This article was first published in the Jan/Feb 2023 issue of The Therapist, a publication of the California Association of Marriage and Family Therapists (CAMFT). It was written by Sergio Ocampo, SEP, B.Eng, EMDRII, MA, LMFT, an SEI board member.
Much has been written and said in recent years about trauma and being ‘trauma informed.” Countless courses on the topic are now offered for professional development and as part of graduate-level programs. These offerings provide a rudimentary understanding of what trauma is and how it arrives, and they address how the symptoms and signs of trauma often become part of a person's daily life. But what these educational resources frequently miss are the simple and important questions, such as what specifically can we do about trauma and its looming presence in our world? How can we heal from it? And what is it exactly?
It's true that we've become more informed about trauma, yet we remain puzzled about how to help people fully and effectively recover from their traumatic experiences and achieve wholeness.
How do we fill in this gap? How do we acquire a better understanding of what trauma truly is and how people can heal permanently from its extensive and harmful effects?
As a mental health clinician who specializes in trauma and applies the tools of Somatic Experiencing, the answers begin with acknowledging that trauma lives in the body, in the nervous system. More specifically, it lives in the emotional/autonomic nervous system, the more primitive neural network that we inherited from our ancient ancestors. This system becomes active whenever we face an imminent threat to our physical or emotional safety, resulting in powerful, automatic, unconscious emotions that sometimes get stuck in our body. Here, I am referring to the fight, flight, or freeze response inherent to all mammals. Deeply wired in us, it is strongly connected to many functions in our brain and body.
When this system is fully activated, we experience strong physiological responses. Furthermore, this process can inundate its recipient with intense emotions that are experienced in the body. In other words, they are embodied emotions: We feel them in our body and encounter them in ways that can be entirely overwhelming. These emotions range from sadness to extreme fear, terror, and rage. We may feel our chest or belly constrict and our breath become shallow, we may experience our visual focus blurring, we may be captured by a sense of restlessness, or we may collapse completely. These signs indicate that our more primitive system is facing overdrive–it's overreacting to a familiar threat or a previous life experience that has not yet been resolved or released from the body.
As we examine issues involving mental health, we find that powerful, unrestrained emotions are frequently part of the client's therapeutic process. The process of therapy is designed to help the client deactivate these intense emotions and move toward greater agency. As mental health practitioners, we have traditionally helped our emotionally troubled clients by assisting them in the creation of new narratives. In other words, we support them in the process of learning how to use their cognitive minds to frame their experiences differently and thus enhance their ability to navigate the requirements of daily life. I have often found this approach to have its clinical limitations. What I've witnessed over and over is clients having overwhelming emotional experiences that never seem to find resolution. Clearly, the true sources of anxiety, depression, and other emotional conditions live more in the body than in the thinking brain.
When our strong emotional responses are in full force, they can quickly take over. This physiological occurrence is an ancient, survival-oriented biological process present in the anatomical makeup of the entire mammalian world. In humans, the fight, flight, or freeze response is centered in the limbic system and the hypothalamic-pituitary-adrenal (HPA) axis, which both play vital roles in the body's response to stress. When these systems are triggered by a threat, an attack, a trauma, or emotional overwhelm, it impacts the entire process of survival because the majority of the functions of the cognitive brain are automatically turned off. When this occurs, logical thinking and problem-solving are drastically limited, or even nonexistent at times. In this state, most of a person's neural activity is dedicated to escaping or fighting against whatever is perceived as overwhelming or threatening.
As a person confronts a threatening event that occurs too fast in an unsafe environment, they beco1ne overwhelmed, which leads to a shutdown with strong emotional wounding. These emotional wounds commonly get stuck in the nervous system. Such disconcerting events can “bump up” our nervous system to a highly charged state. This process transpires because our innate survival system has been activated by the autonomic nervous system, where fight, flight, or freeze originates. These impulses take precedence over any other type of human response.
The typical pattern that unfolds is that we end up getting stuck in an acutely activated state that fails to return to its previous normal instead of coming down to a more harmonious and grounded state. In the language of Somatic Experiencing, we refer to this condition of our nervous system as being “dysregulated.” We cease to be in flow. It is our body that informs us how we are “feeling” in our daily life. When the body is burdened by a nervous system in chaos, our sense of joy and presence becomes limited.
The symptoms of anxiety, depression, and other emotional disturbances are all features of a dysregulated nervous system, which describes a physiological system that cycles rapidly a round high degrees of charge and leads to intense feelings of emotional despair. The way to resolve this trauma effectively is not through appealing to the logical brain but through directly approaching the emotional/autonomic nervous system, the real source of the overwhelm. It is at this point that talk therapy approaches conclude and somatic healing practices begin. There are no more words to describe what is happening, and as the client begins to loop back around to the same stories over and over it feels next to impossible to reach an effective solution to the problems at hand.
However hard we may try, we cannot talk ourselves out of a dysregulated emotional/autonomic nervous system. When activated, this automatic process takes precedence over the functions of the cognitive brain. Our intense emotions hijack our reasoning abilities because our prefrontal cortex, which is responsible for impulse control and cognitive flexibility, turns off. It is possible to find clever ways of regulating ourselves by using coping mechanisms related to different ways of seeing the world. However, when our nervous system is overwhelmed or traumatized, the persistent emotional upset requires an appropriate release for it to cease being problematic. Non-somatic approaches do not fully resolve this distress and, consequently, symptoms tend to get more ingrained and pronounced as we age.
We may ask ourselves how we got to the point where we are completely overloaded with feelings of depression and anxiety. When we are exposed to overwhelming experiences that we can't resolve, override, or escape, they can get “stuck” in the body. The nervous system reaches such a high level of activation that it is unable to settle on its own. This physiological process often occurs following traumatic events, and it can also be the result of early childhood overwhelm, interpersonal violence, and emotional abuse, among other sources. This overwhelm in our emotional experience is a sign of a nervous system stuck in the “on” position that can no longer reach a state of calm and ease. This is the definition of trauma: a nervous system stuck at a level of activation as high as when it was originally overwhelmed or traumatized. When the body reaches this point, it does not know how to return to a sense of safety on its own.
We can clearly see that the actual sources of trauma and emotional difficulty can be found in our emotional/auton0mic nervous system, where strong emotional signals cycle through the body continuously. When in this state, we are in “survival mode,” a highly aroused state. As the fight, flight, or freeze response of the autonomic nervous system is at work, we also endure significant bodily experiences such as tissue constriction, stress hormone elevation, hypervigilance, chronic pain patterns, digestive issues, and nausea. Symptoms in the body can take on a life of their own. For example, when most people experience fear, they have a physical response in their belly. When in survival mode, the belly sends a signal to the brain via the vagus nerve informing it of the presence of fear and potential danger. This causes the brain to send a signal back to the belly to constrict even more. The cycle is persistent and vicious, ultimately intensifying the experience of fear using the body's feedback loop system. Here is where we say fear is “embodied,” and this is indeed the case, as we feel our body and our brain react to this distress. To resolve and heal such overwhelming e motions, it makes sense to address the
embodied emotional experience thoroughly.
But wait – there is more than just anger and fear: What is often not addressed is the freeze response, our most ancient reaction to extreme stress. When the emotions fueled by our fight or flight response have reached their maximum threshold, the freeze response “tums on” and takes over. It is the nervous system's ultimate attempt to create calm in the face of what feels like a life-or-death struggle. In this state, we feel physically and emotionally numb, and tend to dissociate–we depart our body or disconnect from the world around us. This response can get stuck in the body the same way fight-or-flight does and become habitually activated throughout our lived experience. When we experience stressful situations, this freeze response can arise automatically. It can be alarming to exist in a chronic state of freeze, as we may “check out” and not be fully present in our daily life.
It is easy to see how emotional overwhelm can deeply affect humans. For instance, individuals who suffer from PTSD following war traumas often confront the powerful effects of overwhelming experiences that have become embodied. This intense fear and rage is visceral in nature and often affects the nervous system to the point where severe dissociation and hallucinations occur. Furthermore, other chronic symptoms such as high blood pressure, persistent pain patterns, and IBS may arise. Here, we often see fight, flight, or freeze responses that are perpetually present at fluctuating levels.
In working with bodily and emotional overwhelm as they relate to trauma, somatic approaches are masterful in alleviating symptoms and resolving the sources of emotional disturbance. ln my clinical practice, I specialize in using the therapeutic approach of Somatic Experiencing™ (SE), which is a trauma resolution mode designed to reverse the effects of emotional dysregulation and overwhelm permanently.
Created by Dr. Peter Levine, SE uses interoception to assess dysregulation in the autonomic nervous system. When given the proper circumstances, the body will move through a process of discharge that brings the nervous system to a lower range of activation. This approach directly addresses the profuse emotions that have become embodied and consequently cause mental ailments such as anxiety, depression, and dissociation. Studies have shown that SE therapy results in lower levels of distress among subjects who have suffered traumatic and distressing experiences.
SE uses a gentle approach to deactivate a highly charged nervous system gradually and bring it to a place of internal harmony (coherence). Take a moment to imagine everything that has ever happened to you from birth to the present moment as a large mound reaching toward the ceiling. That ceiling serves as the limit of how much your nervous system can carry on a daily basis. With this imagery in mind, it is clear that the unresolved overwhelm stuck in the nervous system can be a tremendous burden.
In each SE session, the practitioner helps dissolve that mound a little more, creating more spaciousness and less constriction in the client's body. What we achieve is the gradual deactivation of the nervous system. Over time, clients treated with SE feel as if they have more breathing space and report more emotional stability. In fact, with the tools of SE, we can bring the client's nervous system completely back to the state in which it is meant to exist. Ultimately, this can enhance life experiences as the client learns to respond more calmly and mindfully to the world around them.
How exactly does this therapeutic approach work? SE entails tapping into what is named the felt sense, our awareness of the signals and messages that our body is sending eve1y moment of our life. When we are standing, we can perhaps sense our ability to balance, our skin temperature, the movements in our bowels, even the sound of our heartbeat through our eardrums. These precise messages are the language of the body. They serve to inform us about how we are doing in the world at any given time. It is with our felt sense that we “feel” emotions. For instance, when, we are upset, we may find our throat, chest, or belly constricting, or our shoulders and neck stiffening. These signals are echoes of our embodied emotions. As SE practitioners, we work directly with these physical sensations by encouraging our clients to bring them into their awareness. We are careful to hold a space of safety and offer containment throughout the healing process. What unfolds is that the body's nervous system tends to reverse long-held patterns spontaneously. In the same way, the nervous system constantly adjusts the heart's contractions, so it can correct impulses in the emotional nervous system that are not useful. This auto-connection ultimately returns the nervous system to a non-reactive level of activity.
Many of my clients seek my services because non-somatic therapies stopped working and never helped them achieve emotional relief. Most have endured emotional overwhelm that occurred during their developmental years and have suffered from traumatic experiences related to sexual abuse, accidents, surgeries, near-death experiences, difficult births, and even war. I have also encountered many who are unable to remember traumatic experiences but report a history of small-“t” traumas such as childhood misattunement with caregivers, bullying, marginalization, racism, and exclusion. All these experiences can lead to the emergence of symptoms as extensive and disturbing as those that stem from other types of traumatic experience. In fact, difficult early life experiences can cause interpersonal and emotional issues as we grow and our nervous system evolves. Such early emotional injuries often expand into adulthood and can be accompanied by full-blown symptoms of PTSD. Indeed, the nervous system cannot differentiate between different types of trauma. It can easily become overwhelmed and overburdened by the presence of a domineering parent or an ongoing sense of marginalization. For a young nervous system, an invasive adult can be toxic. The emotional nervous system then moves to a much higher level of activity and gets permanently stuck there moving forward. In all these cases, the tools of SE work powerfully and effectively to return people to wholeness. No matter the original source, dysregulation in the nervous system can be healed somatically. In tandem with other therapeutic models, SE serves to complement and strongly potentiate healing of both the mind and the body.
Clinicians can introduce some basic SE tools into their practices to help clients settle and become more aware of their intemal
environment. Orienting is an essential tool that helps clients ground themselves and achieve self-awareness. Here, we invite the client to scan their surroundings slowly with a sense of curiosity while we encourage them to notice the different colors, textures, and shapes present in the room. We then guide their awareness to the weight of their body and gently move that awareness through the spine, into the sacrum, through the pelvis and sit bones, down through the legs, and into the ankles and feet. In what manner are they sitting? Are they allowing the chair to fully support their body weight? Or are they bracing away from the chair, akin to floating? We then orient the client to a third sense by inviting them to notice the various sounds both present in the space and coming in from outside, including wind, birds, airplanes, and passing traffic. This could also include the voice of the therapist or the heartbeat in their ears. Next, we invite them to observe the messages their body is sending them in that very moment, not from a place of judgment but from a place of curiosity, as if their consciousness were merely a casual observer. As the client continues to orient to the environment using their primary senses, their nervous system tends to settle, often leading to a feeling of tranquility and stillness. In this moment, the pre-frontal cortex will be more available and active, as will their perception of any embodied emotions. This helps achieve a more open nervous system that is prepared for processing at a deeper level.
The process of SE therapy provides clients with the opportunity to heal from emotional dysregulation and return to a sense of integrity and wholeness. When this manifests, the body stops sending messages to the brain warning it of internal distress. In turn, the brain can relax and put its energy toward orienting to the environment, at last achieving its inherent capacity to create, resolve, and expand human potential. Activated emotional nervous systems consume enormous amounts of human energy. They take the focus away from expansion and instead cause contraction as they chaotically organize around finding a sense of ease. There is simply not enough space for anything else to occur.
Trauma and overwhelm inevitably keep accumulating until a person takes appropriate steps to resolve them. Body-centered psychotherapy practices such as Somatic Experiencing serve as powerful and invaluable therapeutic interventions that can provide great relief from emotional and physical suffering, eventually allowing the client to attain happiness, life purpose, and a sense of being alive.
Sergio Ocampo is a Board Director of Somatic Experiencing International, a Licensed Marriage and Family Therapist and Somatic Experiencing Practitioner, who focuses on helping renegotiate the effects of anxiety, depression and physical, sexual or emotional trauma. Sergio's approach is gentle and humanistic in permanently resolving trauma and emotional difficulties. Sergio researches and writes about generational trauma and healing historical wounds, proposing that anyone can achieve happiness, no matter how difficult or traumatic their lives have been. Sergio's motto is, “Anxiety and Depression are not a life sentence, but a temporary discomfort.” Sergio is fluent in four languages and has lived and worked internationally.
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