Monday, July 30, 2012

Finding F.L.O.W.

 It rained yesterday, after months of parching, dusty dry days, the likes of which this river-crossed state has never seen.  Soft gentle rain fell throughout the morning hours, giving the scorched earth a much needed respite.  No doubt, the trees will show a wide dark ring of mean season beneath their bark; a lasting imprint of nature's sometimes cruelty.  Yet the trees have been offered opportunity for recovery, a chance to drink in nourishment enough to sustain them until cooler, wetter days return.

The dark rings of trauma might be seen beneath the skin of many of us.  Once suffered, trauma will never be undone.  It might be tempting to allow those dark scars to define our future, expecting (like the pessimists of the first blog entry) that to hope for better, might borrow trouble.  To give in to this temptation, is to choose a narrow path through life, one that isolates in the name of "safety."  There is another path, that like the healing rainfall, offers recovery in the water's flow.

Dan Siegel, proposes a simple model of health; a river flowing between two banks, with one side being characterized by chaos, and the other by rigidity. The point of this illustration is that ill health (mental, physical and spiritual) is generally made up of symptoms that fall to one "river-bank" or the other.  Think "Anxiety" (chaos) vs. "Depression" (rigidity); or, in the language of post-trauma diagnoses, "Intrusion" (chaotic reminders of  helplessness and overwhelming terror) vs. "Numbing" (rigid blocking of emotional and physical sensations).  So it follows that health is more a keeping to the middle part of the river, staying in the flow, so to speak.  A simple, but effective, conceptual model of recovery.

I love to be near water.  It soothes my spirit to listen to burbling, splashing, even crashing sounds of water in its many forms. The idea of flowing waters accompanied my meditations during preparation for childbirth, and soothed the fatigue and nausea of chemotherapy.  Perhaps it is not coincidental that I was born under a water sign of the zodiac.  Or maybe it is a universal experience to find healing in water; as human beings, water makes up over 97% of our bodies; we can survive for days without food, but not without water.  Whatever the reason, I became curious about the effects of the experience of, even the sound of the word, FLOW.  Contemplation of the word led me to an appreciation of its use as an acronym for recovery practices.  The particulars are common ideas, but the acronym is of my own making, so I will claim authorship, with credit due to my training in Internal Family Systems Therapy (IFS),, and its developer, Dick Schwartz.

F.L.O.W. refers to mindful attention to unconscious processes via physical and emotional signals.  Instead of pushing past a stiff neck or headache, or the tightness in your gut, take a few moments to sit with that signal from your body.  In other words find and feel its presence. Consider that it holds a message about something you may benefit from attending to, and take the time to listen and learn from it.  In the spirit of all meditative practices, it is essential to avoid making judgments about the body parts or the ideas that may be present in that moment of awareness, so be open to whatever thoughts, images or feelings arise.  It is only by such non-judgmental attention that you can act as a witness to your own story of loss or of hope, and thereby understand the meanings, and inform the intentions, that will carry you forward into recovery and personal development.

Find, Listen, and Openly Witness: FLOW.

Taking the concept of FLOW further, it becomes a powerful tool to support healthy functioning in many realms.  If we are blocked in mind or body - for example plaque in the coronary arteries, or floundering in a state of grief - there are consequences to those blockages (e.g., heart attack, depression, relationship disruptions...).  If instead we actively attend to signals of blockage, we can support movement of whatever the source may be, and get things flowing again.  This doesn't imply that we have control over what happens to us in life, only that we have opportunities in our approach to how we manage those challenges.

Flow can be seen throughout bodily systems: circulatory, respiratory, lymphatic, digestive, hormonal..., and in the range of human emotions available to experience.  Nature is always in a process of flowing; rivers and tides; wind currents; seasons; planetary orbits; and in cycles of life and death.  Seasons change, trees grow, droughts occur, and healing rains arrive, so take a tip from mother nature and go with the flow.

Monday, July 23, 2012

Relationships and Attachment

I was out of town over this past weekend, celebrating a sister's birthday.  While only 4 of 6 sisters were there, it was clear to each of us that the other 2 were present, along with our mother.  In the midst of conversation, it was as if we could hear a comment, sometimes coming out of our own mouths, that was indicative of one of the missing members of our group.  How was it that those who were not physically present could "appear" among us?  This was especially significant since only one of those not present is still living.  The explanation for this phenomenon might be found in the concept of internalization.  This refers to our tendency to create images and "sound bites" of influential others in life, such that we can (sometimes unconsciously) predict and experience their presence or perspective in our daily activities, even though they are not physically there.

We are social animals, and our experience of our social and familial systems shapes who we are.  It is in relationship that we learn our worth; our competence; the trustworthiness of the world, and the people in it.  Attachment is a social science term for the process that takes place in close relationships, especially the initial caregiving relationship(s).  Before a baby is even born, she takes in meanings and messages from the environment in the form of sound, light, and the physiology of her mother's response to her environment.  After birth, more signals are received in rapid succession, from voice, eye contact, physical touch; at all sensory levels.  These signal might be compared to a computer program which establishes codes and translates data, within the parameters of that program.  Thus, attachment is the process by which the infant learns to function in the world, in preparation for eventual movement away from the caregiver, and into peer relationships.  It is an efficient model of learning from receptors that are wide open at the start, but eventually settle into patterns that define our expectations of ourselves in relationship to others.

The result of this process is that we enter later relationships with sets of expectations that may reflect upon each interaction, sometimes enhancing, at other times disrupting the flow of those experiences.  If a person or situation matches the early "program" for safety, we can participate effectively in that relationship.  If, however, the existing model included frequent failures in support, or examples of danger in relationships, it is likely that one's expectations will distort or block reception of signals about the other's intentions.  It can be confusing for all involved when an effort to connect is responded to with anger or anxiety.  Those are examples of times that the internalization of traumatic relationship elements influence one's ability to participate effectively in forming new, safer relationships.  These efforts become even more complex when both members of the newly formed dyad bring their own attachment "baggage" into the conversation.

Even less traumatic interactions, or those that take place in later relationships, despite effective early attachment models, have influence in later interpersonal interactions.  We carry a blueprint from early programs that filters what we see and how we experience others.  Sometimes being aware of the likelihood of those influences allows us to step back from our initial response to see more clearly the possibilities of new, perhaps healing, opportunities to connect.  At other times, the internalized models from significant attachments can be a comfort after that loved one is no longer available for direct contact.  

It makes sense that a gathering of those who share similar attachments to the same people would generate even more of the internal energies from those who loved, and were loved by the different members of the group.  (Or, depending upon the attachment model, negative energy might also be compounded by association.)

The birthday gathering I participated in over the past weekend is a great example of the whole of our sisterhood being greater than the sum a collection of individual family members.  There is great meaning in the joint energy of connectedness, and, for those of us fortunate in the safety of our relationships, comfort in the shared significance of family attachment.

Sunday, July 15, 2012


What do I mean by "Inside-Out"? It is a multi-leveled concept for me, including; the internal and external experience of trauma response, the mind/body connections in recovery; how the trauma survivor is viewed by the self vs. how they are seen by others; the influence of my own trauma history to the work I do; and probably a lot of other things that will show up along the way.  

I am a survivor of trauma, having had breast cancer fourteen years ago.  It was a full year of fear, loss and pain which changed me forever.  While it might sound trite, in retrospect it was the most extended, meaning-filled time I have ever experienced.  That was an inside-out time where the betrayal of my body (tho' I have to ask, "who betrayed who in the first place"?), turned into the unkind gifts of discovery and re-prioritizing that now allows me to speak with authenticity to those in need of my perspective.  

The shock of the diagnosis at 38 years old, with a young family depending on me, a brand new doctoral degree and an active psychotherapy practice, was profound.  It was another inside-out event for my aging parents and my sisters and brothers to have to come to this new possibility of loss, and restructuring of roles, from having their busy, organized and healthy daughter/sister suddenly in mortal danger.  

Other inside-out effects emerged around the people I thought would be there for me, who faded away, and those I barely knew who rose to the occasion to support and encourage me.  In my practice, clients surprised me by demonstrating strengths and reflecting growth in ways I'd never have know possible before that time.  It was then that I realized that I was one of them, a trauma victim, on her way out of a profoundly inside-out experience, and on a journey of uncertain recovery, and it was time to go find a way out.

Monday, July 9, 2012

Perspectives & Meanings in Trauma

What does it mean to be a survivor of trauma?  It is likely that most of us have experienced losses that shake our world, but only some (roughly 25%) end up with a trauma response strong enough to qualify for a diagnosis of Post-traumatic Stress Disorder (PTSD).  There are many contributing factors to this situation; environment, personality, resources and physiology; to name a few of the elements that establish our point of view. In other words, who and where we are in our lives may make us more or less resilient when life throws harsh challenges our way.  Trauma is not a particular event, but a circumstance; a perception of extreme loss of control and impending doom.

Looking at PTSD in this way may help us to understand the mechanisms that block forward movement from such circumstances.  If I feel unprepared and unsupported in a situation that threatens me, I am more likely to freeze up or shut down.  The perspective that I have is one of being trapped in a place of terror.  Since our brains are made to categorize information and problem-solve solutions, this creates a glitch around unprocessed emotions.  If we compare brain functioning to a computer model, this circumstance might be viewed as a virus that causes the hardrive to keep retracing the same data in an effort to reach a solution.  Since there is none available, there is a great deal of energy put into reviewing the data, instead of attending to the next important project.  It is likely that the unprocessed data will further be introduced into current problem solving in disruptive and distorting ways.

If it were possible to change something about the trauma perspective, we might be in a position to move out of the stuck place.  Mindfulness based practices have been found to offer such options, changing perspectives through understanding their meaning differently.  We might be able to look back to those times when our resources were lacking, or information was distorted by a depressed parent or a frustrated teacher, for example.  From there we have an opportunity to direct compassion to our own childhood state, (and maybe to the impaired parent or teacher), and to offer a different perspective.  This new perspective takes place, not only within our emotional perspective, but also within the wiring of our brain.  These changes  can then be applied to create new meanings within the stuck place of trauma, and offer new meaning which allow the survivor to move into healing.

Friday, July 6, 2012

Unkind Gifts: Trauma from the Inside Out

This morning I saw an article about Optimism vs. Pessimism.  There was apparently an outcry from people who object to the idea of holding a positive outlook, and the author questioned their desire to choose pessimism.  It caught my attention because I run into this phenomenon so often with my clients who are survivors of trauma.  The explanation I have heard more times than I can count, is that to expect things to go well is to borrow trouble.  Among this population, often survivors of childhood abuse, they learned to maintain a position of negative expectations, so that when something bad happened they were "ready" for it.  In my field there is another name for this attitude; "External Locus of Control."  Imagine a situation where those who were entrusted with your health and safety turn out to be, intentionally or unintentionally, the source of pain and loss.  Of course your conclusion would be that there is no gain in expecting good things, only the likelihood of greater disappointment.

There is a larger issue at stake, however, since to be in a position of such pessimism invariably means being stressed, and stress is a major player in lowered immune system functioning.  This is clearly a problem throughout our social and medical systems, as was made clear in a study by Kaiser Permanente on the impact of Adverse Childhood Experiences (the ACE Study) on physical health.  The connection between childhood trauma and adult illnesses of major import is clear, and it creates an ongoing cycle of "External Locus of Control", eg., trips to the doctor, the ER; in other words, depending on medical interventions to address social and relationship problems.  Just the tip of the iceberg of the damaging effects of child abuse in our society.  And it isn't just a matter of "getting over it," because the implications are coded in the brain and passed on for later generations in genetic and behavioral ways.  Until these long term issues are addressed, we may have trouble finding something to be optimistic about.