As I try to understand the effects of psychological trauma, often it's the body that tells the story. This was certainly the case with Jennifer (as I will call her). During our first meeting, she entered my office with a veneer of aloofness, but her eyes told a different story; they were darting about, quickly scanning me and my office for any signs of threat. She sat lightly and uprightly on her chair, legs ready to spring into action. Her breathing was shallow and quick, and was probably matched by her racing heart. Her eyes hungrily snatched-up any movement inside and outside my office - always on the prowl for signs of danger. Hers was the body of someone who didn't know safety and probably hadn't known safety for a long time.
During our second meeting, Jennifer and I talked about what it was like for her to always feel as though she was on "red-alert". We talked about her constant scanning of the environment and what that felt like in her body. She described a wad of tightness in her belly that was almost always there - a persistent bodily reminder that she must never let her guard down. Her body was constantly ready to attack or to escape.
I asked Jennifer if she could imagine a scenario where her body could experience even a small degree of safety, so that the wad of tightness in her belly could begin to relax. She described a situation where she was alone in her car driving across the desert. In her mind she could see herself driving fast enough that none of the usual threats could catch up to her - she was untouchable and safe. The car's top was down and the warm desert breeze was blowing her sticky worries and fears from her mind.
Next, I invited her to hold that scene of safety in her mind while also noticing the sensations in her body. As her attention shifted slightly inward, she recognized that the wad of tightness in her belly had loosened somewhat and that she was feeling lighter inside, more spacious and free. The corners of her mouth turned upward ever so slightly and little sprigs of wrinkles formed around her now-moist eyes. In that moment, she literally embodied safety and security.
After about ten seconds however, her facial expression lost some of its buoyancy and she opened her eyes abruptly. She explained to me that the feelings of spaciousness and freedom lasted only for a moment and then she felt herself floating away, unable to hold onto the mental image of safety or the pleasant somatic experience. While the sensations of spaciousness and freedom in her body brought temporary relief, they were quickly followed by trepidation and fear. After all, she wasn't used to letting down her guard... it was a very vulnerable feeling for her.
In that moment, Jennifer, like many others I have worked with, felt discouraged and disheartened. She was able to taste freedom, but it quickly slipped away. She wondered if she would ever be able to maintain the feeling of safety within herself and if she could be free from the nagging need to remain on red-alert at all times.
In situations like these, I am quick to point out that, in the beginning stages of trauma recovery, establishing a sense of safety within the body takes a great deal of patience. Initially, there are small islands of safety - little oases of security in an ocean of seemingly treacherous water. However, once an island of safety has been established, even if it is present for only a moment, then the possibility of creating more islands of safety increases greatly.
In fact, from the perspective of brain science, we know that "when neurons fire together, they wire together". So, when someone interrupts their usual pattern of fearful hypervigilance to cultivate an experience of safety in the body - the brain pathways that facilitate those sensations and feelings of safety are activated! Once those brain circuits are activated, they become easier to activate the next time and can be activated more frequently. The brain is literally able to restructure its connections to support these islands of safety.
With ongoing and consistent therapeutic work, more and more islands of safety begin to appear and the islands increase in size. Pretty soon, the distance of treacherous water between islands diminishes, allowing the person in recovery to "island hop", as it were. As recovery progresses further, the ocean waters slowly recede and the once-isolated islands of safety begin to coalesce into chunks of land and eventually into large landmasses.
This was Jennifer's experience at The Meadows. Together, we were able to establish more islands of safety and she discovered many other islands through various therapeutic activities at The Meadows. Like many others I've worked with in the past, she wasn't always aware of the emerging islands or the coalescing landmasses within herself; but her body told that story too. From my perspective, she finished treatment with a brain that had already begun reorganizing itself to have greater capacity for feeling safe and a body that was clearly experiencing more spaciousness and freedom.
Jon G. Caldwell, D.O., is a board certified psychiatrist who specializes in the treatment of adults with relational trauma histories and addictive behaviors. Dr. Caldwell currently works full-time as a psychiatrist at The Meadows treatment center in Wickenburg, Arizona. For many years he has been teaching students, interns, residents, and professionals in medicine and mental health about how childhood adversity influences health and wellbeing. His theoretical perspective is heavily influenced by his PhD graduate work at the University of California at Davis where he has been researching how early childhood maltreatment and insecure attachment relationships affect cognitive, emotional, and social functioning later in life. Dr. Caldwell's clinical approach has become increasingly flavored by the timeless teachings of the contemplative traditions and the practice of mindfulness meditation.