The concept of "wellness" has gained popularity in today's media and has played a major role in the treatment of trauma and addictions. The word suggests a state of well-being, a balance in the social, emotional, occupational, spiritual, physical, and intellectual aspects of life. At The Meadows, the newly renovated Wellness Program is structured to help patients make choices to build a more successful lifestyle.
Frequently, those suffering the effects of trauma and addictions make poor choices that result in an imbalance in one or more areas of life. Addressing this imbalance has been an integral part of The Meadows' treatment program for the past 34 years. Developed by Pia Mellody, The Meadows' model focuses on the interplay of core issues throughout our development that have culminated in unmanageable symptoms or an imbalance in our lives. The five core issues - self-esteem, boundaries, reality, dependency, and moderation - form the foundation for the treatment program. If patients learn to make good choices in their lives, they will learn to esteem themselves, establish appropriate boundaries in relationships, live lives of moderation, accept their imperfections, and take responsibility for their needs and wants. They will be in a state of wellness.
Wellness Coordinator Courtney Berg will initiate the program by conducting an individual interview with each patient during his or her first week. A wellness questionnaire will be completed, and a medical doctor will be consulted in constructing a wellness plan consistent with the patient's treatment plan and physical condition. The Wellness Coordinator will monitor the wellness plan for each patient through regularly scheduled meetings and progress reports at weekly treatment team meetings.
Patients will begin each day with a walk around campus on a newly marked walking path. Monitored by the Wellness staff, this activity will serve to start the day "on the right foot." The walk itself is low-impact and appropriate for all levels of fitness. Those who are very fit will gain from the camaraderie and team building. Those who are not so fit will begin to build confidence and physical fitness.
The Meadows has historically offered tai chi and yoga. New offerings will include water aerobics, pilates, deeper forms of meditation, and expanded expressive arts activities. Saturday mornings will feature animal and equine therapy.
New programming will include a weekend Grief Workshop, Dating in Sobriety Workshop, Mindfulness in Recovery Workshop, 12 Steps in Recovery, Expressive Arts Experiences, and specialized lectures on the Brain and Trauma, Mind-Body-Spirit Connections, and The Role of Meditation in Treatment.
Peter Levine, PhD, Clinical Consultant for The Meadows, and author of Waking The Tiger and Trauma Proofing Your Kids, talks about how parents can help their worried children and "bounce back." Click Here
In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness
The Meadows presents Peter Levine, PhD
December 3, 2010 Austin, Texas
Trauma is neither a disease nor a disorder, but is rather an injury caused by paralyzing fright, helplessness and loss. If we enlist the wisdom of the living, sensing body and engage our innate capacity to self-regulate high states of arousal and intense emotion, we can transform trauma and be healed. We will explore the roots of addiction in unresolved trauma, insecure attachment and habitual childhood frustration. Drawing on more than 40 years as a pioneering body-oriented clinician, as well as a parallel study of stress, biology, child development and discoveries in the neurosciences, Dr. Levine shows that it is possible to live life robustly with pleasure and creativity, even in the face of the most painful assaults to our humanity- and in the face of deceptively trivial ones. From an evolutionary understanding of the source of trauma, to a spiritual dimension of how we as human beings can be strengthened by traumatic healing, this journey unfolds- if we learn to attend to the "unspoken voice of the body."
This presentation will teach participants the following:
• To recognize the biological and naturalistic roots of trauma and their implications for treatment.
• To explain how sensate awareness is an important vehicle for regulating high arousal states and intense emotions in transforming trauma.
• To describe the relationship between developmental issues, unresolved trauma and addictive processes.
Peter A. Levine, PhD, Clinical Consultant of The Meadows and Mellody House, has a background in medical biophysics, stress and psychology. He is the originator of Somatic Experiencing®, which he has developed during the past 40 years. He teaches this method throughout the world. Levine is the author of the best-selling book Waking the Tiger and the book/CD Healing Trauma. He is also the co-author, with Maggie Kline, of Trauma Through a Child's Eyes: Awakening the Ordinary Miracle of Healing.
Sheraton Austin Hotel
at the Capitol
701 East 11th Street
Austin, Texas 78701
Self-parking at hotel is included.
5.5 Continuing Education Credits
To Register: http://www.themeadows.org/events/index.php?rm=event_details¶m1=show¶m2=135&
Note: This article was originally published in the Winter 2007 edition of MeadowLark, the magazine for The Meadows alumni.
Techniques for Managing Post-Traumatic Stress Disorder
By Lara Rosenberg
This article is based on a workshop that Lara gave February 13 - 14, 2006, in Sri Lanka hosted by the INGO RedR. The workshop is focused on staff working with individuals, families, and communities that have experienced or continue to experience traumatic events. It was an introductory workshop of particular value for staff having community experience, but limited or no psychological training. It was assumed that participants had prior knowledge of stress.
Stress affects us in many ways: cognitively, affectively, physiologically, and behaviorally. "Stress" is a broad term. It's part of all of our lives; each individual has his own ideas of how to define it. There are many definitions given to stress, but the important underlying factor is that stress results from a change in one's environment and requires an adjustment. The environmental changes that require us to adapt and adjust are known as "stressors" they can include anything out of the ordinary. Many think of stress as only negative, but it can be positive and necessary to our healthy development. The ways in which we adapt to our environments leave some stimulated and others with feelings of fear, nervousness, and confusion, which lead us to either solve or avoid a problem. Change always brings extra pressure, as individuals have to adapt to new circumstances.
Humans and animals are born with the capacity to react to threatening situations in adaptive ways; the "fight or flight response" allows individuals to experience resilience in response to danger. Bessel van der Kolk (1994) describes the fight response as hyper-arousal or protest and the flight response as freezing or numbing sensations, which allow individuals to avoid consciously experiencing the event.
Trauma is caused by a stressful occurrence "that is outside the range of usual human experience, and that would be markedly distressing to almost anyone" (Peter Levine, 1997). Post-traumatic stress disorder (PTSD) causes one to experience a prolonged or delayed reaction to an intensely stressful event. According to The DSM-IV Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, PTSD occurs when an individual experiences a threat (actual or perceived) of death or serious injury to self or others with a response of "intense fear, helplessness, or horror." PTSD can occur in adults and children from all socio-economic backgrounds. Most people who are exposed to a traumatic, stressful event experience some symptoms of PTSD in the days and weeks following exposure. According to the National Center for PTSD, data suggest that approximately 8 percent of men and 20 percent of women exposed to trauma develop PTSD; of that group, 30 percent develop a chronic form that persists throughout their lifetimes.
The World Health Organization (WHO) states that the prevalence of mild and moderate common mental disorders in the general population is 10% and can increase to 20% after a disaster. As stated by Dr. Daya Somasundaram from the Department of Psychiatry at the University of Jaffna, Sri Lanka (WHO, 2005), "WHO estimated that 50% may have problems and 5-10% have serious problems needing treatment. One [non-WHO] survey found 40% post-traumatic stress disorder (PTSD) in children," referring to people in Sri Lanka. Other data suggest that the mental health burden in Sri Lanka is even higher. Dr. Roy Lubit (2006), as well as Pia Mellody, a pioneer on the effects of childhood trauma, stresses that the full impact of trauma may not be experienced until a child reaches adulthood, engages in adult relationships and responsibilities, and develops more sophisticated cognitive capabilities.
The National Center for PTSD states that one of every three disaster survivors experiences some or all of the severe stress symptoms that may lead to lasting PTSD, anxiety disorders, or depression. Severe stress symptoms are extreme attempts to avoid memories and feelings. In order to numb their emotional pain, individuals will stay unusually busy, withdraw, and exhibit addictive behaviors. Violent behaviors often become prevalent.
Individuals can experience severe depression as part of PTSD, suffering a complete loss of hope, self-worth, motivation, and purpose. Some might experience disassociation, feeling outside of oneself as if living in a dream, or may become vacant for periods of time. Intrusive re-experiencing can occur through terrifying memories, nightmares, or flashbacks. For some, hyper-arousal manifests in panic attacks, rage, extreme irritability, or intense agitation. Other manifestations include severe anxiety, paralyzing worry, extreme helplessness, obsessive and compulsive behaviors, and feeling responsible for the event. Children often re-experience traumatic or stressful events through recurrent memories, nightmares, and play. Some children become very aroused, exhibiting nervousness, irritability, anger, disorganization, or agitation. Children also shun thoughts, feelings, or places that evoke memories of the event. Occasionally, they experience a loss of developmental patterns or skills, separation anxiety, bed-wetting, and learning difficulties. An 8-year old boy in Sri Lanka could not see for 10 weeks after enduring the terrifying experience of the tsunami, in which he lost his mother and home. This example of physical impairment demonstrates the freezing response described by Bessel van der Kolk (1996), as well as Peter Levine (1997) in his Somatic Experiencing® work.
Disaster stress may revive memories of prior trauma; pre-existing social, economic, spiritual, psychological, or medical problems can intensify. Individuals at higher risk for severe stress symptoms and lasting PTSD include those who have been exposed to other traumas, such as abuse, assault, or combat. Chronic poverty, homelessness, unemployment, or discrimination will often intensify the traumatic event, as can chronic illness and psychological disorders.
Most likely to develop PTSD are those who experience stress at a greater intensity, with unpredictability, uncontrollability, and real or perceived responsibility. Factors such as genetics, early-onset and longer-lasting childhood trauma, lack of functional social support, and concurrent stressful life events also contribute to the disorder. Those who report a greater perceived threat, suffering, terror, and fear are at risk for developing PTSD, and a social environment that produces shame, guilt, stigmatization, or self-hatred can affect sufferers as well.
Individuals experiencing PTSD face an increased likelihood of co-occurring disorders such as alcohol/drug abuse and dependence, major depressive episodes, conduct disorders, and social phobias. According to the National Center for PTSD, "In a large-scale study, it was found that 88% of men and 79% of women with PTSD met the criteria for another psychiatric disorder." Some experience difficulty in their psychosocial functioning, with profound problems in their daily lives. Concurrent prevalent physical problems include headaches, dizziness, chest pain, and other aches and pains. Often medical doctors treat only the symptoms, without considering PSTD development.
At the same time, stressful or traumatic experiences can facilitate personal growth. In treating sufferers, it is most important to restore safety in their lives, build coping strategies, and reduce pain. It is necessary to find out how they are coping with the situation and stress. Healthy coping mechanisms should be slowly introduced if behavior patterns reflect unhealthy habits such as smoking, drinking, or staying unusually busy. When dealing with disclosure, it is important that a secure and confidential environment is maintained. Humanitarian aid workers should teach survivors of trauma that they are not alone in order to help reduce a sense of isolation and rebuild trust. The aid worker should acknowledge and validate the person's feelings and experiences by offering comfort and support.
Aid workers should assume people are doing their best to cope and should empower them to feel as in-control as possible. Victims should not be asked to reveal emotional information, but if they volunteer it, helpers should listen. Access to mental and physical health services should be provided. In addition to reducing anxiety and depression, valued and meaningful goals help individuals regain hope and purpose. Improved access to education and employment opportunities encourages achievement. It is important to restore individual dignity and value, create opportunities for pleasure, and foster connections by maintaining or re-establishing communication with family and the community. Expressing oneself through journaling, reading, or becoming aware of experiences helps to release stress. Eliminating self-blame for what is occurring allows people to grow. Relaxation methods such as walking, breathing, meditation, yoga, prayer, and listening to music also promote healing, as do self-care behaviors such as brushing teeth, showering, and taking care of one's living environment. Small goals should gradually lead to a focus on the big picture.
The majority of trauma survivors will prove resilient; their feelings of fear and anxiety, along with urges to avoid or relive the experience, will decrease over time. Everyone handles life experiences differently, and it is necessary to allow each individual to heal at his or her own pace. The experience will always be a part of this person's life; however, the possibility of growing from the experience becomes more attainable when anxiety is reduced.
Note: This article originally appeared in the Winter 2007 edition of MeadowLark, the magazine for alumni of The Meadows.
A Miracle is Just a Shift in Perception
By Colleen DeRango
In working with clients to help them heal their trauma, many of us in the Somatic Experiencing® community have come to recognize that one component preceding a shift in perception may not be a thought at all: It may be the body's "felt sense" of moving from a state of calm to anxiety and then to calm again, or what is called "pendulation."
Peter Levine's influence at Mellody House has generated a subtle shift in the way we work with clients; our focus is on supporting clients in establishing a sense of "internal resourcing," as opposed to concentrating on difficulties or problem areas. Somatic Experiencing reinforces this focus and gives us the necessary tools and language.
Consider an example: A cat attentively and expectantly watches a mole dig a tunnel under the lawn. The cat waits with positive expectancy for the mole to move. This visual image represents the idea of seizing or grabbing hold of the positive. As counselors, we do this by supporting the client in reconnecting with the felt sense of "I can."Sometimes this "I can" sensation is expressed in a bodily movement. Other times, the client experiences a bodily change, wherein he feels "less tight, less anxious, less painful, less stuck." Gently encouraging the client to experience his "felt sense" of this less painful state is often the beginning of the miracle of moving from "I can't" to "I can." Clients are adept at sensing their own states of non-calm; so we focus on beginning from a place of "safety, calm, centeredness - or when they last felt most like themselves." We reflect on how they experienced these states and, from this place of resource, we support them in "touching into" the edges of the more difficult sensations of "tightness, strain or constriction."
Therapists support clients in listening to what their bodies are sensing, and we challenge them to trust it. For example, in a guided meditation or group session, if a client begins to feel "closed-in" or "anxious," he's encouraged to do what he wants to do - and to experience it from a "felt sense." Oftentimes this includes leaving the room while sensing what it is like to be able to get up and leave. When we introduced this strategy, we thought perhaps clients wouldn't return. Yet they have always returned and quite often shared with the group their sensations of empowerment.
Additionally, we give clients choices; for example, in meditation sessions, they are welcome to follow the guided meditation or to make a choice about how they want to meditate and then do so. Choice, when given to trauma survivors, is powerful; clients often share that they experienced the act of choosing as a felt sense of power, as opposed to the powerlessness many experienced during past traumatic events.
Knowing that trauma is about disconnection and that healing is about reconnection, the client experiences the sensation of being able to move, versus the trauma of being forced to stay. We wondered if clients would use their ability to choose as an excuse to leave group. Interestingly, the clients who left once rarely left again; they shared that they experienced a "sensation of empowerment" as a "life force" versus "life depletion." In SE language, we would identify this as the "miracle" of self-regulation, i.e., activation and deactivation. In SE we also learn that the body has the ability to self-regulate and that "trauma disconnect" interrupts this capability.
Somatic Experiencing® meshes well with The Meadows' model, which is trauma-based. In the powerful Survivors' Workshop, an experiential exercise encourages the client to "identify with his functional adult caring for his inner child." He then shares his reality with the people in his life who have been "abusive, neglectful or abandoning." This involves resourcing prior to touching into the anxiety or pain. The workshop is completed within a community of five or six other clients. As in SE, healing work is meant to be processed with someone, versus by oneself.
At Mellody House, we reinforce the value of community in working toward trauma healing and recovering from addictions and self defeating, addictive behavior patterns. In essence, we encourage clients to support themselves and one another from a place of compassion. Following the SE approach of giving counselors permission to make mistakes while training, we encourage our clients to "experiment and make mistakes," encouraging the "try" without the limitation of the expectation of perfection. The successful part of the try is "pounced on positively," not only by counselors, but by other clients as well. As the client experiences the "felt sense" of "I can do this," energy becomes available to "touch into" more pain, anxiety, frustration or "stuckness." The "I can" part of self-regulation is restored, and the result is a client who senses new empowerment. "I cannot drink" becomes a "felt sense" experience of "I CAN not drink."
Clients who have achieved "self-empowerment" have an energy about them, a "coherence" that other clients seem to move toward. And somewhere along the way, the shift toward healing gains momentum, stronger than perhaps the "triggers to use." As a client discovers that "more of me is available to use my strategic thought" to manage the triggers, he develops resiliency.
I realized early on that I could talk at length with clients about their problems and still not know how to restore their resiliency. But if we can "pounce on the positive" and support clients in identifying their "felt senses" within, their human systems move into healing. The "I can" capacity of the human system is amazing.
In considering the recent Somatic Experiencing Conference, where many of us gathered to learn and to share our experiences, I think about the simple enjoyment of connecting with others in this community. My sensation of restored resiliency was reinforced by a wonderful "ventral vagal" connection with so many SE practitioners. What a strong reminder to balance work with fun, connection and growth.
In closing, instead of saying, "A miracle is just a shift in perception," one might say, "A miracle is the ability to shift and change perception." Either way, I believe in miracles.