Sunday, January 11, 2015

Survival versus Healing Modes in recovery from trauma




     After the traumatic event is over our struggle to survive just started. Now we have to do something about the memories, the images, and the feelings. Our psyche often suggests that there is only one option, which is to keep moving. We have a fear that if we stop, we will fall apart and cease to function all together. So, we employ our body, especially our nervous system,  and our mind  to focus on staying busy and engaged in our present life. Sounds like a great idea, right? However, we cannot really be fully present with our life until we process what happened and heal from it. We are caught between the rock and the hard place. BUT WE ARE SURVIVORS! So, we keep pushing memories, feelings, and later symptoms down and aside. We keep moving and striving. We work hard just to stay afloat.
     This set up may work for us for a while, but after a few months or a few years our minds and our
bodies get exhausted from working non-stop on keeping the horror out of our consciousness. We start getting fatigued, depressed, physically sick, anxious. At this point, dorsal branch of the parasympathetic nervous system gets activated. As a result, we may go into the chronic “freeze” state, which is often accompanied by dissociation and avoidance. Alternatively, we might employ some stronger tactics at that point, like alcohol and drugs or compulsive sex to help us handle our internal mess. All of those tactics might be good in the moment, but they only bring a temporary relief and are accompanied by serious consequences to our health, our relationships, and our lives as a whole. We keep hoping that if we wait long enough, our wounds will get healed by time. However, trauma does not have an expiration date. So, waiting alone is not going to help.
     Sooner or later we face the dilemma. We can’t keep going anymore, because we are exhausted and falling apart, but we are really afraid of letting go, because we are confident we will lose it forever. This is a point of reaching the limits of the survival mode, which has been helpful and is familiar to us. We need to let go of it and shift into the healing mode, but it is unknown and scary as hell. I will help us understand what healing mode is, how we can shift into it, and some of the drawbacks associated with switching into the healing mode.
    At the point when we are forced to turn survival mode off or when our bodies or minds already did it for us, we have a choice to make. Our choice is between falling into the abyss of depression, PTSD, another emotional disorder, getting sick physically OR shifting into the healing mode. We often feel like we DON’T have a choice. We just fall into the abyss. BUT WE DO. We can start working on shifting into the HEALING MODE at any point in the process. It can happen before we reach the limits of the SURVIVAL mode, right at that point, or even afterwards. It is NEVER too LATE J
     Here is how I understand the HEALING MODE.  We heal, when we give ourselves space and time to connect with our Divine core, which is connected with Universe, Higher Power, or God, or
some other Higher Source as you understand it. When we are in the HEALING MODE, we feel calm, connected, loved and loving, supported, expansive, and trusting. Our creativity and our senses are enhanced. Time often stops or slows down in our perception. Healing mode is also associated with the increased activity of the ventral branch of parasympathetic nervous system (as opposed to the dorsal branch, which is responsible for the freeze response in trauma) and decreased activity of sympathetic nervous system.
     According to Peter Levine, the author of Waking the Tiger, animals shift into the healing mode automatically and quickly after objective danger goes away. They do it through the process of discharge, when they shake and vocalize. For humans the shift is not automatic and often does not happen at all. But it does not mean that it could not happen. We can facilitate this process by integrating certain practices in our lives.
SHIFTING INTO THE HEALING MODE
     From the physiological perspective, we need to activate the ventral branch of the parasympathetic nervous system. At this point, science has a lot of data about the ways to trigger this response. 
     1.       Safety
First, this response is easier to trigger, when environment is assessed to be safe. So, two important things to do in the beginning of the process are as follows:
a.       Find an objectively safe place to be (i.e., your bedroom, a secluded natural spot, or any other physical place that is OBJECTIVELY safe).
b.      Once you are in a physically safe place, work on creating a SENSE of being safe by using safe place imagery, praying, meditating, or employing any other safety practice you are aware of.
2.       2. Physical practices
a.       Stretching muscles as in hatha yoga practices triggers ventral parasympathetic nervous system and relaxation response. Note please, that some yoga classes MAY
NOT be appropriate here (e.g., ashtanga yoga, brikham yoga or power yoga). Classes that may be helpful include but are not limited to subtle yoga, beginner yoga, restorative yoga, therapeutic yoga, or yin yoga. If you are using yoga at home go for the poses from the first and last phases of your typical yoga class. Some examples of those poses include cat-cow, child’s pose, legs up the wall, gentle twists, bridge, and shavasana.
b.      Any MILD exercise. I really mean it. Streneous aerobic exercise or running are NOT good choices here. Opt for a walk in nature, dancing, or swimming.
c.       Rhythmical movement is also good. Examples of it include mild vinyasa yoga, dancing, and walking.
3.       3. Rituals and routines
     Rituals and routines are very important in supporting shift into the healing mode. Our nervous system responds well to predictability and repetition, which are basic components of any ritual or routine. So, consider starting and ending your day the same way. For example, having coffee every morning while you journal or starting day with a prayer or a brief yoga practice or just a shower and breakfast are all good ways of calming your nervous system from get go. The content of the routine is LESS important than its repetition and predictability.
     The same goes for the end of the day. Here are some of the ideas of calming pre-sleep routines: (a) having a cup of chamomile tea w/1/2 tsp of honey while reading something calming; (2) taking a WARM shower or bath with aroma oils of lavender, chamomile, rosemary, ylang-ylang or sweet orange; (3) listen to calm music while working on a crossword or puzzle; (4) journal about your day or things that you are grateful for; use words or pictures or scribbles, use colors; (5) do deep breathing and guided imagery exercise.
     One pre-caution in regards to the bedtime routines. Many people love watching TV or surfing the net and believe that those are good calming practices. Even though it may feel calming to you in the moment, those activities do NOT calm our nervous system. You may fall asleep or doze off, because you are exhausted, but the quality of your sleep is not going to be great.
4.       4. Music and use of voice
a.       Listening to calming music, including but not limited to nature sounds, classical and new age music, tends to trigger the ventral parasympathetic response associated with HEALING mode.
b.      Vocalizing like in singing, screaming, or crying may be very helpful
c.       Playing musical instruments intuitively (not learned piece of music or professional performance) and letting yourself express your current state maybe very helpful.

5.       Connecting with the Divine
     Connecting with the Divine in your life may be very helpful. It does not mean going to church and practicing religion. You could use going to church if it works for you. For many people it does not do it. If you are one of these folks, try one of the following:
a.       Identify your own Higher Power and talk to it in your own voice and your own words. Different people have very different understanding and images of Higher Power. For some it may be the Universal Energy, for others – spirits of the deceased ancestors, yet for others it may be Nature or Community. It does not matter what it is, as long as the image speaks to and resonates with you.
b.      Spend time in Natural spots that you like and watch/admire natural beauty and wildlife
c.       Play with and take care of babies
d.      Play with pets

6.       Being in SELF from IFS perspective
    
Being in SELF, as  Internal Family Systems Model defines it, is very healing for our psyches and bodies. There are different ways of getting into that state, which is associated with compassion, curiosity, calmness, clarity, confidence, creativity, courage, and connectedness.
        
One way is to spend 10-15 min listening to your parts from the place of compassion. As each part feels acknowledged and understood, ask it to step back. When all activated parts step back, you are left with the Self. Now you can spend some time in that healing place of acceptance and serenity.
    
Another way is to use one of the more traditional meditation approaches. Self-compassion meditation or mantra-based meditation with the use of one of the C-words may be very helpful in evoking that state. Of course, as with any other practices, repetition and consistency are the keys to reaching and enjoying the benefits of the HEALING Mode. 

7.       Intimate and safe connection with another person   
        
When we look into the loving eyes of another and feel the warmth and tenderness of their touch and their openness to us and our experiences, we are in the healing space. Deliberately focusing on those moments and cherishing them may be very helpful. Whether it is a smile that came from the stranger or a hug from a co-worker or a brief exchange with a family member about your day, be present in that moment and cherish it. Collect those interpersonal moments as opposed to the moments of conflict, disconnect, or misunderstanding that are frequent guests in most of our interpersonal spaces. 

8.       Rest and Relaxation 
    
Sleep and rest are very important components of healing. So, instead of freaking out when you slept for 8 or 10 hours, tell yourself that you let your body and mind restore and repair and increased the amount of goodness in the world. If you can let yourself lay around, read, nap with your pet, watch fire in the fireplace or stars in the night sky, DO IT!!! The healing nature of those activities cannot be overestimated.

     Instead of conclusion
      Working with trauma survivors, I am very aware of how difficult it is for many to shift into and be in the HEALING MODE. In the beginning you may be able to tolerate only brief moments of it and only one or two of the aforementioned practices. AND, IT”S OK! As you continue healing, your ability to tolerate the states of calm and relaxation will increase and with it will increase the effects of being in the healing mode. Be gentle and patient with yourself. Be compassionate towards you as you would be towards a baby, who is learning how to crawl. HAPPY SHIFTING!