the treatment of trauma. It is based on the premise that in order to overcome the sense of being trapped in and by the past, traumatized persons must be able to (Ogden & Fisher, 2015): 1. Recognize old physical patterns and what sensory motor schools call “action tendencies,” 2. Learn to inhibit initial trauma reactive impulses, 3. Bring to completion the incomplete or frozen responses to the trauma that the body has become stuck in, and then 4. Learn and execute more effective and adaptive responses. Skills of tracking psychoemotional responses in the body (a process also known as interoception ) and calming, soothing, and grounding the body are taught with attention to a phase-oriented trauma treatment protocol that focuses first on safety and stabilization and later on processing traumatic memory and integration. One example of the use of this protocol could be recognition of a recoil response in the face of danger. Although the recoil response may have been adaptive at the time of initial threat, it no longer serves a useful purpose in current daily life. Now a trigger event causes danger to be perceived, even though there is no danger. The first step of a sensorimotor intervention would be recognizing the instinctual physical response of recoiling, or backing up, as a current response to an old problem, and then inhibiting that response. (This process is somewhat reminiscent of certain CBT skills.) Next, while attending to the original fear, a new, more empowering physical response in the present can be tried, such as saying no, pushing back, calling for help, or running. When the clinician has learned about and is comfortable with these types of interventions, these options can be role-played during a session so that the client is able to get a physical sense in their body of the differentiated response. Any sort of physical movement can help the body to complete and work through old, unfinished responses. Simply getting up and changing position can help clients to get out of the trauma trance they can fall into when traumatic sensations or memories surface. For clinicians or clients solely interested in practicing and promoting client interoception, rather than also addressing trauma processing and integration, Peter A. Levine’s (2015) “somatic experiencing” is a logical fit. In a way similar to sensorimotor therapy, somatic experiencing cues clients to track their physical sensations and ultimately regulate their physiological reactions to future trauma reminders. In this A useful tool for the assessment of a session or of an intervention that utilizes body-oriented techniques is the Subjective Units of Distress, or SUD, scale (Wolpe, 1969), previously mentioned in Chapter 5. This self-scaling method is based on cognitive-behavioral protocols and is also used as a pre- and posttest in EMDR and most energy medicine techniques. The client identifies the emotions connected with the distress and then rates them on a scale of 0 to 10, from “I am calm and relaxed when I think about this issue” to “This is the worst distress (fear, anger, anxiety, sadness, etc.) I can imagine.” Body-oriented and energy work takes this rating system one step further by asking, “Where do you feel this emotion in your body?” and “What are the sensations that you experience there?” For example, a client may name anxiety as the emotion and feel it in their belly as a churning sensation and in the hands as sweaty palms. Someone else may experience the same emotion of anxiety as a racing heart and shortness of breath. After the emotion has been named, rated, and located, the interventions are case, the interoception is the primary goal. The Subjective Units of Distress Scale
carried out. The SUD scale rating is then taken again, in the hope of providing a concrete subjective indicator for the effectiveness of the actions in reducing the initial distress. If the SUD scale rating has remained the same, or gone up, then a different approach is clearly indicated. Attention to Spirit Trauma is sometimes referred to as “soul shattering”; a spiritual crisis; and a reason for loss of faith in a higher power, in fellow humans, or in the self. One client stated that she felt that “my soul left my body then and just left me this shell to get around in.” In fact, shamanism teaches that during a crisis, the soul strays from the body and a healing ritual, called soul retrieval, is needed to reunite the wandering soul with its home body (Shaman Links, n.d.). One key to transformation of the trauma is to find meaning in life and to be able to identify a purpose for being in the world that in some way encompasses the experience of the trauma that has been survived. According to Peter Levine and Ann Frederick: Trauma amplifies and evokes the expansion and contraction of psyche, body and soul. It is how we respond to the traumatic event that determines whether trauma will be a cruel and punishing Medusa, turning us into stone, or whether it will be a spiritual teacher taking us along vast and uncharted pathways. In the Greek myth, blood from Medusa’s slain body was taken in two vials; one vial had the power to kill, while the other had the power to resurrect. If we let it, trauma has the power to rob our lives of vitality and destroy it. However, we can also use it for powerful self-renewal and transformation. Trauma, resolved, is a blessing of great power. (Levine & Frederick, 1997, pp. 195–196) In order to get to this place of transformation, clinicians must be willing to engage with clients in a dialogue about such issues as faith, beliefs, meaning-making, and spiritual resources. The conversation is not necessarily about traditional religious practice or beliefs, although it may be. The key is ascertaining what, if any, spiritual beliefs or practices the client held before the traumatic events and how the experience of the trauma affected or shaped them. The journey to fullness of self involves a return to prior practices, if they are still useful and meaningful, or the development of an alternate set of beliefs that allows the client to make meaning in their present life, while incorporating the reality of the trauma. Two arenas for spiritual healing following trauma are: ● Finding meaning and purpose in life and establishing an identity other than that of simply a trauma survivor; this can also be seen as being able to be in the center of one’s own personal narrative rather than a character in a story about the past ● Establishing or re-establishing faith, trust, and belief systems that are a positive resource for healing and guidance The clinician can aid in this process by asking carefully timed and paced questions such as “Where do you find your strength? What centers you? What allows you to keep going? How do you understand the nature of good and evil in the world? What do you see as your task or mission when you are ready to give back from what you have learned from this journey? What is your understanding of God or a higher power in your life?” It is important for clinicians to remain open and flexible to a variety of spiritual orientations, regardless of whether they are personally espoused. As long as the spiritual practices and beliefs are a source of comfort, not a cause of fear or danger, they have the potential to provide clients with
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