Physical Recovery from Emotional Trauma

A review by Dr Kerri O’Donnell.

The importance of movement to discharge of stress is very clear, but I was very interested to read Dr Bessel van der Kolk’s description of its importance as a first step to recovery for people with post traumatic stress disorder (PTSD).  At the beginning of an interview with Krista Tippett (On Being) on How Trauma Lodges in the Body, several mentions of terms as yoga and eye movement therapy had me wondering what on earth was going on: Weren’t those treatments extremely light-on for such a serious matter?  Was this story about a yoga fanatic who’d got a little (lot) over-enthusiastic?

As it turned out, those initial thoughts were biased by my ignorance.  PTSD was found to correlate with abnormal heart rate variability, and so Dr van der Kolk’s research has explored means to address the stress at this biological level, rather than pushing sufferers through cognitive therapies that may be of little or no use to them until the heart rate variability is stabilised.

The transcript of the interview flowed in a way that was not easy for me to read, so I would recommend first listening to the podcast, which is introduced a little differently.  (Linjs are included at the bottom of this page.)  Nonetheless, I found the information contained in the transcript interesting, informative and convincing enough that I was inspired to seek out further information.

But what is the relevance of this research to Resilience 101?

The interview took place on 9th March 2017, and the books I found on the topic were all published within the past few years.  This means that there may be many people who do not know that these therapies exist.  Our mission is to help distribute any information that may be of benefit in response to, and recovery from, adversity.

Wider public awareness of cognitive deficits involved in PTSD may be helpful to those attempting to communicate with sufferers,
and the immediate benefits of interventions such as eye movement desensitization and reprocessing therapy, may be of immense help to sufferers and their loved ones.

Of course I do not assert that Dr van der Kolk’s methods will provide a cure, but information is an essential starting point to everything.  This is such a starting point.

The big issue for traumatized people is that they don’t own themselves anymore. Any loud sound, anybody insulting them, hurting them, saying bad things, can hijack them away from themselves. And so what we have learned is that what makes you resilient to trauma is to own yourself fully. And if somebody says hurtful or insulting things, you can say, “Hmm, interesting. That person is saying hurtful and insulting things.” …

Bessel van der Kolk is a professor of psychiatry at Boston University Medical School, and he helped found a community-based trauma center in Brookline, Massachusetts. As medical director there, he works with people affected by trauma and adversity to re-establish a sense of safety and predictability in the world, and to reclaim their lives.

Professor van der Kolk explained the nature of persistent trauma, and identifies an important point of difference between post-traumatic stress disorder and other circumstances that might be successfully treated by talking problems through with counselors.

Bessel van der Kolk knows how some experiences imprint themselves beyond where language can reach… emotional responses are totally at variance with seemingly rational behaviors. We can talk till we’re blue in the face, but if our primitive part of our brain perceives something in a particular way, it’s almost impossible to talk ourselves out of it, which, of course, makes sort of verbal psychotherapy also extremely difficult because that part of the brain is so very hard to access.

He therefore takes a different approach to treatment, focusing on physical therapy, rather than oral communication.  By treating abnormal heart rate variability, the patient becomes calmer, and more attuned to their physical and emotional states, which is an important first step to recovery.

…Sorely lacking in our diagnostic system is simple things like eating and peeing and pooping because they’re the foundation of everything, and breathing. These are foundational things, all of which go wrong when you get traumatized. The most elementary body functions go awry when you are terrified.

So trauma treatment starts at the foundation of a body that can sleep, a body that can rest, a body that feels safe, a body that can move … he’s not cured, but he’s healed.

A podcast of the interview can be heard, or you can read the full interview transcript,  at the On Being site.

Further information about Dr van der Kolk, along with links to his books, can be viewed at The Trauma Center (Justice Resource Institute).

 

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