Remembering Who We Are: Tools to Gain Clarity

Thursday, December 24th, 2009 | Best of MeadowLark | No Comments

Note: This article was originally published in the Fall 2005 issue of MeadowLark, the magazine for alumni of The Meadows.

Remembering Who We Are: Tools to Gain Clarity

Kathleen O’Brien, LCSW

“I want to change, but I don’t know how.”

How many times have you heard yourself utter these very words? Most people come to counseling knowing that their lives need to change, but they often don’t feel confident enough in their abilities to make that happen.

Confusion about what is most important can lead, at the very least, to poor choices and mildly co-dependent behavior and, in the extreme, to serious addiction problems.

It doesn’t work for us to behave in ways that go against our own values. We can suffer depression and/or anxiety when we ignore what we believe to be most important. We then “treat” our unhappiness with self-destructive behaviors, such as dysfunctional relationships, substance abuse, irresponsible spending and so forth. One poor choice leads to another, and soon we find ourselves at the bottom of a very deep hole.

That downward spiral is daunting, to say the least. My experience both personally and professionally has shown me that, in order to make a significant life change, we need to remember who we are, i.e. to have clarity about what we value most.

The truth is that most people know intuitively what is most important to them. When a client finds herself in a predicament, I ask what she would tell a son or daughter to do in the same situation. Almost without fail, she has an instant answer for the problem at hand. It is as though she can access her wisdom for someone else’s benefit (especially her child’s), but not for her own. It’s not that she doesn’t know the answer; she just doesn’t feel entitled to act on her own behalf. As a result, she usually doesn’t develop the skills necessary to get her needs met in a healthy way.

Take a few moments to ponder the following:

• If it did not matter what other people thought, what would you do differently in your life?
• If you knew for certain that you had only a limited time to live (by the way, this is always true), how would you spend that time?
• If you were to die tomorrow, how would your obituary read? Think about what you would be remembered for at this point in time. Who would mourn your passing? What would have been your greatest contribution to the world?

The point here is to focus on remembering who you are. Pia Mellody calls this “remembering that you are precious.”

Over the years, I’ve tried many techniques to help clients clarify how they feel and what they value. I call this “accessing one’s own wisdom.” Here are some techniques I’ve found helpful:

• Write about it. Keeping a daily journal makes it next to impossible to fool yourself for long. There is nothing like hearing yourself complain day after day to get you moving. I speak from experience on this one!
• Consider the best and worst possible outcomes. If the worst happened, how would you deal with it? If you have trouble here, ask yourself what you would tell someone else to do. Sometimes people get stuck because they believe that it’s abnormal to experience pain. They think that life is supposed to be happy all the time. Part of becoming an emotionally mature adult is learning to endure the normal pains of life without resorting to addiction.
• Define what you consider to be universal values. These are the so-called “bottom line” ways of being in the world, e.g. honesty, family, health, integrity, adventure, friendship, love, success, etc. Once you have your own list, take a look to see how closely you are living according to these values. Do your actions match what your heart and mind tell you to do?
• What would other people be surprised to know about you? This is a powerful question to ask yourself – and often very revealing. The answer may offer clues about what you really value.
• Ask someone you trust to write a eulogy for you. It is interesting to get a peek into how others see you.
• Make a collage. Go through old magazines and find pictures that appeal to you; it doesn’t matter why you find them appealing. Trust that your unconscious is leading you to discover more information about yourself. When you find these pictures, rip them out and paste them onto poster board. Place the collage in a place you will see often. What does it tell you about yourself?
• Get away from your problems for a while. Distance can give us a different perspective. Rent a funny movie. Do something physical, such as walking, running, hiking, etc. Experience the nurturance available in nature. A walk on the beach or in a forest can expand perspective and lead to inner calm.
• Look at what you like to do for fun. The way you spend your free time (and your money) can tell you a lot about what you find important.
• Think about how your ideal life would look. Where would you be? What would you be doing? Who would be in your life? Ask yourself why you aren’t doing these things. Try to own the choices you’ve made. It is easy – but not particularly useful – to blame others when it comes to change. How do you want to do things differently? Who might help you?
• Try acting as if you feel confident and competent. What stops most people are negative attitudes such as futility (“nothing ever works anyway”) and fears, including the fear of failure. In reality, we are limited mostly by what we believe is possible. Expect a lot from yourself (and others, too). Define for yourself what your “best effort” would be. Are you doing that? If not, why not?
• Meditate! Use meditation to access your own spirituality. This is not about religion, but about accessing that part of you that needs to connect to your inner self. There is no single way to do this. A class can help you get started. Some medical insurance companies offer meditation classes to help improve health and general well-being.

In conclusion, remember that the way to heal yourself is to know who you are and to live according to what is true for you. When a person acts in truth, it resonates down to the cellular level. You are your own best healer!

Fall/Winter Edition of MeadowLark Now Available

Wednesday, December 16th, 2009 | Best of MeadowLark | No Comments

The Fall/Winter 2009 edition of MeadowLark, the magazine for alumni of The Meadows, has just been published. This issue contains several feature articles:

• The Intimacy Factor by Pia Mellody and Lawrence Freundlich
• Recess Revisited: A Recovery Behavior by Diane Detwiler-Zapp
• Perceptions Create Realities by Charles Atkinson

Also included this issue in are staff spotlights, alumni contributions, a featured workshop (Sexual Recovery), free lectures, and other educational opportunities.  MeadowLark is available in both HTML and PDF formats.

Science and Ancient Wisdom: Treatment Here-and-Now

Thursday, December 10th, 2009 | Best of MeadowLark | No Comments

Note: This article was originally published in the Summer 2008 issue of MeadowLark, the alumni magazine of The Meadows.

Science and Ancient Wisdom: Treatment Here-and-Now

Before reading further, take 20 to 30 seconds to do this exercise: Let your gaze leave this article and let your eyes look around wherever, and at whatever, they want – just 20 seconds or so. (Really, try it, and then come back to reading.) People in my Somatic Experiencing® (SE) Trauma Treatment courses who try this are surprised that, in a very short time, they feel noticeably more relaxed, peaceful, and in the “here-and-now.” Some say they should do this all the time!

Thanks to the forward-thinking people at The Meadows, the connection between trauma and addiction is better understood and more effectively treated. Part of this treatment at The Meadows’ extended-care facilities consists of working with the trauma-resolution skills of Peter Levine’s Somatic Experiencing®. The relationship between trauma and the exercise you just tried is that, according to Bessel van der Kolk, post-traumatic stress is fundamentally a disorder in the ability to be in the here-and-now. This means that the state of- the-art in trauma therapy is no longer intense regressive or cathartic therapy. Instead, state-of-the-art therapy is the process of becoming alive to the moment.

For those I train in SE, like those at The Meadows, working in the here-and-now is a cornerstone of clinical theory and practice. When doing his dissertation decades ago, Peter Levine met Stephen Porges and explored his research. Porges’ “Polyvagal Theory” (Porges, 2001) shows how one pathway of the nervous system engages freeze and another relates to social engagement. Levine discovered how to work with the transition of the nervous system through these phases (freeze and engagement), as well as the phases of fight and flight. This is SE. This article’s focus is on the engagement phase, which must be integrated into all other nervous system phases.

While Porges’ emphasis is based on single linear phase transitions, in SE we work with non-linear and rapid cycling states, for instance, freeze and fight, or flight and orientation. Traumatic symptomology such as intrusion of fight, flight and freeze means that the past has become the present. Flashbacks are the classic example of such disorientation—innocuous cues can trigger an all-out response. In other words, the person temporarily experiences a state that is disconnected from the actual here-and-now environment. One of the antidotes to this traumatic recollection is orientation. I provisionally define orientation as “connecting to the environment through the senses” — in other words, coming back to our senses. This is a broader understanding of engagement than social engagement, per se. For clients whose early life experiences were marked by trauma and abuse, social engagement is actually a trigger for fight, flight and freeze. In this process of orientation, rather than being inundated with a cycle of feelings, thoughts, and sensations associated with unresolved trauma, the client’s attention can be directed to the reality of the environment that is available through the senses. Typically we see decreased blood pressure and decreased heart rate, as well as the subjective experience of greater relaxation and interest. In other words, it is the difference between stopping to smell the roses and reliving getting stuck by a thorn!

With many severely disoriented clients, much of the initial therapeutic work (in addition to establishing rapport) consists of the stabilization that comes from establishing better cognitive pathways or habits of here-and-now sensory attention. In attending to the sensory experiences of the external world, physiological mechanisms for assessing safety are allowed to occur without undue influence from traumatic memory. The mechanisms of this assessment are far too important, in a survival sense, for the slow processing of linear thought or conscious effort. Porges aptly names this subconscious process of safety assessment “neuroception” (Porges, 2004). Thus, a natural orientation to the external environment via the senses facilitates the neuroception of safety.

This approach is receiving increasing scientific and popular attention (Time Magazine: Mind & Body Special Issue, January 27, 2007, pp. 55ff). Whether incorporated into CBT, DBT or meditation, the role of the observer is crucial. The process of orientation is fundamental to this cognitive activity. However, many traditions that recommend observation may not adequately reinforce with clients the importance of orientation to the outer versus the inner environment. For those with significant disorientation, it is nearly impossible to track the interior landscape without being involuntarily drawn into what SE terms the “Trauma Vortex.” The involuntary and repetitive attraction to this “vortex” is the disruption of the approach-avoidance system, and it is one of the dynamics that underlies addiction and compulsive behaviors in general. Although somatically informed therapists draw from Levine’s work, they often make the mistake of inviting clients’ attention to the inward sensate experience, without consideration to the vital criteria that indicate whether a client can negotiate such attention without reactivating and reinforcing trauma states. For instance, one of the most common beginner’s mistakes is when a therapist asks an anxious client to focus on that sensation in the body. For some clients, this can work well and provide a sense of relief and transition to a more relaxed state; for others, this can lead to further discomfort and other states of disintegration. It is vital for the therapist to immediately and accurately assess the client’s capacity in order to determine the appropriate intervention. Without such assessment skill, the safer route is to begin with external orientation, which can stimulate the innate orienting response and build stability.

Once relative stability is attained, a balance of interior and exterior attention can be facilitated. Then a more neutral and practiced observation of the range of experiences can be enjoyed, as the attention can shift naturally between affective experiences, both positive and negative. (This fundamental process at the heart of SE is known as “pendulation,” which I discussed briefly in the Summer 2006 edition of The Cutting Edge) This natural swing between polarities is the normal condition of the balanced nervous system. And interestingly, the resulting integration that comes from this innate oscillation is a broader and more nuanced life in the here-and-now. The experience brings awareness, presence, and a greater ability to experience life on its own terms, without undue constriction or elation. Obtained after significant work of attending, this resulting state can yield an expanse of awareness with an increasing ease of relation and a connectedness to everything that is. This state, known among meditative adepts, is simply our human mind freed of its overlay of conditioning hewn by survival networks related to approach-avoidance. Freed from the dominance of an ill-conditioned approachavoidance paradigm, one enjoys engagement with what is now, new and alive. And so, as clinicians, we can orient to the fact that we live in a time of opportunity, when mind and body are becoming reacquainted, and when science can shake hands with ancient wisdom.

References
Hoskinson, S. (2006) “SE’s Systemic View of Functional Reward Systems.” The Cutting Edge, Summer 2006. See TheMeadows.com.
Porges S. W. (2001) “The polyvagal theory: phylogenetic substrates of a social nervous system.” International Journal of Psychophysiology, 42, 123-146.
Porges, S. (2004) “Neuroception: A subconscious system for detecting threats and safety.” Zero to Three [Online] National Center for Infants, Toddlers and Families. No. 5, May. See zerotothree.org.
Stengel, R. (Ed.). (2007). The brain: A user’s guide [Mind and body special issue]. TIME, 169 (5).

ABOUT THE AUTHOR
STEVEN HOSKINSON, MA, MAT
Under the auspices of Hoskinson Consulting in Encinitas, California, Steven Hoskinson, MA, MAT, is an international consultant and trainer for clinicians and trauma treatment providers. Steven is a Senior International Instructor for the Foundation for Human Enrichment and has done research in creativity, myth and spirituality. His perspectives include evolutionary, developmental, cognitive-behavioral and systems approaches within a mindfulness framework. Other major influences include personal mentoring with Peter Levine, PhD, more than 20 years of experience in the contemplative arts, and a decade as a practicing aikidoist. www.HoskinsonConsulting.org