Tools of the Trade
On my blog, “Tools of the Trade” I am going to regularly post experiential “exercises” that I have created and tested over time. Much of the experiential work that I do is based on the principles of psychodrama and sociometry, however the integration of research alongside experiential exercises, is my own adaptation. The psychoeducational approach of the addictions field has long impressed me as a wonderful way to “teach a client to fish”. I love putting as much knowledge as possible in the hands of the client so that they can not only heal through experiential forms of therapy but grow in their intellectual understanding of their recovery process. I have spent the better part of my thirty year career incorporating up to date research and experiential process and creating easy to follow exercises so that clinicians can easily incorporate these techniques into their practices. I will be posting exercises one at a time, many will be excerpted from The Living Stage, The Drama Within and Relationship Trauma Repair, all available through Health Communication, amazon and where books are sold. Clinicians in our field of addictions, in my experience, are ever creative and adaptive. If you have a way that you use any of these exercises that you feel others will benefit from, please post and share them.
Why Trauma Requires Experiential Healing
As J. L. Moreno, the father of psychodrama, sociometry, and group psychotherapy said, long before his time, “the body remembers what the mind forgets.” Over the last three decades, neuroscience has under- scored the importance of incorporating the body into the healing process when working with emotional and psychological trauma. We need to do more than learn to tell the story of our lives. We need to feel the story of our lives in order to heal it. Trauma shuts feeling down, recovery wakes feeling up. That’s why we need solid recovery supports in place such as twelve-step meetings, affiliative groups, therapy, exercise, good nutrition, and healthy forms of self-soothing. Whether we’re talking about recovery from addiction or trauma or a combination of both, we need a strong healing network that’s available seven days a week in order to help us to learn to hold and manage the intense emotions that recovery will naturally restimulate without acting out or self-medicating. One or two times a week in one-to-one therapy is not enough, in my experience. Emotions aren’t that neat, they come up at the most inopportune times and need to be processed more regularly, at least in early recovery.
Research in attachment theory and bonding help us to understand why it is also so crucial that a therapeutic process be relational. Psychodrama’s triadic system of psychodrama, sociometry, and group psychotherapy provides a full framework for body, mind, and relational healing. Psychodrama is a role play method that allows us to recreate our role relationships so that we can explore them both from our perspective and, through role reversal, through the eyes of the other. Sociometry is the science of applied group dynamics and how the exploration and healing of those dynamics can be made experiential in group therapy. Moreno developed a method that allows the body to move, to feel and to act; a multi sensory experience of feeling and healing, where we use all of our senses, where we feel first then struggle toward the intellectual word or words that best define what we’re experiencing in our hearts, minds and bodies. A relational process in which we not only try to talk about what hurt us but we witness the stories of others with whom we may identify. Where we can hear them struggle to share the same muffled emotions that we too may be carrying, or see as they try to take some of the actions that we, too, have longed to take whether curling up and hiding, running or embracing. Experiential healing provides a process where we can allow the deeper layers of our own experience to unravel before our eyes and make sense of them, layer by layer, as they emerge both within ourselves and in relation to others.
Contrary to what many might think, this material does not necessarily come pouring forth in treatment; it is slow and painstaking work. Often times, as painful memories emerge, the body will react before the client is even aware of what they are feeling, they may shake or shiver, get a pounding headache; their gut might tighten or their throat go dry. It is up to the therapist to read these signals and use them as information in working with the client and to help the client to learn to recognize them in themselves. The trauma survivor may initially come forward tentatively, frightened of retaliation for even thinking what they may perceive to be disloyal or subversive thoughts. Feeling what they have never felt can feel dangerous to them.
Simply saying the words that were never spoken or feeling emotions that were never felt, without shut- ting down, acting out, or self medicating, can be deeply healing for the person who carries frozen or denied pain. This fairly straightforward process can allow them to make sense of themselves and what drives and defines them in their life and relationships. Even shaking off tension in the body while doing experiential exercises or watching a DVD and sharing emotions that come up can result in healing and relief for the person who longs or needs to get in touch with the “stories” and feelings they may be carrying unconsciously. As these feelings come forward, the thinking that was frozen in place starts to come forward, too. The body moves and the mind and heart follow. Identifying that “I want to run, to fight and defend myself, to collapse . . . I want to talk, to hug or to be held” can help individuals to come out from the shadowy depths of their unconscious selves, into the sunlight. This can be a confusing and disequalibrating process. After sharing with moving clarity about something that they have long held in silence, for example, group members often say things like, “Did that make any sense?” or “I feel like I’m babbling.” Quite the contrary, those listening are often riveted, sitting on the edge of their seats as they quiver with identification and emotion. This kind of “aha” moment is healing not only for the one sharing, but for all those watching, who suddenly see that they, too, may have such eloquence and intelligence in their pain. We see such moments in the stories that are a part of the DVDs of RTR, for example.
Why a Multi-Sensory, Experiential Approach to Treating Trauma Is Important
“Fundamentally, words can’t integrate the disorganized sensations and action patterns that form the core imprint of the trauma,” says Bessel Van der Kolk in The Limits of Talk. This is why experiential exercises and psychodrama can be so useful in resolving trauma issues—if it is done slowly and carefully, following the lead of the protagonist. It involves the body as well as the mind and emotions and it allows for a picture of what occurred to emerge in a concrete form first, before it is reflected on in the abstract. “The imprint of trauma doesn’t ‘sit’ in the verbal, understanding part of the brain,” he continues, “but in much deeper regions— amygdala, hippocampus, hypothalamus, brain stem—which are only marginally affected by thinking and cog- nition.” Moreno understood that, “the body remembers what the mind forgets,” understanding, far before his time, that there is such a thing as somatic memory and that the body, as well as the mind, need to participate in therapy for healing to occur. According to Van der Kolk, “If clinicians can help people not become so aroused that they shut down physiologically, they’ll be able to process the trauma themselves.” Experiential psychoeducational exercises, journaling, guided imagery, and psychodrama can stimulate memories and provide a safe arena in which they can be shared and processed.
When someone has been traumatized they may become afraid of action, action becomes bound up with fear and evil or a sense of danger. When they become triggered their whole body becomes the body that they inhabited at the time of the trauma. But as afraid as the traumatized person is to re-experience the “forbid- den” emotions that were shut down out of fear or even terror, they need to re-experience those emotions and disparate fragments of sensorial memory to in order to knit together the fragments of memory that became fragmented through the splintering experience, according to Van der Kolk.
Psychodrama and experiential exercises can allow the protagonist or client to reinhabit that body in a safe and clinical manner along with therapeutic witnesses and allies who can buffer, support, and encourage. One common misconception of psychodrama is that it is necessary to recreate the traumatic scene in order to access traumatic memory. This is not the case. It is only necessary that the client revisit themselves, their own sense of vulnerability or helplessness or rage or whatever they are carrying from the time of trauma. Revisiting the scene can be retraumatizing and is not necessary for healing.
To heal from trauma, we need to shift from our frozenness, from a collapsed, animal-like brain to a state in which we are remembering unfulfilled actions. We need a device or therapeutic process that allows the animal brain to wake up and the thinking brain to make sense of what it is experiencing, to talk out powerful emotional urges rather than act them out or numb them with substances or addictive behaviors.