Άρθρα

Restoring the Internal Capacities for Balance, Resilience, Vitality

In recent years, there is no doubt that the brain and nervous system research and their relation to Psychology and Psychotherapy have accelerated rapidly. As trauma expert, B. Rothschild notes that, due to the new research technologies and the expanding number of research findings, the amount of accessible knowledge, during these few years, is greater than the respective amount of all knowledge of the previous centuries (in Hart).

Among psychotherapists there is often a skeptical, critical attitude toward neuroscience, -which, in the meantime, is of course a major industry in the pharmaceutical and other branches- as they see the danger of medicalization and mechanization of psychotherapy in the expansion of neuroscience (Caroll)· at the same time there is also the increasing estimation that neuroscience provides evidence that psychotherapy, and especially body psychotherapy works and how it works. (Stauffer, Gottwald) So, keeping the necessary critical eye on things and holding a rather modest and open “Socratian”-oriented attitude “Ἓν οἶδα ὅτι ουδὲν οἶδα (One thing Ι know, that I know nothing)”, as an antidote to scientific arrogance, if we take into consideration the development of new understandings, research findings and their significant implications on the field of psychotraumatology, we cannot but acknowledge that neuroscience matters.

More specifically, today we are better “equipped” than ever before:

  • to understand the role of the brain and view mind as a self-organizing, embodied and relational emergent process that regulates energy and information flow ,
  • to understand neuroplasticity, i.e. the brain’s ability to change and rewire itself by corrective experiences, but also its evolutionary survival oriented negativity bias,
  • to appreciate the beneficial impact that mindfulness practices such as -conscious breathing , non judgmental mindful awareness or an inner orientation towards compassion and gratitude- have on brain structure and nervous system regulation, on resilience and well being,
  • to understand the triune brain model and its groundbreaking importance in terms of neuroaffective development,
  • to work with the concepts of affect – self- and interactive regulation – i.e. the neuropsychological foundation of the traditional attachment theory,
  • to apply the knowledge about the multiplicity of mind and self and work with the fragmented and dissociated inner parts towards integration,
  • to recognize the power of imagination as a tool to generate resources of safety and support that can help us go through overwhelming emotions,
  • to learn about the connection of the brain to a big network of neurons in the heart and the gut – the so called enteric nervous system – emphasizing the significance of being mindfully connected to our visceral self
  • to make sense of the importance of implicit memory in processing and integrating traumatic experiences,
  • to understand human connectedness as a biological imperative and the ​​ ​Polyvagal Theory of Social Engagement ​showing how we can work with the body, to help traumatized clients reorient their nervous system so that they can reclaim a sense of safety –

just to name some of the key concepts in the 3 major neuroscientific branches related to psychotherapy – Cognitive Neuroscience / Interpersonal Neurobiology, Psychoneuroimmunology and the more recent Affective Neuroscience.

Αll of those leading-edge recent findings on neuroscience, mindfulness, trauma, attachment therapy and relational psychology are in the service of bridging approaches and widening the perspective of our working hypothesis. Therefore, in the current related bibliography, this stream is often mentioned as a new paradigm in the field of psychotraumatology, aiming to provide support and useful tools in coping with the devastating effects of individual and collective trauma in daily life.

Special emphasis is now given on psychoeducation and its empowering significance in our work. Having the possibility, for example, to explain the trauma responses to clients – giving them the physiological evolutionary frame – helps take away the overlay of shame, eliminates self-blaming about their often elusive physical and psychological symptoms and enhances the sense of being understood and safe. In this regard, this body of knowledge neuroscientific theory brings to psychotherapy and trauma therapy can be a powerful resource. The more clients understand about their brain, nervous system and body, how they function together and how they can improve their interaction, the more empowered they become to advocate for themselves. (Rothschild)

Waking the Tiger, The Body Bears the Burden, Trauma and the Body, In an Unspoken Voice, Healing Developmental Trauma,The Body Keeps the Score… These are some of the most influential handbooks about trauma since the late 90’s stretching the importance to recognize that the trauma is not in the event but in the nervous system, as P. Levine pointed out in his Somatic Experiencing approach· to understand that PTSD, as Bessel van der Kolk emphasizes, is not about the past, it is rather about the body that continues to behave and organize itself as if the experience is happening in the present. Forging ahead and challenging the status quo of traditional psychotherapy in order to decipher what does and what doesn’t work in healing trauma, he clarifies why talking isn’t enough and can even inhibit sometimes the therapeutic process.

Unreleased traumatic energy stays bound and trapped in the three levels of existence: (a) In the physiology and the autonomic nervous system – as high arousal and contraction , (b) in the affective level – as fear or terror and (c) in the level of meaning and cognition – as intrusive thoughts, images, memories and identity distortions. That is why effective trauma treatment needs to address all three levels of experience by integrating the so-called top down and bottom up therapeutic interventions.

Restoring and enhancing the inherent self-regulation capacity of the organism, which is impaired by simple shock or complex developmental trauma, is the primary and most important therapeutic step. Self-regulation, which is not to be misunderstood as self-control, is the ability to flexibly regulate inner states by one self (auto-regulation) and through interactions with others (interactive regulation). As van del Kolk states, the foundation of all effective treatments involves some way for people to learn that they can change their arousal system. The issue of self-regulation needs to become front and center in the treatment of trauma and there is alarmingly little in our mainstream culture to teach that.

Τhe main orientation in somatic trauma treatment – building on E. Gendlin’s paradigm–shifting discovery of the bodily felt sense as a source of meaning and change, (Weiser Cornell) is therefore, to mobilize the power of embodied awareness. In a safe, gentle, non-cathartic, non-retraumatizing, relational and resource-oriented way- the endeavour is, to encourage a mindful, witnessing, befriending reconnecting with the sensing body self –the real story teller- as P. Ogden notes. Therapeutic goal is to effectively help traumatized clients – to feel safe with their feelings and sensations, regain choice control and ownership of themselves and of their body, develop trust to safely start coming out of dissociation, widen their range of resilience to tolerate intensive emotions, as well as  their capacity to contain them, create a new encouraging and coherent narrative, and feel empowered again.

Severe trauma as an archetypal human experience can dramatically influence the quality of life, causing enormous suffering and disabilities. And yet through coping with traumatic events new qualities and meaning in life as well as the ability to grow in ways that were not possible before, -finding courage and strength in vulnerability- can also be discovered, – a phenomenon called post traumatic growth also confirmed by modern research.

So, moving forward to the presentations of our speakers here at this table – all of them addressing some of those important issues in their own special way – and also in general considering the rich, resource-oriented content of lectures and workshops at this congress, if we pause for a moment in awareness, allowing ourselves to deliberately turn down the media broadcasting sound of ongoing trauma and terror, Pablo Neruda’s verse may come to mind: «you can cut all the flowers but you cannot keep spring from coming».

Thank you for your attention.

Lecture on the 15th EABP Congress
EABP Congress 2016 ATHENS
Round Table: Trauma Embodiment and Self Regulation
Zoe Schillat, Dipl.-Psych., ECP, EuroPsy

 

References:

Ann Weiser Cornell (2016) , In Honor of E. Gendlin Article, Somatic Psychotherapy Today | Winter 2016 | Volume 6 Number 1

Roz Caroll ( 2003) , On the Border between Chaos and Order: Neuroscience and Psychotherapy , in (eds.) J. Corrigal & H. Wilkinson Revolutionary Connections: Neuroscience and Psychotherapy, Karnac.

Roz Caroll (2009) , Self-regulation – an evolving concept at the heart of body psychotherapy in : Contemporary Body Psychotherapy The Chiron Approach , ed. L. Hartley, London Routledge.

Christian Gottwald (2015), Bewusstseinsprozesse und Körper in der Psychotherapie-neurobiologische Aspekte, Psychologische Medizin, 1: 15-35, Facultas-Universitätsverlag, Wien.

Susan Hart (2008), Brain, Attachment, Personality: An Introduction to NeuroΑffective Development, KARNAC.

Laurence Heller, Aline La Pierre (2012), Healing Developmental Trauma: How Early Trauma Affects Self-Regulation, Self-Image, and the Capacity for Relationship, North Atlantic Books.

Bessel van der Kolk (2013), What Neuroscience Teaches Us about the Treatment of Trauma, Article, The National Institute for the Clinical Application of Behavioral Medicine.

Peter A. Levine (2010), In An Unspoken Voice: How the Body Releases Trauma and Restores Goodness, North Atlantic Books.

Pat Ogden (2013), How Neurobiology Changed the Way We View Trauma Treatment, Article, The National Institute for the Clinical Application of Behavioral Medicine.

Maggie Phillips, Peter Levine, Stephen Porges (2014), Healing Trauma and Pain Through Polyvegal Science and Its Interlocking Somatic Interventions Webinar Sessions Transcripts.

Babette Rothschild (2010), 8 Keys to Safe Trauma Recovery, W.W. Norton NY, London.

Allan N. Schore (2011), Affect Regulation and Mind-Brain-Body Healing of Trauma, Article, The National Institute for the Clinical Application of Behavioral Medicine.

Kathrin Stauffer (2009), The Use of Neuroscience in Psychotherapy : Theoretical and Clinically Relevant Aspects, in: Contemporary Body Psychotherapy The Chiron Approach, ed. L. Hartley, London Routledge.