Let this video of an impala being rescued teach us about trauma and trauma treatment in psychotherapy

I watched this video about an amazing rescue of an impala, and cannot help but feel a tremendous sense of wonder for the nature of the nervous system.

This video shows us an animal’s natural response to a traumatic event, being stuck in a situation which is life threatening. Then it comes across rescuers who saved its life.

How is this connected to trauma treatment?

Well, if we observe carefully the behavior of the impala, we may be able to learn something very valuable about treating post-traumatic stress disorder and complex trauma in humans. Let’s take this video as a metaphor: the impala as the client who seeks the help of a professional, the rescuers. The impala is not aware of its traumatic situation. It only knows that it wants to get out of being trapped. Clients too come to therapy seeking help to get out of a “stuck” situation. They have often little awareness of the big picture. In therapy, the therapist and client find out together what the big picture looks like.

When clients come to therapy, there is anxiety. Just like in the video, as the rescuers approach the impala. It becomes more afraid. Client’s wonder, “Can he/she help me?”,” Will I be hurt by this person?”,”Is therapy a waste of my resources?” “What is he/she doing?” “Is he/she judging me?” etc.

The therapist is there for the client exclusively. In the video, the rescuers genuinely want to save the impala. Hence, it is really important that the therapist is there, in the session, only for the client. Realistically, this can only be possible with therapists who genuinely love the work and who are adequately remunerated for it. Reasons why professionals in the helping professions burn out and become ineffective can be attributed to this point: giving is a two-way process, and overt charity is neither kind nor sustainable.

The therapist’s empathy. A genuinely present therapist will put in the effort and strength to be with the client; just like the man who would put his body in the mud for the impala. The therapist would experience what the client is going through. This is how we can understand empathy.

Therapists also need other therapists to support them. That is why we attend workshops, therapy, supervision and inter-vision. In the video, the rescuer does not work alone. When he is stuck in the mud with the animal while his friends are there with the rope to help to pull him out when the need exists.

A part of therapeutic treatment is about doing nothing together. This is a recovery phase for both therapist and client. When the rescuers finally manage to pull the impala onto safe ground, they take time to be with the animal and to give it some comfort by washing it. We can see in the video that the body of the impala is really still at this point.

The stillness seen in the animal’s body is not merely calmness. It is possibly a somatic response to a highly frightening situation. The body shuts down. It fatigues. The work is far from over. Trauma-focussed therapist will not overlook this. Human clients in this state have varied symptom: of being depressed or numb, get panic attacks, lack focus, forget things, feel the need to throw up or cut themselves, feel like they are dying, lose their sense of reality (…the list goes on). The client needs then to physically recover. For this to happen, he/she needs the support of the therapist. In the video, this process seems natural and smooth for the impala. The rescuers pat the animal on its back, pulls it up and encourages it to get up and go. This is the act of bringing the beast back to its senses. The animal gets on its feet, trembles, pants and bolts.

In human beings, this process often does not happen so smoothly. Steven Porges explains why this is so with the polyvagal theory.

Treating clients at this phase involves a sometimes a long-drawn and difficult process of working through the client’s very difficult feelings despair, fear, guilt, grief plus the bodily reactions accompanying it. Human beings are afraid of these reactions in themselves. Such reactions are somatic, and may include panting, trembling, screaming, hitting or pushing, bolting, crying, and sometimes throwing up. We try, most of the time, to allow this energy to come out in tiny steps. Peter Levine calls it “titration”.

Therapists would also encourage clients to do body-focussed activities like yoga, weight-training, dancing or tai-chi to get more in touch with their bodily sensations.

Trauma-focussed therapy, for whom?

The animal, stuck, finds itself in a panicked state. It’s muscles tense and it tries to fight its way out of the situation. Being really stuck in the mud, all its efforts fail. Its body fatigues. Looking at us human beings, when we find ourselves in a threatening situation, our first impulse is to flee or fight back. In events that cause trauma, this instinct to fight or flee does not lead us anywhere. These traumatic events trap its victims. There is a sense of impending death. Such events can often occur in childhood, as victims of child abuse and neglect are trapped in a life of a child; helpless, vulnerable and dependent on its caregivers. This existence can go on for years.

Many clients come for therapy without the awareness that they are survivors of trauma. As adults, they come to therapy because they encounter symptoms like, depression, suicidality, anxiety, compulsive behavior, rages, emotional dysregulation, feeling numb, fatigued, loss of memory, relationship problems, eating disorders (…the list goes on). These symptoms are now known to be likely somatic reactions to past trauma. Trauma-orientated therapists will pick up on this.

Medication to treat trauma?

Medication stabilizes the body, but it unfortunately does not help the client work through the source of the problem. Medicine does not empower the client with awareness of the self. It does not lead the client towards self-agency. Meds lose their effectiveness with time, when the body adjusts to the chemicals through homeostasis. Imagine the rescuers in the video giving the animal meds, and not doing anything else. The animal will no longer be in distress. It would simply live trapped until it dies.

Conclusion

I hope this article enlightens you the reader on what psychotherapy can look like, and how your symptoms can be perceived and treated.

Psychotherapy, especially therapy that is humanistic, relational and is focussed on empathy, is a great profession because it opens doors for the possibility of healing from the otherwise life-sentence of trauma.

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Complex Trauma: 12 basic concepts of somatic experiencing in healing Trauma

Traumatic events happen in a variety of circumstances. Incidents that happen to us which suddenly shocks us, leaving us overwhelmed, and sometimes frozen, can lead us to experiencing life-long psychological and physiological effects of trauma.

Exposure to traumatic experiences affect us in very individual ways. The consequence of being traumatized, concisely explained, is the effect of our nervous system sensing the danger of the past traumatic experience as if the danger is happening in the present. Harmless situations can trigger feelings of anxiety as a result of trauma.

“The great thing then, in all education, is to make our nervous system our ally as opposed to our enemy.”

William James (1914, Habit)

Since danger and anxiety are buzzwords in trauma, healing trauma in psychotherapy requires big doses of trust. Trust that the suffering from traumatic experiences can be healed. Trust that the psychotherapeutic alliance is a working, trusting one. Trust that, whatever the outcome may be, that the work is worth doing.

This article features part of the very inspirational work of Peter Levine (1997), whose work is a guide for my professional attitude towards trauma.

Importance of Slowing Down during Trauma Work

When working with trauma, it is necessary slow down. Traumatic events and subsequent trigger reactions happen at split second duration, often out of awareness. In the treatment of trauma, the sensory events, feelings and thoughts that arise need to be witnessed with the time slowed down with guidance of the therapist.

Many trauma patients, frustrated at their symptoms, want speedy resolution. Therapists are best advised to reassure their patients, that slowing down is the safer, more effective road to healing.

Traumatic triggers happen out of awareness. The act of slowing down during therapy brings the sensations and thoughts into awareness. It is through awareness that the client gains sovereignty of his/her experiences — and ultimately nervous system.

12 Basic Concepts of Trauma Work

Levine’s work stipulates 12 basic points of trauma work and experiencing. Some clients benefit when theses points are shared with them. I use this as a map in my work, for effective tracking of the patient’s process and progress.

  1. The phenomenon of being riveted. During an overwhelming traumatic event, the shock causes the body to stiffen up. The muscles tense up. The body can get frozen and stuck in this state. The energy is locked up in the body. The state of being riveted is experienced in each patient uniquely. In the therapeutic session, each patient displays his/her own unique symptoms of this phenomenon.
  2. Feelings of defeat and helplessness. During a traumatic event, the sense of being overwhelmed and trapped, leads to the profound feeling that one would never escape. There is overwhelming helplessness. After the traumatic event, this feeling of defeat resides in the body of the traumatized person. People may become unable to work, play or do daily tasks as a consequence of this body memory of the traumatic experience of helplessness. It may be helpful for patients to know that this is happening to them, to allay fears or self judgment for not being able to function as society would like them to.
  3. Tracking with Awareness. in-tunement of inner landscape. feelings, sensations, thoughts. We are not lost in the experience, or disassociated, but looking and tracking it from a close distance. Pendulate between comfortable and uncomfortable situation.
  4. Pendulation between Polarities. To be able to move between expansion and contraction; to having feelings of past memories at one instance and then coming back to the present reality. To feel anxious at one moment, allowing the feelings to pass, taking a break from what one is doing, and slowly breathing towards calm. Pendulation is an exercise of acceptance, and allowing of oneself to move between emotional states, without hinderance.
  5. Resourcing. The process of resourcing is to deliberately take stock of anything of value in one’s life. Resources can come in the form of relationships, material wealth, work, interests, hobbies, vocation and religion. Resources, no matter how little, add foundation to ones sense of stability.
  6. Uncoupling feelings of excitement with experience of fear and trauma. Take time to check in with oneself, and learn to mindfully differentiate between feeling of excitement (pleasant surprise, nervousness about a job interview or performance in public, excitement over positive events, butterfly in the stomach feelings) and fear. Take time also to differentiate between fear of actual fearful stimuli of the moment, and fear that arises out of traumatic memory.
  7. Grounding & centering. Grounding and centering involves mindfully feeling the weight of one’s body pulling itself to the ground. .Gravity is the helper that helps the body rest and center itself. Grounding exercise is usually done by sitting comfortably on a chair and putting two feet flat on the ground. One can also lie flat on the floor and feel one’s weight on the floor. In fear and panic we loose our ground. The earth seems to disintegrate from under our feet. When we are aware of our ground, we can feel more secure.
  8. Strength & resiliency. Building emotional, intellectual, physical strength in whatever form adds to one’s agency. Going for psychotherapy to build emotional strength, learning or studying anything to build intellectual strength, and doing muscle building exercises to gain physical strength adds to the alleviation of the dominance of the trauma symptoms.
  9. Restoration of natural aggression. Get support from a competent therapist or an understanding friend, who is able to listen to the feelings of anger and hate that are related to the traumatic experiences. Traumatic events render the victims helpless, trapped and immobile. Coming to terms with the natural aggression that is locked up in this immobility resets the nervous system. Expressing the anger releases the aggressive energy and restores vagal tone. The body as a result feels the relief.
  10. Running. Similar in the reasoning to restoring of aggression, running is what the body needs to do to escape from the condition of being trapped. One can experience running in the therapy session. One can also simulate running through mindfulness activity, like imagining sprinting to a safe place (even by moving arms and legs quickly while seated) every time one feels trapped. Important is for us to have a mindset that running away from the traumatic situation is actually a positive action.
  11. Orienting. Taking the time to orientate oneself while in different situations is good practice. This sharpens one’s skills in being present in the moment. Orienting, grounding and centering enhance physical stability.
  12. Completion of self regulation. With the support of a psychotherapist who works with emotions, one learns to experience a full repertoire of emotions, energies and perceptions. Traumatic experiences cause our senses to shut down, leaving us incapable to completing our natural self-regulatory cycles. Completing these cycles of self-regulation releases energy and brings calmness to the body.

Psychotherapists who work with trauma know that trauma is locked in the body. Being aware of, and checking into the somatic experience of the client is essential to the work. This is possible when a trusting, therapeutic alliance is already established.

Do seek professional advise if you or someone you know suffer symptoms related to trauma. It is a safer approach to healing than ignoring the symptoms or trying to treat the symptoms unprofessionally.

Bibliography

Levine, P. A. (1997). Waking the tiger: Healing trauma: The innate capacity to transform overwhelming experiences. North Atlantic Books.