Dealing With One’s Inner Sensations to Move Beyond Trauma

Thursday, January 29th, 2009 | Best of The Cutting Edge | No Comments

Note: This article was originally published in the Spring 2005 edition of Cutting Edge, the online newsletter of The Meadows.

Dealing With One’s Inner Sensations to Move Beyond Trauma
by Bessel van der Kolk

Studying the psychological impacts of traumatic life experiences helps to clarify many issues of human suffering. Understanding how the brain fails to integrate traumatic memories (Chapter VIII: Trauma and Memory. In van der Kolk BA, McFarlane AC & Meisaeth L: Traumatic Stress: the Effects of Overwhelming Experience on Mind, Body and Society. NY Guilford Press, 1996.) helps explain the nightmares and flashbacks in com bat veterans and rape victims or why a woman who was sexually molested might experience sexual contact as if she were raped, even when she loves her partner.

As trauma became better under stood it provided a way to make sense of why many people with deep-seated problems were chronically anxious and afraid, aggressive or manipulative. Many of them had childhood histories of trauma. They are vulnerable to continue to behave as if their lives are in danger and expect to be hurt at the least provocation, including by the very people who care for them. The legacy of having been physically trapped and unable to protect oneself is expressed in bodily reactions such as chronic physical discomfort and illness; unmodulated emotions; and failure to fully, physically and mentally, engage in the present.

Unfortunately, friends, family and even therapists may fall into the trap of giving advice to those who were traumatized. This advice, of course, rarely works; because frozen bodies cannot generate their own action patterns, nor can they follow the suggestions of others. “Helpful” interventions all too often end up in “irrational” explosions of frustrated advisees or “guiding lights.”

In order to gain a sense of control over one’s physical reactions, it is necessary to mobilize the body. Unless we physically come to terms with the remnants of fear and defensiveness lodged in our physical reality, the imprints of the past may permanently alter whether we feel at home in our bodies or are paralyzed in our capacity to be open to and learn from new experiences.

Mainstream therapy helps people by providing insight into the origins of our misery, often in the context of an understanding and supportive relationship. When done correctly, such understanding and support can give people the courage to face previously intolerable realities and help give voice to what was felt to be unspeakable.

Working with bodily states is relatively recent in western psychology. In contrast, most cultures around the world have ancient traditions, such as yoga and tai ch’i, that emphasize working with bodily states to affect the mind. What unites these various body-oriented methods is the common no tion that in order to change, people need to have physical experiences that directly contradict past feelings of helplessness, frustration and terror.

Neuroscience research shows that there is little connection between the various brain centers involved in understanding, planning and emotion–we simply are not capable of understanding our way out of our feelings–whether they are feelings of love, fear, deprivation or hate. In fact, our logical selves tend to run behind our emotional urges and may primarily function to rationalize our loves and hates. Our minds are much like talk show hosts on television who are trying to explain the day’s events at day’s end.

Psychological conflicts, while often having origins in the past, are now rooted in our self-relationships and to our internal sensations that have become blunted, exaggerated or “stuck.” Hence, the process of psycho logical change fundamentally concerns regaining a healthy relationship with our internal feeling states. In contrast to understanding, paying close attention to one’s internal life and the flow of physical sensations, feelings, internal images and patterns of thought (in short, working with the “felt sense” –the ebb and flow of inner experiences) can make an enormous difference in the ways we feel and act.

The pathway in the brain from the conscious self to the emotions (i.e., they only way that people can effectively influence how they feel) links areas in the conscious mind that convey the sense of being in touch with oneself and one’s bodily states (the medial prefrontal cortex and insula), to the emotional centers of the brain (centering on the amygdale), to the arousal centers and, finally, to the hormonal and muscular output centers. What this means is that working with deep sensations and feelings has the potential of attaining a sense of internal equilibrium and balance.

Only after being able to quiet down and master one’s inner physical experiences do people regain the capacity to use speech and language to convey to others in detail what they feel and “remember”. Some choose to then tell the story of what has happened, while others just go on with their lives.

About the Author
Bessel A. van der Kolk, MC Clinical Consultant for The Meadows and Mellody House, is on of the world’s foremost authorities in the area of post-traumatic stress and related phenomena. His research work has ranged from the psychobiology of trauma, and from the effectiveness of EMDR to to the effects of trauma on human development.

Denial Is Not a River in Egypt

Thursday, January 15th, 2009 | Best of The Cutting Edge | No Comments

Note: This article was originally published in the Summer 2004 edition of Cutting Edge, the online newsletter of The Meadows.

Denial is not a River in Egypt
By Robert Fulton, MA, LISAC, Administrator, The Meadows

One of the wittiest adages we hear in 12-Step recovery is “Denial is not a river in Egypt.” It is so witty, in fact, that many recovering people repeat it without asking themselves the absolutely important question, “If denial isn’t a river in Egypt, what is it?”

The answer seems too obvious for further inspection. Denial is about denying that I had a psychological problem. Most often, I denied that I was an alcoholic or an anorexic or that I was a sex addict. But now that I have admitted to myself and to another person that I am any one of those things, I am no longer in denial. I am back in control.

Sadly, intellectual admission often leaves the deeper denial in place – intact and poisonous. The alcoholic awakens every morning swearing not to have another drink and, by 5 p.m., heads to the bar. The anorexic, who has planned three healthy meals, looks at herself in the mirror, sees a fat woman, and decides not to eat. The sex addict at the SA 12-Step program shares the agony of his addiction and, after the meeting, hits on the attractive newcomer.

In recovery, behavior cannot be the driving force. Intellect and affect are the driving forces that determine my behavior. As an addict, I behaviorally shut off my affect and distort my intellect, so that I maintain the behavior that protects me from the awful confrontation with my childhood shame.

Denial of affect involves disassociating from those feelings that our primary caregivers taught us to regard as shameful. Our caregivers taught us to dishonor our feelings, because to honor them and to communicate was to be punished and to be shamed. We learned to separate self from the emotions generated by the truth of what we witnessed. In order to avoid the worth destroying poison of carried shame, we were forced to deny the feelings we had when we witnessed an emotional event in the family.

In order to medicate the pain of having abandoned our authentic self, we find ways to medicate the dissonance – we deny the truth of what we think; we submerge and camouflage the truth of what we feel. The self that emerges from the pain of denial becomes, in most adults, the only kind of “maturity” to which they have access.

We deny on an intellectual level, and we deny on an affective level. We deny intellectually by telling ourselves that two plus two is five. We were empowered to do that, or conditioned to do that, when we were growing up – and two plus two never added up to four in Mommy and Daddy’s household. Our father was a falling-down alcoholic. We said to Mommy, “Daddy’s drunk out on the lawn. He’s passed out. He looks like he’s dead. I’m scared.” And she said to us, “Don’t worry about it; he’s fine.”

The kid knows that the fear of his father’s drunken abandonment is real, but to have that truth, that reality, denied by his mother is to have his reality denied. The child then wonders what’s wrong with himself. Mind you, he doesn’t ask what’s wrong with his father or his mother. They are the ones acting shamefully, yet it is he who feels ashamed – he is carrying their shame. Because the kid’s real fear of the father’s death is being made illegitimate by the lies of the mother, the child himself is now experiencing a death of self – of his own emotional reality and his access to it. He is not allowed to feel the fear of losing his father.

This is the most damaging kind of shame-based denial, because it attacks the child’s very authenticity. He has learned that to have the terrifying emotions attendant upon Daddy’s drunkenness is not all right. Disassociation from self becomes habitual. Denial of self is honored in the dysfunctional family system.

When the child is older and he witnesses a shameful act, the kind of disassociation he experiences will be covered up with a more sophisticated form of social camouflage than when he was 5. For example, he may think that his father’s shameful drunkenness will disgrace the family in the eyes of the neighbors. The primary lie that Daddy is not drunk is justified by the need to remain socially acceptable. The young adult now needs a defense system that not only deflects his father’s shame, but protects his own social self as well. Such denial is often called loyalty and is praised as being politic. He is often told that his cover-up makes him a good citizen.

The child who has viewed his father’s shameful drunkenness may fear that his father will stop loving him should the father became aware that his son sees him as a failed father. In Michelangelo’s Sistine Chapel fresco The Drunkenness of Noah, Noah’s two sons come into the tent and see him drunk, and they experience intense shame. They identify with their father’s unexpressed shame at having abandoned his children and given up power in regard to his sons. The intended Biblical lesson is that to see someone in his nakedness is to obtain power over them. Rarely has the Bible been so psychologically deluded. It is not the children who have power over the parent; it is the shameless parent who holds power over the children through the mechanism of carried shame, setting off a career of adapted wounded-child codependence.

So denial, better than alcohol, is the best dysfunctional medication for shame. However, denial cannot salve one against that sense of hopelessness and despair that is engendered when one loses connection to self. It is then that we feel the need to buddy up to an addictive process that will give a false sense of power, that  will eliminate the fear in a moment, that yields that one-up posturing of denial and grandiosity.

When dealing with these disconnects, one is driven back not only to the newborn-to-age 5 feelings of shame but to the adapted state of ages 5 to 17 as well. The early shame sets the stage for the acting out, through which each individual learns to dramatize brilliantly his dysfunctional avoidance of emotional truth. It is an artistic way of keeping from connecting to oneself and avoiding the agony of re-experiencing the death of our truth.

There is a Catch-22 in this artistic denial, no matter what relief it seems to give us. Even when we manage to get in touch with our honest feelings, if we do not have the tools to survive the encounter, we cycle right back into the wound of abandonment or of shame.

Feelings then seem to us a trigger to an unhealable vulnerability. They become something that we need to stay away from, which is why one of the first things a good clinician does (once a patient is reasonably stable) is to urge the patient to drop into his honest feelings, and to let him know that it is okay, that he is okay. He needs the security to feel that accessing his affect will not kill him.

This is actually what happens in the Survivors Workshop. People begin to express their affective authenticity, and they are not shamed – they are honored. And they begin to honor themselves. I often remember what I always said in group: that we have to learn to honor our feelings, which is to hold them – and ourselves – in high regard. Our feelings are our windows of insight into the depth of who we are. But all of that is for naught under the guise of affective denial when, in a defended posture, we compulsively seek to offset the initial wound of being defective, of being unworthy.

In reactivity to the carried shame of abusive childhoods, there are those who acquiesced and expressed their shame, pain, fear and anger in neurotic, seditious ways. Then there are those who rebelliously fought for some kind of voice, but who lacked the tools for connection. In either case, the trauma disconnects one from oneself.

The aim of treatment is to allow me to reconnect to me for the first time as the beneficent parent, the loving parent who needs to be nurtured for who and what I am. At the same time, I learn to present my authenticity and accept the vulnerability that my truth may meet within the world, even if the world shuns me. You may be sad, but you will have the joy and power and value of not disconnecting from the self. You do not rise above and go one-up; acceptance of one’s imperfect perfection is a soaring disengagement from that which is destructive.

People taking the first steps to deal with the trauma of carried shame will choose submission rather than surrender. This submission is often an intellectual admission that there is a problem. But unless the submission is also a surrender to the will, this apparent surrender of dignity will leave a bad taste; it will feel dissonant. It will be sensed as a false admission, one made to keep the depth of the real problem at a distance. The feeling of true surrender is internal peace. Only I will know. But I know I have surrendered when I feel that peace.

The concept of denial and surrender being in that same crucible is vitally important, because denial is a form of false security through control. If, by admitting we are addicted, we seek clarity for the sake of control, it is only to give ourselves the illusion of safety. We remain terrified of letting go of control, because if we let go of this charade, we are going to be left in the abysmal pit of carried shame. So our whole life has been to orchestrate this nonsense. We know it to be nonsense, but we don’t know anything other, so we medicate the nonsense.

In recovery, however, I am now invited to go to a place of powerlessness, and that is a miraculous paradox, because it is only there that I can be empowered. The first thing that has to happen is for you to acknowledge that change is impossible without help. When I surrender, I learn to trust another to give me that help, to help me get on the path to recovery. The recovering individual, once the path becomes a reality, takes the path and continues to go forward.

When somebody gets into recovery, and they begin to date again, it is like being back at 14 or 15, even though she is 40 or 50, because it is a whole new experience. There is the similar excitement and fear and passion – it is a whole new way of relating. It is not a state of authenticity and acceptance of self within memory. Because it is new, it is innocent. In recovery, we experience “innocence.”

And so the healthy lineage allows for the delight, the life, the joy, the possibility and the joy-pain – ever new, ever going forward. Healthy, functional shame, not the sickness of carried shame, is what fuels the joy and the richness, because it reminds me of my authentic self; it puts me back on the path, back on line. As you move in a new venture, it is all new and, therefore, a delight.

And you may find that you have overstepped and then feel ashamed of a behavior because it was all new, but it is now functional shame that allows you to become more intimate, to feel more deeply. I am imperfect, and I make mistakes. My mistakes may cause me pain, and they will. But they don’t make me bad. They only make me human. And that, I don’t have to deny.

The Meadows Recognized by PETA for Vegetarian Offerings

Tuesday, January 6th, 2009 | Meadows in the Media | No Comments

The Meadows is proud to announce that its commitment to healthy vegetarian and vegan meal options has been recognized by People for the Ethical Treatment of Animals (PETA).

Our treatment center was recently named of the top five vegetarian-friendly rehab centers, and received a framed certificate of appreciation and congratulatory letter from PETA, which is hanging in our dining room.

Praised for menu offerings such as veggie burgers, vegetarian casseroles, and organic produce, The Meadows is mindful that its patients and guests often have personal or philosophical dietary requirements.

According to Tracy Reiman, PETA’s Executive Vice President, “a healthy, humane vegetarian diet can heal the body, mind, and soul.”

For more information, please see PETA’s Top Five Vegetarian-Friendly Rehab Centers on the PETA Files blog.