mind-body script that tacitly flavors our thoughts, feelings, and behavior. Some of these life events can be so traumatic that we don’t even want to look at the script – we would rather not face the reality of our situation, it’s just too painful. Yet, our bodies and minds still play the part, even when we don’t pay attention to the script; something happens on the stage of life and we just react according to our past experiences, maybe without even being aware of the script. Read more

Apr 17

The Twists and Turns of Recovery Treatment – A Case History

In my third year of medical school, I was mentored by a brilliant surgeon who routinely pontificated about the virtues of his profession, with clear intent to dissuade me from entering psychiatry. On one such occasion, he disrupted my tense and halting approach at a long abdominal incision with the question: “Do you know what makes a surgeon great?” I looked up from the patient’s pale, still body – scalpel still poised. “It’s not the suturing; you can teach any monkey how to sew.” (That didn’t boost my fledgling surgical confidence.) He went on to say, “When you open someone up, it rarely looks like the textbook. It’s messy, unpredictable. Great surgeons effectively respond to each new situation as it arises… they adapt.”

Although this gifted surgeon didn’t dissuade me from the practice of psychiatry, I was persuaded to believe that effective treatment of the body and the mind requires an ability to adapt to each new situation as it arises. Most people enter The Meadows with some idea of their underlying problems and what they want to accomplish in treatment. However, as people give themselves to the recovery process, often the mental and emotional landscape changes in unpredictable ways, presenting new challenges and new opportunities for healing and growth. The following case history highlights the dynamic unfolding of one patient’s experience at The Meadows and some of the treatment modalities that were adaptively employed on the patient’s behalf. Read more

Mar 14

Attachment Theory in Action: Feeling Attachment Security in the Body

Several months ago, as I sat waiting to board a flight, my attention was captivated by an active toddler sitting (for the most part) on her mother’s lap. Beneath naturally curly locks of hair, her eyes, bright and curious, darted about the busy terminal, feasting on the smorgasbord of novel stimuli. When a scruffy-looking man passed by in a wheelchair and offered a gnarled hand to the young child, she fearfully buried her face in her mother’s loose-fitting sweater. The girl’s mother instinctively pulled her close and whispered softly in her ear while giving the grizzled man an apologetic smile. As the man pushed on, his course laugh still lingering in the air, the girl gingerly emerged from her safe, sweater-cocoon to survey the scene. Still within her mother’s secure embrace, the girl stood-up and ventured an inquisitive glance in the direction of the retreating man. Her fear had been down-regulated and she was able to explore the environment once again.

Interactions like this between a parent and child are repeated on a regular basis throughout early development. From the perspective of attachment theory, these dyadic experiences are the foundation for all social-emotional development. It is noteworthy that, from the earliest moments of life, attachment experiences are interactions between two minds and two bodies. As illustrated by the example above, the mother sensitively responded to the nonverbal intentions and emotions of the child by communicating safety and security through an embodied interaction with her child. In this way, attachment experiences, whether secure or insecure (as in the case of relational trauma and abuse), are incorporated into the body’s self-regulatory systems, and as a result, can play an important role in how the body reacts and responds in close relationships later in life.

This article is part of a series on attachment theory and relational trauma (see the first article for an overview) and is meant to illustrate how attachment theory can guide a therapeutic approach that incorporates working with emotions and the body. To ensure patient confidentiality and anonymity, the clinical example in this article is a fictional account based on many different patient histories and various treatment experiences. Although the following clinical information isn’t associated with one particular person, it is representative of many people who have experienced relational trauma. Read more

Feb 10

Allowing the Unbreakable to Bloom from Broken Trauma Defenses

Long before I was a psychiatrist, I worked at a golf course rummaging through thorny shrubbery and dense pockets of oak trees to find golf balls that had strayed from their masters. As an eight-year-old boy, this hardly seemed like work – it was more like a treasure hunting adventure, complete with the threat of poison ivy and villainous snakes. After a couple of cycles in the ball-cleaner, a relatively unscathed Titleist could fetch a dime, and a bucket of similar balls could finance an extravagant trip to the candy store.

Occasionally I would come across a ball that looked as though it had been mauled by a wild animal (or, more likely, a large lawnmower); the ball’s hard shell filleted open, allowing the mangled elastics to protrude through the untidy gash. Such a ball had no monetary value at the time – but these many years later, the image of the ruptured golf ball has become a meaningful metaphor in my work with individuals who have experienced trauma.

For humans, trauma can take a myriad of forms, yet the immediate response is surprisingly predictable. Like most animals, trauma in humans evokes an automatic and primitive instinct to survive. The traumatic stress response has little need for logic or reason, but instead relies on the unconscious reflexes of fight, flight and freeze. Therefore, out of necessity, the tender and vulnerable aspects of trauma are often swallowed up and pushed away. Survival is the goal. Read more

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