We all are familiar with PTSD. Most often in the news concerning returning veterans. Walker's books is about Complex PTSD (cPTSD.) The added 'c'We all are familiar with PTSD. Most often in the news concerning returning veterans. Walker's books is about Complex PTSD (cPTSD.) The added 'c' essentially extends many of the ideas of trauma recovery to childhood developmental traumas. Most specifically childhood traumas arising from poor parenting and troubled home environments.
It is delineated by common features: emotional flashbacks (unlike PTSD there is not usually visual component), toxic shame (directly drawing from the work of John Bradshaw Healing the Shame that Binds You, self-abandonment (carrying on abandonment with self sabotage even when out of toxic environment), a vicious inner critic (typically turned against self and not those who screwed you over) and social anxiety.
A common result of toxic parenting is feeling of abandonment and depression, which turns to fear and shame, this activates an overly defensive toxic inner-critic, which relentlessly moves us into an adrenaline fueled fight/fight response. Over time this can lead to (naming a few) low self-esteem, low self-compassion, little motivation and insidiously repeating the bad relationship dynamics with problems like codependency. Walker expands the fight/flight response into what he calls the 4F's.
The 4F's are as follows: Fight - a narcissistic dominance of others, Flight - anxious productivity, Freeze - disassociation into right brain fantasizing or even left brain intellectualizing , and Fawning trying to be pleasing or helpful to forestall rejection and angry responses. All are often accompanied by social isolation that only reinforces the shame and fear.
It is not real necessary to spend too much time figuring out which one may apply because they are inexact and vary in degrees and can work together. But, the fundamentals of Walker's relationship therapy apply to all of them. In part, turning shame, that is essentially blame turned wrongly against the self, to the real source.
Flashbacks and the inner-critic are the driving forces from trauma rooted in abandonment issues. Childhood abuse both physical, and that resulting from neglect where nobody was ever physically harmed, create an understandable reaction. A child by nature compensates for the weaknesses of parents: like soothing the violent household by being overly agreeable (fawning) and being vigilant for signs of violent behavior, parenting siblings for absent parent, accepting complete lack of attention as the-way-things-are and never forming any interests, and hundreds of other issues big and small.
I wrote in my review of a Waking the Tiger by Peter A. Levine that Levine sees traumatic fight/flight as a natural response to events and that the problems arise only when the higher rational neo-cortex gets stuck in its release of that trauma after the triggering event has passed.
Walker might agree. The toxic inner-critic, through flashbacks and shame, not only keeps the emotions from the triggering events fresh, but through random happenstance adds many others via association. It can really be ANYTHING, the color of a car, mustaches, broken objects, dirt, a reoccurring dream. The effect is what matters. The mind recalls unresolved toxic experiences (often just the emotion, may take time to trace the source), ruminates on them, and starts to feel guilt, and many other emotions that ultimately puts the one experiencing into the 4F responses. A sequence of triggered negative thinking often called a 'shame spiral.' Typically self-inflicted, though, toxic relationships may fuel this inner dialogue as a means of control.
The effects of such a flashback can be observed in MRI, it is an over activation of the right brain where emotion and childhood memory reside and greatly deactivated left brain activity in the areas of reason. There is a saying, 'to be in your right mind,' which is used to suggest mental stability. But in this case, being too much in the right mind creates emotional struggles deprived of reason.
The basis of healing is often to restore a healthy level of anger for self-defense. Anger is also a right brain emotion, that properly directed, can aggressively short-circuit the inner-critic not by attacking the self but outward to irrational fears, and toxic relationships. A luxury a small dependent child can't use to protect against a toxic environment, but an adult can.
A left-brained, objective approach of embracing critic is rarely helpful unless it is balanced with subjective, right-brained capacity for assertive self-protection. Perhaps this is because the inner critic appears to operate simultaneously with right-brain flashback dynamics. Perhaps toxic inner critic processes are so emotionally overwhelming that efforts to resist them rationally and dispassionately are too weak to be effective. p. 183
The therapy would then extend to grieving for the pain and loss, and then using techniques of mindfulness and self-compassion to restore order in the mind. The last step actually leads to increasing the connective network between left and right brain so that the two can resolve issues in conjunction.
At the heart of an effective treatment is a trusted relationship. This relationship should provide a safe and empathetic connection to help sit with the affects. Attachment disorder often accompanies cPTSD. So the first step in attaching to unsettled mind, is connecting to a trustful and safe model.
Walker writes, 'without the development of a modicum of trust with me, my cPTSD clients are seriously delimited in their receptivity to my guidance, as well as the ameliorative effects of my empathy.'
Four keys to development of trust for a therapist (also acts as modeling): Empathy - through listening, mirroring, paraphrasing, validation of emotions. Authentic Vulnerability - I am a vulnerable person like you but can model that it is safe to feel and express all emotions, balanced emotional self-disclosure, Dialogicality - a balanced conversation between speaking and listening, not just therapist lecturing or client rambling but a conversation that works toward feelings and then feeling the affects, and Collaborative Relationship Repair Walker states, '... probably the most transformative, intimacy building process that a therapist can model.' Misattunements and disaffection are common to every relationship of substance. Working through the disaffection, while immediately affecting safety of relationship, can be a deeper relationship (through the fair-weather-friend-stage).
Walker is a practitioner with decades of experience, much of that comes through, he can repeat same ideas in different ways so may need to read then skip about. This is not a be all, end all, just one practitioner's framing of his counseling experience. There is not a particular method (no copyrighted and protected system like Levine) as much as it provides a basis around which the problems of trauma treatment might be discussed. This is a long book but he is careful to identify how many of our toxic thoughts manifest themselves. ...more
I love the hero's tale. A quick glance of my other reviews will confirm as much. But I also believe those wonderful tales perform a valuable purpose.I love the hero's tale. A quick glance of my other reviews will confirm as much. But I also believe those wonderful tales perform a valuable purpose. They can provide guidance for difficult transitions through the use of symbols and metaphor. Levine's book was a useful discussion on healing trauma. Don't expect a lot of "inspiring" stories or case examples like psychology books often contain.
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Peter Levine made an explicit connection between trauma, and in this case, the tale of the hero Perseus and the Gorgon Medusa. When Levine spoke of trauma, it was a buffet of any trauma the world can devise: cPTSD, war veterans, car crashes, death in family, abuse, toxic parenting, surgery, etc... For instance, in Section IV, Levine offered advise on immediate 'emotional first aid' to be used to address trauma involving a car crash (think EMTs) and for children (He suspects, often the ones most impacted but last to get help.)
Levine wrote,
"In the myth of Medusa, anyone who looked directly into her eyes would quickly turn to stone. Such is the case with trauma. If we attempt to confront trauma head on, it will continue to do what it it has already done - immobilize us in fear. Before Perseus set out to conquer Medusa, he was warned by Athena not to look directly at the Gorgon. Heeding the goddess's wisdom, he used his shield the reflect Medusa's image: by doing so, he was able to cut off her head. Likewise, the solution to vanquishing trauma comes not confronting it directly, but by working with its reflection, mirrored in our instinctual responses."(p. 65)
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Levine felt trauma is not an unnatural experience that needs to be medicated, etc... but a natural and necessary biological reaction to real and/or perceived dangerous experiences, a bodies reaction since the dawn of the evolution of organisms. Levine felt, it was just our evolved higher stage neo-cortex human brain which had mucked up the experience and over-ridden our instinctual mind and our ability to shake-off a bad event.
In a simplistic sense, I suppose the more instinctual mind would flee like a rat from a sinking ship the moment a relationship became abusive, or a soldier in his instinctual mind would go no where near a raging battlefield. But we humans can remain fixed in a situation, both physically and mentally, and in many cases suffer, locked in a vigilant and hyper-sensitive stance that will become our new emotional mind.
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Continuing, Levine described the human brain's three levels and the experience of the hunted gazelle. The layers are: base reptilian brain (conscious choice is not an option, instinctual response is the entire game); the limbic brain (mammalian mind, source of social and herd instinct, Levine's gazelle is here, a positive example of how animals properly shake off trauma); and the higher rational neo-cortex. (An aside, I seem to recall other mammals can show signs of stress as well, harder to measure an elephant's trauma, I suppose. Levine may be oversimplified in his view of animals.)
Levine's premise is that while the neo-cortex is not strong enough to override the primitive instincts to flee, fight or freeze in the face of danger, it is strong enough to lock those reactions into a frozen state (that may last days, weeks, years,) that we know most familiarly as a veteran's PTSD but it can be any trauma. And like many veterans groups recently, Levine would probably like to drop the 'D' of Disorder from PTSD.
In Section II, Levine went directly into the symptoms of trauma. These are the fundamentals of the traumatic reaction including: Hyperarousal, Constriction, Dissociation, Helplessness. Valuable information present in an accessible way for neo-cortex bound humans to help recognize that our Medusa may be near. He acknowledged this may be a just quick rehash for professionals and learned laymen.
What Levine had to offer to the subject, besides an appealing hero's tale framing of the subject area, is the idea of beginning the healing process with FELT SENSE, or internal body sensations. The term was coined by Eugene Gendlin in his book Focusing. Levine admitted this is a hard term to define. Gendlin wrote, "A felt sense is not a mental experience but a physical one." Levine then suggest some exercises and discussion that would help you access this felt sense. This is part of Levine's program called Somantic Experiencing (a registered trademark) Best if you read the book if this sounds promising. Or just jump to the chase and hit the web page: Somantic Experiencing: Traumatic Institute Reconnecting with body to help heal the mind.
In completing the recovery from a trauma, we go back to the story of Medusa.
"In dreams, mythical stories, and lore, one universal symbol for the human body and its instinctual nature is the horse. ... When Medusa was slain two things emerged from the body: Pegasus, the winged horse, and Chrysaor, a warrior with a golden sword. ... The sword symbolizes absolute truth, the mythic heroes ultimate weapon of defense. It conveys a sense of clarity and triumph, of rising to meet extraordinary challenges, and of ultimate resourcefulness. The horse signifies instinctual grounding, while wings create ... an image for rising above earthbound existence." (p. 66)
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I liked Levine's connecting myth with real human experience. Getting in touch with trauma is not only an exercise in feeling starting with how your butt feels in your chair, somantic experience, though it has a place for the disconnected. Though it probably easily works with mindfulness, exercise and talk therapy that embraces a role for connecting with our physical body. Yoga.
The community aspect reminded of stories of the Bataan Death March and the forced use of prisoners to build roads and facilities in WWII. Trauma in the extreme example, the weak were bayoneted by the road, no health care was provided, and there was very little food. A common trait of the survivors: a caring somebody to watch over them and to whom they cared when time arose. A human connection to life where everything else was inhuman in nature. Taking care of others can help form trust and mutual care. (Unless the other is a narcissist, or is the reason for the trauma, etc...)
The suggestion that community played a role in healing trauma and that trauma is a natural reaction to bad experiences is also a important element. That a physical connection/grounding plays a role in restoring a wandering spirit (a shamanic image) is interesting. Mostly, I tend agree with Levine, looking at the trauma directly and reliving it is at best not helpful (his clinical practice strongly affirmed this view), at worst, only making matters worse.
I'm not a counselor but I've watched them on TV. :-) Personally, I am particularly intrigued by the veteran's experience of PTS, I love to see when these veterans make real progress with PTS, because their efforts may be blazing a path for all of us. A real heroes journey....more