Recognising the connection between thoughts, feelings, and body sensations allows individuals to exert some control over their well-being. It is, therefore, vital to learn how to reframe emotions and cultivate healthy approaches to thinking and feeling1.

The Mind-Body Connection

Different emotions bring different physical changes in the body. For example, at times of distress, the heart rate will increase in response to external stimuli. Each emotion facilitates different sensations, all facilitated by the vagus nerve, which in turn is the source of the mind-body connection2. By looking at some of the most common emotions, it is possible to see how they facilitate certain bodily responses:

• Happiness – This is an emotion that facilitates the greatest connection and communication between mind and body and is felt all over the body. When people are happy, the physiological response can be seen in a stable heartbeat, optimum digestion, and release of hormones that manifest as the feelings of contentment and relaxation associated with happiness.
• Depression – Depression has almost the opposite effect as it does not stimulate any form of brain activation. This emotion contributes to a general lack of activity in the brain and body.
• Love – Stimulates almost the entire body. However, unlike happiness, feelings of love tend to have higher intensity, so contentment is combined with anxiety and nervousness.
• Anger – Anger facilitates a cacophony of physiological responses that prepares the body for action. These can include elevated blood pressure, dilated pupils, heightened alertness, and increased levels of stress hormones such as adrenaline.
• Shame – This is a highly complex emotion inextricably linked to social engagement and societal expectations. Much like anger, shame can prepare the body for action, potentially even triggering the fight or flight response3.

It is important to note that specific responses to these emotions can vary from person to person. The differences depend on the complex interplay between biological, psychological, and social factors that are unique to each individual. However, they do highlight how control over emotions and responses means a certain level of control over the body.

The Nervous System

The nervous system plays a pivotal role in the mind-body connection. The central nervous system (CNS) consists of the brain and spinal cord, while the peripheral nervous system (PNS) comprises the nerves that extend throughout the body.

The nervous system interacts with other systems in the body, such as the digestive system and crucially, the endocrine system, which produces hormones that influence mead. For example, in times of stress, the nervous system will recognise the stressor and facilitate the release of cortisol – the stress hormone – in the endocrine system4.

Acknowledging this relationship between mood and bodily sensations is vital for understanding the benefits of reframing thought patterns.

Positive Thinking Patterns

Since emotions have a great impact on physical well-being, it follows that positive thinking patterns can improve overall health.

• Gratitude – By practising gratitude, individuals can acknowledge the positive aspects of their lives. This facilitates a shift in perspective where negativity transfers to positivity.
• Acceptance – Embracing the realities of letting go of what cannot be changed introduces balance to people’s perspectives.
• Empathy – Being aware of the emotions of others not only strengthens relationships and connections but it also cultivates kindness and compassion that can also be transferred inward.
• Positive self-talk – By replacing negative perceptions about the self with positive affirmations, individuals can boost self-esteem and overall mood5.

Negative Thinking Patterns

There are a variety of different thinking patterns that have negative consequences. These are largely subconscious and are, therefore, difficult to manage. For example, some people struggle with black-and-white thinking, whereby they perceive everything as absolute. These individuals may find that they think in extremes, and so they are predisposed to overly emotional responses to everyday situations6.

Other examples of negative thinking patterns include personalisation where individuals internalise external problems, or catastrophizing, in which people constantly anticipate the worst possible outcome.

Recognising and challenging these negative thought patterns allows for a more positive, balanced mindset7. There are a few practical techniques that can change or disrupt negative thinking patterns – most of these are related to the idea of reframing.

Reframing Your Thoughts

Applying practical techniques that reframe thoughts has great physical and emotional benefits. By reducing stress, promoting healthy behaviour, and enhancing resilience, it has a positive ripple effect on the body in its entirety. Embracing the power of reframing creates harmony between the mind and body. This means that individuals can harness the power of their own thoughts and start to live in happier and healthier ways.

However it is often easier said than done. While there are a variety of practical ways to do this it is best to start with a trained professional who can recommend specific therapies. Khiron clinics offer a diverse range of services that cater to a variety of needs including trauma, specific mental health struggles and more. Our esteemed colleagues can empower you to harness the power of thoughts to improve your physical and emotional wellbeing.

Endnotes

1. Trauma Research UK (2023) You become what you think about, Trauma Research UK. Available at: https://traumaresearchuk.org/blog/you-become-what-you-think-about/ (Accessed: 13 June 2023).
2.  Selva, J. (2023a) Exploring the body mind connection (incl. 5 techniques), PositivePsychology.com. Available at: https://positivepsychology.com/body-mind-integration-attention-training/ (Accessed: 13 June 2023).
3. Selva, J. (2023a) Exploring the body mind connection (incl. 5 techniques), PositivePsychology.com. Available at: https://positivepsychology.com/body-mind-integration-attention-training/ (Accessed: 13 June 2023).
4. Navarro, X., 2002. Physiology of the autonomic nervous system. Revista De Neurologia, 35(6), pp.553-562.
5. Mayo Clinic (2022) How to stop negative self-talk, Mayo Clinic. Available at: https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/positive-thinking/art-20043950#:~:text=The%20health%20benefits%20of%20positive%20thinking&text=Lower%20rates%20of%20depression,psychological%20and%20physical%20well%2Dbeing (Accessed: 13 June 2023).
6. Mayo Clinic (2022) How to stop negative self-talk, Mayo Clinic. Available at: https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/positive-thinking/art-20043950#:~:text=The%20health%20benefits%20of%20positive%20thinking&text=Lower%20rates%20of%20depression,psychological%20and%20physical%20well%2Dbeing (Accessed: 13 June 2023).
7. Meteor Education (2018) How does thinking positive thoughts affect neuroplasticity?, Meteor Education. Available at: https://meteoreducation.com/how-does-thinking-positive-thoughts-affect-neuroplasticity/#:~:text=Every%20thought%20releases%20some%20type,a%20feeling%20of%20well%2Dbeing. (Accessed: 13 June 2023).

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The science behind the effectiveness of creative therapies is grounded in the powerful impact of non-verbal expression, neuroplasticity, stress reduction, symbolic representation, and social connection. By providing unique avenues for self-expression and healing, creative therapies offer individuals a holistic approach to addressing emotional and psychological challenges. 1

What are Creative Therapies?

Creative therapies encompass a range of artistic practices, including Dance/movement, music, art, poetry, drama, expressive writing and psychodrama. Creative therapy practitioners must be accredited, and unlike arts-based support groups or healthcare practices, creative therapy centres on a person’s involvement in the therapeutic process as part of a targeted psychotherapeutic intervention.

Much like talk therapy, creative therapies have various approaches and aims. For some people, creative therapy can serve as a way to communicate feelings or emotions they struggle to verbalise or use a creative process to bring that not yet seen into a client’s awareness. Some creative therapies can also increase a client’s connection to their body, something they might have lost due to trauma or mental illness.

A Look at the Science

Researchers have identified three key brain networks involved in creativity: the default mode network, the executive control network, and the salience network. These networks work together, with the default mode network generating ideas, the executive control network evaluating them, and the salience determining which things tend to be noticed and which go unnoticed. For those with PTSD, the salience network is constantly scanning for threats.

It is thought that creative therapies may be particularly helpful when working with trauma as they can help you process traumatic experiences, which are often stored non-verbally in the brain. 2

Let’s look at the science of how creative therapies work.

Non-Verbal Expression and Emotional Release

One key factor in the benefit of creative therapies lies in accessing non-verbal forms of expression. Art, music, movement, and drama allow individuals to communicate, process and release emotions that may be difficult to express verbally. Studies have shown that engaging in these creative processes activates brain regions associated with emotional regulation and release, helping clients let go of emotions that may have been stuck and reducing psychological distress. 3

Neural Plasticity and Rewiring of the Brain

Creative therapies have the potential to promote neuroplasticity. This is the brain’s ability to reorganise its structure, form new neural connections, and strengthen existing ones.3 It enables learning, recovery from harm and adaptation as the brain rewires itself based on experiences, learning, and the environment. Artistic activities stimulate multiple sensory pathways, cognitive processes, and motor skills, engaging various brain regions simultaneously. This complex stimulation strengthens neural networks and promotes adaptive changes in the brain. As a result, creative therapies can enhance cognitive flexibility, emotional resilience, and problem-solving abilities.

Stress Reduction and Relaxation

Engaging in creative activities has been found to induce and enhance a relaxation response in the body. It helps reduce stress hormone levels such as cortisol and activates the parasympathetic nervous system, which is responsible for the body’s rest-and-digest response.3 Music therapy, in particular has been shown to lower heart rate and blood pressure, promoting relaxation and calmness. By providing a means of self-expression and unwinding, creative therapies offer a safe space to process and alleviate stress and anxiety.

Symbolic Representation and Meaning-Making

The use of symbols and metaphors in creative therapies can facilitate the exploration and understanding of deeply rooted and even hidden emotions and experiences 4. Artistic creations, movement patterns, or improvised performances can act as symbolic representations of inner conflicts, personal narratives, and unconscious processes. With the support and guidance of a trained therapist, individuals can explore these symbols and derive personal meaning, leading to increased self-awareness, insight, and a sense of empowerment. This can help with identifying triggers and practising acceptance.

Social Connection and Support

Creative therapies often involve group settings, fostering social connections and a sense of belonging. Group art therapy, for instance, allows individuals to share their artistic creations, engage in collaborative projects, and receive feedback and support from peers. This social interaction promotes empathy, validation, and a shared sense of humanity, crucial elements in the healing process. Positive social experiences within creative therapy settings can greatly improve self-esteem, reduce feelings of isolation, and promote overall well-being.

Many people have the misconception that they need to be proficient in creative practice to participate in that kind of therapy. However, creative therapies are about the artistic and therapeutic process instead of the result. The value of a session is in the effect on well-being as opposed to the aesthetic of the artwork.

Endnotes

1. Chiang, M., Reid-Varley, W. B., & Fan, X. (2019). Creative art therapy for mental illness. Psychiatry research, 275, 129–136. https://doi.org/10.1016/j.psychres.2019.03.025
2. Sussex Publishers. (2018). Your brain on creativity. Psychology Today. https://www.psychologytoday.com/gb/blog/experimentations/201802/your-brain-creativity
3. Ziff. (2010). Expressive Therapies Continuum: A Framework for Using Art in Therapy by Lisa Hinz. Journal of Creativity in Mental Health, 5(2), 221–225. https://doi.org/10.1080/15401383.2010.485121
4. Lusebrink, & Hinz, L. D. (2020). Cognitive and Symbolic Aspects of Art Therapy and Similarities With Large Scale Brain Networks. Art Therapy, 37(3), 113–122. https://doi.org/10.1080/07421656.2019.1691869

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In this article, we will cover:

• The internal family systems model
• Ego state therapy
• How parts therapy can treat trauma
• The limitations of parts therapy

The Internal Family Systems Model

Developed by renowned therapist Richard Schwartz, the internal family systems model (IFS) focuses on working with different parts of an individual. Parts can be forced out of their valuable roles by trauma and other events.^[1] He writes that there are three common parts:

• Exiles – vulnerable and emotional; exiles are the parts of the Self that are locked away after a negative event or experience. They are the part that is protected by the other two parts below.
• Managers – manage a person’s life in response to trauma, whether that is in a positive or negative way. In a negative light, managers can be incredibly controlling.
• Firefighters – defined as a radical version of a manager, firefighters can be impulsive and extreme, trying to distance themselves from the feelings of exile through coping mechanisms such as drugs, alcohol, or work.

These parts can interact together in response to trauma. Managers might compartmentalise and push the exiles aside, or the firefighter could drown out both parts by using healthy or unhealthy coping mechanisms.

The internal family systems model has five basic tenets:

• Our minds are split into many parts
• Everyone has a Self which should coordinate the inner family
• There is no bad part
• Growth and change affect the inner parts in good or bad ways depending on the events
• Change to the internal system will change the external system as well

The goal of the IFS model is to reconcile each part to collaborate with the Self, which is the subconscious part of a person that is the natural leader. After experiencing trauma, abuse, or other negative events, firefighters or managers jump to protect the Self. IFS therapy models aim to help these parts step back and trust the Self to lead.

Ego State Therapy

Ego state therapy is another parts-based therapy model developed by John G. Watkins in the 1990s. It focuses on ego states, which are various identities and roles that people adopt in response to trauma and the world around them. People can have multiple ego states depending on their situation and who they are around, and ego state therapy helps to collate these egos into one Self.

For instance, someone may act childish around their family but mature around their friend or co-workers as a response to negative childhood events. Ego state therapy aims to reconcile them together by unburdening trauma.

There are four ego states identified by psychologists:

• Conflicted ego states – occur when various parts are in opposition to each other, causing inner turmoil and conflict. Here, ego state therapy assists in resolving conflicted states and encourages each of the states to communicate and work in cohesion.
• Retro ego states – these are ego states that were once useful but are not harmful. Ego state therapy helps these states only to appear when they are useful.
• Vaded ego states – this is a state that arises in response to a traumatic event. Causing emotional reactivity, the goal of ego state therapy is to reconcile and heal vaded ego states.
• Normal ego states – developing normal ego states is the goal of this type of therapy. They are not in conflict with any other states and help with healthy expression of the S

Ego state therapy is a parts-based therapy approach that takes a relatively brief time compared to other therapy models. It is popular among therapists who use hypnosis to treat clients.

How Parts Therapy Can Treat Trauma

Therapists use both the internal family systems model and ego state therapy to treat trauma, post-traumatic stress disorder, and mental health conditions. Parts-based therapy approaches may be especially effective in treating trauma by breaking down the personality into manageable parts that the client can then reconcile to create a coherent Self.

Both approaches concentrate on parts that have experienced trauma and collaborate with them in positive ways. There are no negative parts in either – only parts that are trying to protect the person. Therapists help clients interact with the parts carrying the trauma and build a healthy relationship with the other parts.

IFS and ego state therapy work in diverse ways, but the end goal is the same: to help clients process trauma and form a coherent Self that is mentally healthy. By unburdening various parts – the exile in IFS or the vaded ego state – both forms of therapy are highly effective at helping people to process trauma.

The Limitations of Parts Therapy

Although using the concept of parts is a widely used form of therapy, there are some limitations.^[2] Criticisms of the IFS model include:

• It can be anxiety-inducing for clients
• It might not work well with paranoid or schizophrenic people who could misuse or misinterpret the idea of parts
• The lack of an external support system can limit the benefits

Despite these limitations, parts therapy can be an effective treatment for a range of issues, especially trauma. Whether participating in ego state therapy or using the IFS model, using the concept of parts to treat clients is a unique and effective form of treatment that has proven positive results.

f you have a client or know of someone struggling to heal from psychological trauma, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and outpatient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long-lasting recovery. For more information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

[1] https://ifs-institute.com/resources/articles/evolution-internal-family-systems-model-dr-richard-schwartz-ph-d

[2] Deacon, Sharon A.; Davis, Jonathan C. (March 2001). “Internal Family Systems Theory: A Technical Integration”. Journal of Systemic Therapies. 20 (1): 45–58. doi:10.1521/jsyt.20.1.45.19410.

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The occurrence of intergenerational trauma is frequently examined as part of historical trauma. One of the first studies that documented intergenerational trauma was in 1966, when Canadian psychiatrist Vivian M. Rakoff, MD, noted high rates of psychological distress among descendants of Holocaust survivors.^[1]

Since this significant study was carried out, researchers have assessed PTSD, anxiety, depression, and other trauma-related disorders among trauma survivors and their children. Throughout this wide pool of research, there is shown to be a consistent prevalence of trauma disorders among offspring.

Yael Danieli, Founder and Director at the Intergenerational Center for Multigenerational Legacies of Trauma, states, “it behoves us to study this area as widely as possible, so we can learn from people’s suffering and how to prevent it for future generations.”^[2]

Understanding Intergenerational Trauma

The most common source of reference to intergenerational trauma is that of Holocaust survivors and their families. However, all types of trauma to a parent, such as sexual abuse, the sudden death of a loved one, an accident, racism, neglect, domestic violence etc., are all shown to impact the mental health of offspring negatively.

Studies evidence specific maladaptive behaviour patterns within the trauma survivor’s progeny, including immature dependency, codependency, an obsession with the trauma event, control issues, avoidant attachment, and an over-protective attitude to parents or associated family members.

These reactions are known as reparative adaptational impacts. This reflects an offspring’s desire to repair the traumatic past of their parents and create a world where the parent feels safe and one where future generations of the family are secure.^[3]

Research has found the mothers post-trauma adaptive victim style has the strongest effect on whether the child develops trauma-related issues, such as generalised anxiety disorder and major depressive episodes. The severity of impact on the children of trauma survivors varies depending on this victim style.^[4]

Danieli has been extensively studying this topic since the 1980s. She devised a three-part questionnaire for adult children to understand the impact of their parent(s) trauma history on their upbringing, attachment type, their family behaviours, medical history, and how it has further influenced their adult life.

The Danielli Inventory is now widely acclaimed and is used worldwide as part of psychiatric assessment and subsequent treatment for trauma-related disorders. In its first use, the findings demonstrated that out of 484 children, 35% had generalised anxiety disorder, 26% had major depressive episodes, and 14% had PTSD. These findings closely connected to the post-trauma adaptive victim styles of the parent(s).

Danieli found three key victim styles of note:^[5]

• Victim
• Numb
• Fighter

The adult children whose parents had vulnerability behaviours associated with victim and numb styles were found to be far more likely to develop trauma disorders than those whose parent(s) had adapted to have the fighter style.

Aside from a parent(s) victim styles, there are numerous other ways traumatic effects may be transmitted throughout familial generations, including the body itself.

Understanding Epigenetic Trauma

Epigenetic trauma is part of a growing body of research that states that parental trauma triggers biological, genetic alterations which are passed down through a familial line to children and potentially grandchildren.

For example, Rachel Yehuda, PhD, found that children of Holocaust survivors with PTSD had reduced methylation levels, a type of epigenetic factor, which is a stress-related glucocorticoid receptor associated with anxiety and depression.^[6]

Michael Skinner, a biologist at Washington State University, has traced this inheritance of trauma to the epigenome. His research suggests that changes to the epigenome, a combination of biological factors which determine how genes are expressed, can be passed down through multiple generations.^[7]

Studies in this area are small, and there are concerns over the handling of such sensitive data. Proving that emotional trauma can be passed down through generations through genetics is difficult. What’s more, it is extremely complicated to disentangle these potential genetic alterations to those of social inheritance, which is an evidenced key factor for intergenerational trauma.

It would not be helpful to insinuate that a child’s inherited trauma disorders were inevitable or that they cannot be healed. Through trauma therapy, it is possible for sufferers to free themselves from introjected bonds and develop a true sense of autonomy, fulfilment, and well-being.

Trauma Disorders Need Not Be Inevitable

Although more understanding of intergenerational trauma and its transmission mechanisms is required, clinicians are delivering successful interventions and therapeutic treatments to help sufferers.

As the very nature of intergenerational trauma is familial, it is essential for treatment programs to be targeted towards the whole family. Through improved communication skills, reduced conflict strengthened resilience, and a deep understanding of how the trauma and associated behaviours impact, the family can grow together and heal as a unit.

In therapy, the psychologist will work with the client and their family to understand the origin of the trauma and its broader implications. A helpful tool is for a trauma family tree to be created, which incorporates multi-generations in order to provide transparent details of trauma history. This assists families in developing essential communication skills which focus on honesty – allowing them to move beyond secrecy, shame, or resentment and towards growth and positive connection.

This multigenerational family tree could additionally include genogram methodology, which incorporates health and psychological patterns which will help highlight family relationships and why certain behaviour patterns have been passed down.

Continuing to explore the intergenerational effects of trauma is essential for the ongoing effort to treat psychological pain and trauma disorders at their roots.

If you have a client or know of someone struggling to heal from psychological trauma, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and outpatient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long-lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

[1] “Intergenerational Trauma And Residential Schools | The Canadian Encyclopedia”. Thecanadianencyclopedia.Ca, 2021, https://www.thecanadianencyclopedia.ca/en/article/intergenerational-trauma-and-residential-schools.

[2] DeAngelis, Tori. “The Legacy Of Trauma”. Https://Www.Apa.Org, 2019, https://www.apa.org/monitor/2019/02/legacy-trauma.

[3] Danieli, Yael et al. “The Danieli Inventory Of Multigenerational Legacies Of Trauma, Part II: Reparative Adaptational Impacts.”. American Journal Of Orthopsychiatry, vol 85, no. 3, 2015, pp. 229-237. American Psychological Association (APA), doi:10.1037/ort0000055. Accessed 26 July 2021.

[4] Guthery, Lisa S. “Exploration Of Intergenerational Transmission Of Trauma In Exploration Of Intergenerational Transmission Of Trauma In Holocaust Survivors Holocaust Survivors”. Scholarworks.Smith.Edu, 2016, https://scholarworks.smith.edu/cgi/viewcontent.cgi?article=2791&context=theses.

[5] Danieli, Yael et al. “The Danieli Inventory Of Multigenerational Legacies Of Trauma, Part I: Survivors’ Posttrauma Adaptational Styles In Their Children’s Eyes”. Journal Of Psychiatric Research, vol 68, 2015, pp. 167-175. Elsevier BV, doi:10.1016/j.jpsychires.2015.06.011. Accessed 26 July 2021.

[6] Yehuda, Rachel et al. “Influences Of Maternal And Paternal PTSD On Epigenetic Regulation Of The Glucocorticoid Receptor Gene In Holocaust Survivor Offspring”. American Journal Of Psychiatry, vol 171, no. 8, 2014, pp. 872-880. American Psychiatric Association Publishing, doi:10.1176/appi.ajp.2014.13121571. Accessed 26 July 2021.

[7] Curry, Andrew. “Parents’ Emotional Trauma May Change Their Children’S Biology. Studies In Mice Show How”. Science | AAAS, 2021, https://www.sciencemag.org/news/2019/07/parents-emotional-trauma-may-change-their-children-s-biology-studies-mice-show-how.

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Levine began to develop Somatic Experiencing following his observations of animals in the wild. He noticed that, when facing threat, animals display a range of threat responses similar to humans – fight, flight, and freeze. Unlike humans, however, Levine noticed that animals were adept at releasing the physical energy charged up by the threat response, able to recover quickly and return to a state of internal homeostasis. Humans, unfortunately, have a much harder time releasing this energy.

Even though we may be safe now, our nervous system can become ‘stuck’ in its threat response. When we live our day to day lives with a frozen threat response, we continue to sense danger in the environment, are on high alert and in a state of high reactivity. Alternatively, we become numb and apathetic, unable to live fully in the present.

Somatic Experiencing helps to restore clients to health by assisting them in releasing their frozen energy and gaining a visceral understanding of safety.

Trauma and the Brain

Let’s simplify the brain into two basic primary modes; ‘safe’ and ‘survival’. Safe mode allows us to relax, engage with others, and learn new information. When we are safe, we are healthy, open, and sociable.

In safe mode, the branch of the Autonomic Nervous System^[1] (responsible for regulation of physiologic processes) activated is the Parasympathetic Nervous System, responsible for rest and digestion.

In survival mode, we are on high alert, constantly surveying our environment for threat, and highly reactive to stimuli. Or we are emotionally shut down, numb and apathetic to our surroundings. Decisions in survival mode are often fear-based. In survival mode, it is the Sympathetic Nervous System (responsible for the fight/flight response) that is activated.

In the face of threat, we enter survival mode, which ensures our safety. When the threat has passed, we may still be in survival mode, because the threat was overwhelming that we froze. While our threat responses aim to ensure our survival, they can be detrimental to our health if they are prolonged. Prolonged activation of our threat response leads to a range of physical and psychological health issues^[2], including anxiety, depression, poor concentration, strained interpersonal relationships, flashbacks, and other mood and personality disorders.

How does Somatic Experiencing work in Practice?

 To release the grip of our frozen threat responses on our well-being and functionality, the accumulated energy from the response must be discharged. A trained SE therapist guides the client in becoming aware of their physical sensations when talking about their past experiences. The client’s narrative of the experience is not the centre of focus in therapy, Instead, focus is placed on the physical, inner sensations that arise when the experience is revisited.

Unlike traditional talk therapies, which take a ‘top-down’ approach, focusing on cognitive processing, Somatic Experiencing uses a ‘bottom-up’ approach, where focus is given the bodily sensations linked to traumatic memories.

In the early stages of SE therapy, clients are educated on the nervous system and how it is affected by a traumatic event. This serves to dispel any confusion as to why a person is experiencing difficult trauma-related symptoms.

Before visiting the traumatic memories, therapists help clients to resource their own innate strength, peace and resilience by discussing positive aspects of the client’s life, perhaps people or places that bring them a sense of peace and calm.

Once the resources for strength and resilience have been identified, a gradual revisiting of the traumatic memories can take place. This stage of the process, known as titration, allows clients to slowly accept the memory and the associated feelings. The process is gradual to prevent overwhelm and retraumatization.

As the memories are revisited, the trained SE therapist will witness and track the clients sensations and physicality, such as a change in breathing, postural shifts, or a change in tone of voice. The client collaborates with the therapist by informing them about invisible sensations, like a change in body temperature or a dizzy feeling.^[3]

When sensations arise, clients may respond by shaking, trembling, or crying. There may be muscular tightening, clenching of hands, clenching of the jaw. These phenomena are considered to be a release of the frozen energy, and are encouraged. At the same time, the therapist will help the client come to a calmer state by encouraging the use of the cultivated resources at the beginning of therapy^[4]. Over time, the movement from activation to calm becomes a lot smoother, and further exploration can take place.

What are the Benefits of Somatic Experiencing?

 Somatic Experiencing offers a range of benefits to clients who have experienced trauma, such as child abuse, neglect, sexual abuse, violence, natural disasters, or motor vehicle accidents.

Following a course of SE therapy, clients may experience^[5]:

• A greater sense of self
• Increased confidence
• Reduction in PTSD symptoms
• Improved concentration
• Improved relationship with one’s body

Unresolved trauma permeates into all aspects of our lives. It can lead to a host of disruptive and inhibitive physical and psychological symptoms that get in the way of us being able to fully live our lives. With Somatic Experiencing, clients can find that healthy functioning is restored, and maladaptive behaviours, or survival strategies, can be reduced. Ultimately, Somatic Experiencing helps clients find balance and regulation in their nervous system, which is integral to leading a healthy life.

If you have a client, or know of someone who is struggling and could benefit from participating in treatment modalities such as somatic experiencing, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and out-patient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

^[1] McCorry, Laurie Kelly. “Physiology of the autonomic nervous system.” American journal of pharmaceutical education vol. 71,4 (2007): 78. doi:10.5688/aj710478

^[2] Selye H. The Stress of Life. New York: McGraw-Hill; 1956.

^[3] Healthline. n.d. Somatic Experiencing: How It Can Help You. [online] Available at: <https://www.healthline.com/health/somatic-experiencing#considerations> [Accessed 25 June 2020].

^[4] Healthline. n.d. Somatic Experiencing: How It Can Help You. [online] Available at: <https://www.healthline.com/health/somatic-experiencing#considerations> [Accessed 25 June 2020].

^[5] Khan, K., 2018. How Somatic Therapy Can Help Patients Suffering From Psychological Trauma. [online] World of Psychology. Available at: <https://psychcentral.com/blog/how-somatic-therapy-can-help-patients-suffering-from-psychological-trauma/#:~:text=Somatic%20therapy%20offers%20a%20variety,a%20heightened%20ability%20to%20concentrate.> [Accessed 5 August 2020].

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Internal Family Systems is a model that was first developed in the 1990s by Dr. Richard Schwartz. Schwartz conceptualised a core self, one that is at the essence of a person and is undamaged by external circumstances. Schwartz believed that along with the core self, there are also different sub-personalities, known as Exiles, Managers, and Firefighters^[1].

The idea of a person containing different aspects of the self was not new to Schwartz. In the 50s, Freud developed the concept of the ego, superego and the id, all as functional parts of the self. Eric Berne’s Transactional Analysis considered the parent ego state, the adult ego state, and the child ego state as they relate to our interactions with others.

Exiles, Managers and Firefighters

Exiles are the parts of ourselves we have suppressed. They are commonly associated with feelings of guilt and shame. They are the parts of the self that are wounded. These parts are placed in exile by the managers and firefighters, who prevent these wounded parts from rising to the conscious mind.

Managers are the parts of ourselves which are responsible for daily functioning. They direct our behaviour by orienting us away from potentially being hurt, perhaps by becoming too dependent on another person or by being rejected. They make decisions for us based on potential dangers and influence how we relate to others.

Firefighters are involved in survival or avoidant behaviours, such substance abuse, sexual risk-taking, compulsions, and self-harm. These behaviours happen when an exile begins to rise to the surface, perhaps triggered by a person, place or memory.

When we experience a trauma – like an attachment injury – we carry extreme beliefs and emotions, known in the IFS model as burdens. Guilt and shame are examples of burdens that are carried by the exiles.

When we assume that a part is a burden itself, it makes sense that other parts will go to war against it. Parts are not burdens, they carry burdens.

The Self in the Internal Family System

Other than exiles, managers, and firefighters, we have a core self that retains its essence despite external circumstances^[2], like trauma related to neglect or abuse. The self is not a visible, compartmentalised aspect of the person; it is the ‘I’ that witnesses thoughts, feelings, behaviours, memories, and judgments.

Related to the self are positive attributes, such as confidence, compassion, connectedness, wisdom, acceptance, perspective, and leadership.

In IFS, the aim is to identify the exiles, managers, and firefighters and recognise them as parts of the self, not the full self. The therapist and client work together to address the burdens that parts are carrying and attempt to unburden them, restoring these wounded parts with a sense of trust and harmony alongside the rest of the internal system.

IFS believes that the self, when present, is able to speak to these burdened parts in a way that promotes release and healing, ultimately achieving harmony across the internal family system.

Who can benefit from IFS?

IFS is used in the treatment of psychological wounds and other mental health conditions. In particular, IFS may be used to treat those who have experienced childhood abuse or neglect, where a part of the self has come to believe it was inherently bad, shameful, or unworthy of love.

IFS has been used in the treatment of issues such as^[3]:

• Psychological trauma.
• Various forms of abuse (physical, emotional, sexual).
• Depression.
• Anxiety.
• Issues with body image.
• Fears and phobias.
• Substance abuse.

What happens in IFS Therapy?

The structure of an IFS session is similar to that of traditional talk therapies, whereby a person relays their thoughts and feelings through a narrative. But, IFS also involves guidance towards noticing one’s internal environment in relation to how they feel, whilst paying attention to any ‘parts’ that are carrying a particular burden^[4]. For example, a person who suffers from an eating disorder may be guided towards paying attention to the part of the self that wants to binge.

The client is then asked to identify how they feel towards that part. Their response may involve feelings of fear, hatred, guilt, or shame, to name just a few.

Communication is then encouraged between the self and the wounded part. With a clear mind cultivated and developed through mindful awareness, clients can begin to listen attentively to the part of themselves that is carrying the burden and potentially hear it explain its behaviour. With the guidance of an attained therapist, the part can be asked to take on safer, more effective coping mechanisms to deal with its pain.

Untangling the Parts, Finding the Self

IFS works by identifying and addressing the parts of ourselves that carry our burdens, and uncovering the deeper, unaffected self to help those parts heal from their pain. For healing to occur, those parts are guided towards letting go of the protective (yet simultaneously destructive) roles they have taken on as a result of difficult experiences. The result is a harmonious internal family system that is led by the confident, calm, connected, and curious self.

Get in touch

If you have a client, or know of someone who is struggling to heal from psychological trauma and could benefit from Internal Family Systems Therapy, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and out-patient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

^[1] Ifs-institute.com. n.d. The Internal Family Systems Model Outline | IFS Institute. [online] Available at: <https://ifs-institute.com/resources/articles/internal-family-systems-model-outline> [Accessed 7 August 2020].

^[2] Ifs-institute.com. n.d. The Internal Family Systems Model Outline | IFS Institute. [online] Available at: <https://ifs-institute.com/resources/articles/internal-family-systems-model-outline> [Accessed 7 August 2020].

^[3] Leading Edge Seminars. n.d. Clinical Applications Of Internal Family Systems (IFS) – Leading Edge Seminars. [online] Available at: <https://leadingedgeseminars.org/event/clinical-applications-of-internal-family-systems-ifs/> [Accessed 7 August 2020].

^[4] Goodtherapy.org. 2018. Internal Family Systems Therapy. [online] Available at: <https://www.goodtherapy.org/learn-about-therapy/types/internal-family-systems-therapy> [Accessed 7 August 2020].

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However, one significant element of restoring health which is often overlooked is proper nutrition. Our bodies work by consuming fuel, which is used to support the functioning of every bodily system. The quality of the fuel we use matters, just like the quality of fuel we use for a car makes a difference to how well it functions.

The body should be the healthiest it can reasonably be as the healing process is unfolding, so the person can begin to feel that emotional freedom in a healthy body. Nutritional therapy can help to achieve a healthier balance between both the body and the mind, setting a strong foundation for recovery.

Trauma and Stress

PTSD and trauma-related issues typically involve elevated levels of stress^[2]. Traumatic events can overwhelm our nervous system, sending us into fight or flight mode to ensure our survival, and keeping us trapped in a threat response when we freeze^[3] (shutting down as a last resort if fight/flight is not viable). Our response to the threat – which may have been a natural disaster, a motor accident, or physical, verbal, or sexual abuse, neglect, or anything else that compromised our sense of safety – can become stuck within the body. The high levels of stress experienced at the time may not subside but instead live in the body, resurfacing as anxiety, depression, flashbacks, poor concentration, sleeplessness, physical ailments and illness, and impaired social functioning. Traumatic stress wears down the mind and body, so it is essential that, while getting the professional help we need to heal, we support the body as much as possible.

Psychotherapy and Medication as Traditional Treatments

Psychotherapies and medications are amazing tools we have in our toolkit to work towards healing trauma. They have allowed many trauma survivors to find some relief from their symptoms. However, trauma is a complex issue and approaches that work well for some may not work as well for others. It will also vary depending on the severity of symptoms and an individual’s capacity to do the healing work.

Trauma is deeply held and releasing it takes courage and strength. A nutrient-rich balanced diet is key to supporting the individual in both mind and body to take the necessary steps forward on the journey to health.

The Power of a Healthy Diet

A healthy diet is well known for contributing to good physical and mental health^[4]. Managing physical and mental health is challenging for those suffering from trauma, so the body must have the fuel it needs to function.

Chronic stress – like that experienced in the aftermath of trauma – breaks down healthy tissues in the body.^[5] To counteract the breaking down of tissues, as well as inflammation that occurs as a result, the body needs to be provided with certain nutrients to function effectively.

We can do this by adopting a healthy diet, which involves:

• Eating regular meals: This helps to maintain blood sugar levels and prevents the body from sending signals to the brain that food is scarce, thereby reducing stress signals.
• Increasing intake of Omega 3 fatty acids: Omega 3 fatty acids, like those found in salmon and tuna, nuts, seeds, and plant oils, have inflammatory properties, reducing inflammation in the body caused by stress.
• Eating foods that are rich in protein: Protein-rich foods support tissue repair, help to regulate blood sugar, and are key for the production of neurotransmitters (chemical messengers), thus supporting cognitive function.
• Increasing intake of magnesium: Magnesium promotes healthy nerve and muscle functioning and helps to relax tight muscles. This is particularly helpful for reducing the negative impact of stress on the muscles of the body.
• Increasing intake of antioxidants: Antioxidants help counteract the effects of oxidative stress on the body, which is commonly linked to anxiety.
• Limiting stimulants: Stress can be reduced by limiting intake of stimulants like caffeine. Too much intake of stimulants can lead to disruption of sleep and increase the release of stress chemicals in the body.
• Optimising hydration: Hydration is key for both digestive and cognitive function, as well as effective cell functioning.

Nutritional Supplements for Stress Reduction

While it is important to follow a healthy diet incorporating the basic guidelines listed above, traumatic stress can affect us in such a way that we may find it difficult to even think about food. Not only does stress suppress the appetite, or alternatively cause us to eat more with disregard for the quality of that food, but for some trauma survivors, food itself can be a trigger. Others, for example those who have lost their homes due to natural disasters, may not have access to a functioning kitchen, making it harder to get the right nutrients.

Trauma treatment can be supported by an increased intake of nutrients, and not just through food. Following the Christchurch earthquakes in 2011, many people were affected by loss of loved ones, their homes and even jobs.

Studies took place examining the levels of stress in the earthquake survivors, with participants made up of members of the general population^[6]. Three groups were studied – one which was not given any nutritional supplements, one which was given a B-Complex supplement, and one which was given a supplement containing over 30 vitamins and minerals.

The B-Complex group showed a significant reduction in stress after two weeks, which was maintained at four weeks, and decreased significantly over one year.

The group with the nutrient-rich supplements showed greater decreases in stress than the B-Complex group at two weeks, four weeks, and one year.

Both groups that received supplements showed a much greater reduction in stress than the control group, implying the important role of nutrition in recovering from stress.

The Relationship with the Body

Eating the right food promotes a healthy relationship between you and your body. Trauma recovery involves coming back into the body in the present, instead of being stuck in the past. When you treat your body well, it serves you.

Consider the ‘Ben Franklin effect’: “If you want somebody to like you, get them to do you a favour.” This is based on the idea that, even if the favour is seemingly insignificant, there is an underlying message sent that the favour must have been done because the recipient was liked. If you can do your body a favour by providing it with natural, nutritional foods, you will come to feel that your relationship with your body is a little more compassionate.

Get in touch about nutritional therapy

If you have a client, or know of someone who needs support through trauma recovery, and could benefit from nutritional therapy, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and out-patient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

^[1] nhs.uk. 2018. Post-Traumatic Stress Disorder (PTSD). [online] Available at: <https://www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/> [Accessed 7 August 2020].

^[2] Bremner, J Douglas. “Traumatic stress: effects on the brain.” Dialogues in clinical neuroscience vol. 8,4 (2006): 445-61.

^[3]  Schmidt, Norman B et al. “Exploring human freeze responses to a threat stressor.” Journal of behavior therapy and experimental psychiatry vol. 39,3 (2008): 292-304. doi:10.1016/j.jbtep.2007.08.002.

^[4] MD, E., 2015. Nutritional Psychiatry: Your Brain On Food – Harvard Health Blog. [online] Harvard Health Blog. Available at: <https://www.health.harvard.edu/blog/nutritional-psychiatry-your-brain-on-food-201511168626> [Accessed 7 August 2020].

^[5] Mariotti, Agnese. “The effects of chronic stress on health: new insights into the molecular mechanisms of brain-body communication.” Future science OA vol. 1,3 FSO23. 1 Nov. 2015, doi:10.4155/fso.15.21.

^[6] Nutrition & Mental Health. “Nutrition for Trauma and PTSD.” YouTube, 20 Nov. 2019, www.youtube.com/watch?v=pVRUQ6Cv8Wg. Accessed 7 Aug. 2020.

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Pat Ogden, developer of SP and founder of the Sensorimotor Psychotherapy Institute, first began to develop her innovative treatment approach while working in a psychiatric clinic in California in the 1970s. As a dance and yoga teacher, Ogden observed that many of the patients in the clinic appeared to be deeply disconnected from their bodies, and this disconnection prevented resolution of their psychological issues. Missing from traditional talk therapies, Ogden noticed, was attention to the body.

The concept

The theory behind the approach is that traumatic threat stimulates the body’s emergency stress response. Release of adrenaline results in an increase in heart rate and breathing along with instinctive animal defense responses that compel us to automatically fight, freeze in terror, flee, or collapse in total submission (the ‘feigned death’ response seen in animals).  To allow these instinctive responses to be successful, the prefrontal cortex or ‘thinking brain’ is inhibited.  We sense what to do rather than decide what to do. But with an inhibited prefrontal cortex, we can’t put the experience into words.

Following the traumatic experience, the brain does not encode a chronological verbal memory of the event but instead stores the ‘memory’ of the trauma in the form of nonverbal physical and emotional memories. These implicit unresolved memories cannot be recalled, but they are continuously stimulated by even very subtle cues connected in some way to the event or events. These triggers evoke the same threat responses to danger, and our bodies respond as if we were.

Over time, the traumatic event does not resolve because it is activated over and over again by triggers. The traumatised individual still feels unsafe, frightened, and at risk or hopeless and numb. Bessel van der Kolk describes this phenomenon as “the body keeps the score.”  The trauma cannot be resolved because the body responses keep re-activating it.

Healing the body

For a long time, talk therapies have been the go-to approach for treating traumatised clients. While they can be helpful in increasing insight and self-compassion, the physical effects of trauma go unchanged or can even be exacerbated by the telling and re-telling of the events.

With a traumatised nervous system unable to effectively regulate emotions and impulses and a body easily stimulated by triggers, the individual often remains on high alert, anticipating new dangers.  The result is either emotional numbing (often labeled ‘depression’) or chronically high anxiety or impulsive and self-destructive.

A dysregulated nervous system affects all areas of life, from the ability to feel safe in the world to personal satisfaction and contentment, from the quality of our relationships to our ability to perform well at work or school.  Nervous system dysregulation is also the underlying ingredient in anxiety disorders, mood disorders and personality disorders.

How it works

‘Traditional talking therapies (including psychodynamic psychotherapy, psychoanalytic methods, cognitive-behavioural treatment, and exposure techniques) can effectively address the emotional, relational, and cognitive symptoms of trauma-related disorders and/or manage the secondary symptoms to ensure patient safety, but traditional psychotherapy models generally lack techniques that directly treat the autonomic and somatic effects perpetuating the psychological symptoms.’^[1]  – Janina Fisher

Here is where sensorimotor psychotherapy aims to intervene. Sensorimotor psychotherapy uses a somatic (body-based) and mindfulness-oriented approach in which clients are asked to become aware of the physical sensations accompanying their painful thoughts and feelings.

Each traumatised individual uniquely encodes an event or events in the form of images, smells, sounds, autonomic responses, visceral and muscular sensations, movements and impulses, emotions, and cognitive and narrative components.^[2]

By avoiding interpretation of the sensations or autonomic responses as danger signals and instead focusing on increasing the capacity to tolerate their feelings and physical reactions, most clients experience a calming effect. With practice and repetition, they begin to feel a greater sense of control over their overwhelming or numbing reactions.

In a sensorimotor psychotherapy session, the therapist focuses not on the events but on how the traumatic experiences are encoded in the client’s body. Mindful curiosity is encouraged, which itself helps with affective and autonomic regulation.

Sensorimotor Psychotherapy, Mindfulness and Dual Awareness

By cultivating their ability to be mindful, clients can foster a sense of dual awareness.  They can feel the uncomfortable or distressing feelings in their bodies while also holding awareness of present time and safety: “I feel scared though I can see that I am here with you and not in danger.” Dual awareness keeps the prefrontal cortex or ‘thinking brain’ active, allowing individuals to distinguish a threat from a trigger. In addition, the brain’s threat center (the amygdala) decreases its activity when there is increased activity in the medial prefrontal cortex. With practice, aided by increased connection to clients’ innate strengths and inner resources, the nervous system becomes more regulated. The result is the acquisition of the ability to connect to themselves without becoming numb or overwhelmed.^[3]

With a more regulated nervous system and more access to mindful curiosity, clients can then begin to transform the ways in which the trauma responses have become encoded in the body. The completion or transformation of old traumatic reactions occurs through the practice of physical interventions, such as a deep breath to expand the chest or a lengthening of the spine or the completion of defensive actions not available at the time. As traumatised individuals experience a physical sense of power, boundary, and mastery, their ability to tolerate their feelings and manage their impulses begins to grow, increasing the capacity for pleasure and connection in daily life.

In Conclusion

Sensorimotor psychotherapy addresses how traumatic memory is held in the body. Clients are supported and guided in becoming aware of how the body ‘remembers’ the trauma or communicates feelings and emotions. Focus is centred around befriending and managing trauma-related thoughts, feelings, and impulses so they are less disruptive to the client’s wellbeing.

Mindfulness and curiosity are combined with a cultivation of the client’s inner resources and strengths, along with psychoeducation, to help the client experience present moment safety, connection, and a bodily sense that ‘It’s over, and now I am safe.’

Get in touch

If you have a client, or know of someone who is struggling and could benefit from sensorimotor psychotherapy, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and out-patient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

^[1]  Fisher, J., n.d. Sensorimotor Approaches To Trauma Treatment. [ebook] Available at: <https://janinafisher.com/pdfs/trauma.pdf> [Accessed 5 August 2020].

^[2]  Fisher, J., n.d. Sensorimotor Approaches To Trauma Treatment. [ebook] Available at: <https://janinafisher.com/pdfs/trauma.pdf> [Accessed 5 August 2020].

^[3] Ogden P, Minton K, Pain C (2006) Trauma and the body: a sensorimotor approach to psychotherapy. W.W. Norton.

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