Thursday, August 27, 2015

Somatic experiencing: using interoception and proprioception as core elements of trauma therapy

The balance between associating with a traumatic experience, and thereby resolving it, and being flooded or overwhelmed by it, is so delicate. It needs to be done slowly and safely. Peter Levine uses the mythology of Medusa as an example of how to approach trauma safely. You never look her directly in the eye or she can turn you to stone (i.e. immobilise you), and the same goes for trauma, it does need to be 'faced', but safely. If we don't approach trauma safely, we run the risk of retraumatising ourselves and the proverbial black hole becomes bigger and more frightening.

I'd like to share an excerpt from an excellent article from Peter Payne, Peter Levine and Mardi Crane-Godreau below. As the article says "Yet Simon is correct: the trauma around the accident cannot and should not be avoided indefinitely". If we don't face our trauma, we also run the risk of being constantly triggered (and overwhelmed) which often, if not always, results in retraumatisation. Here is an excerpt of the article:

Despite my attempt to keep things slow, Simon slipped into the “trauma vortex”; the memory of getting into the car triggered an intense recollection of the accident accompanied by strong activation of the ANS and the rest of the CRN, and I had to act quickly to bring him back to the present so that his nervous system could regain its balance. In SE [somatic experiencing] one is walking the tightrope between not enough activation, in which case there is no discharge because there is no activation to discharge; and full-blown reactivation of the trauma memory, in which aspects of the trauma are relived and the person again experiences overwhelm. This can actually be harmful, and can compound the original trauma. Such a “dive” into the black hole, the “vortex of trauma,” involves a self-reinforcing positive feedback loop, in which the proprioceptive and interoceptive feedback (somatic markers Damasio et al., 1991, 1996) from the neurally encoded memory trace (engram), becomes a trigger for further activation (Liu et al., 2012); a runaway loop which can lead to extreme simultaneous activation of both sympathetic and parasympathetic (dorsal vagal) bringing about a dissociated state within seconds; see Figure 6. One of the tasks of SE is to interrupt this destructive loop. To this end, SE uses concurrent evocation of positive interoceptive experiences, which may help alter the valence of the disturbing memories (Quirin et al., 2011); this process has been demonstrated in rats (Redondo, 2014). Other aspects of the mechanism whereby SE prevents the traumatic positive feedback loop are discussed below as “biological completion.” Continue reading the article for free 

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