Category: Blog

How to Help Someone with Post-Traumatic Stress

I’m pleased to announce the publication of an article I wrote!

My article is published at GoodTherapy.org, where they have recently invited me to become a topic expert on somatic therapy and post-traumatic stress.  The article provides basic education about how to help someone who has post-traumatic stress.

Here’s the link! Feel free to share it with anyone who might find it helpful.

In the meantime, here’s a photo of an Icelandic waterfall, to hopefully brighten your day just a bit.

Iceland UK 2016 615

Being Healthy

….isn’t only about what we eat, or how often we exercise.

Our emotions have a huge role to play in our physical health; but many don’t realize that, and so this is often overlooked.  

Emotions are electric charges in the sympathetic nervous system. The body’s creation of them requires considerable energy. They are intricately related to the fight/flight impulses arising in response to threats to our survival. So yeah, there can be a great cost to the body in neglecting them. 

Here, in this article, Dr. Gabor Mate spells it out for us. His writing is eloquent and backed by decades of research and clinical experience:

How To Build A Culture of Good Health

What You Do Is What You Get

Somatically, at least.

What I mean by that is, our bodies are incredibly adaptive.  They tend to form themselves according to how we use them.  

Of course, disabilities and chronic illnesses are a major exception to this rule.  For example, if someone has Duchenne’s muscular dystrophy, their bodies are going to weaken despite exercise and superior care.  I consider this one of life’s profound unfairnesses. 

But for the most part, our behaviors are incredibly important in determining our long term physical and mental health.  If we put a consistent demand on our bodies to do something, they will strengthen themselves very specifically to adapt to this demand. Unless the demand is too much, beyond its capacity to adapt; in that case, the body part tends to break down.  I think this is one reason why runners have a high incidence of injury (besides the high potential for poor biomechanical form). It’s because running can become so fun and gratifying on so many levels, that it’s easy to put too much demand on the body, too quickly or with insufficient recovery time, resulting in overuse injury.

Of course, the capacity of a specific body part to strengthen/adapt, varies widely, according to genetics, history of injury/illness, etc.  This is why people with a history of heart disorders have to strengthen that muscle very carefully, and under medical supervision!

I think this tendency towards specific adaptation even includes our reflexes. Here’s a very interesting article about how myopia (nearsightedness) has been dramatically increasing. Apparently, its incidence has basically doubled in about 30 years. This is far too short of a time for it to be attributed to evolution. This is a major change within our lifespans–and not a good change.  

The article says that scientists can’t agree on why this is happening.  However, it’s already known that agricultural nations, whose citizens spend more time outside and physically active, tend to have less myopia and (I think) fewer eye disorders overall. I feel that while the scientific community is busy investigating research protocols (perhaps a little myopically?)  it wouldn’t hurt most of us to use a little common sense: If we sit inside all day and look at things that are close, like computer screens and cell phones, which tend to cause eyestrain, then our bodies will try to adapt, that is, improve their capacity to see close things, potentially at the expense of seeing farther things under a variety of light conditions.  Furthermore, if we push our eyes too much to strain all day at these screens, particularly under conditions of emotional (hence somatic) tension, our eyes might begin to break down. So following that (non-scientific, common sense) hypothesis, perhaps a deliberate effort to get outside, move our bodies and expose them to all sorts of visual distances and natural light conditions, would be a good investment of our time and effort. I mean, a little more balance in our lives couldn’t hurt, right?

Now, consider how this might apply to the ways in which we think and feel.  Thoughts and emotions can actually be considered behaviors. I know I’m kinda pushing this use of the word “behaviors” a little bit, in that an outside observer can’t directly observe thoughts (hence Skinner’s famous “black box”) or emotions–although a trained observer can certainly see evidence of various thoughts and emotions in process.  

However, thoughts and emotions are indeed things that we do, and they are usually habitual. This is why persons with post-traumatic stress often find themselves in a survival panic, when there is nothing currently threatening. Or else they might find themselves numb, even though it’s a beautiful day, and it would be great to be able to be present and take it all in. Here is a great article about how our attention can cause neural pathways to form, pathways that either harm us or help us.  For my clients: This article pretty much explains why I’m always bugging you to direct your attention to pleasant experiences, and feel into them! We’re trying to hardwire a sense of good into your system! Attention + consistent repetition = changes in hardwiring and neural pathways.  

So think about it. How are you using yourself today? 

If you don’t like the way you are using yourself, what are you willing and able to do about it?

If your efforts fail, don’t be quick to blame yourself.  Hardwired patterns can be very difficult to change, especially when trauma or overwhelm has been involved in the formation of the patterns. Efforts to change might become even more difficult when society and/or the demands of life seem to support the old pattern (e.g., too much computer work and no exercise; stress eating; too much caretaking others and little self-care time; etc.). This is where the support of a good somatic therapist can be extremely helpful! 

In any case, I am frequently amazed by our bodies, especially their consistent efforts to protect and help us.  Somatically and neurologically informed therapies help us learn to “speak” the “language” of our bodies and unconscious minds, so that we can be internally consistent, all parts of us learning to work together, instead of pitting ourselves against ourselves.  

 

Great article about happiness

Hello everyone,

I found this article today and thought it worth sharing.

It struck me as thoughtful, well-written, and quite practical.  The section about experiences reminds me of some of mine, each of them treasures that I carry with me in my heart at all times.

I invite you to peruse it, and mull over how it might apply to your own life.

Happiness

Good basic info on vagus nerve: Becoming calm

This is a very nice article that summarizes the biomechanics of being calm. I think it has a lot of good, useful information, making it a worthwhile read. 

The article also addresses why the mind calms when the body is calm: It’s because the body sends these nice, “everything’s OK” signals from body to mind, along the vagus nerve.  (Note that non-somatic therapies that limit their focus on calming the mind would inadvertently neglect this major innate mechanism.)

I might add that I can’t personally vouch for all the methods the author lists for activating the vagus nerve.  I haven’t tried all of them; but I do know that some of the methods she lists, don’t work for some of my clients, or for some other folks who have considerable traumatic residue in their systems.

There’s no need to despair if someone doesn’t find the list at the end of the article helpful for them, in activating their own, individual bio-calming response. There are many more methods for increasing vagal tone (and calming) that the author hasn’t listed–including a good somatic therapy session!

In somatic therapy, we put a lot of attention onto supporting the development of the vagal brake, that is, the vagus nerve’s ability to slooooooowwww dowwwwnnn the sympathetic nervous system’s fight or flight response. Which is what becomes revved up too quickly and too chronically, at the wrong times, in post-traumatic conditions. This is essentially the same thing as downregulation, which my clients hear me talk about all the time.

Vagal braking capacity isn’t really present in babies, and it takes a lot of caregiver soothing over a long time, to get it going.  This is why babies and children tend to be fussy or needy for quite a while. A major task of childhood is to develop the vagus’, and the person’s, ability to stop that fight or flight response and bring oneself back into calm.

The bad news is, many kids grow up without ever having really developed this capacity. For whatever reason, their parents weren’t able to pass it along to them, although most of the parents certainly would have if they had been able to.  This results in the now-grown-up person, walking around every day without the core ability to self-soothe. (Which explains a lot of problematic behaviors,  but that’s another blog entry in itself. Think about substance abuse, overeating, other compulsions. Or just plain old chronic somatic bracing, in which the muscles and fascia stiffen up, to try to contain the charge the body is holding, since it can’t discharge.) The good news is that this calming capacity is just waiting to be developed! See also neuroplasticity.

Again, patience and compassion with oneself is so important in this work. So is consistency.  Don’t give up! Our bodies are just waiting to help us, if we can only find some ways to get their innate support needs met.

Happy Holidays….or, You Are Not A Lizard!!

So the holiday season is in full swing now, with all of its colors, parties, mandated commercialism, and admonitions to spend time with family (among other features).  

Some people love the trappings of the holidays: sentimental songs, dreidels and Christmas wreaths, a frenzy of gift-giving, and much overeating.  It’s a well-known fact that for people with depression, anxiety, grief and/or loss, the holidays can be a time of great misery. Some people know exactly why they (or others) react poorly; whereas some are mystified by this reliable effect of “Bah, humbug”.  I wanted to look a little deeper at some reasons behind holiday-induced depression, as well as what we can do to help ourselves and each other get through it.

Part of the issue is that we are not reptiles.  Reptiles, as I wrote in an earlier blog, don’t cruise down the street in herds or gangs.  They don’t hang out with their best buddies.  Because they don’t really have best buddies! Despite the enthusiastic owner who gets super attached to their python or iguana, reptiles pretty much couldn’t care less about other creatures around them. Unless it’s time to (a) run away, (b) eat that other creature or (c) mate with it.  

Let’s look at biology for a moment. This lack of reptile socializing is because reptile survival strategies are generally solo.  Now, I’m sure that somewhere in the fantastic diversity that is biology on this planet, there are species of reptiles that do group together for survival. But on average, reptiles tend to run solo. They are not warm and cuddly, and they don’t depend on each other for survival.

People are mammals. It was a great shift in evolution when warm blooded creatures discovered they could be more effective in groups.  For one thing, this strategy of interdependence allows for the more gradual development of bigger, more complex brains. An extended childhood, where the child is dependent on caretaker(s) for a looooong time, makes us smarter. 

Do you see where I’m going with this? 

We are wired to be together.

It’s deep in our bones  and nervous systems as a survival strategy, and we don’t feel or function right without it. 

In fact, togetherness is so deep in our evolution, our bodies need pleasant social time in order to be well-regulated. Therapists use this fact in the office. By being pleasant, interested, engaged, supportive and having a well-regulated nervous system ourselves, we support our client’s system coming into regulation. The same thing happens, albeit less consciously, at most any pleasant, fun social gathering.  See Porges’ polyvagal theory for more information.  

Simply put, in a social group which feels good, not threatening, people’s nervous systems are basically going zap! zap! zap! off of each other, and that zapping feels good. It supports the body’s sense of safety and well-being. 

Many people find they can pretty much adapt to being alone for long periods of time.  This does not mean it’s good for you.  I just googled “loneliness and mortality” and picked one of the first articles that comes up.  Notice that it doesn’t just refer to the subjective sensation of feeling “lonely”, it implicates social isolation as a risk factor for mortality.  

Unfortunately, people tend to do things first, and then many years later ask whether or not what we’re doing is good for us.  We have created a society in which it’s easier than ever to be alone, even when we’re physically surrounded by people.  

We drive around isolated in metal boxes (cars), fear speaking with strangers on the subway, in the grocery store.  “Bedroom communities” cut drastically down on opportunities to get to know our neighbors, even–gasp–hang out with them.  It used to take an entire community to raise a child, with uncles and aunts and neighbors and grandparents and kids’ friends’ parents.  Now, it’s often left to two (or one) overworked parent(s) and a really overworked, underpaid teacher.  All of this creates aloneness. We look to smartphones and the Internet for disembodied companionship. In so doing, our entire younger generation is, in my opinion, gradually losing the capacity to be face to face, human-to-human with another person.

For those who aren’t entirely alone, who still have family around, the season’s expecations of loving together time may serve as a painful reminder of difficult or even toxic family dynamics.  As in, we’re supposed to feel good and loving together as a family, but it just brings up old hurts. Or there might be the internal battle between “do I go to this awful family celebration and gut it out, to fulfill my obligation? Or do I put myself first and spend it alone or with friends? If the latter, what will be my cost in guilt?”

Also, I have no evidence to support this, nor have I bothered to look it up. But it seems to me that there are an awful lot of death anniversaries in the last quarter of the calendar year.  Perhaps people who are losing their physical or mental health just can’t make it through the long winter. At any rate, grief tends to really complicate the holiday season for survivors.

Lest this blog entry seem unrelentingly grim, there are solutions. We can use our knowledge of mammalian biology and SE to create a better situation for oursevles. Patterns can be reworked and replaced.  

I’m not going to wrap up this blog entry with one of those prescriptive lists, because I find those terribly annoying. “Do this and do that, and you’ll feel better.” Uh-uh.

What if we held in our hearts, this knowledge of how people need each other, along with the awareness of how it’s gone terribly wrong for so many?  

Given that, what do you feel moved to do, to increase our sense of community? For yourself, for others?

It could be as tiny as holding a door open for someone whose arms are full of holiday shopping bags.  Or as large as organizing a holiday dinner for those in need–of food, or of simple companionship.  

It could be something, anything during the rest of the year.  Smiling at someone and saying hello.  Attending a PTA meeting at your kid’s school. Going to the monthly beach cleanups here in Long Beach.  Anything. Sometimes, just simply being present, fully present, with another person is enough. 

The thing about taking even a tiny step to create community is, it tends to help us as much as it helps the other person.  

At the very least, I suggest that we recognize how particularly difficult the holidays can be for many people, and hold them–ourselves–in our awareness with compassion. And watch for opportunities for constructively and non-intrusively being with other people.  If you’re struggling over the holidays, there is hope, and there are people out there to help. Call someone. Orienting towards resources (lovely, pleasant things or activities) can often be very helpful. 

Happy Holidays everyone. I wish everyone the very best, the most lively and enjoyable holiday season.  

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Repair

“To restore to sound condition after damage or injury.” The FreeDictionary.com

Right, you might say; we already know that. What is this, elementary vocabulary blog?

But wait, I say. Did you know that repair isn’t just for houses or machines–it’s also for relationships?

In fact, the capacity to repair is possibly the most important predictor of whether or not a person will have long and satisfying relationships in their life.  Also, enduring relationships are hugely important factors in happiness, and in having good mental and physical health.

Interpersonal repair is so important, it’s an integral part of Steps 4-10 of the Twelve Steps of Alcoholics Anonymous, a hugely popular, worldwide self help program to heal from alcoholism and other addictions of all sorts.

That’s right: AA thinks repair is fundamental in keeping people sober–so much that it comprises more than half of their famous Twelve Steps.

So yeah, this is great stuff to know about!  And so the following is a summary of what I think is important about interpersonal repair.

First off, both parties in the relationship have to have at least some capacity to repair. “It takes two to make it and one to break it,” as the old saying goes–probably one of the most heartbreaking facts about human relationships. (Sigh.)

Relational repair has two parts:

1.  Initiating repair. This involves the courage to approach the other party and actually begin that difficult conversation. You know how when you consider doing this (particularly when the stakes are high) you might get a lump in your throat, or nervous stomach? And it might seem just soooo much easier to just not say it? Yeah, well, you gotta say it. (This may involve some self preparation beforehand.)

Initiating repair also involves the ability to speak one’s viewpoint from a place that is at least somewhat calm and non-attacking. This is typically where the use of “I” statements is helpful: “When I heard you say (x), I thought (y) and I felt (z).” That is, you are saying how it went for you, from your fallible, human perception; you are not really decreeing, “This is how it is/was and it all totally sucks!” You are leaving room for correction of misunderstanding.  It’s also important to avoid the use of inflammatory words or statements. Our emotions will often leak in when we’re not looking; it’s okay, even good, to allow them to show a bit. That’s being authentic. But we must show emotion in a moderate and contained way. Otherwise, the discussion tends to degenerate into unbridled emotions and fighting.  Please note that it’s completely okay to be firm about what you want/need from the other party. Stating this in a non-charged manner is very helpful, and respectful of both parties.

2.  Receiving repair. This involves the capacity to really listen, hear, and be fully present, in this communication moment with the other person. It means not deflecting or avoiding the subject with anger, or a change of topic, or any attempt to shut down the other person’s concerns.  Listening and hearing means having the openness to take in what the other person is saying, not just waiting for them to finish so you can talk. It means having the openness to consider adjusting one’s point of view at least somewhat, based on what this presumably valued person is saying.

See, there’s kind of a lot to this repair stuff, isn’t there?

And there’s a few more things going on here implicitly:

One has to have enough self-regulation capacity to remain calm and stable; to not get angry in an uncontained or bullying fashion. And the self-regulation to not check out (dissociate); and not become so anxious that one is unable to be present.

Also, people have to have the desire to repair, to make the relationship better.  If one or both parties aren’t available for this process, it isn’t going anywhere. Note: this is all applicable even if the people don’t plan to ever see each other again.  You can still leave things on better terms than they had been.

Repair involves holding the other person in sufficient esteem and value to say, hey, I would like to put at least a little effort in trying to better things. Repair is especially vital for relationships you see as vital.

And really, I think repair involves holding yourself in high value.  It means you love and support yourself enough to want to at least try to clean this up a little. I mean, why live with all this unfinished stuff buzzing softly (or loudly) in the background of your life, if you don’t have to?

Lastly, I think it’s both important and helpful to see repair as a normal part of life. Repair, I believe, is an inevitable part of our imperfect, not-omnipotent selves interacting with other imperfect, not-omnipotent human beings.  We can think of it as kind of an emotional oil change: routine maintenance on valued relationships with important people.

So go for it! I’d encourage sitting down with yourself first, for centering, reflection and preparation. Of course, a qualified somatic therapist or other trusted mentor can help you prepare if you’re not quite there yet on your own.

 

Integration

We are living in a society that tremendously undervalues rest.  

I suspect this is a major reason why the National Institutes of Health and the National Geographic Channel combined forces to produce “Sleepless in America”, a documentary I recommend to nearly every one of my clients.  This documentary details the profound consequences of sleep deprivation, and can be seen online here, at no charge.

Rest is a biological imperative, and athletes, coaches and personal trainers understand this. When we engage in physical exercise, our muscles are actually torn up. The muscle fibers suffer tears. It is during the resting period that our bodies rebuild them–stronger than they had been before. This is a form of stress adaptation, and it is entirely dependent on that resting period. The body is working during that resting time, making things better. Even professional and/or fanatic athletes alternate days; they don’t work the same muscle two or more days in a row. Ignoring the rest period leads to a condition known as “overtraining”, in which further work actually causes regression.  

Think about that. You work harder, and things get worse. You feel worse; your performance gets worse; your measurable output gets worse.  (In athletes, their resting heart rate rises, appetite plummets, and they may feel ill. They also tend to lose muscle tone.)

In this circumstance, many of us have been taught to soldier on, push harder.  Obviously, the exact opposite approach is needed. Even those who sadly don’t inherently value themselves enough to adopt this more humane approach, can’t argue with the “bottom line” of better performance.  

Somatic therapy is like that.  We often want to charge right into the heart of our issues, in a heartfelt but ultimately misguided attempt to “solve” them.  Sometimes the more we think think think about them, the worse things get in our heads!  

It’s in the stepping away, the resting, that the progress comes.  In session, we work on the issue a little bit, for seconds or minutes, and then we step away, move our attention to something else.  We might do several “waves” of this during a session; and then the client goes home and rests, engages in something else.  I have seen, and experienced first-hand, that the opposite approach, overworking an issue, leads to regression.

The period of resting between cycles of work is called integration.  Many of my clients leave my office physically tired and/or hungry.  I should rent the office across the hall from me, and set up couches and a snack bar.  

This fatigue/ hunger is a good thing.  Their bodies are demanding rest and replenishment after the “workout”. I lean on my clients to go with it.  Not get stressed, not force themselves into more hard work, right after going into their own personal caves to do battle with their personal dragons.

Most little kids don’t have an issue with this. They’re tuned into their bodies’ natural rhythms. They burst with exuberance when they’re energized, and they crash asleep when tired. Sometimes they need a little encouragement from their parents to sleep–they’re cranky and crabby; but life is new and wonderous and they don’t want to miss anything while they’re sleeping!  

Over time, however, we learn to over-ride our bodies’ rhythms, to push ourselves. We ignore the subtle signals that our bodies need a break.  Or we feel them, but feel guilty about them. Or we push ourselves to the point of collapse, into an unproductive, unmotivated and numbed-out state which is different from true rest.  

One of the very most important things I’ve learned from Dr. Peter Levine, and Somatic Experiencing, is the wisdom and grace of dancing with one’s issues.  Peter devised an elegant approach, which he calls “pendulation”: the moving in and out of the traumatic material.  We practitioners support and guide the system towards pendulation until it does it on its own: With a momentary swell of emotion, the body deactivates its stress response, and balance and peace are restored.

Working in this attuned, nuanced way also requires us to develop an ability to tolerate whatever “the issue” is that we’re dancing with. To move in and out of it, we have to accept that it’s there, however temporarily.  We also have to learn to trust that our body knows what to do with it.  We can’t will (or think) our nervous system to be “done” with an issue. We have to hold space for it and basically take a leap of faith that the deactivation of the trigger will come with time.  

Crucial to this healing process is rest.  We have to breathe, get ourselves out of the singular, locked focus that characterizes the threat response.  We have to look around, see what else is going on around us, in the world outside.  But above all, rest. 

FAQs

Greetings everyone,

I thought it might be helpful to post a list of frequently asked questions, or FAQs, about post-traumatic stress, anxiety, depression, and somatic therapy. Please note: Despite the format of this post, these answers only reflect general trends I see frequently.  None of these answers constitute any therapeutic advice for any individual. Please consult with a qualified professional for that.  See also my post here regarding terms for use of this website.

1.  WHAT IS TRAUMA?

In the somatic perspective, trauma is in the body, not in the event. It’s the body’s internal reaction of overwhelm to any circumstances that are bigger than its ability to cope.

According to Peter Levine, founder of Somatic Experiencing (SE) therapy, the fight or flight response can’t complete itself because the person’s defenses or coping resources are overwhelmed. Whatever happpened was too big, or too much, or for too long. So the response becomes stuck in the body, causing symptoms.  Not surprisingly, then, some people experience a lot of energy from trauma: anxiety, irritability, hypervigilance, etc. Others’ bodies say, “whoa, this is too much!” and so they shut down and experience depression, low energy, numbness.  

Incidentally, this framework explains why several different people can have very different reactions to the very same event.  It also explains why children are more easily traumatized: They don’t have physical strength, life experience, or independence to fight things off, or flee, so they are easily overwhemed.  It’s also noteworthy that trauma can be in reaction to either external circumstances or internal, such as injury or illness.

2.  WHY AM I FEELING THIS WAY? IT ISN’T LOGICAL! AM I CRAZY?

Remember, traumatic stress is survival energy that’s stuck in the body.  It is a huge amount of the body’s life energy, trying to survive! So that’s why it can feel so immense and out of control.  

Dr. Levine defines trauma as a normal response to abnormal, intolerable circumstances.  So no, people who have post-traumatic stress or something similar, aren’t “crazy” in the sense of out of touch with reality.  If we can slow down and really listen to what our bodies are trying to say, with the assistance of a skilled facilitator–we often see that they are really in touch with reality–even if it’s the reality of the past, not the present.

3.  WHY CAN’T I RELAX?

Again, because at some level the body thinks it has to act NOW in order to survive. That’s not compatible with relaxing or resting. Many cases of insomnia come from this type of problem.

4.  BUT I DIDN’T HAVE ANY TRAUMA. I KNOW SO MANY PEOPLE WHO HAD IT MUCH WORSE THAN I DID. WHAT’S WRONG WITH ME?

Well, we all know about what is sometimes called “Big T” Trauma: things that are conventionally recognized as trauma. These include being assaulted, being in a war, or a big car crash, or a natural disaster.

However, there’s not nearly as much recognition of “small t” trauma: things that can still be overwhelming, even though people aren’t aware their bodies might react this way. Common examples of “small t trauma” include:  surgeries, childhood illnesses, falls, loss of a significant relationship. Young children, whose bodies and nervous systems are still developing, are particularly sensitive to what might seem like small disruptions, or disruptions that are acknowledged but seen as necessary or for the child’s own good.  

There are also many underacknowledged categories of trauma, including racism, homophobia, and other forms of discrimination; poverty; and academic trauma, which may or may not relate to a history of having struggled with learning disabilities.

5.  IS IT PERMANENT?

As Dr. Levine frequently points out, humans are designed to endure and overcome tremendous adversity.  Many of us have survived and even thrived after incredibly difficult circumstances. We have systems in our bodies that help us move the stuck activation through and out; and I am forever grateful to Dr. Levine and his colleagues for “discovering” and learning how to access these recovery systems.  

I would add, the degree to which an individual recovers depends on several different factors.  I have seen many cases of complete recovery, and many other cases of substantial improvement. In my opinion, symptoms of traumatic experience tend to be much less permanent than traditionally thought. In any case, it’s nearly impossible to begin healing with the idea that it won’t work, or that the condition will never improve. 

6.  OKAY, SO, HOW DO I GET RID OF IT?

Because these events and symptoms tend to be overwhelming, it’s really important to work with someone who’s well trained and competent in resolving these symptoms.  And no, this post is truly not an ad for my practice. In my experience, this is just the way it is. People are social creatures, and we need each other’s help. We’re wired that way, as a species.  We need a stable, calm, competent nervous system to help us move past this stuff.  

Fortunately, there are many good practitioners out there.  SE itself has truly become a global community, with trainings and practitioners available on every continent besides Antarctica! There are many other trauma healing modalities, including Hakomi, Sensorimotor Psychotherapy, Bodynamics, EMDR, and others.  

In my view, SE has a particular strength. This is a vital ingredient; without it, I have seen many other trauma therapies go awry, even inadvertently worsening symptoms. The first thing we SE practitioners are taught is how to titrate. That means, we do not expose the client to more of their own stress reaction than they can tolerate. In my view, taking it a little bit at a time, and gradually building the client’s capacity, often makes the difference between success and failure in trauma therapies.

So, those are a few of the most frequent questions I hear regarding stress, trauma and recovery.  I’ll update this post from time to time if I can think of anything further to add to it.  My warmest wishes to all on their life’s journey towards health and healing.  

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