“Sometimes I wake up & have to remind myself: ‘There is nothing wrong with me. I have patterns to unlearn, new behaviors to embody and wounds to heal. But there is nothing wrong with the core of me and who I am. I am unlearning generations of harm and remembering love. It takes time.’” -Yolo Akili
“If you want to go quickly, go alone. If you want to go far, go together.” -African proverb
This month, I did a three day deep dive on Bainbridge Island near Seattle with the founder of The Trauma Foundation Chris Rutgers, trying to solve the problem of democratizing effective trauma healing tools for anyone with physical or mental health-related trauma symptoms who is ready to do the hard, slow inner work.
In order to tackle the task at hand, we started with trying to answer the question “What really safely and effectively heals trauma?” It’s hard to scale trauma healing in an affordable, accessible delivery method beyond the one-on-one format if we can’t find consensus about what works and what doesn’t.
We started by noodling this question ourselves and doing our best to synthesize what both of us have learned from our ten years of study of healing and trauma recovery. Between the two of us, we have studied the work of trauma healing, resilience, and emotional mastery model-builders like Richard Schwartz (Internal Family Systems), Asha Clinton (Advanced Integrative Therapy), Peter Levine (Somatic Experiencing), Kathy Kain and Steven Terrell (Nurturing Resilience), Steve Hoskinson (Organic Intelligence), Deb Dana and Stephen Porges (Applied Polyvagal Theory), Cynthia Price (Mindful Awareness in Body Oriented Therapy), Laurence Heller (NeuroAffective Relational Model), Nkem Ndafo (The Resilience Toolkit), Dawson Church (Emotional Freedom Technique), Sensorimotor Psychotherapy (Pat Ogden), Gabor Mate (Compassionate Inquiry), Karla McLaren (Dynamic Emotional Integration), Somatic Transformation (Sharon Stanley), EMDR (Francine Shapiro), and Thomas Hubl (Collective Trauma Healing), to name a few. Chris read 83 books about trauma. I’ve read about 30. So we’ve learned a few things and have some opinions about what seems consistent between model builders and where various healing methods seem to overlap.
As research for my book Sacred Medicine, I have also spent ten years studying many trauma-supportive healing methods, such a yoga, Tai Chi, Qigong, acupuncture, sound healing, meditation, mind-body medicine practices, embodiment dance practices like Open Floor Dance (Kathy Altman & Lori Saltzman), 5 Rhythms (Gabrielle Roth), and Nia (Debbie Rosas), creative practices like Intentional Creativity (Shiloh Sophia) and energy healing models like those created by Donna Eden (Eden Energy Medicine), William Bengston (Bengston Energy Healing Method), and Eric Pearl (Reconnective Healing).
When it comes to trauma healing, Chris and I each have our biases and areas of greater education and training. He’s more focused on somatic and touch-based therapies, while I have more expertise and experience in Internal Family Systems (IFS) and the energy psychology method Advanced Integrative Therapy (AIT.) We both believe that many trauma healing modalities have great benefits, and all of them also have limitations and potential side effects and contraindications, just as a pharmacopoeia of medicines all have different indications and different side effect profiles. One size never fits all, and no medicine- pharmaceutical or trauma healing or energy healing or nutritional healing- ever fits all. Our goal was to try to figure out which methods work best for which trauma survivors, in which order, and at what pace.
Developmental trauma expert and co-author with Oprah Winfrey of What Happened To You? Bruce Perry, MD created the Neuro-Sequential Model Of Therapeutics to apply to children and help triage which modalities might be best used when. But given that most therapists are not cross-trained like our “unicorns,” therapists tend to see all trauma as one kind of nail and they hammer it with whatever they might have chosen to get trained in outside of grad school, since most of the effective, cutting edge trauma healing methods aren’t even taught in grad school, which primarily teaches therapists to use Cognitive Behavioral Therapy (CBT).
Of course, in a one-on-one practice, healing methods would be individualized, like you’re concocting a unique recipe every time that might mix and match various elements of different healing methods- 2 parts IFS, 1 part psycho-education about polyvagal theory, 1 part energy psychology, 1 part EMDR, and 2 parts Somatic Experiencing. But very few therapists get even one certification in a cutting-edge trauma healing method outside graduate school. Even fewer are cross-trained in multiple modalities, which is why we’re calling them the “unicorns.” Short of expecting therapists to seek out many additional certifications, could we get therapists to agree upon some consensus of what is needed to heal trauma?
To attempt to answer that question, we sought out “unicorn” therapists, those who are cross-trained in many trauma healing methods and are not die-hard evangelists of only one method. I also crowdsourced this question on social media, since there is great wisdom in the room in our online spaces, which are populated by many experts in trauma healing. Before I arrived for our mastermind session, Chris and some unicorns had already broken down their understanding of what heals trauma into five categories. We played with listing various trauma healing methods under each category. None of the existing trauma healing methods, in our assessment, hit each bucket, but many hit a few.
1) PSYCHOEDUCATION: We found that, especially for more cognitively-minded trauma survivors, understanding why we are the way we are and why we do the things we do is helpful in developing not only insight but also self-compassion. This includes understanding the difference between shock trauma and developmental trauma, beefing up on polyvagal theory so we can grok what happens in the traumatized autonomic nervous system, learning psychoneuroimmunology, and raising awareness about how to recognize common trauma symptoms, such as dissociation, disembodiment, addiction, chronic pain, and pretty much all mental health disorders. It can be helpful for trauma survivors to understand how they may be vulnerable to using spirituality to prevent them from feeling the uncomfortable feelings trauma elicits via “spiritual bypassing.” Learning the depathologizing lens of Internal Family Systems (IFS) on “parts” of ourselves that might be hard to love helps some people develop a compassionate, humanizing lens that builds shame resilience and promotes authentic self-love. Psycho-education also helps us understand why other people behave the way they do and helps us have a more compassionate lens on those who traumatized us, allowing us to strengthen our sense of self-worth, see the big picture from a less self-absorbed lens, and transform our narratives about who we are, how the world is, and how we belong in it. Especially for those of us who intellectualize as a defense strategy against uncertainty and feeling emotions, learning what’s happening inside can be empowering and comforting. Understanding Autonomic Nervous System Dysregulation, IFS, NeuroAffective Relational Model (NARM), and Deb Dana’s Polyvagal Theory in Therapy work are all really good at hitting this bucket.
2) UNDERSTANDING ADAPTIVE SURVIVAL STRATEGIES: As a subset of psychoeducation, this bucket refers to the cognitive awareness of why we develop the intelligent defense strategies, coping skills, and “protector parts” we learn as a way to survive trauma. Although these once adaptive strategies can become maladaptive after the acute phase of the trauma has passed, we often get stuck in old ways of being and need to learn new, healthier ways of being and behaving. Healing tools such as Internal Family Systems (IFS) and NeuroAffective Relational Model (NARM) work well for this aspect of healing trauma. They help us have compassion for ourselves and facilitate shame resilience so we can tolerate doing our shadow work without getting flooded or turning away from the darkness trauma injects into us all. IFS is particularly helpful in this case because it introduces the idea that we’re likely to double down on our survival strategies until we understand them, work with them, and heal what they think they’re protecting us from.
3) EMBODIMENT/SOMATIC MINDFULNESS: This category covers tools meant to help trauma survivors get back in their bodies, become more sensitive to internal bodily sensations, and develop “interoception,” the ability to feel your body and feel your emotions in your body so you can perceive the state of your nervous system (ventral vagal, sympathetic, dorsal vagal). Developing accurate interoception helps you track how your autonomic nervous system state can create your story. For example, if your nervous system is threatened when it’s actually safe out there, your mind might make up a paranoid delusion to try to make sense of your faulty “neuroception” (when your nervous system inaccurately perceives safety as unsafe and danger as falsely safe.) Healing tools such as Somatic Experiencing (Peter Levine), Kathy Kain and Stephen Terrell’s Nurturing Resilience work, Somatic Transformation (Sharon Stanley), Neuro Affective Relational Model (Larry Heller), Mindful Awareness in Body Oriented Therapy (Cynthia Price), Organic Intelligence (Steve Hoskinson), Sensorimotor Psychotherapy (Pat Ogden), dance, yoga, martial arts, qigong and Tai Chi, expressive arts therapy, certain kinds of...