The Meadows Blog

Note: This article was originally published in the Spring 2006 edition of Cutting Edge, the online newsletter of The Meadows.

In Terror's Grip: Healing the Ravages of Trauma
By Bessel A. van der Kolk, MD

From research on trauma's impact on various victim populations, we have learned that the great majority of people not affected immediately and personally by a terrible tragedy sustain no lasting damage. Most of those who witness devastating events are able, in the long term, to find ways of going on with their lives with little change in their capacity to experience love, trust, and hope for the future.

The critical difference between a stressful but normal event and trauma is a feeling of helplessness to change the outcome. This is obvious when people are trapped physically, or their cries for help go unheeded. A nightmarish example is the experience of waking up during anesthesia, which is thought to happen to some 30,000 people a year undergoing surgical procedures in the United States. If this were to happen to you, you would be conscious and aware of where you were and what was happening but, because of muscle relaxants and other drugs, you would be unable to move or speak. Psychological trauma is a frequent result.

As long as people can imagine having some control over what is happening to them, they usually can keep their wits about them. Only when they are faced with inevitable catastrophe do victims experience intense fear and feelings of loss and desertion. Hearing unanswered screams for help or witnessing mutilated human bodies, as happened to some survivors of the September 11th attacks in Manhattan and Washington D.C., is particularly disturbing. In addition, many trauma survivors, including rape and torture victims, have come face-to-face with human evil, witnessing people taking pleasure in inflicting humiliation and suffering.

Feeling helpless against a dire threat, people may experience numbness, withdrawal, confusion, shock, or speechless terror. Staying focused on problem solving, on doing something, however small, about the situation - rather than concentrating on one's distress - reduces the chances of developing post-traumatic stress disorder (PTSD). In contrast, spacing out (dissociating) during a traumatic event often predicts the development of subsequent PTSD. The longer the traumatic experience lasts, the more likely the victim is to react by dissociating. Once a person dissociates, he becomes incapable of goal-directed action.

People's responses to the traumatic event change as time passes. Usually, there is an initial outcry, seeking of help and attempt to re-establish social connections. Once victims have regained a sense of physical safety, they can assess the damage and begin to adjust or assimilate - a process that may take months or years. It is primarily their social context that re-establishes the feeling of safety vital for successful recovery. This initial social response will shape the way the victim comes to perceive the safety of the world and the benevolence or malevolence of others. If people in the social environment refuse to step in when a person's own resources are exhausted, this may become as great a source of devastation as the original trauma itself, seeding further helplessness, rage, and shame. Many people who feel powerless to change the outcome of events resort to "emotion-focused" coping; they try to alter their emotional state instead of the circumstances giving rise to it. About one-third of traumatized people eventually turn to alcohol or drugs in a (usually ill-fated) search for relief. This coping behavior is often a prelude to developing PTSD.

Failing to reset their equilibrium after a traumatic experience, people are prone to develop the cluster of symptoms that we diagnose as PTSD. At the core of PTSD is the concept that the imprint of the traumatic event comes to dominate how victims organize their lives. People with PTSD perceive most subsequent stressful life events in the light of their prior trauma. This focus on the past gradually robs their lives of meaning and pleasure.
People who merely remember a specific event usually do not also relive the images, smells, physical sensations, or sounds associated with that event. Instead, the remembered aspects of the experience coalesce into a story that captures the essence of what happened. As people tell others the story, the narrative gradually changes, and the event is understood as something belonging to the past.

Thus, the core pathology of PTSD is that certain sensations or emotions related to traumatic experiences are dissociated, keep returning in unbidden ways, and do not fade with time. It is normal to distort one's memories over the years, but people with PTSD seem unable to put an event behind them or minimize its impact.
Traumatized people rarely realize that their intense feelings and reactions are based on past experience. They blame their present surroundings for the way they feel and thereby rationalize their feelings. The almost infinite capacity to rationalize in this way keeps them from having to confront the helplessness and horror of their past; they are protected from becoming aware of the true meaning of the messages they receive from the brain areas that specialize in self-preservation and detection of danger.

If the problem with PTSD is dissociation, treatment should consist of association. Freud wrote in Remembering, Repeating and Working Through that "While the patient lives it through as something real and actual, we have to accomplish the therapeutic task, which consists chiefly of translating it back again in terms of the past." Thus, psychotherapy has emphasized helping patients to give a full account of their trauma in words, pictures, or some other symbolic form, such as theater or poetry. For traditional therapy, this has meant focusing on the construction of a narrative that explains why a person feels a particular way, the expectation being that, by understanding the context of the feelings, the symptoms (sensations, perceptions, and emotional and physical reactions) will disappear. Unfortunately, there is little evidence that simply creating a narrative, without the added process of association, succeeds.

Under ordinary conditions, the brain structures involved in interpreting what is going on around us function in harmony. The subcortical areas of the brain represent past experience differently than the more recently evolved parts of the brain, which are located in the prefrontal cortex. These higher cortical structures create language and symbols that enable us to communicate about our personal past. When people are frightened or aroused, the frontal areas of the brain, which analyze an experience and associate it with other knowledge, are deactivated.

In people with PTSD, specific deactivation of the dorsolateral prefrontal cortex (which is responsible for executive function) interferes with the ability to formulate a measured response to a threat. At the same time, high levels of arousal interfere with the adequate functioning of the brain region necessary to put one's feelings into words: Broca's area. Traumatized people suffer speechless terror.

Under conditions of intense arousal, the more primitive areas of the brain - the limbic system and brain stem - may generate sensations and emotions that contradict one's conscious attitudes and beliefs. Sensations of fear and anxiety coming from the subcortex can cause traumatized people to behave irrationally in response to stimuli that are objectively neutral, or merely stressful.

The usual regulatory system of adults is a kind of top-down processing based on cognition and operated by the brain's neocortex. This allows for high-level executive functioning: observing, monitoring, integrating, and planning. The system can function effectively only if it succeeds in inhibiting the input from lower brain levels. However, top-down processing techniques relied upon by traditional psychotherapy inhibit rather than process (or integrate) unpleasant sensations and emotions. A prime characteristic of both children and adults with PTSD is that, in the face of a threat, they cannot inhibit emotional states that originate in physical sensations.

When asked to put their trauma into words, many people respond physically - as if they were traumatized all over again - and so do not gain any relief. In fact, reliving the trauma without being firmly anchored in the present often leaves PTSD sufferers more traumatized. Because recalling the trauma can be so painful, many people with PTSD choose not to expose themselves to situations, including psychotherapy, in which they are asked to do so. A challenge in treating PTSD is to help people process and integrate their traumatic experiences without feeling retraumatized - to process trauma so that it is quenched, not kindled.

Above all, treatment should seek to decondition people from their trauma-based physical responses. Medications such as selective serotonin reuptake inhibitors can alleviate the distress of PTSD, but survivors still need to find ways to put the traumatic event into perspective - as an element of their personal history that happened at a particular time, in a particular place.

In summary, there are three critical steps in treating PTSD: safety, management of anxiety, and emotional processing.
When people's own resources prove inadequate to deal with a threat, they need to rely on others for safety and care. It is critical that trauma victims re-establish contact with their natural social support system. If that system is inadequate to ensure one's safety, the help of institutional resources will be needed.

After safety is assured, psychological intervention may be needed. People have to learn to put words to the problems they face, to name them, and to formulate appropriate solutions. Victims of assault must learn to distinguish between real threats and the haunting, irrational fears that are part of the disorder. If anxiety dominates, victims need help to strengthen their coping skills. Practical anxiety management skills may include training in deep muscle relaxation, control of breathing, role-playing, and yoga.

Trauma victims must gain enough distance from their sensory imprints and trauma-related emotions to observe and analyze them without becoming hyper-aroused or engaging in avoidance maneuvers. One tool for this is serotonin reuptake blockers, which can help PTSD patients gain the necessary emotional distance from traumatic stimuli to make sense of what is happening to them.

After alleviating the most distressing symptoms, it is important to help people with PTSD find a language for understanding and communicating their experiences. To put the traumatic event in perspective, the victim needs to relive it without feeling helpless. Traditionally, following Freud's notion that words can substitute for action to resolve a trauma, victims are asked to articulate, in detail, what happened and what led up to it, their own contributions to what happened, their thoughts and fantasies during the event, the worst part of it, and their reactions to the event, including how it has affected their perceptions of themselves and others. This exposure therapy is thought to reduce symptoms by allowing patients to realize both that remembering the trauma is not equivalent to experiencing it again, and that the experience had a beginning, middle, and end. It belongs to their personal history - to the past, not the present.

The study of trauma has been perhaps the most fertile area within psychiatry and psychology in terms of promoting deeper understanding of how emotional, cognitive, social, and biological forces interact in human development. Trauma study has yielded entirely new insights into the way extreme experiences may profoundly affect our memory, how our bodies as well as our minds respond to stress, our ability to regulate our emotions, and our relationships to other people. Now, it promises to shed light on the fundamental question of how the mind integrates experience to prepare itself for future threats, even as it distinguishes between what belongs to the present and what belongs to the past. These discoveries, together with a range of new therapy approaches, are opening entirely new perspectives on how people who have been traumatized whether by an individual in a private act of violence or by a disaster affecting an entire society - can be helped to overcome the tyranny of the past.

About the Author
Bessel A. van der Kolk, Clinical Consultant for The Meadows and Mellody House, is one of the world's foremost authorities in the area of posttraumatic stress and related phenomena. His research work has ranged from the psychobiology of trauma to traumatic memory, and from the effectiveness of EMDR to the effects of trauma on human development. He is professor of psychiatry at Boston University School of Medicine and medical director of the Trauma Center in Boston, a Community Practice site of the National Child Traumatic Stress Network. The Trauma Center is one of the foremost training sites in the country for psychologists and psychiatrists specializing in the treatment of traumatized children and adults.

Published in Blog

Note: This article was originally published in the Fall 2005 edition of Cutting Edge, the online newsletter of The Meadows.

Inner-Child Work: Some Evolutionary and Neuroscientific Reflections

By John Bradshaw, MA

For the last 27 years, I've reflected on the power and efficacy of inner-child work. Recently I found two areas of knowledge quite interesting and enlightening: the evolutionary theory of neoteny and the neuroscientific study of the brain.

Neoteny

In 1988, I was presenting my inner-child workshop to a group of holistically oriented dentists. I arrived the day before I was to begin and discovered that one of my most revered mentors, Dr. Ashley Montagu, an anthropologist at Princeton, was giving the keynote address.

When I began my workshop the next day, Dr. Montagu, 84 years young, was in the audience. He participated in the entire two-day workshop, doing all the experiential exercises. At the end of the workshop, he gave me a manuscript copy of a book he had written that was to be published later that year. The book was called Growing Young. It presented an extremely complex argument for the theory of neoteny, an evolutionary theory that many biologists, ethnologists and anthropologists believe is a necessary complement to Darwin's theory of evolution. Montagu told me that what he had experienced in the workshop mirrored what his book outlined as a major focus for psychotherapy.

Neoteny is defined in biology as "the retention of fetal or juvenile traits by the retardation of developmental processes." The prolonged childhood of humans is unique among all life forms. Since humans are the apex of evolution, there must be some evolutionary reason for our prolonged childhood.

Montagu cites a number of renowned scientists who believe that Darwin's theory of natural selection is not fully sufficient to account for human evolution. There is, they believe, another mechanism at work in evolution, first noted by Edwin Drinker Cope in 1870. Cope discovered what he called the law of acceleration and retardation.

While I'm not qualified to present the scientific argument for the theory of neoteny, I'll tell you what excites me about it in terms of inner-child work.

Retardation of development allows us humans to avoid limiting our brain development to the specialized focus of survival.

The juvenile chimpanzee is quite humanlike compared to the adult chimpanzee. The adult's head and jaws are elongated and no longer round. The elongation is due to the fact that chimps must focus all their attention on survival. The early need for specialization forces the ape's brain into an elongated pattern. The vast number of neurons in the chimp's brain are pruned to a relative few concerned only with survival.

For us humans, our prolonged childhood (from birth to 14 years) opens the door to many experiences that allow our brains to expand. This non-specialized use of our brain offers us enormous possibilities for creativity and freedom.

Montagu quotes from the Journal of Auroville, which recounts communication from a flying saucer. The alien says, "The trouble with earthlings is their early adulthood. As long as they are young, they are loveable, openhearted, tolerant, eager to learn and eager to cooperate with others. By the time of adulthood, most human adults are mortal enemies." I'm not prone to believe this statement came from an alien. However, the human race says it wants peace more than anything, yet we keep having wars.

For Montagu and his biological colleagues, the goal of human maturity is not adulthood as we now conceive it, but adulthood as actualizing our childlike traits, such as openness, tolerance, docility, spontaneity, love for others and willingness to cooperate.

To sum up neoteny, Montagu asserts that "we are designed to grow in ways that emphasize rather than minimize childhood traits." Montague asserts that the understanding of neoteny is urgent in terms of human survival. History teaches us "that only the races with the longest childhood were able to stay in the cultural mainstream."

A century of clinical psychology and psychotherapy has helped us understand that we are by nature open, curious, tolerant, loving, playful and joyful. Life is not an ongoing warfare, as philosopher Thomas Hobbes and others have believed. All humans have a deep and persistent desire for wholeness and, when we are emotionally dis-eased, we deeply desire recovery. We intuitively know that being violent to ourselves and/or others and hating ourselves and/or others are not what our nature intended and will not bring us happiness.

Psychotherapy helps us clearly see that violence and hatred of ourselves and others are primarily reactions to childhood, trauma, abandonment, neglect and chronic abuse of one kind or another.

The inner child is a symbolic metaphor for the natural child's preciousness, as well as the natural child's adaptation to trauma, abuse, abandonment, neglect and enmeshment (the wounded child).

Inner-child work aims at helping us re-own the natural child within us (the precious child). In order to reconnect with the primal energy of our natural child, we need to grieve the wounds resulting from our abandonment, neglect and abuse. Once we've grieved our early losses, we can learn the things we needed to learn at each of our developmental dependency stages. These learnings create the self-esteem and the safe boundaries that we need in order to be open, tolerant, non-judgmental, spontaneous (rather than forever on guard), loving and cooperative. It seems clear that our neotenous nature demands that we do "inner-child" work when we have been traumatically abused, abandoned, neglected or enmeshed.

When I was actively addicted, I used my addiction to feel my childlike aliveness. Without my addiction, I felt dead. Addictions are abortive ways we choose in order to be restored to the natural childlike traits of our beginnings. Ultimately, addictions result in irresponsible childish behaviors. Healing the wounded inner child is necessitated by the theory of neoteny.

Recent Development in Neuroscience

Recently, Thomas Hedlund, the supervising clinician in more than 35 of my recent inner-child workshops, excitedly told me that he had just finished a workshop with Dr. Allan N. Schore, a clinical faculty member of the U.C.L.A. David Geften School of Medicine and an internationally recognized expert in the neuroscience of the brain. In the workshop, Dr. Schore had presented a complete neuroscientific explanation for the effectiveness of inner-child work in general and my inner-child workshops in particular.

Dr. Schore is one of the major pioneers of a paradigm shift in understanding psychopathogensis and therapeutic change. This paradigm shift that directly affects clinical practice focuses on the centrality of emotional processes and the role of the self in human function and dysfunction.

What Dr. Schore has made clear is that childhood abuse, abandonment, neglect and enmeshment damage a child's need for healthy attachment, i.e. secure bonding. Attachment disorders damage the functionality of the right (or non-dominant hemisphere) of the brain.

With a "good enough" early attachment, a person can learn to handle stress without overreacting. Because they have been loved, touched and given appropriate space, they feel loveable and can be loveable to others. The empathic mutuality of "good enough" bonding is the foundation of a unified sense of self.

Dysfunctional Attachment and the Non-dominant Hemisphere

Dysfunctional attachment impacts the nondominant hemisphere in any or all of the following ways:

Loss of ability to cope with stress

Post Traumatic Stress Disorder (P.T.S.D.), which reflects a severe dysfunction of the right hemisphere system

Since early trauma is usually cumulative and chronic, there is evidence that longterm autonomic reactivity can lead to "neuronal" structural changes, involving atrophy, shrinkage and permanent damage

Since the right hemisphere has an adaptive capacity to regulate affect - the most significant consequence of the stressor of early relational trauma is the loss of the ability to regulate the intensity and duration of affect - (REACTIVITY)

Loss of the capacity to assimilate new experiences - the personality cannot enlarge

Tendency to disengage socially

Dissociation and defensive projective identification.

I invite the reader to explore Dr. Schore's work in his two volumes, Affect, Dysregulation and the Disorders of the Self and Affect, Regulation and the Repair of the Self. In my "inner-child" workshop, I work on the first three childhood developmental stages. I place great emphasis on the attachment bond and our early developmental dependency needs (the needs that can be met only by depending on another person). Codependency is the major outcome of attachment disorder because its primary symptomology is the result of a failure to get our developmental dependency needs met.

Most inner-child work is aimed at the nondominant hemisphere of the brain. I use a lot of imagery meditations and age regressive techniques (so that a person can grieve his wounds at the age-appropriate stage at which his attachment rupture took place). I use music to stimulate the "felt thought" intelligence of the right brain. I divide participants into groups of six or eight, and let the group members become non-shaming "benevolent witness." They serve as mirroring faces who offer validating feedback, which legitimizes the pain of the person sharing a story or scene of shameful abuse. The group work helps the sharing person reduce his dissociation and own his prospective identifications. Being reconnected with his own feelings, a person can begin his grief process.

"Inner-child" work is thus conceived as grieving and redoing each developmental stage of early and middle childhood.

The new relationship that emerges is the relationship with one's functional adult and inner child (the reconnection of the self with the self). The inner child is understood as a metaphor for our natural child of the past, whose feelings, needs and wants were bound in toxic shame.

Dr. Allan Schore expresses his conception of the paradigm shift in treating attachment disorder as follows: "The treatment of attachment pathologies is currently conceptualized to be directed toward the mobilization of fundamental modes of development and the completion of interrupted developmental processes."

Happily, many of us have been using this model for quite some time.

I could write a lot more about the neuroscientific basis of inner-child work as a paradigm shift in understanding psychopatho-gensis and therapeutic change, but the limits of this short article do not allow it.
I hope this modest presentation has been stimulating for the reader. I invite those interested to read the work of Joseph Le Deux, Diane Foshe and Antonio Damasio, along with the work of Ashley Montague and Dr. Allan S. Schore.

About the Author

John Bradshaw, Fellow of The Meadows, has combined his exceptional skills as counselor, author, theologian and public speaker for the past four decades to become a world renowned figure in the fields of addictions, recovery, family systems and the concept of toxic shame. John has written three New York Times best-selling books: Homecoming: Reclaiming and Championing Your Inner Child; Creating Love; and Healing the Shame That Binds You.

Published in Blog
Wednesday, 25 March 2009 20:00

We Are All Neighbors

Note: This article was originally published in the Summer 2004 edition of Cutting Edge, the online newsletter of The Meadows.


We Are All Neighbors
By Peter A. Levine, PhD.

What has happened to our world? Why this large-scale killing, maiming and torture as human populations increase in number and complexity - and as their access to Ethernet information grows each year, seemingly in inverse proportion to their compassion? Even when competing for their most basic resources - food and territory - animals typically do not kill members of their own species. Why do we?

While there are many theories of war, post-traumatic stress is one root cause not widely acknowledged, even though it is the single most important instigator of the perverse cruelty of modern warfare. Mankind's history of war, xenophobia and genocide has generated a legacy of trauma-induced dysfunction fundamentally no different from that experienced by individuals, except in its scale. There remains, however, an enormously important question: Can recovery from trauma be replicated on a larger, societal scale, with similar healing effects? At The Meadows, this has become our living promise.

Let us review what happens when a person is traumatized. First, his internal system remains aroused; he is always on edge, unable to relax or tune down. He is constantly aware of a pervading sense of danger, suspicious of everything and everyone. Not knowing why he feels threatened, this fear and reactivity escalate. This, in turn, amplifies the need to identify the source of the threat. Propelled by a tremendous terror and rage lurking just beneath the surface, he is unconsciously driven into re-enactments to help regulate the ongoing escalation of arousal.

Imagine now an entire population of people with a similar post-traumatic history. In fact, imagine two such populations located in the same geographical region, perhaps with different languages, religions and traditions. What will happen? Croatian civilians are sawed in half by Serbian soldiers. Atrocities are committed, in turn, by Croatian troops. Dozens of truces are called, and each time the result is the same: The urge to kill and destroy takes over, and insanity once again prevails. The Serbs and Croats have been repeating their violent patterns as virtual instant replays of World Wars I and II. Middle Eastern nations can readily trace their wars to Biblical times. Even when wars do not repeat with the kind of ferocity and brutality seen regularly around the globe, suffering in the form of societal dislocation, child abuse and other forms of hatred will. There is no avoiding the traumatic aftermath of war; it reaches into every segment of society.

Transforming Cultural Trauma

Trauma is an inherent part of the primitive biology that brought us here, biology which cannot be changed without completely redesigning us, down to our very cells. To release ourselves from reenacting our traumatic legacy, both individually and as a society, we must transform it. We can do so only by addressing the problem at its roots: in our physiology.

Several years ago, Dr. James Prescott, then at the National Institute of Mental Health, engaged in some important anthropological research on the effects of infant and child rearing practices on the prevalence (and absence) of violence in aboriginal societies. He found that the societies in which child rearing was characterized by close physical bonding and stimulation through rhythmical movement had low incidences of violence. Conversely, the societies with diminished or punitive physical contact with their children showed clear tendencies toward violence in the forms of war, rape and torture.

As we know from the studies of Dr. Prescott and others, the time around birth and infancy is a critical period. It is then that the infant associates the states of its parents with basic security and ability to regulate arousal. When parents are traumatized, they have difficulty imprinting their young with this sense of basic trust and resource. And without this sense of trust, children are more vulnerable to later trauma. One solution to breaking the cycle of cultural trauma is to involve infants and their mothers in an experience that generates trust and bonding before the child has completely assimilated the parents' anxious state.

In Scandinavia, I am involved in some exciting work inspired by my Norwegian colleagues. This project uses what we know about this critical period around infancy to allow not just one individual, but an entire group of people, to begin transforming the trauma of their past encounters. This method of bringing people together requires a room, a few simple musical instruments and some blankets strong enough to hold a baby's weight.

The process works as follows: A group of mothers and infants from opposing factions are brought together at a home or community center. The encounter begins with this heterogeneous group of mothers and infants taking turns teaching one another simple folk songs of their respective cultures. Holding their babies, the mothers dance while they sing the songs to their children. A facilitator uses simple instruments to enhance the rhythm in the songs. The movement, rhythm and use of voice in song strengthen the neurological patterns that produce peaceful alertness and receptivity. As a result, the stuckness and fixation produced by generations of strife begin to soften.

At first, the children are perplexed by the events, but they soon become interested and involved. They are enthusiastic about the rattles, drums and tambourines the facilitator passes to them. When not provided with rhythmic stimulation, children of this age do little more than try to fit such objects into their mouths. In this situation, however, the children join in generating the rhythm, with great delight, squealing and cooing.

Because these infants are not blank slates, but highly developed organisms even at birth, they send signals that activate their mothers' deepest senses of serenity, responsiveness and biological competence.
In this healthy exchange, the mothers and their young engage in an exchange of mutually gratifying physiological responses that, in turn, generate feelings of security and pleasure. It is here that the cycle of traumatic damage begins to unravel.

The transformation continues as the mothers place their babies on the floor and allow them to explore. Like luminous magnets, the babies gleefully move toward each other, overcoming barriers of shyness as the mothers quietly support their exploration from a circle around them. The joy and mutual connection generated by their small adventure is difficult to describe or imagine - it must be witnessed.

The group then continues, with smaller groups of a mother and infant from each culture working together. Two mothers swing their infants gently in a blanket. These babies aren't just happy; they are completely blissful. They generate a roomful of love so contagious that soon the mothers are smiling and bonding with members of a community they earlier feared and distrusted. The mothers leave with renewed hearts and spirits they are eager to share with others. The process is almost self-replicating.

Once a group of people has participated in the experience, the group can easily be trained to replicate it. The impact of this experience is so powerful that participants want to spread it throughout their communities, and many of them do so. The beauty of this approach to community healing lies in its simplicity and effectiveness. An outside facilitator begins the process by leading the first group.

The experience offers a gentle alternative to the destructive cycle of trauma, suffering and violence by allowing the biological imperative for natural bonding and love to assert itself. Resistance to stress and trauma, the development of basic trust, and the capacity for enduring personal and peaceful relationships are forged during a critical period of life.

Developing physiological and neurological patterns give us the instinct of the animal and the intelligence of the human being. Lacking either, we are doomed to act out our hostilities. With the two working together, we can advance on our evolutionary path, utilize all our human capacities and bring our children into a world that is safe.

Non-traumatized humans prefer to live in harmony. Yet traumatic residue creates beliefs that we are unable to surmount our hostility and that misunderstandings will always keep us apart. It is imperative that we make every effort to discover and teach treatment modalities like the Scandinavian model I described previously. We must be passionate in our search for effective avenues of resolution. Not just peace, but survival, depends on it.

Nature cannot be fooled. Evolution happens as a result of forces that threaten to destroy the species. Trauma is one such force.

Cutting Edge Editorial Board comments in response to this article:
The theory of childhood development and immaturity developed by Pia Mellody and its application to the patients at The Meadows is a most encouraging demonstration of how post-traumatic stress can be treated and individual destinies turned to the path of self-knowledge and relational peace. And while The Meadows applies its processes of analysis and recovery to individuals, at its center lies a template that we must apply on a broader societal scale.

Published in Blog

I come from a family of worriers, and I’ve done a lot of worrying in my life. I now do it less than ever, but there was a time when I thought I was a “worry addict.” Of course, a feeling of any kind can be “addictive” – we can use one feeling or mood to alter another. That’s how I once used worry. When I obsessed about fearful possibilities or regarded things as more threatening than they were, I didn’t have to feel my loneliness or anger, which was far more frightening than worry. So worry was a way for me to stay in my head and not have to feel my feelings.

Worry begins in childhood, modeled for us by our parents. They nag at us with an endless stream of anxious reminders: “Sit up straight.” “Don’t hold your fork that way.” “Be careful.” Don’t talk to strangers when you leave the house.” Some of these admonitions are good and necessary, but when they’re delivered chronically and inappropriately, they create a sense of terror in a child. And it’s now recognized that these early impressions can have long-term effects.

A New York Times article describing experiments at the National Center for Post-Traumatic Stress Disorder stated that a single catastrophic experience occurring when one feels helpless is sufficient to change brain chemistry. The article suggested that it’s as if a rheostat that controls adrenaline release is turned up, creating a surge. In my work, we call this hyper-vigilance, and I believe it can be traced to early childhood fear and terror.

Imagine the impact on a 3-year-old who hears a normally quiet and gentle parent raise his or her voice for the first time. We have probably all been through that. We all undoubtedly carry some ill effects from the experience of having been tiny and powerless in the first six years of our lives – and those ill effects sometimes manifest themselves as worry, depending on the level of anxiety that our parents projected at the time.

The ways we choose to worry are usually the ways we learned from observing our parents. In “awfulizing,” one form of thought distortion, we see the hole and never the doughnut. Most of us are quite unlike the optimistic little boy in the famous story that is supposed to teach us to count our blessings. According to the tale, the child got nothing but donkey dung for Christmas. “I got a donkey,” he is supposed to have exclaimed, “but he got away!” This story has always irritated me, because it’s about somebody who looks on the bright side. This is an attitude I was never fortunate enough to have.

“Catastrophizing” is another species of worry. It is characterized by the mind rushing to the worst possible scenarios. I think of the passage in Carlos Castaneda’s Journey to Ixtlan in which Yaqui sorcerer Don Juan says, “We either make ourselves miserable, or we make ourselves strong. The amount of work is the same.”

Compulsive worrying takes a tremendous toll on the body because it forces us to live in a constant state of alertness, prepared to fight or run. So it’s important to do something about it. One technique I’ve used is to replace insecure thoughts with secure thoughts. I might ask myself, “What is the best thing that could happen from this experience?” This forces me to think in positive ways. Or I might ask myself to look at occasions in the past that worried me but that had happy outcomes. The most effective tool I’ve used against worry is a slogan that comes from AA: One day at a time. Many years ago, I didn’t know how to live one day at a time. Part of my mind was always in next Thursday, next month, next year. I was always out there in the future, “awfulizing.”

People who aren’t troubled by addictions find it hard to imagine what it’s like to be overcome by worry. They say, “Plan, stupid. Then you don’t have to worry.” But that’s not how it worked with me. My concerns for the future were often so great that they impaired my ability to function in the present. You could say that my hyper-vigilance wore me out physically, while my “awfulizing” drove me to the distraction of alcohol – anything to quiet my fears for just a little while. When I found my way into AA and started to work the 12 Steps, a dedicated daily effort to live in the now finally restored me to sanity. Today I live today. I give my best attention to what I am able to do right now, and I tell myself that I’ll deal with tomorrow when it gets here. And the remarkable thing is that it works. -

- Written by John Bradshaw, MA and featured in the September edition of The Meadows’ Cutting Edge, a Publication for Professionals.

Published in Blog
“This is one of the largest disasters America has ever faced,” stated Gov. Greg Abbott of Texas.

By now you have seen the news accounts and photographs regarding the situation in Texas. News reports have stated there are least 10 people are dead, with many more injured, as parts of the Houston area were inundated with more than 40 inches of rain, with totals possibly reaching 50 inches as the rainfall continues.

Published in Trauma

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