Treating Trauma Holistically


Trauma occurs when our threat-response capacity is overwhelmed and becomes harmfully altered. Trauma may come from life-threatening shocks, heart-breaking betrayals, assaults against our physical and psychological wellbeing, catastrophic illness, loss of loved ones, and abuse. It may be unconsciously transmitted from one generation to the next, even in the absence of maltreatment, if one is raised by someone with unresolved trauma. The earlier in life we are traumatized, the more pervasive and devastating are the effects and the less able we are to cope with future stressors.

Extreme neglect of the dependent child’s physical, emotional, and attachment needs is experienced as life-threatening and can be considered traumatic. Neglect may have even more pernicious effects than overt abuse. Its symptomatology has been barely studied or understood.

Unresolved traumatic stress underlies many, diversely diagnosed disorders of body and mind. In fact, the conceptual split between body and mind is fallacious. Traumatic stress is in the entire body, not just “in the head.” Leading-edge treatments resolve traumatic stress in the whole body.

Talking about traumatizing events often re-traumatizes. Just telling the story of such events does not heal altered threat-response systems. Trauma affects the nervous, immune, endocrine, cardiovascular, respiratory, urogenital, digestive, and muscular systems. Insight-oriented talk therapies, such as CBT and psychodynamic therapy, are “top-down.” They work at the level of the cerebral cortex. However, verbal thinking alone barely scratches the surface of traumatic injury and has little-to-no effect on the deeper lying areas of the brain and autonomic nervous system that are disrupted by traumatic stress.

Body-inclusive therapies for trauma are “bottom-up.” Through mindful, rhythmical breathing, movement, meditation, and possibly touch, they work on restoring balance to the autonomic nervous system throughout the body. They directly affect the stress-mediating pathways of the monoamine neurotransmitters--epinephrine (adrenaline), norepinephrine (noradrenalin), dopamine, and serotonin--that permeate all brain areas from the brainstem up. To exemplify how the entire body is involved in our stress response, remember that epinephrine and norepinephrine are produced in the adrenal medulla; dopamine is produced in brain regions, including the substantia nigra and ventral tegmental area, and released by the hypothalamus; and serotonic is synthesized by specialized cells in the gut and specialized neurons in the central nervous system. Similarly, the stress hormone cortisol comes from the adrenal cortex.

Examples of researched body-inclusive therapies are, to name a few, Bruce D. Perry’s neurosequential model of therapeutics, Bessel van der Kolk’s uses of yoga therapy, Peter Levine’s somatic experiencing, Stephen Porges’s therapeutic applications of polyvagal theory and research, David Berceli’s trauma-releasing exercises, Pat Ogden’s sensorimotor psychotherapy, Francine Shapiro’s EMDR, and Bidyut K. Bose’s yoga-based transformative life skills taught through the Niroga Institute.

Regardless of the modalities of treatment, traumatized patients need to experience the practitioner as physically and emotionally safe. We convey safety when we are centered, mindful, self-regulating, attentive, and responsive. Our clients pick up cues about how safe we are from the prosodic qualities of our voice, our muscular tone and relaxation, our facial expressivity, our rhythms, and the congruence of our nonverbal and verbal behaviors. In other words, we need to embody safety. In order to do so, and for our own resilience, self-care, and healing from vicarious trauma, we professionals need our own holistic practice. In this regard, my daily practice of raja yoga, qigong, and meditation is essential for regaining my balance following exposure to the intense traumatic stories and trauma-related disorders of my counseling clients.

Unresolved traumatic stress disrupts the ability to focus attention, regulate emotions, engage in emotionally healthy relationships, and be present here and now. Traumatized individuals often dissociate. A primary physiological measure of traumatic stress is a lack of heart rate variability (HRV). Good HRV implies excellent coordination of heart and lung functions. HRV involves a coherent increase in heart rate with each inhalation and a decrease with each exhalation. HRV is mediated by the frontal branch of the parasympathetic vagus nerve. Body-inclusive treatments for trauma become effective when they enhance vagal tone and thereby improve HRV.

While mindfulness is necessary for effective therapy, it is risky for traumatized patients to practice mindfulness meditation without including breathing practice and body movement, such as through yoga, qigong, or tai chi. Stationary meditation alone can give rise to the patient’s becoming overwhelmed with trauma-associated intrusive thoughts, images, memories, and sensations. By breathing and moving mindfully, the patients can become more present and can experience their bodies as safe containers for their inner experiences. In view of the foregoing considerations, it is hoped that behavioral health practitioners will recognize the value of gaining skills in an evidence-based, body-inclusive therapy for treating trauma holistically.

-Dr. Mitch Hall is a Holistic Wellness Advisor with years of service dedicated to holistic healing. With warmth, empathy, creativity, and respect, he helps clients explore their wellness goals, lifestyles, relationships, values, needs, options, obstacles, and pathways to thriving. As appropriate, he integrates mindful breathing and movement practices, visualization, sound healing, and meditation into the counseling sessions.

Dr. Hall has a B.A. in Religion from Columbia University and an M.A. in Sociology from the University of Chicago.

In 2013, he was awarded a Ph.D. (h.c.) in Alternative Medicines for his work in Holistic Psychological Healing by the Indian Board of Alternative Medicines in Kolkata.

He sits on the Board of Directors of Parents and Teachers Against Violence in Education. In recent years, he has spoken at annual meetings of the American Psychological Association, at professional summit conferences on "National Leaders in Nonviolence and the Child," at the 12th International Conference on Violence, Abuse, and Trauma, and in the annual Season of Nonviolence series at San Francisco State University.

During his career, he has gained rich life experience as a wellness counselor for disadvantaged, traumatized, inner-city youth; a holistic wellness counselor for complex-care patients on public assistance; a Peace Corps volunteer teacher in Togo, west Africa; a peace and environmental movement organizer in Europe with the Fellowship of Reconciliation; a professor, adviser to international students, academic program director, and academic dean in higher education; a French-English interpreter for African refugees; a writer, translator, and storyteller; and more.

You may find more information about him and his services through his website:

www.breathepeacefully.com

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