Excerpt from Chapter 5
"In An Unspoken Voice - How The Body Releases Trauma and Restores Goodness"
Dr. Peter Levine.
Somatic Experiencing® provides therapists with nine building blocks. These basic tools for "renegotiating" and transforming trauma are not linear, rigid or unidirectional. Instead, in therapy sessions, these steps are intertwined and dependent upon one another and may be accessed repeatedly and in any order. However, if this psychobiological process is to be built on firm ground, Steps 1, 2, and 3 must occur first and must follow sequentially. Thus, the therapist needs to:
1. Establish an environment of relative safety.
2. Support initial exploration and acceptance of sensation.
3. Establish "pendulation" and containment: the innate power of rhythm.
4. Use titration to create increasing stability, resilience and organization. Titration is about carefully touching into the smallest "drop" of survival-based arousal, and other difficult sensations, to prevent retraumatization.
5. Provide a corrective experience by supplanting the passive response of collapse and helplessness with active, empowered, defensive responses.
6. Separate or "uncouple" the conditioned association of fear and helplessness from the (normally time-limited but now maladaptive) biological immobility response.
7. Resolve hyperarousal states by gently guiding the "discharge" and redistribution of the vast survival energy mobilized for life-preserving action while freeing the energy to support higher-level brain functioning.
8. Engage self-regulation to restore "dynamic equilibrium" and relaxed alertness.
9. Orient to the here and now, contact the environment and reestablish the capacity for social engagement.
Step 1. Establish an environment of relative safety.
Such soothing support in the midst of chaos is a critical element that trauma therapists must provide for their unsettled and troubled clients. This truly is the starting point for one's return to equilibrium. The therapist must, in other words, help to create an environment of relative safety, an atmosphere that conveys refuge, hope and possibility. For traumatized individuals, this can be a very delicate task. Fortunately, given propitious conditions, the human nervous system is designed and attuned both to receive and to offer a regulating influence to another person. Thankfully biology is on out side. The transference of succor, our mammalian birthright, is fostered by the therapeutic tone of working alliance you create by tuning in to your client's sensibilities.
With the therapist's calm secure center, relaxed alertness, compassionate containment and evident patience, the client's distress begins to lessen. However minimally, his or her willingness to explore is prompted, encouraged and owned. While resistance will inevitably appear, it will soften and recede with the holding environment created by the skilled therapist. One possible roadblock, however, happens between sessions when they are without their therapist's calm, regulating presence, clients may feel raw and thrown back into the lion's den of chaotic sensations when exposed to the same triggers that overwhelmed them in the first place. The therapist who provides only a sense of safety (no matter how effectively) will only make the client increasingly dependent — and thus will increase the imbalance of power between therapist and client. To avoid such sabotage, the next steps are aimed at helping the client move toward establishing his or her own agency and capacity for mastering self-soothing and feelings of empowerment and self-regulation.
Step 2. Support initial exploration and acceptance of sensation
Traumatized individuals have lost both their way in the world and the vital guidance of their inner promptings. Cut off from the primal sensations, instincts and feelings arising from the interior of their bodies, they are unable to orient to the "here and now." Therapists must be able to help clients navigate the labyrinth of trauma by helping them find their way home to their bodily sensations and capacity to self-soothe. To become self-regulating and authentically autonomous, traumatized individuals must ultimately learn to access, tolerate and utilize their inner sensations. It would, however, be unwise to have one attempt a sustained focus on one's body without adequate preparation. Initially; in contacting inner sensations, one may feel the threat of a consuming fear of the unknown. Or, premature focus on the sensations can be overwhelming, potentially causing retraumatization. For many wounded individuals, their body has become the enemy: the experience of almost any sensation as an unbidden harbinger of renewed terror and helplessness.
To solve this perplexing situation, a therapist who (while engaging in initial conversation) notices a momentary positive shift in a client's affect - in facial expression, say, or a shift in posture—indicating relief and brightness, can seize the opportunity and try to direct the client toward attending to her sensations. "Touching in" to positive experiences gradually gives a client the confidence to explore her internal bodily landscape and develop a tolerance for all of her sensations, comfortable and uncomfortable, pleasant and unpleasant. The client can now begin to allow the underlying disowned sensations — especially those of paralysis, helplessness and rage — to emerge into consciousness. She develops her experience of agency by choosing between the two opposing states: resistance/fear and acceptance/exploration. With a gentle rocking back and forth, oscillating between resistance and acceptance, fear and exploration, the client gradually sheds some of her protective armoring.
This shifting, in turn, reduces fear's grip and allows more access to the quintessential and unencumbered (by emotion) immobility sensations. This back-and-forth switching of attention (between the fear/resistance and the unadulterated physical sensations of immobility) deepens relaxation and enhances aliveness. It is the beginning of hope and the acquiring of tools that will empower her as she begins to navigate the interoceptive (or the direct felt experiencing of viscera, joints and muscles) land-scape of trauma and healing. These skills lead to a core innate transformative process: pendulation.
Step 3. Pendulation and containment: the innate power of rhythm
While trauma is about being frozen or stuck, pendulation is about the innate organismic rhythm of contraction and expansion. It is, in other words, about getting unstuck by knowing (sensing from inside),