Shock – Trauma and the Craniosacral System

1. Trauma is a challenge to the coping mechanisms of the mind and body. It triggers fight / fright responses in the body.
2. Shock occurs when the mind – body resources are overwhelmed.
3. Traumatization is repeated shock that is driven deeper and is compressed into one’s body and brain. This creates a memory pattern of distress in the right hemisphere of the brain.
4. Shock Affects are the expressions of embodied shock and trauma. They occur over one’s life span as a disruption between the linked cohesion between parts of the self especially sensation, imagination, behavior, emotion and memory. The cumulative pattern of shock affect in a person is called a trauma schema.
5. Resources are anything brought to a situation involving traumatic stress that helps resolve it.
6. Biodynamic Craniosacral Therapy is a crucial resource in the treatment of shock and trauma.

Traumatization to the craniosacral system occurs when shock and trauma is recapitulated over the life span. The core link may be a traumatic birth experience, then a broken arm in childhood, then several car accidents, etc. These repeated traumas are layered throughout the body and nervous system and recapitulate the core link. As you see in the next chapters, one’s natural ability to cope or be resourced and to orient to reality is greatly diminished.

Resources are anything we bring to a situation to resolve it. Resources are external-friends, family, nature and internal-journalizing, art, meditation, prayer, etc. Resources may frequently be lost in cases of sexual abuse, rape, surgery, car accidents, and orthopedic injuries. Even witnessing violence on TV such as millions of people did on September 11, 2001, is shocking to the nervous system. Other resources include safe sensation or areas of strength in the body, visualizing a safe place or contacting a safe person who is a resourcing friend. All of these are found within the soma and psyche as well as within one’s social and cultural milieu. The key word here is safety. Safety as a felt sense in the body is lost in trauma. Therefore, the most important resource is safety and anything associated with safety especially the therapist.

There is also another type of resource called a survival resource. It is much deeper and more primitive than our usual resources. A survival resource is a primal defensive strategy such as dissociation, contraction or immobilization. These survival mechanisms are found deep in the limbic system of the brain or in the tissues and fluids of the embryo before there was a nervous system. They must be respected by the therapist. As a principle, Biodynamic Craniosacral Therapy looks for the health and meaning within the survival resource without challenging it, which can lead to retraumatization of the patient. So to begin with, therapists must have a deep understanding of resources and the lack thereof in many clients.

When the body’s natural resources are overwhelmed, at least three physiological events occur: the first is called hyperarousal. The sympathetic nervous system speeds up the right hemisphere of the brain, activates body’s memories and triggers strong physiological reactions such as the fight / flight response in the body. Emotional flooding, claustrophobic thinking and confusion characterize the internal experience of hyperarousal since the right hemisphere is non-verbal. The right hemisphere is where memories of shock and trauma are stored and consistently get activated when someone re-experiences traumatic stress. Past traumas and shocks are stacked in the right hemisphere of the brain, as compressed experience, like poker chips. It is hard to find a patient with only one trauma in her life given its pervasiveness in the culture. When the emotional intensity of a shock or trauma memory begins to flood the body, it may have the affect of re-traumatizing the patient by placing her, once again in a situation where she feels helpless and overwhelmed. Therefore, it is vital to come into relationship with shock and trauma without physical collapse or psychological disintegration. I ask myself questions while I’m working such as: How has the shock affected the whole body? Where is the health in all of this? When we are able to hold these non-verbal questions, we create a container for different healing possibilities.

The second shock affect involves dissociation. Dissociation is the failure to neurologically integrate sensory experience from the body. Among other things, the right hemisphere of the brain is responsible for monitoring the totality of the body’s sensorium. Dissociation involves a profound activation of the parasympathetic nervous system that is usually a learned response to infant and childhood traumatic stress. The common theme in dissociation later in life is a partial or complete loss of the normal integration between memories of the past, awareness of self-identity, misinterpretation of body sensations and control of bodily movements.

Dissociative disorders and the study of its neurobiology are important for two reasons. The first is because of the overwhelming speed and volume of information that confronts the body and nervous system in the modern world. The second reason is the sheer magnitude of prenatal and perinatal neglect and abuse that contribute to disorganized attachments between infants and their primary caregivers. The first dissociation is contemporary and the second dissociation is developmental. The latter was set in place before, during and after birth. This means that one’s body and behavior has maladapted because of shock and trauma when brain development was primarily focussed on the dyadic regulation of emotions (with a primary caregiver) exclusively through the right hemisphere of the brain. This damages a person’s ability to self-regulate the autonomic nervous system not only with other people but also when alone throughout life. Furthermore, there is a much greater susceptibility to post-traumatic stress disorder in adulthood.

The third affect is closely related to dissociation is the withdrawal and contraction of one’s physical energy. Withdrawal causes either a freezing response or a collapse in the body. Whether one gets stiff or goes slack is genetically programmed in the individual as a survival response generated by an overactive sympathetic nervous system or conversely an overactive parasympathetic nervous system or both uncouple from their reciprocal function and are simultaneously overactive. Immobilization of physical energy causes the body and mind to fragment and lose its cohesiveness. Mental and physical experience becomes disorganized. We are able to feel some parts of our body and the world around us but not others; it also changes one’s behavior. Basically, the parts of the body don’t feel like they fit together. Typically withdrawal and immobilization occur in the extremities of the body, the arms and the legs. It is here where the fight/ flight mechanism is thwarted. A patient may report parts of her body being numb or having no sensation at all. Other patients report brief episodes of intrusive pain and sensation.

How does a therapist work with this appropriately? It is important to establish a verbal contract regarding the use of touch with a patient. This provides a boundary for the relationship. It also involves the need to be ethical by informing the patient of the therapist’s exact training and experience and how it is brought to the therapeutic relationship. Further, it is essential to enter into a dialogue about the quality of the touch and what feels comfortable. I regularly ask my patients; Are you comfortable? In this way, the therapist is able to assist the patient in reassociating with resourced sensations that underlie emotional states. This integrates the left hemisphere, which is responsible for maintaining an accurate connection to outside reality. This ability is diminished to a greater or lesser degree of trauma.

Only one layer of shock and trauma is worked with at one time. We must move slowly to integrate the left hemisphere with the right. Touch and boundaries are constantly renegotiated in order to avoid retraumatization of the patient. The therapist becomes a skilled observer of all the effects and nuances at the edge of the patient’s trauma schema. It is the skill of staying at the edge that allows the patient to self-regulate and helps her to develop an unbiased witness, both of which hare damaged in trauma. The therapist is merely listening to the patient’s story as it is told through the fluids. This builds resources in the body, reconnects the two hemispheres of the brain and creates wholeness in the patient.

In this regard, it is important for the therapist to be able to evaluate how ready or prepared a patient is to contact her shock and trauma issues. Criteria to look at includes:

1. The patient’s capacity for body awareness. Is her intention inside or outside the body?
2. The patients capacity for containment (making space for strong emotions).
3. The patient’s ability to maintain boundaries by not moving prematurely into deeper issues. 
4. What emotional age is the patient functioning from?
5. How available her witness self to her? Has she formed a relationship between the situation and an internal unbiased observer or fair witness?

The resolution of shock and trauma comes about through reassociation to sensation in the therapeutic relationship. Therefore, exquisite sensitivity to the patient’s state of both sympathetic and parasympathetic activation is required. One of the most powerful tools the therapist has is to verbally bring awareness to the value of the patients’ shock affects such as contraction and withdrawal, rather than trying to challenge or remove them. Biodynamic craniosacral therapy helps the patient reassociate to sensations around and underneath the survival resources in the body. This transforms the survival resource into a healing resource. This means that rather than thinking about emotions or impulsively acting them out, one identifies with the sensory experience of the body and is able to talk about it from a witness perspective rather than relive it. This uncouples the sensation from the intensity of the emotional state. There is a big difference between saying: “I’m angry” and I’m noticing the sensation of anger coming up right now.” I also ask the patient to focus on the edge of body sensation rather than the center of the emotions that ultimately, the patient can witness her experience and have body sensation be a resource.

The skills of pacing and slowing in biodynamic craniosacral therapy require the ability to track the mutual unfolding experience of both the therapist and the patient during the session. This tracking skill becomes an artistic ability to see and listen with presence and bearing witness to the client’s pain and suffering. Tracking a deep listening also involves sensing the sacredness of the therapeutic space, which means the therapist symbolically, places his ego outside the office room. This is called establishing right distance and creates a matrix for empathy and compassion to ripen in this relationship. Making a boundary in this way decompresses the nervous system and is a critical antidote when encountering shock and trauma.

Healing trauma is a slow process. It involves working with the overall schema in small increments. I am frequently asked if we are ever able to successfully resolve trauma. The answer is yes, however it is important to remember that trauma does not disappear forever from our body and consciousness but rather that the memories and physiological states loose their debilitating power over us. We will no longer feel like a prisoner in own body. To get to that place involves growing and developing resources so that the antidotes for traumatic stress are readily available now and we are therefore empowered to lead our lives to their full potential today and tomorrow. This empowerment not only is reflected in our own life, but also radiates out to those around us and ultimately to the society as a whole. Finally, healing trauma involves stopping it at its source with better prenatal care; saner birth practices and teaching parents to be better at what they do by being better resourced. Together, these measures will improve our capacity to love because after all, love heals all things, especially shock and trauma. Love is the greatest resource.