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.
You wouldn’t know it by looking at me now, but there was a time when I had luscious locks of hair – truly, it was a thing to behold! I used to spend large chunks of my mornings carefully coaxing my hair into perfect shapes with the help of Aqua Net hairspray… (remember that stuff?) My hair was a vital part of my identity – it was synonymous with what I knew of myself. No doubt, I derived some of my personal worth and esteem from my hair.
Then in medical school, my hair began to “thin” (which is a euphemism for “fall out in droves”). During that time, I would wake up in the morning with a sense of dread as I assessed the damage on my pillow. Some mornings it looked like someone had snuck into my room in the middle of the night and rubbed their shedding cat all over my pillow. Absolutely nightmarish.
As you might imagine, this unexpected change of events was troubling for me. After all, I had great expectations for my hair and me – we were going places – we were going to live out our lives together in follicular bliss. I went through the classic stages of grief: denial (for a long time), anger, bargaining, and depression. The final stage, acceptance, eluded me for some time because it required that I look into the void – the hole in my self-worth (and on the top of my head) that was left by my over-identification with my hair.
While it is true that losing one’s hair can be difficult, many of us have lost much more. The experience of change or of losing something dear to us is all the more difficult when it is connected with a sense of who we are… our very identity! When we lose something that is tied to our inner worth, it can be excruciating – like a part of our very being goes away – leaving a terrible feeling of vacancy and emptiness.
Yet, the very nature of this life, this incarnated existence with our imperfect bodies and minds, is that we will experience change! Really, the only thing we can surely count on is impermanence. All of us have experienced change and loss… and we are bound to experience more of it.
So, this begs the question: In this sea of change – this constantly shifting landscape - how do we come to understand our true nature?
Like the sea, I think we often attach our worth and our identity to surface waves. For example, at one time in my life, I attached my self-worth to my hair and I rode that wave for as long as I possibly could. But like all ocean waves, it eventually died out (or in this case, fell out) and I was left facing the uncomfortable emotions that come with the inevitability of impermanence.
Sometimes we hitch our identity and our worth to a particular wave and when it fizzles we quickly hop onto another wave and ride it as long as we can. After all, we are desperately afraid of sinking – of facing the potential emptiness or pain that is left behind by our loss of self. Sometimes the surface waves that are buoying up our sense of worth languish and we are left with no more waves to catch… we find ourselves sinking, heading straight for rock bottom.
But, what if our true nature is not necessarily the transient waves, but is more like the deep blue ocean below the surface! What if we could allow ourselves to drop below the waves and tap into an ocean of beingness that could make enough space for the constantly shifting tides at the surface? What if our worth and our identity didn’t need to ride each surface wave in a desperate attempt to stay afloat, but instead could find peace and calm in a deep awareness of our true nature?
This may seem a little abstract, so let’s explore some of the typical waves that we seem to ride. Perhaps the clearest example is our tendency to hitch our self-worth and identity to external things, like clothing, cars, homes, neighborhoods, money, family name, heritage, prestige, social status, education, degrees, etc. We can do this in a “one-up” way or a “one-down” way. In other words, we can over-identify with external things in a way that keeps us trapped in a small sense of ourselves (e.g., “If I don’t have a fancy car, I’m not worthwhile”) or in a way that falsely exaggerates our sense of worth (e.g., “Because I live in this neighborhood, I am worthwhile”). Both are false and keep us from experiencing our true nature.
Do these external things bolster our self-worth? Well, at least temporarily they seem to give us a little “esteem hit”, but the effect usually doesn’t last long. If the effect does last, it is often incomplete, like there is a nagging feeling of hollowness or emptiness attached to it. Not only are these waves transient, but when we fearfully cling to them, we miss out on the opportunity to drop below the surface and experience a deeper awareness of ourselves. We miss out on the oceanness of our being and with it we miss out on finding the peace and calm that can accompany this deeper awareness.
Well, if we can’t trust external things to lead us to our true nature, maybe other people can do the job for us? You may be shaking your head “no way” right now… but isn’t it so tempting to ride this surface wave – to tether our worth and our identity to another person? Often, we implicitly ask others to fill in the gaps that we sense within ourselves. We want them to live the unlived parts of our life. At some level, we long for others to fix our own feelings of unworthiness, to make it all better.
Yet, people and relationships are impermanent too. And even if the parent, family member, friend, or romantic partner could fill the void… it would never last – fatigue and resentment would begin to eat at the relationship like a cancer. No one else can do for us what we cannot do for ourselves. If we have tethered our worth and identity to another person, it is very likely that we are going to have an intense growing experience!
Well then, in trying to connect with our worth and identity, perhaps we can rely on the opinions and feedback of other people? After all, maybe other people can see us more clearly than we can see ourselves? This is a wave that we commonly ride in an attempt to satiate the emptiness inside ourselves by feeding on compliments and adoration from others. Yet, without having a sense of our own true nature, feeding on compliments from others is like eating Cheetos: the little air-filled puffs bring a moment of yummy goodness, but the pleasure fades quickly and is followed by intense jonesing for another, and another…
And then there are the times when the compliments and the adoration don’t come or worse yet, somebody offers negative feedback or criticism. Without a connection to our own truth, most of us tend to be Teflon for compliments – they just slip right off… and we tend to be Velcro for criticism – they stick real good!
The fact is that other people don’t always have an objective view of us – often they see us through their own filters, which are tainted with various biases, beliefs and unconscious intentions. This doesn’t mean we should disregard all input from others, but we can benefit a great deal from maintaining a strong “internal boundary” – which means that we allow ourselves to hear what others are saying, recognizing that it comes through that person’s own filter, while simultaneously staying connected to our own truth.
If a richer awareness of our true nature doesn’t come from external things or other people, then maybe we can rely on our own senses and the massive power of our highly evolved brain? After all, shouldn’t we be able to form a rational, logical and objectively accurate view of ourselves and make inferences from that information about our own worth? Well, I’m not so sure.
For example, have you ever had one of those “good hair days”? (I don’t have those days anymore, but you know what I mean.) On a good-hair-day you look in the mirror and think, “I am smokin’ hot!” But have you ever had a good-hair-day and then the next day, or maybe even later that same day, you look in the mirror and you think, “All wrong… completely wrong!” Do you really think your appearance changed that dramatically from one time-point to the next? Maybe. Or, maybe your brain interpreted the same information differently.
Sometimes our brains filter and alter incoming data to protect the integrity of the psyche by putting a positive spin on things. For example, when I was in denial about my hair loss – I wasn’t ready to face the reality of my situation. So, when I looked in the mirror, my brain was constantly tweaking the incoming data and was giving me “mental hair plugs”. I remember watching a home video and thinking to myself, “who is that balding guy with his back turned to the camera…. oh crud… that’s me?!” I almost didn’t recognize myself. I saw what I needed to see because I wasn’t ready to see the truth.
Our brains can distort incoming information in a negative way too, as in the case of eating disorder. Due to a host of very complex psychological and biological factors, individuals with an eating disorder look in the mirror and see something very different from reality. Their brains are distorting the incoming data. While this might be an extreme form of this brain-bending phenomenon, it nevertheless is proof that we may not be able to trust our own perceptions, thoughts and beliefs 100% of the time. In some ways, our own thoughts are merely shifting waves on the surface and can’t be relied on as the definitive source of our true nature.
In fact, when we look in the mirror, I think it might be useful (and at least closer to the truth) to say to ourselves, “Oh, so this is what my brain makes-up about my appearance right now” or “Wow, my brain is generating an interesting representation of reality today.” In this way, we practice awareness of our brain’s biases and we open to the possibility that our true nature may run even deeper than what our brains make-up about us.
So, if we cannot rely on external things, other people or even our own thoughts to ascertain our true nature… what are we to do?
Ironically, I think it has less to do with “doing” and more to do with “being”. In fact, I wonder if it’s the quality of being that matters most – our capacity to bring a wholehearted presence to ourselves, just as we are, right here, right now. As illustrated in the examples above, our true nature isn’t manufactured or created, by us or by anyone else, but under the right conditions we can feel it begin to take root, expand and grow within us. When we are able to make space for the perfectly imperfect life that is right here, our true worth and identity emerges naturally, all on its own.
Dropping beneath the surface waves into a deeper awareness of being involves letting go of what we think we know about ourselves and opening to the mystery and wonder of our true nature. It’s about letting go of rigid expectations of how we should be and coming to accept what is already here, right now. This form of acceptance doesn’t mean long-term resignation, but instead is about, “In this moment, can I be with the way that it is?” Whenever we are fighting with “what is” – we are bound to experience the suffering associated with surface waves. Accepting the isness within us can be frightening, but can also bring incredible peace and joy.
Surrendering to the oceanness of our true nature requires a sincere intention to bring a non-judgmental presence to ourselves, as we are, in this moment. It means exercising compassion for ourselves and for others by letting go of perfectionism and rigid ideals. The capacity to be with ourselves doesn’t come easy – most of us go to great lengths to avoid this quality of presence. We tremble at the thought of facing our inner sea monsters lurking in dark crevices below the ocean’s surface. Yet, when we cling to the transient waves above, we also miss out on the buried treasures below – those flecks of gold glimmering in the still waters of our true nature.
As we more fully honor the sincere intention to bring a non-judgmental and compassionate presence to all parts of ourselves, a profound transformation starts to take place within us. We begin to embrace our vulnerabilities instead of running from them, recognizing that moving into the fear, shame, loneliness, pain, grief, etc. is actually the gateway to our true nature. The once-feared sea monsters from the deep become revered teachers and honored guests in the vast ocean of our being. We begin to recognize that our emerging true nature isn’t hitched to the surface waves of external things, other people or even our thoughts, but instead is a quality of presence that can hold the inevitable impermanence of this life with steadiness and grace.
As we make deeper and more regular contact with the life that is right here, our foibles and shortcomings become gentle reminders of the wondrously unique path we have travelled and they reconnect us with our own humanity and with other beings all around us. Those struggles that at one time kept us clinging to surface waves become the very support we need for resting in a deeper awareness of our unconditional and infinite worth. In time, a quiet confidence begins to unfold from authentic presence. This is the path to befriending our true nature.
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.
The Meadows recently announced Alexandra Katehakis, MFT, CSAT-S, CST-S, as a new Meadows Senior Fellow. Katehakis is the Founder and Clinical Director of the Center for Healthy Sex in Los Angeles, Calif.
Katehakis is an expert in the treatment of sexual addiction and other sexual disorders and has incorporated interpersonal neurobiology into her Psychobiological Approach to Sex Addiction Treatment (PASAT). Ms. Katehakis is author of “Erotic Intelligence: Igniting Hot Healthy Sex After Recovery From Sex Addiction,” 2010 and contributing author to Making Advances: A Comprehensive Guide for Treating Female Sex and Love Addicts, in M. Feree (Ed.), 2012. She has published in the Journal of Sexual Addiction & Compulsivity and the Psychotherapy Networker.
Katehakis is currently writing a book for the prestigious W.W. Norton Interpersonal Neurobiology Series edited by Allan Schore and Daniel Siegel titled, Sex Addiction As Affect Dysregulation: A Holistic Healing Model (2014). Recently, Katehakis is the 2012 recipient of the Carnes Award, a distinguished acknowledgement for her significant contributions to the field of sex addiction.
“We are thrilled to welcome Alexandra Katehakis to The Meadows as a Senior Fellow,” said Jim Dredge, The Meadows CEO. “As we see an increased prevalence of sexual dysfunction and sexually addictive behaviors in the individuals seeking help at The Meadows, Alex’s wealth of knowledge and experience in this field will undoubtedly be a benefit to our patients.”
Additional Meadows’ Senior Fellows include: Pia Mellody, John Bradshaw, Peter Levine, Bessel van der Kolk, Jerry Boriskin, Shelley Uram, and Claudia Black. Each Meadows Senior Fellow is involved in world-wide practice and research in their area of expertise - lecturing patients on clinical works, publishing works in numerous professional publications, and providing their teachings and expertise to the patients and therapeutic staff at The Meadows.
The Meadows is an industry leader in treating trauma and addiction through its inpatient and workshop programs. To learn more about The Meadows’ work with trauma and addiction contact an intake coordinator at (866) 856-1279 or visit www.themeadows.com.
For over 35 years, The Meadows has been a leading trauma and addiction treatment center. In that time, they have helped more than 20,000 patients in one of their three inpatient centers and 25,000 attendees in national workshops. The Meadows world-class team of Senior Fellows, Psychiatrists, Therapists and Counselors treat the symptoms of addiction and the underlying issues that cause lifelong patterns of self-destructive behavior. The Meadows, with 24 hour nursing and on-site physicians and psychiatrists, is a Level 1 psychiatric hospital that is accredited by the Joint Commission.
The surveys are in and the 2013 Alumni Retreat held from January 25 to January 27, 2013 is being called one of the best Alumni events in Meadows history! More than 75 people from around the country converged on the Franciscan Renewal Center in Paradise Valley, Arizona for three days to renew old friendships and attend some great lectures and workshops all while being immersed in The Meadows culture of acceptance, strength and hope.
Even though it rained throughout the event, nothing seemed to dampen the excitement or the experience. On the first evening, Wally P. demonstrated a rarely seen side of the 12 Step model in his ‘Back to Basics” lecture. Wally is known for his extensive research into how 12 Step programs began and although you may think this was just a boring talk about history… those who came would call it anything but that! Wally showed us how you could take someone through all the 12 Steps of Recovery in just a couple of hours. His unique blend of energy and humor kept everyone laughing.
On Saturday, The Meadows staff put on what could only be described as a Meadows Road Show which started with Dr. Shelly Uram’s presentation on “12 Steps, the Brain and You: A Case of Mistaken Identity and the Journey Home.” Dr. Uram explained that the journey home is reclaiming your true nature or reclaiming who you really are. She considers the 12 Steps a thorough method of going “home” because the Steps heal the “animal” brain in all of us. The brain stem is considered the “animal brain” because it is designed to keep us alive and procreate. Pain or discomfort are caused when it gets out of control or becomes unregulated. For those of you who were inpatients, you probably remember Dr. Uram’s presentations on how the brain stem, limbic brain and prefrontal cortex each respond to addiction.
The afternoon featured a series of break-out sessions designed to remind Alumni of the keys to their Meadows experience such as attachment and mindfulness, loneliness and addiction, self-care and self-regulation, and healthy esteem: building connection with self and others. Of course no Meadows event would be complete without a painting room so there was even a session on expressive painting! The rain continued Saturday night but it didn’t dampen the fun. The evening was filled with laughter thanks to two comics, Tony Vicich and Jim Vance who told very funny stories of their recovery while poking fun at members of the audience.
Perhaps the best was saved for last because on Sunday there were two information packed presentations by Dr. Jon Caldwell and John Bradshaw. Dr. Caldwell spoke on befriending our true nature. He described how we attach our identity to things that can go away like cars, jobs, friends and money. However, he says the truth is that to befriend our true nature, we have to create an intention to befriend it, love whatever it is, and then be that love.
Finally, there was John Bradshaw. In what most considered the key-note address, Mr. Bradshaw spoke on gratitude and the work he is doing for his latest book. Perhaps one of the most interesting messages he shared is that it is important for people with traumatic pain to grieve that pain and then move on. He says there is no reason to hold onto it. Yes, it is part of who we are, but it is not our defining quality as he learned many years ago when someone told him that “suffering is ordinary” and that all of us are called upon to do something utterly unique or out of the ordinary.
He then went on to talk about how important gratitude has become in his life and suggested that everyone in the audience create an inventory of gratitude that can be reviewed when times get rough.
Besides the lectures, there were 12 Step Meetings, Yoga, Meditation and Tai Chi classes. There was truly a taste of everything that helps set The Meadows Program apart from the rest. So if you didn’t make it to Arizona for this annual event, be sure to plan on attending next year because we promise it is only going to get better!
Here is the list for the Texas Alumni Inspired Recovery Meetings for 2013. For more information, please contact Betty Ewing Dicken, LCDC, Business Development Liaison: 972.612.7443 | firstname.lastname@example.org or Morgan Day, Alumni Coordinator: 800.240.5522 email@example.com or go to www.themeadows.com/alumni.