Healing trauma - organismic regulation

Unresolved traumatic experiences, to varying degrees, disconnect people within themselves and from the world around them. The symptoms of trauma are survival strategies and attempts to sooth and regulate states of intense fear and terror arising from a sense of there being no safe place even within their own body which seems to manifest all types of weird and wonderful reactions over which they feel they have no control. 

According to Leslie Korn (1997) ‘trauma alters the eco-system of the body, mind and spirit’. While Sue Gerhardt (2004) highlights the loss of connection with others stating ‘the bonds that tie you to others are broken. Your physical and psychological integrity is breached. The world that you took for granted, the structure that underlies reality; is shattered’. 

Wounding and trauma seems to be an inevitable part of life from which no-one escapes. But some people’s wounds appear to heal and others do not. What is it that distinguishes whether a person will continue to feel these wounds to the extent that it limits their experience of life? That it prevents them from experiencing satisfaction in their relationships and work?

There may be wounds so injurious that it may be almost impossible for them to be soothed and healed. But on the whole it is not so much the injury that wounds but the lack of sufficient soothing and the ability to be soothed. In childhood soothing comes from our adult caregivers. From them we also learn how to self-sooth. Without adequate soothing wounds do not heal. Without the ability to self-sooth, we do not learn how to heal ourselves. 

According to the Oxford Dictionary, sooth is to ‘gently calm and relieve pain and discomfort’. This is a core part of affective self-regulation, a process whereby caregivers attune to and modulate a child’s physiological and emotional arousal enabling him or her to come back into balance (Schore, 1994). Limitations in this capacity are likely to play a major role in long-term vulnerability to psychopathological problems after exposure to potentially traumatic experiences (Schore, 1994). 

Organismic Regulation 

In body psychotherapy self-regulation means bringing the (human) organism back to a state of equilibrium, homeostasis or balance on a vegetative, muscular and psychological level after a startle, shock or a period of stress. We think about self-regulation as a downswing on the vasomotoric cycle. 

The vasomotoric cycle is a way of conceptualising our movement from rest through to expression and back to rest. It also represents the two sides of the autonomic nervous system with the sympathetic nervous system representing the upswing and the parasympathetic nervous system representing the downswing. After a period of stress, startle or shock we need to return to a state of equilibrium which includes finding ways to discharge residual emotional or energetic charge the failure to do so can break up the co-operation and integration of the three layers of embryonic tissue (Boadella, 1987) i.e., endoderm (vegetative/autonomic nervous system), mesoderm (muscle) and ectoderm (psychological/nervous tissue and sense organs including skin). 

These three layers can also be understood as representing feeling (vegetative/endoderm), acting (muscle/mesoderm) and thinking (psychological/ectoderm). We can see the split in these three layers particularly in those people who have been scared out of their bodies – scared out of their lives - fleeing to their heads and intellectualising (ectoderm). When people integrate the fragments of their traumatic experience they also bring together the disconnected parts of the self. 

Vertical and Horizontal Regulation 

Another way we think about self-regulation is as vertical and horizontal process. Vertical self-regulation refers to the regulation of internal processes particularly the rise and fall of emotional energy (Southwell, 1982).  The ability to regulate vertically is what enables us to be rooted in self. Horizontal regulation relates to the external interpersonal world where we relate to others.  The ability to regulate horizontally brings the possibility of real relationships with others. 

These regulatory processes are similar to what Beebe and Lachmann have labelled interactive regulation and self-regulation (Wallin, 2007). Interactive regulation is where someone helps us to manage our emotional states and the intensity of our arousal. Self-regulation is when we perform this function for ourselves. According to Wallin (2007) a balance between the two predicts a secure attachment style, which in itself is a predictor of a person’s capacity to manage stress and recover following a traumatic event. 

It is these patterns of self-regulation that develop in early childhood as a result of the quality and security of attachment relationships that are pivotal to our ability to re-establish our equilibrium after a period of stress, startles or shocks. 

Rothschild (2000), Brantjberg et al. (2004) and Levine (1997) write about the importance of resources in working with trauma. Our primary source of resources comes via the experience of secure attachment. It is these resources that give people the ‘capacity to land safely back in the ego after a trauma’ (Brantbjerg et al. 2004). It is these resources that do not develop when we are exposed to ongoing relational trauma in childhood. 

The resources that securely attached infants and adults are able to draw upon means they are more likely to have a more rooted relationship with self and real relationship with other. They are more likely to have more connection between the three layers of self that we spend so much time enabling those people with trauma residue to connect or re-connect with through body awareness and felt sense. They are more likely to have a basic trust and feeling of safety in themselves and in others that those with particularly disorganised attachments do not have. 

The Role Of The Therapeutic Relationship In Healing Trauma 

For some time research has pointed to the relationship between the client and the psychotherapist as being the deciding factor in the satisfactory outcome of psychotherapy (Clarkson, 1995). 

Advances in neuroscience have provided concrete evidence regarding the importance of relationship not only in our early development but also throughout our lives in determining our well-being. What many in the psychotherapeutic world have believed regarding the importance of relationship has been borne out by research. According to Siegal (1999) “human connections create neural connections”. He also states “the brain becomes literally constructed by interactions with others...our neural machinery...is, by evolution, designed to be altered by relationship experiences (Siegal, 2003). It has been shown that nurturing relationships are correlated with better physical health including heart and immune function and resistance to stress (Fishbane, 2007). 

I have already mentioned how trauma disrupts our ability and potentially our desire to connect deeply, intimately, with others. This ability to connect is essential to our health. Our social interactions play an important role in the everyday regulation of our internal biological systems throughout our lives, such an important role that we cannot do without significant ‘others’ and remain in health. 

For psychotherapy to support healing the therapist must be perceived as an ally.  The creation of trust and safety is paramount and needs to be in place before working with traumatic material.  There is less of a focus, if not a clear intention to avoid, inviting transference and counter-transference. For some people trauma work is all about ‘feeling secure in relationship with another’ and traumatic material will arise in the interaction between them. The healing occurs in working through the anxiety that being in relationship can provoke and re-establishing trust and safety in the presence of another. 

References

Boadella, D (1987) Lifestreams: an introduction to Biosynthesis, Routledge & Kegan Paul, London 
Brantbjerg H., M., Marcher, D., Kristiansen, M. (2004) Resources in coping with shock, a pathway to a resource-oriented perspective on shock trauma: Copenhagen, Kreatick Publishing 
Clarkson, P. (1995) The Therapeutic Relationship in Psychoanalysis, Counselling Psychology and Psychotherapy: London, Whurr Publishers Ltd
Gerhardt, S. (2004) Why love matters; how affection shapes a baby’s brain: London & New York, Routledge 
Levine, P.A. (1997) Waking the Tiger; Healing Trauma: California, North Atlantic Books 
Rothschild, B. (2000) The body remembers; the psychotherapy of trauma and trauma treatment: New York & London, Norton 
Schore, A.N. (1994) Affect Regulation and the Origin of Self, Lawrence Erlbaum Associates Inc., New Jersey 
Siegel, D. (1999) The developing mind; how relationships and the brain interact to shape who we are: New York, Guildford Press 
Siegel, D.J. (2003) An interpersonal neurobiology of psychotherapy; the developing mind and the resolution of trauma: New York, Norton 
Wallin D.J. (2007) Attachment in Psychotherapy, Guilford, New York 
Journal Articles & Papers: 
Fishbane, M.D. (2007) Wired to Connect: Neuroscience, Relationships, and Therapy. Family Process, Vol. 46, No.3. 
Southwell, C., Biodynamic massage as a therapeutic tool – with special reference to the biodynamic concept of equilibrium, Journal of Biodynamic Psychology, Journal of Biodynamic Masage, No 3, Winter, 1982 
WWW: 
Korn, L. (1997) Community Trauma and Development; Presented at The World Conference on Violence and Co-existence; Dublin, Ireland. Available at: http://www.centerfortraditionalmedicine.org/research/com_trauma.pdf