David L White

Trauma and Healing

 

BodyScore

This is not about me trying to paint anyone, including you or me, into a corner. This is me trying to grasp a pattern of stories told by dozens or hundreds of practitioners about the stories they have collected by hundreds or thousands of patients.

This is me beginning to realize the complexities of human existence. It’s like using a butterfly net to catch a ghost.

On July 1st 2015, Sally the Psychic called me a healer. She called me other things, too. All of them right on the money. A healer? Me? I’ve spent two and half years attempting to figure this out.

At the this same time I also met a person that seemed to be requesting help, or healing? It seemed desperate to me.

I took Reiki level 2, some reflexology, researched jin shin jyutsu, coloring, clay, music, drumming, dance, breathing, … etc.

I became convinced that holism provided a path. Discipline to any single doctrine may provide some relief but the proof is in the patient. What works? And what part does play play?

Richard Gordon, author of books exploring the quantum touch idea, indicated that the healer would be the one needing, NEEDING, the healing. ie., we can put ourselves into the field of a person with higher vibrations, but we can only heal ourselves.

The new ‘friend’ batted away every attempt at assistance to such a degree that my interest into healing became an investigation into trauma.

Perhaps it is me that needs the healing.

In addition to the quoted passages from the book there are fascinating reading to be done about narcissism, symptoms of BPD, trauma bonding, C-PTSD and Repetitive Compulsion, some of which can be started here:

https://www.abuseandrelationships.org/Content/Survivors/trauma_bonding.html

and herehttp://gettinbetter.com/dance.html

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel Van Der Kolk has provided me with some helpful insights as to the nature of connection and disconnection.

I continue to play with play as a way to open, learn, relax, and reconnect.

Finally; how to add, love, compassion, and understanding into the complexity?

__________________

Here are my notes from a second reading of The Body Keeps the Score. Most of the text is direct quotes. Occasionally I made abbreviations. There may be typos.

The page numbers refer to the hard copy edition. The areas on a given page indicate the position on a page.
PAGE ##
tt  = top top
tm = top middle
tb = top bottom
mt = middle top
mm = middle middle
mb = middle bottom
bt = bottom top
bm = bottom middle
bb = bottom bottom

I read to gather notes and quotes. Finding the notes is important.
any hoo

The Body Keeps the Score
Brain, Mind, and Body in the Healing of Trauma
Bessel Van Der Kolk M.D.

https://www.amazon.com/Books-Bessel-van-der-Kolk/s?ie=UTF8&page=1&rh=n%3A283155%2Cp_27%3ABessel%20van%20der%20Kolk
At the beginning of my second reading of this book I thought to take notes.
The page numbers refer to the hard cover, Viking Penguin edition, (c) 2014

My notes are meant to support a perspective which I would like to share with a friend. You might google quotations from:
https://www.goodreads.com/work/quotes/26542319-the-body-keeps-the-score-brain-mind-and-body-in-the-healing-of-trauma

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Rorschach
While the majority of the veterans were greatly upset by what they saw, the reactions of the remaining five or even more alarming: they simply went blank. “This is nothing,” one observed, “just a bunch of ink.” They were right of course but the normal human response to ambiguous stimuli is to use our imagination to read something into them.

We learn from these Rorschach tests that traumatized people have a tendency to superimpose their trauma on everything around them and have trouble deciphering whatever is going on around them. There appeared to be a little in between. We also learned the trauma affects the imagination. The five men who saw nothing in the blots had lost the capacity to let their minds play. But so, too, had the other 16 men, for in viewing scenes from the past in those blots they were not displaying the mental flexibility that is the hallmark of imagination. They simply kept replaying an old reel.

Imagination is absolutely critical to the quality of our lives. Our imagination enables us to leave our routine every day existence by fantasizing about travel, food, sex, falling in love, or having the last word – all the things that make life interesting. Imagination gives us the opportunity to envision new possibilities – it is an essential launchpad for making our hopes come true. It fires our creativity, relieves our boredom, alleviates our pain, enhances our pleasure, and enriches our most intimate relationships. When people are compulsively and constantly pulled back into the past, the last time they felt intense involvement and deep emotions, they suffer from a failure of imagination, or loss of the mental flexibility. Without imagination there is no hope, no chance to envision a better future, no place to go, no goal to reach.

P18 bb revisiting the past

Whether the trauma had occurred 10 years in the past or more than 40, my patients could not bridge to gap between their wartime experiences and their current lives. Somehow the very event that caused them so much pain had also become their sole source of meaning. They felt fully alive only when they were revisiting the traumatic past.

PS 29
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Learned helplessness
Inescapable shock on dogs.

After administering several courses of electric shock, the researchers open the doors the cages and then shocked the dogs again. A group of control dogs that had been shocked before immediately ran away, but the dogs that had earlier been subjected to inescapable shark made no attempt to flee, even when their door was wide open – they just lay there whimpering and defecating. The mere opportunity to escape does not necessarily make traumatized animals, or people, take the road to freedom. Like these dogs, many traumatized people simply give up. Rather than risk experimenting with new options they stay stuck in the fear they know.

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Many traumatized people simply give up. Rather than risk experimenting with new options they stay stuck forever in the fear they know.

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physical movement to emulate escape

Dragging the dogs out of the cage that had the electric grid. Did my patients also need to have a physical experience to restore a visceral sense of control? What if they could be taught to physically move to escape a potentially threatening situation that was similar to the drama in which they had been trapped in ….,

Scared animals return home, regardless of whether home is safe or frightening. I thought about my patients with abusive families that 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?

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drug addiction

We may get hooked on recreational drugs because they right away make us feel so good, but activities like sauna bathing, marathon running, or parachute jumping, which initially cause discomfort and even terror, can ultimately become very enjoyable. This gradual adjustment signals that a new chemical balance has been established within the body, so that marathon runners, say, get a sense of well-being and exhilaration from pushing their bodies to the limit.

At this point, just as with drug addiction, we start to crave the activity and experience withdrawal when it’s not available. In the long run people become more preoccupied with the pain of withdrawal then the activity itself. This theory could explain why some people hire someone to beat them, or burn themselves with cigarettes, or why they are only attracted to people who hurt them. Fear in a version, in some perverse way, can be transformed into pleasure.

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Broca area shuts down on left side

Shifting to the one side of the brain
The scans also revealed that during flashbacks, our subjects brains lit up only on the right side.… Or scans clearly show that images of past trauma activate the right hemisphere of the brain and deactivate the left. We now know that the 2 halves of the brain do speak different languages. The right is intuitive, emotional, visual, special, and textual, and the left is linguistic, sequential, and analytical. While the left half of the brain does all the talking, right half of the brain carries the music of experience. That communicates through facial expressions and body language and making the sounds of love and sorrow: by singing, swearing, crying, dancing, or mimicking.

Also loss of executive function

When something reminds traumatized people of the past, the right brain reacts as if the traumatic event were happening in the present. But because the left brain is not working very well, they may not be aware that they are re-experiencing and reenacting the past – they are just furious, terrified, enraged, ashamed, or frozen. After the emotional storm passes, they may look for something or someone to blame for it.

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Insidious

Adrenaline is one of the hormones that are critical to help us fight back or flee in the face of danger. Increased adrenaline was responsible for participants dramatic rise in heart rate and blood pressure while listening to their traumatic narrative. Under normal conditions people reacted with a temporary increase in their stress hormones. As soon as the threat is over, the hormones dissipate and the body returns to normal. The stress hormones of traumatized people, in contrast, take much longer to return to baseline and spike quickly and disproportionately in response to mildly stressful stimuli. The insidious effects of constantly elevated stress hormones include memory and attention problems, irritability, and sleep disorders. They also contribute to many long-term health issues, depending on which body system is most vulnerable in a particular individual.

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Mm

For 100 years or more, every text book of psychology and cycle therapy has advised that some method of talking about distressing feelings can resolve them. However, as we’ve seen, 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 emotional brain out of its own reality. I am continually impressed by how difficult it is for people who have gone through the unspeakable 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.

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HRV
Heart Rate Variability
Page 76 bottom: a window into the nervous system. Up to page 77. All are a product of the synchrony between the two branches of the autonomic nervous system ANS the sympathetic, which acts as the bodies accelerator, and the parasympathetic, PNS, which serves as it’s brake. These are the reciprocals Darwin spoke of, and working together they play in important role in managing the body’s energy flow, one preparing for us expenditure, the other forest conservation.

The sympathetic nervous system is responsible for arousal, including the fight or flight response.

The second branch is the parasympathetic nervous system, which promotes self preservative functions like digestion and wound healing. Triggers the release of acetylcholine to put a break on arousal, slowing the heart town, relaxing muscles, and returning breathing to normal.

There’s a simple way to experience these two systems for yourself. Whenever you take a deep breath, you activate the SNS. The resulting burst of adrenaline speeds up your heart, which explains why many athletes take a few short, deep breath before starting competition. Exhaling, in turn, activates the PNS, which slows down the heart. If you take a yoga or meditation class, your instructor will probably urge you to pay particular attention to the exhalation, since deep, long breaths help calm you down.

As we breathe, we continually speed up and slow down the heart, and because of that the interval between the two successive heart beats is never precisely the same. A measurement called heart rate variability HRV can be used to test the flexibility of the system, and good HRV, the more fluctuation, the better – is a sign that the brake and the accelerator in your arousal system are both functioning properly and in balance. We had a breakthrough when we acquired an instrument to measure HRV, and explain in chapter 16 how we can use HRV to help treat PTSD.

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Many traumatized individuals are too hypervigilant to enjoy the ordinary pleasures that life has to offer, while others are too numb to absorb new experiences – or to be alert to signs a real danger. When the smoke detectors of the brain malfunction, people no longer run when they should be trying to escape or fight back when they should be defending themselves.

The landmark ACE, adverse childhood experiences, study, discussed in more detail in chapter 9, showed that women who had an early history of abuse and neglect are seven times more likely to be raped in adulthood. Women who, as children, had witnessed their mother being assaulted by their partners had a vastly increased chance to fall victim to domestic violence.

… Achieving any sort of deep intimacy – a close embrace, sleeping with a mate, and sex – requires allowing oneself to experience immobilization without fear. It is especially challenging for traumatized people just to discern when they’re actually safe and to be able to activate their defenses when they’re in danger. This requires having experiences they can restore the sense of physical safety, a topic to which will return many times in the chapters to follow.
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Many more times likely to be raped

P86 polyvagal tech
End chapter

Sadly, our educational system, as well as many of the methods that profess to treat trauma, tend to bypass this emotional engagement system and focus instead on recruiting the cognitive capacities of the mind. Despite the well-documented effects on anger, fear, and anxiety on the ability to reason, many programs continue to ignore the need to engage the safety system of the brain before trying to promote new ways of thinking. The last things that should be cut from school schedules are chorus, physical education, recess, and anything else involving movement, play, and joyful engagement. When children are oppositional, defensive, numbed out, or enraged, it’s also important to recognize that such bad behavior may repeat action patterns that were established to survive serious threats, even if they are intensely upsetting or off-putting.

Porges’s work has had a profound effect on how my trauma center colleagues and I organize the treatment of abused children and traumatized adults. It’s true that we would probably have developed a therapeutic yoga program for women at some point, given that yoga had proved so successful in helping them calm down and get in touch with their dissociated bodies.

But the poly vagal theory helped us understand and explain why all these disparate, and unconventional techniques work so well. It enabled us to become more conscious of combining top down approach is to activate social engagement with bottom up methods, to calm the physical tensions in the body. We were more open to the value of other age old, non-pharmacological approaches to health that have been long practice outside Western medicine, ranging from breath exercises, pranayama, to chanting, to martial arts like qigong to drumming and group singing and dancing. All rely on interpersonal rhythms, visceral awareness, and vocal and facial communication, which help shift people out of fight or flight status, re-organize their perception of danger, increase their capacity to manage relationships.

The body keeps the score. If memory of trauma is encoded in the viscera, the heartbreaking and gut- wrenching emotions, in auto immune disease orders and skeletal muscular problems, and if mind brain visceral communication is the royal road to emotion regulation, this demands a radical shift in our therapeutic assumptions.

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BPD
tm
Borderline personality disorder. Requires some research onto itself.

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Incidents of abuse are never stand-alone events.

ACE or adverse childhood experiences
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Long term effects of incest
The results were and ambiguous: compared with girls the same age, race, and social circumstances, sexually abused girls suffer in a large range of profoundly negative affects, including cognitive deficits, depression, dissociative systems, troubling sexual development, higher rates of obesity, and self mutilation. They dropped out of high school at a higher rate than the control group and had more major illnesses and healthcare utilization. They also showed abnormalities in their stress hormone responses, had an earlier onset of puberty, and accumulated host of different, seemingly unrelated, psychiatric diagnoses.

Over time the body adjusts to chronic trauma. The consequences of numbing is that teachers, friends coming and others are not likely to notice that a girl is upset; she may not even registered herself. By numbing out she is no longer reacts to distress the way she should, for example, by taking protective action.

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Sexually abused girls

The sexually abused girls have an entirely different developmental pathway. They don’t have friends of either gender because they can’t trust; they hate themselves, and their biology is against them, leading them either to overreact or numb out. They can’t keep up in the normal envy driven inclusion exclusion games, in which players have to stay cool under stress. Other kids usually don’t want anything to do with them – they’re simply too weird.

But that’s only the beginning of the trouble. The abused, isolated girls with incest histories mature sexually or year and a half earlier than the non abused girls. Sexual abuse speeds up their biological clocks in the secretion of sex hormones. Early in puberty the abuse girls had 3 to 5 times the level of testosterone and androstenedione, the hormones that fuel sexual desire, as the girls in the control group.

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However, trauma is much more than a story about something that happened long ago. The emotions and physical sensations that were imprinted during the trauma or experienced not his memories but as disruptive physical reactions in the present.

In order to regain control over yourself, you need to revisit the trauma: sooner or later we need to confront what has happened to you, but only after you feel safe and will not be re-traumatized by it. The first order of business is to find ways to cope with feeling overwhelmed by the sensations and emotions associated with the past.

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Recovery from trauma involves the restoration of executive functioning and with it, self-confidence and the capacity for playfulness and creativity.

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Accessing the emotional brain. The rational, analyzing part of the brain, centered on the dorsolateral prefrontal cortex, has no direct connections with the emotional brain, where most imprints of trauma reside, but the medial prefrontal cortex, the center of self-awareness, does.

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Some 80 percent of the fibers of the vagus nerve which connects the brain with many internal organs are afferent; that is, they run from the body into the brain. This means we can directly train our arousal system by the way we breathe, chant, and move, a principal that’s been utilized since time immemorial in places like China and India, and in every religious practice that I know of, but that is suspiciously ideas ‘alternative’ in mainstream culture.

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Mainstream Western psychiatric and psychological healing traditions have paid scant attention to self management. In contrast to the western reliance on drugs and verbal therapys, other traditions from around the world relying on mindfulness, movement, rhythms, and action.

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Tai Chi, Chi gong, rhythmical drumming. The cultures of Japan in Korean Peninsula have spawned martial arts, which focus on the cultivation of purposeful movement and being centered in the present, abilities that are damaged in traumatized individuals. I Quito, Judylc, taekwondo, can do, and jujitsu, as well as copeira from Brazil, are examples. These techniques all involve physical movement, breathing, and meditation. Aside from yoga, a few of these popular non-western healing traditions have been systematically studied for the treatment of PTSD.

At the core of recovery is self awareness. The most important phrases in trauma therapy are “Notice that” and “What happens next?”

Traumatized people live with seemingly unbearable sensations: they feel heartbroken and suffer from intolerable sensations in the pit of their stomach or tightness in the chest. Yet avoiding feeling these sensations in our body increases our vulnerability to being overwhelmed by them.

 

body awareness … more …

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If the people whom you naturally turn to for care and protection terrify or reject you, you learn to shut down and ignore what you feel. When your caregivers turn on you, you have to find alternative ways to deal with feeling scared, angry, or frustrated. Managing your chair all by yourself gives rise to another set of problems: dissociation, despair, addictions, chronic sense of panic, and relationships that are marked by alienation, disconnection, and explosions. Patients with these history is rarely make the connection between what happened to them long ago and how they currently feel and behave. Everything just seems unmanageable.

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When we play together, we feel physically in tune and experience a sense of connection. Improvisational exercises such as those found at learnimprov.com also are a marvelous way to help people connect enjoy an exploration. The moment you see a group of grim faced people break out in a giggle you know that the spell of misery has broken.

5. Getting in touch.
However, the most natural way that we humans calm down our distress it by being touched, hug, and rocked. This helps with excessive arousal and makes us feel intact, safe, protected, and in charge.

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Mm
Body work Lucia Sky
“ I never begin a bodywork session without establishing a personal connection. I’m not taking history; I’m not finding out how traumatized person is or what happened to them. I check in where they are in their body right now. I asked him if there’s anything they want me to pay attention to. All the while, I’m assessing their posture; whether they look me in the eyes; how tense or relax they seem; whether they’re connecting with me or not. The first decision I make is if they will feel safer face up or facedown. If I don’t know them, are usually start face up. I’m very careful about draping; very careful to let them steal safe with whatever clothing they want to leave on. These are important boundaries to set up right at the beginning. Then, with my first touch, make firm, safe contact. Nothing forced or sharp. Nothing too fast. The touch is slow, easy for the client to follow, gently rhythmic. It can be a strong as a handshake. The first place I might touch is their hand and forearm, because that’s the safest place to touch anybody, the place where they can touch you back. You have to meet their point of resistance – that place that has the most tension – and made it with an equal amount of energy. That releases the frozen attention. You can’t hesitate; hesitation communicates a lack of trust in yourself. Slow movement, careful attuning to the client is different from hesitation. You have to meet them with tremendous confidence and empathy, let the pressure of your touch meet the tension they are holding in their bodies.“

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Integrating traumatic memories
Traditional cycle therapy has focused mainly on constructing a narrative that explains why a person feels a particular way.… Telling the story is important; without stories, memory becomes frozen; and without member you cannot imagine how things can be different.… Telling the story about the event does not guarantee that the traumatic memories will be laid to rest.

There is a reason for that. When people remember an ordinary event, they do not also relive the physical sensations, emotions, images, smells, or sounds associated with that event. In contrast, when people fully recall their dramas, they have the experience. They are engulfed by the sensory or emotional element of the past.

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In contrast to its affective this for irrational fears such as spiders, CBT has not done so well for traumatized individuals, particularly those with history of childhood abuse. Only about one and three participants with PTSD who finished research studies show some improvement that was a complete CBT treatment usually have few were PTSD symptoms, but they rarely recover completely. Most continue to have substantial problems with her health, work, or mental well-being.

Been traumatized is not just an issue of being stuck in the past; it’s is just as much a problem of not being fully alive in the present.

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MDMA
Most relevant for trauma treatment, it increases peoples awareness of themselves; they frequently report a heightened sense of compassion energy, accompanied by curiosity, clarity, confidence, creativity, and connectedness.

It decreases fear, defensiveness, and numbing, as well as helping to access inner experience.

P232 Breaking the silence
Page 233
As long as you keep secrets and suppress information, you are fundamentally at war with yourself. Hiding your core feeling steaks in a Normas amount of energy, it’s ups your motivation to pursue worthwhile goals, and it leaves you feeling bored and shut down. Meanwhile stress hormones keep flooding your body, lead to headaches, muscle aches, problems with your bowels or sexual functions – and irrational behaviors that may embarrass you and hurt the people around you. Ignoring into reality also eats away at your sense of self, identity, and purpose.

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The capacity of art, music, and dance to circumvent the speechlessness that comes with terror maybe one reason they are used his trauma treatment some cultures around the world.

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We start by establishing inner islands of safety within the body. This means helping patients identify parts of the body, pastures, or movements where they can ground themselves whenever they feel stuck, terrified, or in raged. These parts usually live outside the reach of the Vegas nerve, which carries the messages of panic to the chest, abdomen, and throat, and they can serve as allies in integrating the trauma. I might ask a patient if her hands feel OK. And if she says yes, I’ll ask her to move them, explore their lightness and warmth and flexibility. Later, if I see her chest tightening their breath almost disappear, I can stop her and ask her to focus on her hands and move them, so that she can feel herself as separate from the trauma. Or I might ask her to focus on her out breath and notice how she can change it, or ask her to lift her arms up and down with each breath – a she got movement.

For some patients tapping acupressure points is a good anchor. I asked others to feel the weight of their body in the chair or to plant their feet on the floor. I might ask a patient who is collapsing into silence to see what happens when he sits up straight. Some patients discover their own islands of safety – they begin to get that they can create body sensations to counterbalance feeling out of control. This sets the stage for trauma resolution: 10 deleting between states of exploration and safety, between language and body, between remembering the past and feeling alive in the present.

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Dealing with reality bottom bottom studies found of people with PTSD have more general problems with focused attention and with learning new information. Test group as many words beginning with a letter in one minute. Normal average 15 words. Those with PTSD averaged three or four.

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Becoming somebody

“The psychical trauma or more precisely the memory of the trauma acts like a foreign body which long after it’s entry was continue to be regarded as an agent that is still at work.“

P247 mm
Being constantly assaulted by, but consciously cut off from, the origin of bodily sensations produces alexithymia: not being able to sense and communicate what’s going on with you. Only by getting in touch with your body, by connecting this early with yourself, can you regain a sense of who you are, your priorities and values.

… it goes on. Keywords. Alexithymia, dissociation, and shut down all involved the brain structure that enable us to focus, know what we feel, and take action to protect ourselves. When essential structures are subjected to inescapable shock the result maybe confusion and agitation or it may be emotional detachment, often accompanied by out of body experience. The feeling that you’re watching your self from far away. In other words trauma makes people feel like either some body else or like no body.

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EMDR
… Loosens up something in the mind brain that gives people rapid access to loosely associated memories and images from their past. This seems to help them put the traumatic experience into a larger context or perspective.
People may be able to heal from trauma without talking about it. EMDR enables them to observe their experiences in a new way, without verbal give-and-take with another person. Line EMDR can help even if the patient and the therapist do not have a trusting relationship. This was particularly intriguing because trauma, understandably, rarely leaves people with an open, trusting heart.

He goes on to say “I have done EMD are with patients that only spoke Swahili, Mandarin, and Bretonne, all languages in which I can only say notice that, the key EMDR instruction. I’ve always had a translator a very available but primarily to explain the steps of the process. Because EMDR does not require patients to speak about the intolerable or explain to a therapist why they feel so upset, it allows them to stay fully focused on their internal experience, with sometimes extraordinary results.”

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Rape
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Association and integration

Unlike conventional exposure treatment, EMDR spends very little time revisiting the original drama. Drama itself is certainly the starting point, but the focuses on stimulating and opening up the associative process.

Why we don’t yet know how precisely how EMDR works, the same is true of Prozac. Prozac has an affect on serotonin…. We don’t know precisely why talking to a trusted friend give such profound relief, and I’m surprised how few people seem eager to explore that question.

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The Numbing Within

One of the ways the memory of helpless this is stored is as muscle tension or feelings of disintegration in the affected body areas: head, back, and limbs in accident victims, vagina and rectum in victims of sexual abuse. The lives of many trauma survivors come to revolve around bracing against and neutralizing unwanted sensory experiences, and most people I see in my practice have become experts in such self numbing. They may become serially obese or anorexic or addicted to exercise or work.

When people are chronically angry or scared, constant muscle tension ultimately to spasms, back pain, migraine headaches, fibromyalgia, and other forms of chronic pain. They may visit multiple specialists, undergo extensive diagnostic tests, and be prescribed multiple medications, some of which may provide temporary relief but all of which failed to address the underlying issues. Their diagnosis will come to define the reality without ever being identified as a symptom of their attempt to cope with trauma. QQ
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finding our way to yoga

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Yoga and HRV
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Apps and HRV

There’s much more of the book. Interoception. Learning to communicate. Self-awareness. Self leadership. And lots and lots of notes. Oh yes… Neural feedback rewiring the brain.

Perhaps the study doesn’t really end. And the study, or the thinking part, is only the part that asks for action and participation.

So? Perhaps it’s time to engage.