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Episode 114: How We Heal from Trauma (With or Without a Therapist)

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Summary

The last 2 weeks we've talked about how trauma affects the brain (giving you an external locus of control, reduced impulse control, and impaired memory) and how trauma affects the body (reduced metabolism, fibromyalgia, autoimmune disease, just to name a few). 

And after hearing all that, you may be feeling a bit hopeless, wondering if your past trauma is going to define and limit the possibilities for your future. 

It isn't. Not if you're willing to do the work. 

Now before you click away thinking 'the work' automatically means throwing major money down for a therapist for the next 10 years, think again. 

If you've been following this blog/podcast you know I am in love with therapy and my life wouldn't be the same without it. But healing is not relegated to those of us getting professional help.

In 'The Body Keeps the Score', Dr. Van Der Kolk lays out a plethora of incredibly powerful, scientifically proven healing practices you can do on your own completely for free. 

To get the most from this episode, I strongly recommend you click the link at the top to listen. 

Below are simply my notes from the book that will be guiding our conversation on the podcast. 

And as always, if you love this episode please share it with your friends and family or on social media. We need this conversation to reach far and wide. I think most people listening to this will wish they had these lessons earlier, so let's get it out there!  

  • Top-Down Self-Regulation.
    • "Involves strengthening the capacity of the 'watchtower' (of the brain) to monitor your body's senses. Mindfulness meditation and yoga can help with this." 
    • This is what traditional talk therapy relies on, focusing on the logical brain to do the healing work. 
  • Bottom-Up Self-Regulation.
    • "Involves recalibrating the autonomic nervous system (ANS) which originates in the brain stem. We can access the ANS through breath, movement, or touch."
    • This is where we change our relationship with our body sensations with practices like breathing patterns, tapping acupressure points, rhythmic interactions with others (like bouncing on a pilates ball or tossing a ball back and forth), drumming, or dancing to music. 
      • Inhaling activates the sympathetic nervous system (fight or flight), while exhaling activates the parasympathetic nervous system (rest and digest). So when doing breathing practices, it's helpful to emphasizes and lengthen the exhale. 
  • Mindfulness.
    • Mindfulness is the ability to calmly hover over and observe our thoughts, feelings, and reactions. From a place of mindfulness, the executive brain has the ability to override the hardwired emotional responses of the reptilian brain. 
    • To work through trauma we need to feel we have agency over ourselves, and agency starts with self awareness. With awareness of ourselves comes the ability to manage ourselves.  Knowing what we feel and why we feel it gives us a greater capacity to control our lives. Which is why mindfulness practices that foster this self awareness are so powerful in overcoming trauma. 
    • "The only way we can change the way we feel is by becoming aware of our inner experience and learning to befriend what is going on inside ourselves."
    • Mindfulness meditation has been shown to have a positive effect on numerous psychiatric and stress related symptoms like depression and chronic pain, as well as broad effects on physical health like improving immune response, blood pressure, and cortisol levels. It also activates the part of the brain involved in emotional regulation and decreases reactivity to potential triggers by calming down the amygdala. 
  • Connecting with and trusting our body.
    • Trauma can hijack the body's sensations, leaving us disconnected from ourselves and not feeling safe inside our own bodies. But we need to feel safe in our own bodies so we can trust our instincts and internal signals. This is why sensing, naming, and identifying what's going on inside is the first step to trauma recovery. 
      • Exercise: notice and describe the physical sensations in your body associated with different emotions you're experiencing. 
    • Yoga is a great way to connect with the interior world and build a caring and loving relationship with the self. Yoga brings awareness that feelings are transitory and it helps you tolerate discomfort because you know there is an end.
    • "If you are not aware of what your body needs, you can't take care of it. If you don't feel hunger, you can't nourish yourself. If you mistake anxiety for hunger, you may eat too much. And if you can't feel when you're satiated, you'll keep eating. This is why cultivating sensory awareness is such a critical aspect of trauma recovery."
      • 10 weeks of yoga markedly reduced signs of PTSD even after regular methods were used and didn't work. 
    • Karate, acting, rhythmic tapping, and other movement styles are great ways of connecting with the body and relaxing it, which then allows you to more easily work on the mind.
    • When dealing with hard emotions and memories, establish islands of safety within the body that you can connect with so you don't get overwhelmed.
      • Examples: focusing on your hands, tapping acupressure points, raising arms and lowering them in sync with your breath.
    • "As we begin to re-experience a visceral reconnection with the needs of our body, there's a brand new capacity to warmly love the self. We experience a quality of authenticity in our caring which redirects our attention to our health, our diets, our energy, our time management. This enhanced care for the self arises spontaneously and naturally. Not as a response to a should, we are able to experience an immediate and intrinsic pleasure in self care." -Stephen Cope 
  • Social support.
    • Being able to feel safe with others is the most important aspect of mental health. "Numerous studies of disaster response around the globe have shown that social support  is the most powerful protection against becoming overwhelmed by stress and trauma. 
    • For our physiology to calm down, we have to feel viscerally safe which means it isn't enough to be around people. We have to feel seen, heard, understood, and safe.
    • Play!! It makes you feel safe, connected, and joyful (all of which are robbed during trauma). 
    • The most natural way we calm down our distress is being touched, hugged, and rocked. This helps with excess arousal and makes us feel safe, protected, and in charge. 
      • No one to hug? You can benefit from therapeutic massage.
  • EMDR (eye movement desensitization and reprocessing)
    • This practice allows you to access memories of the trauma without being overwhelmed by them. "When the brain areas whose absence is responsible for flashbacks can be kept online while remembering what has happened, people can integrate their traumatic memories as belonging to the past."
  • Cognitive Behavioral Therapy
    • Patients are gradually desensitized to irrational fears by bringing to mind what they are most afraid of. Or they're placed in actual anxiety-provoking situations. Or they're exposed to virtual reality. The idea is when you're repeatedly exposed to a trigger without bad things happening, you gradually become less upset. 
    • This style of therapy also helps patients face their tendency to avoid. 
    • Research has shown that over 100 minutes of flooding (in which anxiety provoking triggers are presented in an intense, sustained form) are required before decreases in anxiety are reported. 
  • MDMA
    • This drug increases people's awareness of themselves. It leads to a heightened sense of compassionate energy, curiosity, clarity, confidence, creativity, and connectedness. It can enhance the effectiveness of psychotherapy because it decreases fear, defensiveness, and numbing, and it also helps you access inner experience. It increases your window of tolerance so you're able to revisit traumatic memories without overwhelming yourself. 
  • Acupuncture, massage, yoga, and EMDR were reported as the most used and most helpful tools that 9/11 survivors relied on to cope. 
  • Speak it.
    • Naming our trauma offers a different kind of control than staying silent. As long as we keep feelings hidden away, we are perpetually at war with ourselves. 
    • Holding in your emotions and pain is exhausting and zaps us of the energy and motivation to pursue goals and trying to ignore our reality damages our sense of self. 
  • Write it. 
    • Writing is one of the most effective ways to connect with inner feelings. 
    • "When you write to yourself you don't have to worry about other people's judgement, you just listen to your thoughts and let their flow take over." 
    • If you ask your inner-editor to leave you alone for a while, you'll be shocked at the things that come out. 
      • Activity: Pick a random object, and write the first thing that comes to your mind. Then keep going without stopping, rereading, or crossing out. 
    • In a study of UT students, a professor divided his class into 3 groups: group 1 wrote about what was currently going on in their lives, group 2 wrote about the details of a traumatic or stressful event, and group 3 would recount their traumatic experience, their feelings about it, and what effect they thought it had on their lives. Those who wrote both the facts and emotions related to their trauma benefited the most. They had a 50% drop in doctors visits compared to the 2 other groups. 
    • Study after study shows writing about upsetting events improves physical and mental health. 
    • A group of trauma survivors were told to express their trauma through dance each morning and then write about it. Over the course of 3 months they noticed marked improvements in their health, happiness, and GPA. 
  • Internal leadership among our parts.
    • We all have a parts of ourselves that are childlike and fun, but they are the parts that are most harmed by abuse. They carry the terror with them, making them toxic, and making us lock them away inside. These parts are called the Exiles.
    • The protective parts then come to shield us from the exiles:
      • The Managers, who can be critical, overly productive, and perfectionistic in an attempt to remain in control.
      • The Firefighters, who act impulsively any time we experience triggers (they'll bulldoze the house to put out the fire). They're oblivious to the idea that there are better ways to guarantee emotional safety than drinking, eating, excessively working out, cutting, or other forms of 'firefighting'. 
      • The Managers and Firefighters will struggle against each other until the Exiles are allowed to come out and be cared for.  
        • Once the protectors feel safe, the Self will emerge as leader of the inner family. Making sure everyone feels safe, heard, and protected. 
  • Role Playing/Acting
    • By replaying our trauma (in a safe environment run by a therapist), and then rewriting it the way we wished it was, we can create new emotional scenarios real enough to diffuse and counter some of the old ones. 
    • Story of the little boy who struggled with chronic fatigue, learning disabilities, and other mystery illnesses. After getting cast as a confident character in a school play, he started walking around the house role playing the swagger of that character. This was the turning point in his recovery. 
    • Theater is the opposite of dissociation where you're out of your body and trying to disappear. Theater is about feeling emotions deeply so you can convey them to the audience which is powerful for traumatized people who are usually fearful of their emotions and the lack of control associated with them.

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