Trauma Training Tip
Can your patients notice something novel in their environment, such as a door closing or a voice in the hallway, without a lot of activation? Can they easily come back to the present moment, or do they become consumed by their arousal and “go away”? This is an expression of the vitality and flexibility in their parasympathetic nervous system – and the spirit of their Lung and their Po, or animal soul.
The Po initiates our self-protective response. It provides us with sensate, embodied awareness. The Po helps us distinguish excitation from threat. When is a tickle fun, and when is it intrusive? Why is a parent’s touch soothing and a stranger’s similar touch fearful for a toddler? The Po informs these distinctions. When we hear a twig snap, feel a stranger’s touch, or see a car driving erratically, the Po informs our primal, animal nature to prepare for danger.
When the Po senses that “something is amiss”, we stop, our focus narrows and our orienting system comes online. We evaluate the likelihood of threat. There is a slight arousal to help us focus. We lose broad scope and curiosity with our focus on pending danger. This is the first step in the Self Protective Response. It we become “stuck” in this stage of the self-protective response, we may find ourselves consumed by sensations of alarm, and unable to return to a more flexible and curious experience of the present moment. The result? Less aware of the present moment, we are ironically, less safe.
The Self-Protective Response can be broken down into 5 steps that mirror the movement of the Five Elements. We can develop skills to identify the precise disruption a particular patient experienced – and focus our clinical interventions more precisely. If we don’t understand the steps in the self-protective response, all will experience is generalized disruption. The Tao of Trauma workshop series will walk participants through the 5 Steps of the Self Protective Response, using the Elements and their corresponding tissues, substances, organs, emotions and spirits to inform nuanced approaches to working with trauma survivors.
Join me on September 16&17 for Awakening Arousal. We will explore:
- The five steps of the Self Protective Response, and how they are reflected in the 5 Elements.
- What happens in the breath at the first hint of danger, and its impact on the systems of diaphragms throughout the body.
- How the skin learns to distinguish between excitation and threat.
- The role of the Po in helping us discern a felt sense, and how to help patients cultivate body-awareness when the body was where an overwhelming event happened, perhaps long ago.
You will learn:
- Approaches to working with the skin as a boundary organ,
- The system of diaphragms as containers of affect,
- Ways to use mindful hands to track the movement of the breath through the diaphragms and
- Approaches to restoring the felt sense of the animal soul.
Alaine’s Two Cents
Acupuncturists Without Borders of the National Capitol Area is a new local organization. We are opening free clinics for immigrants, refugees and neighbors in need in Hyattsville and Silver Spring in September. You can download flyers to give to friends and neighbors and learn more about us at: https://www.facebook.com/
We still have openings for volunteer acupuncturists,acupuncture students and community members to help staff these clinics. We are using the 12 Points for Restoration & Balance auricular acupuncture model. Training in that model is available at http://www.acuwithoutborders.
Next orientation session for volunteers will be Sunday, September 24, 2017, from 2-5 pm at Crossings, 8270 Georgia Avenue, Suite 300, Silver Spring, MD. Acupuncturists should submit their certificate of completion of the 12 Points training, your license and your malpractice insurance. 3 PDA’s. $50 for acupuncturists; free for student and community member/assistants.
Email us your questions at awb.nca@gmail.com.
You can also donate to help us with our modest expenses by mailing your check to:
Acupuncturists Without Borders,
PO Box 25011, Albuquerque, NM 87125
Please note: “AWB.NCA” in the notes section.
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Clinical Curiosity
Q. As a practitioner who struggles with the metal element, I find myself having trouble staying present in the moment with patients. Two things pull me away – judgment or sympathy. Either way, I am distracted. Sometimes I find myself of the verge of tears, and totally wrapped up in their “story.” Other times, especially when they talk about their diet, exercise, or self-care habits, I’ll be virtually unable to keep my judgement and disapproval to myself. I also have trouble controlling my own hyper-arousal — I’ll get distracted by sounds in the hallway, sensations in my own body, identifying the direction of the heat or A/C, or worries about politics and world events. Qi Gong, breathing, and lots of things help…but I still find myself out of service to my patient and more wrapped up in my own experience. Any tips?
A. First off, I so appreciate your humility and vulnerability. Yours is such a universal experience. You speak beautifully to the importance of our own self-regulation as our most important tool. Simply noticing when we are either activated or absent is the first step. Once we notice, then we can come back to more somatic mindfulness. Collecting a “library” of things that help us be present – coming back to our breath, pressing our feet into the floor, saying a mantra or prayer silently, bringing a spiritual presence into your treatment room, or inviting the matrix of healers and friends who are always at our back (or in our hearts) into our space are some of the things that can help us stay present with challenging patients.
Taking a moment to acknowledge “You know, I just spaced out, but I’m back now” can be critically helpful to patients with pre-verbal trauma. They may have never experienced a caregiver telling them the truth (e.g. “Mommy’s not mad” spoken with teeth and voice clenched) and and so had no opportunity to develop their capacity to trust messages that come from their guts about integrity or security with a caregiver. The healing is in the repair of the breach, not in any attempt at the illusion of perfection.
The other thing that may help is to maintain a stance of curiosity. Curiosity about their story, their life-choices, as well as your reaction. If we are curious, it is easier to be in relationship, and harder to be in either arousal or collapse. Curiosity builds the parasympathetic nervous system.
Self-care — you mention Qi Gong and breathing — and I will add our own acupuncture treatment, can help us work through the bits of our own history that get triggered into judgment or sympathy; arousal or collapse. Our work is a life-long journey and you are in a great place with it!
All good wishes to you.