In a series of brief articles, beginning below, Pia Mellody illustrates how living The Meadows' model has brought balance to her life.
In beginning the draft of my fifth book, I find myself continuously re-examining the relationship between body, mind, and spirit. In doing so, I have become even more acutely aware of the spiritual battle that rages between the ego and the soul. This topic becomes more poignant as I watch The Meadows' treatment model continue to gain worldwide recognition as the "spiritual model for the treatment of trauma and addictions."
Treatment at The Meadows has always been all-encompassing, addressing the body, mind, and spirit. Treating the body through our Wellness Program contributes to the healing process. Treating the mind through readings, lectures, workshops, and group interactions leads to healing through a shift in cognition's role in our lives. Treating the spirit is about treating spiritual impoverishment; different forms of spiritual practice include, but are not limited to: meditation, tai chi, yoga, and following 12 Step practices. These, in effect, engage the patient in spiritual balance.
Looking at the role of ego in the spiritual battle, I see it as attached to "I," "me," and "my." Self-examination can reveal how the ego has been destructive in life processes. If the ego is too powerful, the individual cannot see how it's creating misery. Our treatment goal in this scenario is to get the patient to self-examine what he's doing via his own self-destructiveness. The ego is attached to the body and naturally seeks pleasure. Our senses lead us to addictive processes and compulsions to seek pleasure and thereby medicate ourselves. When we use substances (alcohol, drugs), processes (sex, gambling), or people (love addiction), ultimately we will experience misery, as we are self-medicating.
When we cover our soul with our ego, we lay the foundation for spiritual impoverishment. We have buried our value, power, and abundance. The soul, in this scenario, plays a pivotal role; it remembers that we - and others - have inherent worth.
As I work on the new book, I will continue to share my thoughts on the rich connections between mind, body, and spirit, as well as show how value, power, and abundance affect individuals and the greater world. In the next article, I will illustrate how to truly heal through the understanding and application of the five core issues.
Self-medication and PTSD: A Path to Greater Complexity and Addiction?
Readers familiar with their own journeys or observing the struggles that loved ones endure know that PTSD symptoms sometimes demand immediate relief. Mood-altering chemicals, especially alcohol and marijuana, often provide temporary relief from anxiety, anger, depression, and other "limbic" surges. For many, alcohol and marijuana "take the edge off." They numb intense feelings, appear to quiet repetitive thinking, and afford some sleep and relief from the aftermath of trauma. In fact, in Western culture, alcohol has been a favored method of "recovering" among warriors, firefighters, and others who engage in vital but dangerous missions. Temporary relief usually comes in the form of "feeling no pain."
Actually, for a small but significant percentage of survivors, alcohol and other chemicals permit relief from the absence of feeling. In other words, getting drunk or high permits some feeling - any feeling - to break through the numbing produced by PTSD. Self-medicating is a devilishly seductive way of managing trauma. Self-medication provides temporary relief - a shortcut with the illusion of healing - but, oh, the price you pay! Alcohol, for example, will add to depression, confuse thinking, poison core relationships and, for some, set off violent behavior. For many, self-medicating will become a full-blown addictive disorder. Instead of one problem (PTSD), they now have two! Self-medication can involve food, sex, and the usual suspects: cocaine, opiates, amphetamines, cigarettes, alcohol and marijuana.
Academics and clinicians differentiate drugs from medicines: Drugs are self-administered without controls for dose, purity, etc. Medicines are taken only as prescribed (but often abused by active addicts). It's an oversimplification to say that all medicines are good, and all self-medication is evil. Many medicines cause harm; benzodiazepines and some sleep medicines can become addictive. However, in the hands of a skilled practitioner, medicines can provide much-needed symptom relief while the patient masters natural techniques that are highly effective in managing PTSD's multidimensional symptoms.
Recovery takes hard work and support. Re-stabilizing one's body and soul requires more than simple, singular solutions, sayings or insights; it is a process we know works. Self-medicating is not only risky, it is often tragic. Too many soldiers and civilians have been further injured by self-medicating. Simplistic, seductive, addictive, compulsive, and self-administered "treatments" too often result in broken marriages, broken careers and broken bodies. Life is hard enough without trauma, and trauma is hard enough outside of addiction.
The path to healing takes work, and work sometimes requires peer and professional support. John Barleycorn and Jack Daniels are not healthy supports or tools for recovery. If you are new on the journey of healing, do not be seduced by the temporary fixes offered by alcohol, drugs or other self-medicating behaviors. Recovery requires new skills. It's a process of integrating and healing, achieving and connecting - not masking, numbing or avoiding. Keep it simple and do not be intimidated, distracted or seduced by the siren song of medicating oneself.
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&
Recently John Bradshaw, Clinical Consultant for The Meadows, and author of three New York Times bestselling books including Homecoming: Reclaiming and Championing Your Inner Child; Creating Love; and Healing the Shame That Binds You, was quoted in an article on NBC's Ivillage with his thoughts about alcohol addiction. See http://www.ivillage.com/once-addict-always-train-wreck/4-a-296860
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.