Enjoyed the post THOUGHTS ON THE BODY KEEPS THE SCORE, published earlier today. Have found the book very helpful and return to it often for insight into my own anxiety, depression and the present-day triggers that continue to elicit physical responses from trauma endured during my (27) years in a severely legalistic cult church. It’s been over 20 years since I escaped that bizarre world, and yet the things I experienced so long ago still remain vividly real — as if they happened only yesterday.

Below are a few of Dr. Bessel van der Kolk’s ideas and discoveries excerpted from the book that have helped me most in understanding the nature of trauma. I encourage others to read the book for themselves.

“Trauma is not just an event that took place sometime in the past; it is also the imprint left by that experience on mind, brain, and body. This imprint has ongoing consequences for how the human organism manages to survive in the present.”

We have the ability to regulate our own physiology, including some of the so-called involuntary functions of the body and brain, through such basic activities as breathing, moving and touching.

“When something reminds traumatized people of the past, their right brain reacts as if the traumatic event were happening in the present.”

“Medications, drugs and alcohol can also temporarily dull or obliterate unbearable sensations and feelings. But the body continues to keep the score.”

“If you want to manage your emotions better, your brain gives you two options: You can learn to regulate them from the top down or from the bottom up. Knowing the difference between top down and bottom up regulation is central to understanding traumatic stress. Top-down regulation involves strengthening the capacity of the watchtower to monitor your body’s sensations. Mindfulness meditation and yoga can help with this. Bottom-up regulation involves recalibrating the autonomic nervous system … We can access the ANS [autonomic nervous system] through breath, movement or touch. Breathing is one of the few body functions under both conscious and autonomic control.”

“The trauma that started “out there” is now played out on the battlefield of their own bodies, usually without a conscious connection between what happened back then and what is going on right now inside. The challenge is not so much learning to accept the terrible things that have happened but learning how to gain mastery over one’s internal sensations and emotions. Sensing, naming, and identifying what is going on inside is the first step to recovery.

“Self-regulation depends on having a friendly relationship with your body.”

“How can people open up to and explore their internal world of sensations and emotions? In my practice I begin the process by helping my patients to first notice and then describe the feelings in their bodies—not emotions such as anger or anxiety or fear but the physical sensations beneath the emotions: pressure, heat, muscular tension, tingling, caving in, feeling hollow, and so on. I also work on identifying the sensations associated with relaxation or pleasure. I help them become aware of their breath, their gestures and movements. I ask them to pay attention to subtle shifts in their bodies, such as tightness in their chests or gnawing in their bellies, when they talk about negative events that they claim did not bother them.”

“Our maps of the world are encoded in the emotional brain, and changing them means having to reorganize that part of the central nervous system, the subject of the treatment section of this book. Nonetheless, learning to recognize irrational thoughts and behavior can be a useful first step.”

Rage that has nowhere to go is redirected against the self, in the form of depression, self-hatred, and self-destructive actions.”

“Our great challenge is to apply the lessons of neuroplasticity, the flexibility of brain circuits, to rewire the brains and reorganize the minds of people who have been programmed by life itself to experience others as threats and themselves as helpless.”

What has happened cannot be undone. But what can be dealt with are the imprints of the trauma on body, mind, and soul: the crushing sensations in your chest that you may label as anxiety or depression; the fear of losing control; always being on alert for danger or rejection; the self-loathing; the nightmares and flashbacks; the fog that keeps you from staying on task and from engaging fully in what you are doing; being unable to fully open your heart to another human being.”

“Trauma robs you of the feeling that you are in charge of yourself, of what I will call self-leadership in the chapters to come. The challenge of recovery is to reestablish ownership of your body and your mind—of your self. This means feeling free to know what you know and to feel what you feel without becoming overwhelmed, enraged, ashamed, or collapsed. For most people this involves (1) finding a way to become calm and focused, (2) learning to maintain that calm in response to images, thoughts, sounds, or physical sensations that remind you of the past, (3) finding a way to be fully alive in the present and engaged.”

“Trauma is much more than a story about something that happened long ago. The emotions and physical sensations that were imprinted during the trauma are experienced not as memories but as disruptive physical reactions in the present.”

“As the previous parts of this book have shown, the engines of post-traumatic reactions are located in the emotional brain. In contrast with the rational brain, which expresses itself in thoughts, the emotional brain manifests itself in physical reactions: gut-wrenching sensations, heart pounding, breathing becoming fast and shallow, feelings of heartbreak, speaking with an uptight and reedy voice, and the characteristic body movements that signify collapse, rigidity, rage, or defensiveness.”

“The only way we can change the way we feel is by becoming aware of our inner experience and learning to befriend what is going on inside ourselves.”

“Learning how to breathe calmly and remaining in a state of relative physical relaxation, even while accessing painful and horrifying memories, is an essential tool for recovery. When you deliberately take a few slow, deep breaths, you will notice the effects of the parasympathetic brake on your arousal. The more you stay focused on your breathing, the more you will benefit, particularly if you pay attention until the very end of the out breath and then wait a moment before you inhale again. As you continue to breathe and notice the air moving in and out of your lungs you may think about the role that oxygen plays in nourishing your body and bathing your tissues with the energy you need to feel alive and engaged.”

“At the core of recovery is self-awareness. The most important phrases in trauma therapy are “Notice that” and “What happens next?” Traumatized people live with seemingly unbearable sensations: They feel heartbroken and suffer from intolerable sensations in the pit of their stomach or tightness in their chest. Yet avoiding feeling these sensations in our bodies increases our vulnerability to being overwhelmed by them.”

“Body awareness puts us in touch with our inner world, the landscape of our organism. Simply noticing our annoyance, nervousness, or anxiety immediately helps us shift our perspective and opens up new options other than our automatic, habitual reactions. Mindfulness puts us in touch with the transitory nature of our feelings and perceptions. When we pay focused attention to our bodily sensations, we can recognize the ebb and flow of our emotions and, with that, increase our control over them.”

“Telling the story is important; without stories, memory becomes frozen; and without memory you cannot imagine how things can be different.”

The Body Keeps the Score by Bessel van der Kolk, M.D. on iBooks
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