COMMENTARY - THE BODY KEEPS THE SCORE: Brain, Mind and Body in the Healing of Trauma by Bessel Van der Kolk, MD

1. INTRODUCTION: Trauma causes alcoholism

2. Damaging emotional conflicts below the level of consciousness

3. Trauma damages left brain speech

4. BIOFEEDBACK: Meditation on Steroids

5. INTEROCEPTION: Traumatic Awareness

6. What were you thinking right before you acted out your childhood trauma?

7. Communication is the opposite of trauma

8. ALEXITHYMIA: Emotional Retardation

9. EMDR reprocesses body awareness and does not revisit the original trauma in factual detail

10. EMDR is for patients so traumatized that full recovery is thought to be impossible

11. Lock down your childhood trauma instead of acting it out

12. Final Healing: patient’s internal landscape manifests critical mass of Self

13. Restructuring inner mind maps and movies

14. EPILOGUE: Seeking Safety

2. Twelve Steps & Twelve Traditions: Damaging Emotional Conflicts Cause Alcoholism

“Very deep, sometimes quite forgotten, damaging emotional conflicts persist below the level of consciousness. At the time of these occurrences, they may actually have given our emotions violent twists which have since discolored our personalities and altered our lives for the worse.” -12 Steps & 12 Traditions, Step 8, pp. 79-80

“Our main problem is not how we are to stay married; it is how to be more happily married by eliminating the severe emotional twists that have so often stemmed from alcoholism.” -12 Steps & 12 Traditions, Step 12, p. 112

If these severe emotional twists occurred before our drinking began, if we were traumatized so long ago that the emotional twists are “sometimes quite forgotten”, then then according to the A.A. literature, our “damaging emotional conflicts” and “severe emotional twists” contributed to our developing the disease of alcoholism.

THE BODY KEEPS THE SCORE PART ONE: Posttraumatic Stress Disorder (PTSD)

In 1980, psychoanalysts treating war veterans successfully lobbied the American Psychiatric Association to create a new diagnosis: posttraumatic stress disorder (PTSD). However war is not the only calamity that leaves human lives in ruins. In many ways victims of sexual abuse and incest were suffering from symptoms no different than solders who were psychologically damaged from the trauma of war. The majority of Americans experience a violent crime at some time during their lives. -The Body Keeps the Score

Violence and Damaging Emotional Conflicts Caused My Alcoholism

Thirty years ago when I was a litigation paralegal at a major insurance company, one of my co-workers remarked behind my back that I was a ticking time bomb just waiting to go off. She was correct. My whole life I knew something was seriously wrong with me. After fifteen years of recovery the anesthesia finally started to wear off. I became truly sober. I actually experienced a power greater than myself restoring me to sanity. It was only after practicing the spiritual principles of love and forgiveness that a sixty year-old memory suddenly resurfaced with clarity.

Childhood Trauma

Once when I asked my parents about my getting hit in the head with a rock as a child, my Mexican mother told me that I was too young to remember. But I did remember. My body kept the score. My mother was a master of denial and she passed her gift on to her children.

Permanent Piñata Party

When I was four years old at a piñata party in East Los Angeles, the violence of children whacking a hanging doll full of candy did not appeal to me. So as I went exploring this strange new barrio, some older Mexican kids threw a fist sized rock at my head when I wasn’t looking. I was the new kid in town and they decided to teach me a lesson that would haunt me for a lifetime. My first sucker punch and it almost killed me. I woke up in the emergency room of Children’s Hospital in downtown Los Angeles with a concussion. My negligent parents took me back to the very same house where the violence happened, my great-grandmothers residence, and laid me down on great-grandma’s bed. Now I was surrounded by Catholic icons and statuettes. I vividly remember the Black Madonna and how it both frightened and intrigued me.

For the next sixty years I was re-experiencing this entire incident from beginning to the end. I internalized the violence as my mind detached further and further from my feelings and my body kept the score. I spent a thousand hours of my thought life reliving an incident that took a few hours. I kept getting hit in the head by that rock over and over and over again.

My overwhelming childhood experiences affected my innermost sensations and my relationship to my physical reality–the core of who I am. This is particularly tragic, since it is very difficult for growing children to recover when the source of terror and pain is not the shell shock of war but the criminal negligence of their own caretakers. My PTSD made me into one of the most broken souls ever to recover his lost soul. -The Body Keeps the Score

Eye Movement Desensitizing Reprogramming (EMDR)

EMDR by a trained therapist incorporates the same rapid eye movements that the body produces while dreaming. Much like dreaming allows the subconscious mind to organize and heal from the events of our daily lives, EMDR allows the trauma stored in the body to be healed and purged. Only after I underwent EMDR therapy did I begin to get completely well.

Now when I am at Zoom AA meetings I can discern the trauma of my fellow alcoholics in their complicated speech and logic. We now know that more than half the people who seek psychiatric care have been assaulted, abandoned, neglected or even raped as children, or have witnessed violence in their families. One of the things that I find surprising in AA meetings is how little attention recovering alcoholics pay to who they love; what motivates and engages them, what made them feel at peace. This lack of peace seems to be one of the causes of alcoholism that I can see. That is why when I am sharing at AA meetings I say: my peace I give unto you. I would love to help other recovering alcoholics discover their own PTSD and causes of their alcoholism.

The greatest sources of our suffering are the lies we tell ourselves

Most human suffering is related to love and loss and the job of therapists is to help people “acknowledge, experience, and bear” the realities of life–with all its pleasures and heartbreak. The greatest sources of our suffering are the lies we tell ourselves. People can never get better without knowing what they know and feeling what they feel. Healing depends on experiential knowledge: You can be fully in charge of your life only if you can acknowledge the reality of your body, in all its visceral dimensions. Scared animals always return home, regardless of whether home is safe or frightening. Van der Kolk thought about his patients with abusive families who kept going back to be hurt again. Are traumatized people condemned to seek refuge in what is familiar? If so, why, and is it possible to help them become attached to places and activities that are safe and pleasurable? -The Body Keeps the Score

Addicted to Trauma: The Pain of Pleasure and the Pleasure of Pain

According to van der Kolk, many traumatized people seem to seek out experiences that would repel most of us, and patients often complain about a vague sense of emptiness and boredom when they are not angry, under duress, or involved in some type of dangerous activity. I see this in myself. My addiction to danger is one of the causes of my alcoholism.

Most sharing of pain in A.A. meetings is harmful to me now because it stops short of the complete and utter transformation that I seek

Freud had a term for such traumatic reenactments such as me yelling at strangers. Freud called it “the compulsion to repeat.” He and many of his followers believed that reenactments were an unconscious attempt to get control over a painful situation and that they eventually could lead to mastery and resolution. There is no evidence for that theory–repetition leads only to further pain and self-hatred. In fact, even reliving the trauma repeatedly in therapy may reinforce preoccupation and fixation. Traumatic reenactments seem to produce endorphins and that is why I seek out traumatic situations. That strong emotions can block pain was the result of morphinelike substances manufactured in the brain. This suggests that for many traumatized people, reexposure to stress might provide a similar relief from anxiety. Thus when recovering alcoholics are discussing their stress, it is probably temporarily relieving their anxiety. Wouldn’t it be more therapeutic to get down discussing the root trauma that they experienced as a child?

I WOULD LIKE TO SPEAK ON DAMAGING EMOTIONAL CONFLICTS AS A TOPIC IN A.A. MEETINGS

According to The Body Keeps the Score: The brain-disease model overlooks four fundamental truths: (1) our capacity to destroy one another is matched by our capacity to heal one another. Restoring relationships and community is central to restoring well-being; (2) language gives us the power to change ourselves and others by communicating our experiences, helping us to define what we know, and finding a common sense of meaning; (3) we have the ability to regulate our own physiology, including some of the so-called involuntary functions of the body and brain, through such basic activities as breathing, yoga, moving and touching; and (4) we can change social conditions to create environments in which children and adults can feel safe and where they can thrive.

3. Trauma damages left brain speech

COMMENTARY: The Body Keeps the Score by Bessel Van der Kolk and how it relates to A.A. meetings. Focusing on a shared history of trauma and victimization alleviates the recovering alcoholics searing sense of isolation, but usually at the price of having to deny their individual differences: Members can belong only if they conform to the common code. The A.A. sub-cult of Primetime may provide solace, but it does not provide the mental flexibility needed to be fully open to what the complete and utter transformation of recovery has to offer and as such can not liberate its members from their traumas. In Primetime A.A. the goal is to engage the monkey mind in a clever monologue designed for laughs. The meditations are not silent, they either involve counting or “talking” to God. Conversations With God by Neal David Walsh has had a profound impact on Primetime Alcoholics Anonymous.

All Trauma is Preverbal

Upon analyzing images of the brain on trauma, one of van der Kolk's most surprising findings was the loss of function in Broca's area, one of the speech centers of the brain located on the left side. When stroke patients lose their blood supply to their Broca's area, they lose the ability to speak. Their left brains are damaged. Without a functioning Broca's area, you cannot put your thoughts and feelings into words. The left side of the brain is responsible for analytical and reasoning functions. Trauma victims have damaged functioning of their left brains.

When something reminds traumatized people of the past, their right brain reacts as if the traumatic event were happening in the present. But because their left brain is not working very well, they may not be aware that they are reexperiencing and reenacting the past--they are just furious, terrified, enraged, ashamed, or frozen After the emotional storm passes, they may look for something or somebody to blame for it. They behaved the outrageous way that they did because you were five minutes late, or because you made some minor mistake.

For over a hundred years, every textbook of psychology and psychotherapy has advised that some method of talking about distressing feelings can resolve them. However, trauma treatment now reveals that the experience of trauma itself gets in the way of being able to do that. No matter how much insight and understanding we develop, the rational brain is basically impotent to talk the emotional brain out of its own reality. Van der Kolk is continually impressed by how difficult it is for people who have gone through unspeakable trauma to convey the essence of their experience. It is so much easier for them to talk about what has been done to them--to tell a story of victimization and revenge--than to notice, feel, and put into words the reality of their internal experience. The body keeps the score and not the mind.

Long after the actual traumatic event has passed, the brain may keep sending signals to the body to escape a threat. Trauma survivors are prone to "continue the futile attempt at action, which began when the thing happened.

People with PTSD have their floodgates of perception constantly wide open. Lacking a filter, they are on constant sensory overload and high alert. In order to cope, they try to shut themselves down and develop tunnel vision and hyperfocus. If they can't shut down naturally, they may enlist drugs or alcohol to block out the world. The tragedy is that the price of shutting down includes filtering out sources of pleasure and joy as well. I my case, I became shut down to my feelings for other people. My childhood trauma made me an emotional basket case.

The Expressions of the Emotions (1872) by Charles Darwin:

If an organism is stuck in survival mode, its energies are focused on fighting off unseen enemies, which leaves no room for nurture, care, and love. As long as the mind is defending itself against invisible assaults, our closest bonds are threatened, along with our ability to imagine, plan, play, learn, and pay attention to other people's needs.

Intense emotions involve not only the mind but also the gut and heart: "Heart, guts, and brain communicate intimately via the 'pneumogastric' (vagus) nerve, the critical nerve involved in the expression and management of emotions in both humans and animals. When the mind is strongly excited, it instantly affects the state of the viscera; so that under excitement there will be much mutual action between these, the two most important organs of the body"

Of course we experience our most devastating emotions as gut-wrenching feelings and heartbreak. As long as we register emotions primarily in our heads, we can remain pretty much in control, but feeling as if your chest is caving in or we've been punched in the gut is unbearable. We'll do anything to make these awful visceral sensations go away, whether it is clinging desperately to another human being, rendering ourselves insensible with drugs or alcohol, or taking a knife to the skin to replace overwhelming emotions with definable sensations. How many mental health problems, from drug addiction to self-injurious behavior, start as attempts to cope with the unbearable physical pain of our emotions? The solution requires finding ways to help people alter the inner sensory landscape of their bodies. This is why hatha and kundalini yoga have been so instrumental to my recovery from alcoholism.

The Alcoholics Anonymous Sub-Cult of Primetime

Many traumatized people find themselves chronically out of sync with the people around them. Some find comforts in specialized A.A. groups where they can replay their negative, indecisive and problematic thinking with others who have similar alcoholic thinking or experiences. Focusing on a shared history of trauma and victimization alleviates their searing sense of isolation, but usually at the price of having to deny their individual differences: Members can belong only if they conform to the common code. The A.A. sub-cult of Primetime may provide solace, but it does not provide the mental flexibility needed to be fully open to what the complete and utter transformation of recovery has to offer and as such can not liberate its members from their traumas.

Isolating oneself into a narrowly defined A.A. sub-cult of elitists of the special "negative self-talk" group of A.A. promotes a view of others as irrelevant at best and dangerous at worst, which eventually only leads to further alienation. Well functioning people are able to accept individual differences and acknowledge the humanity of others.

The Self Under Threat

In 2000 Antonio Damasio and his colleagues published an article in the world's foremost scientific publication, Science, which reported that reliving a strong negative emotion causes significant changes in the brain areas that receive nerve signals from the muscles, gut, and skin--areas that are crucial for regulating basic bodily functions. The team's brain scans showed that recalling an emotional event from the past causes us to actually reexperience the visceral sensations felt during the original event. Each type of emotion produced a characteristic pattern, distinct from the others. For example, a particular part of the brain stem was "active in sadness and anger, but not in happiness or fear." We acknowledge their involvement every time we use one of the common expressions that link strong emotions with the body: "My heart sank"; "I was all choked up"; "You make me sick."

To people who are reliving a trauma, nothing makes sense; they are trapped in a life-or-death situation, a state of paralyzing fear or blind rage. Mind and body are constantly aroused, as if they are in imminent danger. They startle in response to the slightest noises and are frustrated by small irritations. This can rigger desperate attempts to shut those feelings down by dissociation.

AGENCY: OWNING YOUR LIFE

"Agency" is the technical term for the feeling of being in charge of your life: knowing where you stand, knowing that you have a say in what happens to you, knowing that you have some ability to shape your circumstances.

Because traumatized people often have trouble sensing what is going on in their bodies, they lack a nuanced response to frustration. They either react to stress by becoming "spaced out" or with excessive anger. Whatever their response, they often can't tell what is upsetting them.

Trauma victims cannot recover until they become familiar with and befriend the sensations in their bodies. Being frightened means that you live in a body that is always on guard. Angry people live in angry bodies. The bodies of child-abuse victims are tense and defensive until they find a way to relax and feel safe. In order to change, people need to become aware of their sensations and the way that their bodies interact with the world around them. Physical awareness is the first step in releasing the tyranny of the past.

Medications only blunt sensations and do nothing to resolve them or transform them from toxic agents into allies.

4. EEG charts measuring brain waves indicate the meditative state of consciousness.

THE BODY KEEPS THE SCORE, Brain, Mind and Body in the Healing of Trauma by Bessel van der Kolk, M.D. In Chapter 19, there is a section on using electro encephalograms (EEG) for meditation. Meditating helps heal trauma. A EEG machine can monitor brain waves to indicate which states of meditative consciousness you are in.

A test subject is quoted as saying that using an EEG machine to monitor your brain waves is like “meditation on steroids.” It got me all fired up to purchase my own home EEG monitor. So I began researching affordable hardware and software.

THETA is the meditative state of consciousness

I have been meditating for over forty years and my meditation practice just keeps getting better and better. Anything new that I can learn about meditation really turns me on. I wanted to be able to know exactly when I was in THETA and ALPHA states of consciousness. THETA brain waves indicate meditative & intuitive states of consciousness. The next higher frequency are ALPHA waves indicating visualization & creative states of consciousness.

Save your money and just meditate

Yesterday afternoon I was ready to pull the trigger and purchase a $200 EEG head set on Amazon that included software to run on a mobile phone app. Then I read a review that stated: “Don’t waste your money, this does not do what a real EEG machine does, save your time and money and just meditate!”

Someday we will have home EEG machines just like we have home computers

The bottom line is that home EEG machines are just not here yet in the same way that home computers have arrived. You need to spend over $10,000 on head set hardware & hookups and the monthly software licensing is $200/per month.

JUST VISUALIZING THESE CHARTS HELPS ME TUNE MY BRAIN WAVES

Just viewing these wonderful royalty free charts helps me to gauge what state of consciousness I am in. In six months I will be on Medi-Care instead of my bargain basement insurance plan. I wonder if Medi-Care will cover the cost of a few sessions of real EEG monitoring?

Dr. van der Kolk’s book says that all you need are a few sessions hooked up to EEG monitoring to permanently lock in perfect meditation. Oh well, until then I will do like the man said and just keep meditating!

5. INTEROCEPTION: Traumatic Awareness

Emotional things are emotionally discerned.

Interior things are discerned by interoception. In much the same way that spiritual things are spiritually discerned, emotional things are emotionally discerned. Our emotions exist within our limbic systems. The only way to access our emotions is by practicing the ancient Eastern art of self-awareness.

Interoception is accomplished by consciously activating the limbic system located within the medial prefrontal cortex. This is the part of our brain that allows us to feel what we are feeling. The scientific term for self-awareness is interoception.

Meditation is interoception

In meditation, interoception is the process whereby the thinker observes her thoughts without actively engaging those thoughts. The Zen master can feel his emotions without actively engaging those emotions. Controlling the emotions is the most important component of healing trauma.

Healing trauma by conquering our own minds

Most of our consciousness is devoted to focusing on the external world: dealing with other people, places and things. However, this does not help us to manage ourselves. Meditation teaches us that the only way we can change our emotional state is by becoming self-aware of our inner experience. Good leaders lead other people, great leaders practice self-leadership. The greatest warrior learns to conquer his own mind before he conquers the world.

Breathing is an indication of our emotional state

We can train and master our arousal system by the way we breathe, chant and move. When we are upset or anxious be breath shallow. We hold our breath when we are scared. Last night I caught myself holding my breath while watching an exciting and suspenseful motion picture! Slow, deep and full breathing helped heal me of my anxiety. By breathing in fully and holding the breath for a moment, and then exhaling completely and waiting a moment before you inhale, you can reach an optimal emotional state of calmness. These are basic principles taught by yoga masters for optimal meditation. Yoga is about breathing during meditation. One of the constant themes in this website is yoga and meditation. In yesterday’s blog I wrote about how we can dial in our perfect meditative state by monitoring our THETA brain waves with eeg machines. My mind is obsessed with meditation. Meditation is the key to my happiness.

Getting your body to do this requires emotional control

PRACTICING MEDITATION WHILE PRACTICING DIFFICULT YOGA ASANAS IS PRACTICING EMOTIONAL CONTROL

The ancient traditions of the East rely upon mindfulness, movement, chanting and the rhythmic action of yoga tai chi and quigong. Going to the edge of your ability to attain perfect form of a difficult yoga asana develops the ability to control your emotions. Your body may not be able to perfectly perform the posture but your emotional state can remain perfectly calm.

Mainstream Western psychiatric and psychological healing traditions are focused on over reliance upon pharmaceutical and verbal therapies. Would you rather be on psychiatric medications and totally reliant upon your therapist, or would you rather play an active role in your own healing by practicing yoga and mediation?

6. What were you thinking right before you acted out your childhood trauma?

There is no mind without mindfulness.

Practicing mindfulness calms down the localized reflexive nervous system so that we are less likely to be thrown into fight, flight, freeze, or fuck. What were you thinking right before you threw yourself into a dry drunk? What was going on inside your mind right before you acted out your emotional trauma?

Supermarket check-out line therapy

A few days ago when I wheeled my shopping cart up to the supermarket checkout line I wanted to tell the un-masked young man in front of me that he should be wearing a mask. But instead of saying anything I kept my mouth shut. It felt good. I am older and wiser now and so I did not need to hear his infantile bullshit. I need to be safe and happy. So I let him pay for his groceries so that I could then pay for my own goods and continue on my way unimpeded. I didn’t let a selfish person delay me on the way to the golden silence of blissful solitude inside my home.

At the core of recovery is self-awareness

The most important phrases in EMDR and trauma therapy are “Notice that” and “What happens next?” Traumatized alcoholics live with exploding sensations. They feel loneliness and isolation in the core of their bodies. Alcoholics often state how they feel a “hole in my gut”. I used to walk around on the verge of a heart attack. Then one day I had a near fatal heart attack. These feelings cannot be avoided by ignoring them. Living in the unhealed psychic distress of trauma will eventually lead to acting out our trauma in one way or another. The childhood images imbedded deep within our sub-conscious are activated in the present moment. What happens next? Lashing out in an infantile rage or tuning into my body by practicing interoception?

What happens next . . . how about a little interoception instead of my usual automatic over-reacting?

Mindfulness of our brain and body enables us to practice interoception. Simply noticing my annoyance with un-masked individuals and the anxiety they create in my body is the first step. Notice that happens next? Do I choose to lash out at un-masked imbeciles in the supermarket or do I practice gratitude for my shopping cart full of clean healthy food? I am excited about turning 65 in a few months because then I will be on Medi-Care. So how about celebrating the fact that I have survived and thrived despite my traumatic childhood? When I look at the lives of my fucked-up siblings I become supremely grateful.

Practicing mindfulness helps me to shift my perspective and opens up new options other than my automatic, habitual over-reactions. Self-awareness puts me in touch with the transitory nature of my feelings and perceptions. Even though trauma is a thing of the past, the emotional brain keeps generating sensations that make my fear and suffering give me a feeling of perpetual helplessness. This timeless, ever-present experience of trauma-mind in my pain body are my proverbial demons that made me into an alcoholic. Practicing mindfulness conquers my demons!

7. The opposite of being traumatized is to communicate fully.

Traumatic events are almost impossible to put into words. We all need someone to whom we can express our feelings that words cannot describe. Our initial imprints of the events of September 11 are not stories but images and feelings. We obtain sublime emotional gratification in expressing our minds-eye to close friends, 12 Step meetings, or a therapist. One of the sublime benefits of attending a 12 Step meeting of Alcoholics Anonymous is the opportunity to express inner feelings of helplessness that we have never had the opportunity to express anywhere else. Public story and inner experience finally become integrated. The ability to communicate our inner feelings, our interiority, is the opposite of being traumatized.

During the pandemic isolation, writing about upsetting events in these blogs improves my physical and mental health more than attending 12 Step Zoom meetings. The mere expression of trauma is not sufficient. Health does appear to require translating experiences into precise language. It is easier for me to communicate by blogging than by Zooming.

"Doctor, I would like to express my deep feelings of distrust of any medical professional who would wear ratty looking jeans and athletic shoes to conduct my psychotherapy session."

Feeling listened to and understood changes our physiology. Being able to articulate a complex feeling and having our feelings recognized lights up our limbic brain. Activating our emotional brain creates a moment of enlightenment. In contrast, being met by silence and incomprehension kills the spirit. Or, as John Bowlby so helpfully worded it: "What cannot be spoken to the [m]other cannot be told to the self." Being blessed with a mother who can fully communicate with you when you are young is the opposite of being traumatized.

If I hide from myself the fact that my negligent parents allowed a group of Mexican kids to hit me in the head with a rock when I was young, I am constantly vulnerable to triggers like a frightened chattering monkey in the jungle. My whole life I have been in a full-body response as my brain is constantly secreting the hormones that signal danger. Without language and context, my awareness is limited to: "I'm scared." Determined to stay in control, I avoided anybody or anything that reminded me even vaguely of my trauma. I became a ghost in the big city. I alternated from being inhibited and uptight to being reactive and explosive--all without knowing why. My trauma radically changed me so much that I never felt like "myself." Sometimes you will hear people in A.A. meetings share that they felt like they never received their copy of "The Owners Manual for Human Beings" when they were born.

"Doctor, I feel like we should trade clothes. Please let me loan you my slacks, button-down shirt and cashmere sweater. I will squeeze into your jeans and t-shirt so that I can perceive you as being more professional that you appear."

We are better at talking about others than talking about ourselves.

It was excruciatingly difficult to put that feeling of no longer being myself into words. Language evolved primarily to share "things out there," not to communicate our inner feelings, our interoception. Most of us, especially those of us in recovery, are better at describing someone else than we are at describing ourselves.

By keeping my secrets to myself and suppressing my feelings and information, I was fundamentally at war with myself. Hiding my feelings took an enormous amount of energy. It sapped my motivation to pursue worthwhile goals and it left me shut down. When I was a child I wanted to be an oceanographer. But then after I became a teenager, I spent the first half of my adult life trying to be a successful musician so lots of people would "like" me. And I had no native musical talent! My stress hormones kept flooding my body and so it exploded with shingles and a heart attack. I engaged in irrational and embarrassing behaviors that hurt myself and everyone around me. Only after I identified the source of my responses did I start to really understand myself.

By practicing mindfulness, I am able to stop myself before I act out in my infantile rage at being hit in the head and getting knocked unconscious by that rock when I was four years old. Expressing that childhood injury to my body, mind and soul was the the opposite of being traumatized. I had to learn to listen to the frozen anxiety in my body.

Listen to your body!

Body perception is the foundation of emotional awareness

We can get past the limitations of words by practicing mindfulness of the self-observing, body-based self system. Perceiving the body speaking to us through visceral sensations is the very foundation of emotional awareness. Listen to your body tonight, it's gonna treat you right!

As functioning members of society, we are conditioned to be cool in our day-to-day interactions and subordinate our feelings to the task at hand. When we talk with someone with whom we don't feel completely safe, our social editor jumps in on full alert and our guard is up. Social psychologist James Pennebaker says that a healthy respect for the importance of inhibition, of keeping things to yourself, is the glue of civilization. Conversely, he also said that people pay a price for trying to suppress being aware of the eight hundred pound gorilla in the room.

"God grant me the serenity to accept the things I cannot change, courage to change the things I can, and the wisdom to know the difference."

We are healed within the context of a welcoming community

It is an enormous challenge to find safe places to express the pain of trauma, which is why survivor groups like Alcoholics Anonymous, Al-Anon, Adult Children of Alcoholics and other support groups can be so instrumental in recovering from addiction as well as trauma. Finding a responsive community in which to tell your truth makes recovery possible. It is as if we are all in the same life-boat together.

Some are sicker than others

However, as the most broken man ever to recover from alcoholism, I also needed to finally find a professional therapist who was trained in eye movement desensitizing and reprogramming (EMDR) and who could listen to my childhood trauma and help me clear it out of my neural pathways. Re-experiencing and reprograming my childhood trauma within the context of EMDR therapy was the opposite of being traumatized.

William Griffith Wilson (November 26, 1895 – January 24, 1971), also known as Bill Wilson or Bill W., was the co-founder of Alcoholics Anonymous (AA). He was abandoned by his parents and raised by his grandparents. This probably gave him the post-traumatic stress disorder that contributed to his alcoholism.

Unity

Bill Wilson, the co-founder of A.A. said that the whole 12 Step program could be summed up in three words: recovery, service and unity. Why do we practice unity in A.A? Because it is a moral imperative? No, alcoholics are not inherently moral people. Do we practice inclusiveness because it is the law? No, addicts are not inherently law-abiding citizens. Do we practice diversity because it is a current buzzword, because it is hip, trendy and all over the news and public protests? No, we practice unity because diversity makes us stronger. We need a constantly enlarging gene pool to evolve and heal. Practicing unity in 12 Step meetings makes us stronger and is the opposite of being traumatized.

Practicing A.A. unity is the opposite of being traumatized

8. ALEXITHYMIA: Emotional Retardation

"The reason that traumatized people become overwhelmed by telling their stories, and the reason they have cognitive flashbacks, is that their brains have changed. As Freud and Breuer observed, trauma does not simply act as a releasing agent for symptoms. Rather, 'the psychical trauma-or more precisely the memory of trauma acts like a foreign body which long after its entry must continue to be regarded as an agent that is still at work.' Like a deep seated splinter that causes an infection, it is the body's response to the foreign object that becomes the problem more than the object itself.

Brain Damage

Modern neuroscience solidly supports Freud's notion that many of our conscious thoughts are complex rationalizations for the flood of instincts, reflexes, motives, and deep-seated memories that emanate from the unconscious. Trauma interferes with the proper functioning of brain areas that manage and interpret experience. A robust sense of self--one that allows a person to state confidently, "This is what I think and feel" and "This is what is going on with me"--depends on a healthy and dynamic interplay among these areas.

Abnormal Insula

Almost every brain-imaging study of trauma patients finds abnormal activation of the insula. This part of the brain integrates and interprets the input from the internal organs--including our muscles, joints, and balance (proprioceptive) system--to generate the sense of being embodied. The insula can transmit signals to the amygdala that trigger the fight/flight responses. This does not require any cognitive input or any conscious recognition that something has gone awry--you just feel on edge and unable to focus or, at worst, have a sense of imminent doom. These powerful feelings are generated deep inside the brain and cannot be eliminated by reason or understanding.

Alexithymia

Being constantly assaulted by, but consciously cut off from, the origin of bodily sensations produces alexithymia: not being able to sense and communicate what is going on with you. Only by getting in touch with your body, by connecting viscerally with your self, can you regain a sense of who you are, your priorities and values. Alexithymia, dissociation, and shutdown all involve the brain structures that enable us to focus, know what we feel, and take action to protect ourselves. When these structures are subjected to inescapable shock, the result may be confusion and agitation, or it may be emotional detachment, often accompanied by out-of-body experiences--the feeling you're watching yourself from far away. In other words trauma makes people feel like either some body else or no body. In order to overcome trauma, you need help to get back in touch with your body, with your Self.

Becoming Some Body

There is no question that language is essential: Our sense of Self depends on being able to organize our memories into a coherent whole. This requires well-functioning connections between the conscious brain and the self system of the body--connections that are often damaged by trauma. The full story can be told only after those structures are repaired and after the groundwork has been laid: after no body becomes some body." --THE BODY KEEPS THE SCORE, pp 248, 249.

9. EMDR DOES NOT REVISIT THE ORIGINAL TRAUMA IN DETAIL

The factual details of the childhood trauma do not matter as much as the body memory of the images behind the eye movements that are desensitized and reprocessed.

Association and Integration

"Unlike conventional exposure treatment, EMDR spends very little time revisiting the original trauma. The trauma itself is certainly the starting point. But the focus is on stimulating and opening up the associative process. As our Prozac/EMDR study showed, drugs can blunt the images and sensations of terror. But they remain embedded in the mind and body. In contrast with the subjects who improved on Prozac--whose memories were merely blunted, not integrated as an event that happened in the past, and still caused considerable anxiety--those who received EMDR no longer experienced the distinct imprints of he trauma. It had become a story of a terrible event that had happened a long time ago. As one of my patients said, making a dismissive hand gesture: "It's over."

"It had become a story of a terrible event that had happened a long time ago."

We don't know exactly how EMDR works

While we don't yet know precisely how EMDR works, the same is true of Prozac. Prozac has an effect on serotonin, but whether its levels go up or down, and in which brain cells, and why that makes people feel less afraid, is still unclear. We likewise don't know precisely why talking to a trusted friend gives such profound relief, and I am surprised how few people seem eager to explore the question.

In 40 years will EMDR have become mainstream?

Clinicians have only one obligation: to do whatever they can to help their patients get better. Because of this, clinical practice has always been a hotbed for experimentation. Some experiments fail, some succeed, and some, like EMDR, dialectical behavior therapy, and internal family systems therapy, go on to change the way therapy is practiced. Validating all these treatments takes decades and is hampered by the fact that research support generally goes to methods that have already been proven to work. I am much comforted by considering the history of penicillin: Almost four decades passed between the discovery of its antibiotic properties by Alexander Fleming in 1928 and the final elucidation of its mechanisms in 1965."

--The Body Keeps the Score, pages 263 and 264

IS EMDR THE NEXT BIG THING? Prince Harry is only the cover shot of this video. See Inside Edition episode behind this screen shot of I.E. producer demonstrating treatment with the butterfly method.

10. EMDR IS FOR PATIENTS SO TRAUMATIZED THAT FULL RECOVERY IS THOUGHT TO BE IMPOSSIBLE

"Traumatized people suffer from many different types of clinical disorders. Dissociative identity disorder (DID) at one time was called multiple personality disorder. As dramatic as its symptoms are, the internal splitting and emergence of distinct identities experience in DID represent only the extreme end of the spectrum of mental life.

Warring Impulses

The sense of being inhabited by warring impulses or parts is common to all of us but particularly to traumatized people who had to resort to extreme measures in order to survive. Exploring-even befriending--those parts is an important component of healing.

These adaptations to trauma can so interfere with the capacity to function that health-care providers and patients themselves often believe that full recovery is beyond reach.

We all know what happens when we feel humiliated: We put all our energy into protecting ourselves, developing whatever survival strategies we can. We may repress our feelings; we may get furious and plot revenge. We may decide to become so powerful and successful that nobody can ever hurt us again. Many behaviors that are classified as psychiatric problems, including some obsessions, compulsions, and panic attacks, as well as most self-inflicted destructive behaviors, started out as strategies for self-protection. These adaptations to trauma can so interfere with the capacity to function that health-care providers and patients themselves often believe that full recovery is beyond reach. Viewing these symptoms as permanent disabilities narrows the focus of treatment to finding the proper drug regimen, which can lead to lifelong dependence--as though traumatized survivors were to be warehoused in a locked psychiatric ward.

Traumatic Adaptation of Sexual Offender

It is more productive to see aggression or depression, arrogance or passivity as learned behaviors: Somewhere along the line, the patient came to believe that he or she could survive only if he or she was tough, invisible, or absent, or that it was safer to give up. Like traumatic memories that keep intruding until they are laid to rest. Traumatic adaptations continue until the organism feels safe and integrates all the parts of itself that are stuck in fighting or warding off the trauma.

Resilience

Every trauma survivor I've met is resilient in his or her own way, and every one of their stories inspires awe at how people cope. Knowing how much energy the sheer act of survival requires keeps me from being surprised at the price they often pay: the absence of a loving relationship with their own bodies, minds, and souls.

Coping takes its toll., page 281

Coping takes its toll. For many children it is safer to hate themselves than to risk their relationship with their caregivers by expressing anger or by running away. As a result, abused children are likely to grow up believing that they are fundamentally unlovable; that was the only way their young minds could explain why they were treated so badly. they survive by denying, ignoring, and splitting off large chunks of reality: They forget the abuse; they suppress their rage or despair; they numb their physical sensations. If you were abused as a child, you are likely to have a childlike part living inside of you that is frozen in time, still holding fast to this kind of self-loathing and denial. Many adults who survive terrible experiences are caught in the same trap. Pushing away intense feelings can be highly adaptive in the short run. It may help you preserve your dignity and independence; it may help you maintain focus on critical tasks like saving a comrade, taking care of your kids, or rebuilding your house.

The problems come later

After seeing a friend blown up, a soldier may return to civilian life and try to put the experience out of his mind. A protective part of him knows how to be competent at his job and how to get along with colleagues. But he may habitually erupt in rage at his girlfriend. He may become numb and frozen when the pleasure of surrendering to her touch makes him feel he is losing control. He probably will not be aware that his mind automatically associates passive surrender with the paralysis he felt when his friend was killed. So another protective part steps in to create a diversion. He gets angry. Having no idea what set him off, he thinks he's mad about something his girlfriend did. Of course, if he keeps blowing up at her (and subsequent girlfriends), he will become more and more isolated. But he may never realize that a traumatized part is triggered by passivity and that another part, an angry manager, is stepping in to protect that vulnerable part. Helping these parts to give up their extreme beliefs is how therapy can save people's lives.

As we saw in chapter 23, a central task for recovery from trauma is to learn to live with the memories of the past without being overwhelmed by them in the present. But most survivors, including those who are functioning well--even brilliantly--in some aspects of their lives, face another, even greater challenge; reconfiguring a brain/mind system that was constructed to cope with the worst. Just as we need to revisit traumatic memories in order to integrate them, we need to revisit parts of ourselves that developed the defensive habits that helped us to survive."

THE MIND IS A MOSAIC, page 282

We all have parts. Right now a part of me feels like taking a nap; another part wants to keep writing. Still feeling injured by an offensive e-mail message, a part of me wnts to hit "reply" on a stinging put-down, while a different part wants to shrug it off. Most people who know me have seen my intense, sincere, and irritable parts; some have met the little snarling dog that lives inside me. My children reminisce about going on family vacations with my playful and adventurous parts.

When you walk into that office in the morning and see the storm clouds over your boss's head, you know precisely what is coming. That angry part has a characteristic tone of voice, vocabulary, and body posture--so different from yesterday, when you shared pictures of your kids. Parts are just not feelings but distinct ways of being, with their own beliefs, agendas, and roles in the overall ecology of our lives.

How well we get along with ourselves depends largely on our internal leadership skills--how well we listen to our different parts, make sure they feel taken care of, and keep them from sabotaging one another. Parts often come across as absolutes when in fact they represent only one element in a complex constellation of thoughts emotions and sensations. If Margaret shouts, "I hate you!" in the middle of an argument, Joe probably thinks she despises him--and in that moment Margaret might agree. But in fact only a part of her is angry, and that part temporarily obscures her generous and affectionate feelings, which may well return when she sees the devastation on Joe's face.

Every major school of psychology recognizes that people have subpersonalities and gives them different names. In 1890 William James wrote: "[I]t must be admitted that . . . the possible consciousness may be split into parts which coexist, but mutually ignore each other, and share the objects of knowledge between them. Carl Jung wrote: "The psyche is a self-regulating system that maintains its equilibrium just as the body does." "The natural state of the human psyche consists in a jostling together of its components and in their contradictory behavior," and "The reconciliation of these opposites is a major problem. Thus, the adversary is none other than 'the other in me.

Modern neuroscience has confirmed this notion of the mind as a kind of society. Michael Gazzaniga, who conducted pioneering split brain research, concluded that the mind is composed of semiautonomous functioning modules, each of which has a special role. In his book The Social Brain (1985) he writes, "But what of the idea that the self is not a unified being, and there may exist within us several realms of consciousness?"

11. SELF-LEADERSHIP: Lock down your childhood pain rather than eternally act it out and inflicting it upon yourself and the world.

"The critical insight is that all these parts have a function: To protect the self from feeling the full terror of annihilation. The final stage of healing is developing self-leadership skills to manage the fully integrated relationship all of the parts of the psyche to ensure the emotional survival of the fittest. You are no longer a small child who can be manipulated by adults. It is time to put the defensive aspects of your personality away. We thank them for making their presence known. Their anger is no longer needed at this time.

Children who act out their pain rather than locking it down are often diagnosed with "oppositional deviant behavior," attachment disorder," or "conduct disorder." But these labels ignore the fact that rage and withdrawal are only facets of a whole range of desperate attempts at survival. Trying to control a child's behavior while failing to address the underlying issue--the abuse--leads to treatments that are ineffective at best and harmful at worst. As they grow up, their parts do not spontaneously integrate into a coherent personality but continue to lead a relatively autonomous existence.

Parts that are "out" may be entirely unaware of the other parts of the system. Most of the men I evaluated with regard to their childhood molestation by Catholic priests took anabolic steroids and spent an inordinate amount of time in the gym pumping iron. These compulsive body builders lived in a masculine world of sweat, football, and beer, where weakness and fear were carefully concealed. Only after they felt safe with me did I meet the terrified kids inside.

Patients may also dislike the parts that are out. The parts that are angry, destructive or critical. However, when offered a framework for understanding them, talking to them in a non-pathologizing way, the disliked parts are allowed to safely emerge. Recognizing that each part is stuck with burdens from the past and respecting its function in the overall system makes the angry parts feel less threatening or overwhelming. Take a deep breath and then exhale. Now imagine yourself in your new persona. You are a brand new gay registered sex offender in the gay desert. For at least the next ten years or so, you must register every year with the Mohave County Sheriff's office department of sexual registration.

What gets in the way of accessing our own inner resources? Schwartz says we must show how destructive behavior was needed at one time for survival, but not anymore

"If one accepts the basic ideal that people have an innate drive towards nurturing their own health, this implies that, when people have chronic problems, something gets in the way of accessing inner resources. Recognizing this, the role of therapists is to collaborate rather than to teach, confront, or fill holes for your psyche."

The first step in this collaboration is to assure the internal system that all parts are welcome and that all of them--even those that are suicidal or destructive--were formed in an attempt to protect the self-system, no matter how much they now seem to threaten it.

SELF-LEADERSHIP, page 285:

The cultivation of mindful self-leadership is the foundation for healing from trauma. Mindfulness not only makes it possible to survey our internal landscape with compassion and curiosity but can also actively steer us in the right direction for self-care. All systems--families, organizations, or nations--can operate effectively only if they have clearly defined and competent leadership. The internal family is no different. All facets of our selves need to be attended to. The internal leader must wisely distribute the available resources and supply a vision for the whole that takes all the parts into account.

Richard Schwartz explains that trauma survivors have no self-leadership because they operate around outdated assumptions and beliefs derived from childhood abuse:

The internal system of an abuse victim differs from the non-abuse system with regard to the consistent absence of effective leadership, the extreme rules under which the parts function, and the absence of any consistent balance or harmony. Typically, the parts operate around outdated assumptions and beliefs derived from the childhood abuse. Believing, for example, that it is still extremely dangerous to reveal secrets about childhood experiences which were endured.

BLENDING BAD BELIEFS INTO INDENTITY

What happens when the self is no longer in charge? This "blending": a condition in which the Self identifies with a part, as in "I want to kill myself" or "I hate you." Notice the difference from "A part of me wishes that I were dead" or "A part of me gets triggered when you do that and makes me want to kill you."

Our undamaged essence lies just beneath the surface and will spontaneously emerge

Schwartz makes two assertions that extend the concept of mindfulness into the realm of active leadership. The first is that this Self does not need to be cultivated or developed. Beneath the surface of the protective parts of trauma survivors there exists an undamaged essence, a Self that is confident, curious, and calm. A Self that has been sheltered from destruction by the various protectors that have emerged in their efforts to ensure survival. Once those protectors trust that it is safe to separate, the Self will spontaneously emerge, and the parts can be enlisted in the healing process.

The second assumption is that, rather than being a passive observer, this . . . "

12. FINAL HEALING: INTERNAL LANDSCAPE REACHES CRITICAL MASS

When the patient's internal landscape manifests critical mass of Self, the therapist steps aside.

The Body Keeps the Score, (2014) by Bessel van der Kolk, M.D., Chapter 17 Page 286 Internal Landscape: "The second assumption is that, rather than being a passive observer, this mindful Self can help reorganize the inner system and communicate with the parts in ways that help those parts trust that there is someone inside who can handle things. Again neuroscience research shows that this is not just a metaphor Mindfulness increases activation of the medial prefrontal cortex and decreases activation of structures like the amygdala that trigger our emotional responses. This increases our control over the emotional brain. We can practice self-leadership and get well.

The Self takes an active leadership role during meditation treatment

Even more than encouraging a relationship between a therapist and a helpless patient, IFS focuses on cultivating an inner relationship between the Self and the various protective parts. In this model of treatment the Self doesn't only witness protective parts. In this model of treatment the Self doesn't only witness or passively observe, as in some meditation traditions; it has an active leadership role. The Self is like an orchestra conductor who helps all the parts to function harmoniously as a symphony rather than a cacophony. Meditation plays an active leadership role in conducting the parts into a whole.

GETTING TO KNOW THE INTERNAL LANDSCAPE, page 286

The task of the therapist is to help patients separate this confusing blend into separate entities, so that they are able to say: "This is part of me is like a little child, and that part of me is more mature but like a victim.“ They might not like many of these parts, but identifying them makes them less intimidating or overwhelming.

The next step is to encourage patients to simply ask each protective part as it emerges to "stand back" temporarily so that we can see what it is protecting. When this is done again and again and again, the parts begin to unblend from the Self and make space for mindful self observation.

Patients learn to put their fear, rage, or disgust on hold and open up to states of curiosity and self-reflection From the stable perspective of Self they can begin constructive inner dialogues with their parts. "Perhaps my childlike parts could be less involved than my more mature parts today."

Patients are asked to identify the part involved in the current problem

Like feeling worthless, abandoned, or obsessed with vengeful thoughts. As they ask themselves, "What inside me feels that way?" an image may come to mind. Maybe the depressed part looks like an abandoned child, or an aging man, or an overwhelmed nurse taking care of the wounded; a vengeful part might appear as a combat marine or a member of a street gang. "I feel like a lost and lonely child with nobody to play with." "Who am I today? A lost and lonely old man in the desert?"

What Happens Next?

Next the therapist asks, "How do you feel toward that (sad, vengeful, terrified) part of you?" This sets the stage for mindful self-observation by separating the "you" from the part in question. If the patient has an extreme response like "I hate it," the therapist knows that there is another protective part blended with the Self. She might then ask her patient, "See if the part that hates it would step back." Then the protective part is often thanked for its vigilance and assured that it can return anytime if needed. The therapist functions like a traffic cop keeping the images moving and flowing. Not much time is spent on analysis. We are just watching the sad and lonely movie play. The requests are for feelings. "What did you notice next?"

Treatment goal: critical mass of Self

Once a patient's internal landscape manifests a critical mass of Self, this kind of dialogue begins to take place spontaneously. At this point it's important for the therapist to step aside and just keep an eye out for other parts that might interfere, or make occasional emphatic comments, or ask questions like "What do you say to the part about that?" "That's good, thank you for sharing that." Just keep the associations moving along like the view from the windows of a train. Let the subconscious images flow and heal with the brain spontaneously heals with the rapid eye movements of EMDR.

In the end, for severely traumatized people to heal the strength often comes from deep within. They must be able to deal with their misery and hurt by recruiting their own strength and self-love, enabling them to totally and utterly heal themselves. These cycles will come to a end only when the Self is able to take charge and the system feels safe.

The Burden of Toxicity, page 291

Most incest and emotional abuse survivors hate themselves. Jeff Cowan's brother Alan will tell you that "Jeffrey has no self-respect." These damaged souls feel that they are nothing but that rejected, weak, unloved and abandoned child of ancient and distorted memory. The Self becomes "blended" with the exiles, and every possible alternative for our life is eclipsed. Then as Schwartz points out, "We see ourselves, and the world, through their eyes and believe it is 'the' world. In this state it won't occur to us that we have been hijacked."

We become delusional.

We become delusional. We see conspiracy theories everywhere. We manufacture our own little conspiracy theories. We create and disseminate our lies both to ourselves and our community.

13. How will you mold your inner mind map during the neuroplasticity of youth?

Your life is a gift from God. Youth is brief and should be taken advantage of. You can become who ever you want in life. Within reason. You have to want what is reasonable for your particular life. Have you ever wanted to completely reinvent yourself? Of course you have. Reinvention is as American as immigration. Part of the attraction of a "gay" alternative sexuality is the privilege of completely reinventing yourself sexually and all of the lifestyle explosions that something so radical brings. Restructuring inner landscapes of the sexual mind is easy with all that testosterone molding the plasticity of the young "gay" lifestyle. Indian Holy Men are known to sublimate this sexual life force into achieving oneness with the universe. I learned the technique of sexual sublimation from Napoleon Hill in his life altering little book, Think and Grow Rich.

CHASTE BY CHOICE: Have you ever heard of restructuring inner mind maps in the opposite of gay energy?

What if heterosexual men became as sexually energized as gay men are or beyond. Energized into chaste conduct by choice. What if even heterosexual success was transcended and the patient cleared his sexual neurosis completely. He no longer needs or requires sexual gratification of any type whatsoever. What if there were no longer any trauma to act out by being gay? This is my story of pain and redemption. This post is dedicated to Marcus Dalton and the art of creating gay subculture.

The Gay Delusion

Restructuring inner map, The Body Keeps the Score, (2014) Bessel van der Kolk, M.D.:

How can we help people become viscerally acquainted with feelings that were lacking early in their lives? There is a way to transform their postures and gestures, radiating vitality and engagement--the sort of physical repciprocity that is the essence of attunement. Restructuring inner mindfulness: Rewriting crucial scenes in the movie of your life to give yourself the skills you never received as a young child.

Group role playing is one way to achieve critical mass.

The safety of the group allows you to notice things that you are most ashamed of. When you no longer have to hide, the structure allows you to place the shame where it belongs--on the figures right in front of you who represent those who hurt you and made you feel helpless as a child.

Physically reexperiencing the past in the present and then reworking it in a safe and supportive "container" can be powerful enough to create new, supplemental memories: simulated experiences of growing up in an attuned, affectionate setting where you are protected from harm. Structures do not erase bad memories, or even neutralize them the way EMDR does. Instead, a structure offers fresh options--an alternative memory in which your basic human needs are met and your longings for love and protection are fulfilled.

Revising the Past: Group Therapy

The place holders in group therapy representing the significant people in the protagonist's past almost immediately assume a virtual reality.

The place holders in group therapy representing the significant people in the protagonist's past almost immediately assume a virtual reality.

14. EPILOGUE: Trauma victims are constantly seeking a sense of safety.

In his 2014 bestseller, The Body Keeps the Score, Brain, Mind and Body in the Healing of Trauma, Dr. Bessel van der Kolk predicts that we will become a trauma conscious society. I think Dr. van der Kolk has been proven correct in his prediction. Trauma victims seeking a sense of safety may find many answers in The Body Keeps the Score.

Trauma seems to be the new buzzword in recovery and treatment for addiction. Dr. van der Kolk states that "Trauma victims are constantly seeking a sense of safety in one way or another." I say he is correct again.

Eye movement desensitizing and reprogramming

Using EMDR, it is possible for victims of trauma to attain a sense of safety by reprogramming traumatic memories that make them drink. I myself had to finally deal with the fear, rage and collapse of my life with seventeen years sober. I realized that I was a traumatized man raised by traumatized parents. My alcoholism and social isolation was one of the predictable consequences of having been traumatized. It is almost as if I have been living a dry drunk for the last seventeen years. Treatment for posttraumatic stress disorder is just now becoming of age. I am lucky to be receiving eye movement desensitizing and reprogramming therapy via Zoom.

BUY THIS BOOK: This post is derived from the Epilogue of The Body Keeps the Score, by Bessel van der Kolk

Trauma causes the mental health problem of addiction

As Dr. van der Kolk puts it, "We are fundamentally social creatures. Our brains are wired to foster working and playing together. Trauma devastates the social-engagement system. Trauma interferes with cooperation, nurturing, and the ability to function as a productive member of society. Many mental health problems such as drug addiction, start off as attempts to cope with emotions that became unbearable because of a lack of adequate human contact and support."

My whole life I was in a fight-or-flight state of consciousness until I began to heal from my PTSD. Now I see what I was really trying to cope with. I discovered internal and external resources. By practicing yoga and meditation I was able to calm down. My caring relationship with my body is an investment in myself.

Dr. van der Kolk goes on to say that: "People who feel safe and meaningfully connected with others have little reason to squander their lives doing drugs or staring numbly at television. Aware people don't feel compelled to stuff themselves with carbohydrates or assault their fellow human beings. However if nothing they do seems to make a difference, they feel trapped and become susceptible to the lure of pills, gang leaders, extremist religions, or violent political movements--anybody and anything that promises relief. Child abuse and neglect is the single most preventable cause of mental illness, the single most common cause of drug and alcohol abuse,, and a significant contributor to leading causes of death such as diabetes, heart disease, cancer, stroke and suicide.

Our sense of safety defines our mental health

More than anything else, being able to feel safe with other people defines mental health. Safe connections are fundamental to meaningful and satisfying lives. The critical challenge in a classroom setting is to foster reciprocity. Truly hearing and being heard. Really seeing and being seen by other people. If is important for everyone to recognize and understand the effects of trauma on children and to focus on the importance of fostering safety Children from chaotic backgrounds often have no idea how people can effectively work together.

Emotional things are emotionally known

Emotional intelligence starts with labeling your own feelings and attuning to the emotions of the people around you. Children as well as adults need to experience how rewarding it is to work at the edge of their abilities. Resilience is the product of agency: knowing that what you do can make a difference.

Trauma constantly confronts us with our fragility and with man's inhumanity to man but also with our extraordinary resilience. Read the life history of any visionary and you will find insights and the passions that came with having dealt with devastation.

APPENDIX

CONSENSUS PROPOSED CRITERIA FOR DEVELOPMENTAL TRAUMA DISORDER

The goal of introducing the diagnosis of Developmental Trauma Disorder is to capture the reality of the clinical presentations of children and adolescents exposed to chronic interpersonal trauma. Thereby guiding clinicians to develop and utilize effective interventions and for researchers to study the neurobiology and transmission of chronic interpersonal violence. Whether or not they exhibit symptoms of PTSD, children who have developed in the context of ongoing danger, maltreatment, and inadequate caregiving systems are ill-served by the current diagnostic system, as it frequently leads to no diagnosis, multiple unrelated diagnosis, an emphasis on behavioral control without recognition of interpersonal trauma and lack of safety in the etiology of symptoms, and a lack of attention to ameliorating the developmental disruptions that underlie the symptoms." -The Body Keeps the Score, pp. 349-361.