Dharma Spirit

 

Dharma (c)Kazuaki Tanahash Dharma (c)Kazuaki Tanahash Nautilus (c)Kazuaki Tanahashi

Psychotherapy

Transformation of Trauma 


Click on each or scroll down, to find the following:

Intention

What is Trauma?

The Opportunity for Transformation

The Three Stages of Trauma Recovery

Transforming the Traumatic Past

Tools of Transformation

Goals of Treatment: Core Capacities

The Bardos of Transformation

Transformation Groups: Awareness & Skills to Transform Trauma

Trauma Healing Resources

Weathered Travel Guide

Words to Inspire the Journey

 

Intention

My approach to the treatment of trauma is dedicated to helping you create safety and stability, develop internal and external resources, transform your relationship to past trauma, promote mind-body-emotion regulation and integration, and create the conditions for optimal personal and relational health and well-being.

May the following information help you to meet your suffering with a compassionate heart and re-claim the life you want to live.

What is Trauma?

Trauma is a unique personal experience of a negative or traumatic situation, recent or from the distant past, that threatens the personal or emotional integrity of oneself or another. It includes the early attachment and later relational traumas of neglect and abuse of our feelings, needs, bodies, and safety. Trauma is any event or enduring circumstance that is markedly distressing and overwhelms our ability to cope with a perceived threat to our physical, mental, emotional, and spiritual well being. Trauma is a normal response to an abnormal situation.

“Traumatic injury occurs when a person is overwhelmed by an event, series of events, or set of enduring conditions that are subjectively perceived to be life threatening, leaving the individual feeling overwhelmed, helpless and out of control… The perceived threat can be associated with an acute event such as surgery, rape, accidents, abuse, disaster, war, horror, etc., or with a chronic situation in which the person is overwhelmed, such as ongoing emotional, physical, or sexual abuse from a family member. The natural reaction when one is threatened is to attempt to escape from threat or to defend against it, but unfortunately, survival responses such as these are often unavailable or are inhibited in survivors of trauma.”
~ Pat Ogden Ph.D., Trauma and the Body

”Everyone's hell is their own. We can't really judge what is devastating to one person or another because we are not that person. We have to be very respectful of that other person's interpretation of this threatening situation.”
~ Stephen Porges Ph.D

"Trauma occurs when an event creates an unresolved impact on an organism."
~ Peter Levine Ph.D., Walking the Tiger: Healing Trauma

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The Opportunity for Transformation

When faced with threatening circumstances, we are hard-wired to draw upon the most effective survival strategy available in the moment – fight, flight, freeze, submit, or attach.

“On the biological level, success doesn't mean winning, it means surviving, and it doesn't really matter how you get there. The object is to stay alive until the danger is past and deal with the consequences later.”
~ Peter Levine Ph.D., Walking the Tiger: Healing Trauma

“Each component of the ordinary response to danger, having lost its utility, tends to persist in an altered and exaggerated state long after the actual danger is over.”
~ Judith Herman M.D., Trauma and Recovery

Because each of us responds differently to the perception of physical, mental, emotional, or spiritual threat, we can have a traumatic response to not only large traumas, but also to every-day challenges that trigger physical and emotional dysregulaton. Trauma is determined not by the event that caused it, but by the symptoms we experience. Transformation of trauma not only resolves the symptoms, but also increases the power and resources of health and well being.

Our attempt to manage the arousal that is responding to the perception of threat may result in many different symptoms: emotional and physical distress, over- or under-activation, flashbacks, sleep disturbance, defeating beliefs, self destructive behavior, interpersonal challenges, emotional flooding, shutting down and numbness, or other experiences of distress. These dysregulated states arise from the natural survival strategies needed during the traumatic experience that have not been able to be completed. Without discharging and completing the trapped traumatic response, we will continue to be affected by it – acting it out or turning it inward against the self.

 “Individual implicit memories of how our own bodies once attempted to cope with the threat of being overwhelmed remain. The legacy of trauma is that these somatic (i.e., endocrine and motoric) patterns can be triggered by the slightest provocations, reactivating the physical response of the organism to past terror, abandonment, and helplessness.”
~ Bessel van der Kolk M.D., Founder and Medical Director of the Trauma Center, Massachusets

“Post traumatic symptoms are, fundamentally, incomplete physiological responses suspended in fear. Reactions to life-threatening situations remain symptomatic until they are completed.”
~ Peter Levine Ph.D., Walking the Tiger: Healing Trauma

For those of us who have survived the every-day personal and relational traumas, as well as larger traumatic experiences, internal and external cues can easily trigger distressing emotions, sensations, and memories. Once triggered, without safety, tools, and guidance, we can react, further dissociate from the evoked symptoms, or encapsulate the unresolved trauma, and miss the opportunity for transformation of the symptoms and the potential for resolution and healing. Instead, when traumatic memory is activated, there is an opportunity – with support – to work with, discharge, and integrate the traumatic imprints into a greater experience of stability and well being.

Are there losses and hardship and pain in life? Yes. Is that a problem? No. Suffering is optional. There is another way.

“We all have an innate ability to transform trauma… We are instinctually hard-wired to digest trauma and return to a state of body-mind integration, emotional-regulation, balance and well-being. In the wild, animals who are routinely exposed to life threatening situations avoid traumatization as they shake out and pass through the fight-flight-freeze response and become fully mobile and functional again.”
~ Peter Levine Ph.D., Walking the Tiger: Healing Trauma

Transformation of trauma is much like alchemy – the transmutation of base metals into gold. Martial artists are trained to access and transform the energy of aggression into the energy of action in service of resolution and harmony. There are countless stories from around the world of those who have journeyed through and transformed repeated injury, disability, disaster, violence, and great loss, into wisdom, compassion, service, and well-being in the midst of it all. Same pain and loss. Different response and relationship to the trauma. There is a way through the aftermath of trauma…

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The Three Stages of Trauma Recovery

If traumatic memory is worked with directly, it can contribute to re-living the trauma and further destabilization. Instead, the focus of recovery is on helping you create safety and stability, develop internal and external resources, transform your relationship to past trauma, promote mind-body-emotion regulation and integration, and create the conditions for optimal personal and relational health and well-being.

There are three stages of trauma recovery:

•  Stage 1: Safety and Stabilization: Overcoming Dysregulation
As a first step, you must first learn to comprehend the effects of trauma: to recognize common symptoms and to understand the meaning of overwhelming body sensations, intrusive emotions, and distorted cognitive schemas. The achievement of safety and stability rests on the following tasks:
• Establishing bodily safety: e.g. abstinence from self-injury.
• Establishment of a safe environment: e.g., a secure living situation, non-abusive relationships, a job and/or regular income, adequate supports.
• Establishment of emotional stability: e.g., ability to calm the body, regulate impulses, self-soothe, manage post-traumatic symptoms triggered by mundane events.
The goal of this stage is to create a safe and stable "life in the here-and-now," allowing you to safely remember the trauma, rather than continue to re-live it.

•  Coming to Terms with Traumatic Memories
At this stage, the focus is to overcome the fear of traumatic memories so they can be integrated, allowing appreciation for the person you have become as a result of the trauma. In order to metabolize (not just verbalize) memories, you may make use of EMDR or other mind-body therapies. Pacing ensures that you don't become "stuck" in avoidance or overwhelmed by memories and flashbacks. Since "remembering is not recovering," the goal is to come to terms with the traumatic past.

•  Integration and Moving On
You can now begin to work on decreasing shame and alienation, developing a greater capacity for healthy attachment, and taking up personal and professional goals that reflect post-traumatic meaning-making. Overcoming fears of normal life, healthy challenge and change, and intimacy become the focus of the work. As your life becomes reconsolidated around a healthy present and a healed self, the trauma feels farther away, part of an integrated understanding of self but no longer a daily focus.
(Adapted from Judith Herman, 1992)
~ Janina Fisher Ph.D.

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Transforming the Traumatic Past


“Instead of asking ourselves, “How can I find security and happiness?” we could ask ourselves, ‘Can I touch the center of my pain? Can I sit with suffering, both yours and mine, without trying to make it go away? Can I stay present to the ache of loss or disgrace – disappointment in all its many forms – and let it open me?' This is the trick.”
~ Pema Chödron, Practicing Peace in Times of War

While the transformation of trauma is best supported by a therapist trained in the treatment of trauma, the true guide for this journey is your self, the traveler whose discriminating awareness, choice, and deepest wisdom can begin to navigate through that which is no longer present, no longer serves, and is no longer true. The traces of big and small trauma that remain in your nervous system and mind can be released, freeing a new relationship with your self and your life.

In our work together, I help you to cultivate mindful exploration in which you develop the capacity to be present to your moment-to-moment experience, with awareness and choice, so that you work at a level of exploration and pacing that enables you to remain safe and stable in the session and in your life. Working together with you as a team, I support you in working within your optimal “window of tolerance” that supports your ability to process and integrate your past experience.

“Under conditions of arousal that are either too high or too low, traumatic experiences cannot be integrated… In order to put the past in the past, traumatic experience must be processed in an ‘optimal arousal zone'. Falling between the two extremes of hyper-arousal (increased sensation, emotional reactivity, hypervigilance) and, hypo-arousal (absence of sensation and emotion, numbing) is the zone described as the ‘window of tolerance'. When you work within a window of tolerance, information received from both internal and external environments can be integrated. You are able to think and talk about your experience in therapy and simultaneously feel a congruent emotional tone and sense of self.”
~ Pat Ogden Ph.D., Trauma and the Body

 “Our brains will continue to take in new information and construct new realities as long as our bodies feel safe.”
~ Bessel van der Kolk M.D.,
Founder and Medical Director of the Trauma Center, Massachusets

“For each of us, the mastery of trauma is a heroic journey that will have moments of creative brilliance, profound learning, and periods of hard tedious work. It is the process of finding ourselves a safe and gentle way of coming out of immobility without being overwhelmed. Parts of it may occur in a condensed event. Others are more open-ended, occurring gradually over time.”
~ Peter Levine Ph.D., Walking the Tiger: Healing Trauma

As you develop an increasing capacity for mindfulness – a quality of awareness that notices, without judgment, the emerging moment by moment experience – I help you to gradually uncouple the traumatic activation from the adaptive responses. The mind and body can unwind the defensive responses that were disabled in the past, that can finally be completed and restored for adaptive use in the present. We take one small step at a time.

The transformation of life trauma begins as new skills are developed to remain present and stable in the moment, to study the trauma-related tendencies, and to resolve the effects of the traumatic past on your current organization of experience. We work together to help overcome the fear of traumatic memories so you don't become stuck in avoidance or overwhelmed by the memories or flashbacks. You can begin to come to terms with the truaumatic past.

Traumatic memory imprints our brain and nervous system at multiple levels – thoughts, feelings, sensory experience, movement, and inner body awareness. All three levels of processing –cognitive, emotional, and sensorimotor – are necessary to work with the implicit memories and the neurobiological effects of trauma. Working collaboratively, you and I gradually and gently approach the energy bound up in these imprints with “dual awareness” – rooted both in the safety and stability of the present, as well as witnessing and releasing the traumatic traces of the past.

“Discernment is a form of dis-identification from the activity of our own mind: as you become aware of sensations, images, feelings, and thoughts, you come to see these activities of the mind as waves at the surface of the mental sea. From this deeper place within your mind, this internal space of mindful awareness, you can just notice the brain waves at the surface as they come and go. This capacity to disentangle oneself from the chatter of the mind, to discern that these are “just activities of the mind,” is liberating and for many, revolutionary. At its essence, this discernment is how mindfulness may help alleviate suffering.”
~ Daniel Siegel, M.D., The Mindful Brain

The mind-body inherently organizes in the direction of what is needed for optimal resolution of the past, and optimal functioning in the present. As the past falls away, new more adaptive capacities emerge that are then anchored in an expanded sense of self that is more flexible, adaptive and stable with a greater capacity to experience positive states, inner calm, and pleasure. The trauma is left in the past and you can finally move on.

The fragmented elements that perpetuate traumatic emotion and behavior can be completed, integrated, and made whole again. Along with this wholeness comes a sense of mastery and resolution.”
~ Peter Levine Ph.D., Walking the Tiger: Healing Trauma

“Integration is at the heart of well-being. Integration is the linking of differentiated elements into a functional whole… our lives become flexible, adaptive, coherent, energized and stable. Without this integration, the flow of our minds moves toward rigidity or chaos. Trauma can be seen to fundamentally impair integration of the individual, family, or community. Post-traumatic states are
filled with experiences of rigidity or chaos that continue the devastation of trauma long past the initial overwhelming events. Sifting the mind with curiosity, openness, acceptance, and love – the “coal” that warms the heart of change – enables us to integrate these many elements of our mind in new ways that permit healing to emerge. We can finally achieve the integration that adaptations to trauma had blocked for so long.”
~ Daniel Siegel M.D., Healing Trauma: Attachment,Mind, Body, and Brain

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Tools of Transformation

“Looking deeply gives us the insight that will liberate us from suffering, anger, pain, despair. Suffering can instruct us. Understanding suffering is the key to transcending it. Without suffering there is no way to understand compassion. No mud – No lotus!”
~ Thich Nhat Hanh

”That is a revolutionary step. Becoming intimate with pain is the key to changing at the core of our being – staying open to everything we experience, letting the sharpness of difficult times pierce us to the heart, letting these times open us, humble us, and make us wiser and more brave. Let difficulty transform you. And it will. In my experience, we just need help in learning how not to run away.”
~ Pema Chödron, Practicing Peace in Times of War

In addition to a diverse clinical background, I utilize two approaches widely recognized by leaders in the treatment of trauma for their effectiveness in processing the mind-body imprints of early attachment, relational, chronic and acute traumatic experience: Sensorimotor Psychotherapy and EMDR.

EMDR:
Eye Movement Desensitization and Reprocessing (EMDR), developed in the 1980s by Francine Shapiro Ph.D., is a comprehensive, integrative psychotherapy approach that reprocesses the memory imprints of recent and past traumatic events.

EMDR is an information processing therapy that attends to the past experiences that contribute to distress, the current situations that trigger distressing emotions, beliefs and sensations, and the positive experience needed to enhance future adaptive behaviors and well being. One aspect of the information re-processing involves "dual stimulation" using either bilateral eye movements, tones or taps. During the reprocessing phases, the client attends momentarily to past memories, present triggers, or anticipated future experiences while simultaneously focusing on a set of external bi-lateral movements. During that time, clients generally experience the emergence of insight, changes in memories, or new associations.

EMDR was determined to be an effective treatment of trauma by the American Psychiatric Association in their Practice Guideline for the Treatment of Patients with Acute Stress Disorder and Post-traumatic Stress Disorder. EMDR was also strongly recommended for the treatment of trauma by the Department of Veterans Affairs and Department of Defense in their Clinical Practice Guideline for the Management of Post-Traumatic Stress.
~ The above information is taken from the EMDR website.

Sensorimotor Psychotherapy:
Sensorimotor Psychotherapy was developed in the 1980's by Pat Ogden Ph.D., author of Trauma and the Body, and informed by current leaders in the field of trauma. It is a comprehensive psychotherapy model designed to treat the effects of trauma and complex traumatic stress disorder as well as the related attachment and developmental disturbances. This integrated therapeutic approach facilitates self-awareness and adaptive self-regulation on cognitive, emotional, and sensorimotor levels:

•  “Cognitive Processing refers to the capacity for conceptualizing, reasoning, meaning making, problem solving, and decision making. Difficulty in cognitive processing occurs because traumatized people typically form inflexible, maladaptive interpretations of the trauma or other life experience.

•  Emotional Processing refers to the capacity to experience, describe, express, and integrate affective states. Traumatized people characteristically lose the capacity to draw upon emotions as guides for action. They relive the emotional tenor of previous traumatic experiences, finding themselves at the mercy of intense trauma-related emotions. These emotions can lead to impulsive, ineffective, conflicting, and irrational actions, such as lashing out physically or verbally, or feeling helpless, frozen, and numb. Traumatized individuals are often fixated on trauma-related emotions of grief, fear, terror, or anger.

•  Sensorimotor Processing refers to the capacity to experience, articulate, and integrate physical/sensory perception, body sensation, physiological arousal (hypo- and hyper-arousal), and motor functioning (movement and action). People with trauma-related disorders suffer from both “feeling too much” and “feeling too little”. The capacity to sense and describe your in-the-moment sensation and to uncouple it from trauma-related emotions and cognitions enhances the possibility of re-integrating the somatic experience of trauma in order to establish new meanings and understand the past and one self.”
~ Pat Ogden Ph.D., Trauma and the Body

The following description of Sensorimotor Psychotherapy is written by Janina Fisher Ph.D. and is taken from the “Forward” in the Becoming Safely Embodied Skills Manual: Skills Building Groups for Trauma and Dissociation, by Dierdre Fay MSW:

“Traumatic experience affects not only our minds, emotions, and systems of belief, but also the body. At the moment of life threat, “animal brain” instincts take precedence over reflective decision-making, allowing us to run, duck for cover, hide, fight back, or “huddle and wait for it to be over” – whatever best helps us to survive. Decades after the mind knows that we are safe, the body still responds as if it were under life threat. Triggered by everyday normal life stimuli directly or indirectly reminiscent of the trauma, the same bodily responses are instinctively re-activated that originally helped us to survive. What was once an adaptive survival response has now become a symptom. The body that used its animal brain instincts to negotiate a dangerous world now feels like an enemy, rather than an ally. It is ironic that the very same responses that preserve our physical and psychological integrity under threat also drive the symptoms of post-traumatic stress for months or years after the events themselves (van der Kolk et al, 1997; Ogden, Minton & Pain, 2006). To make matters more challenging, the survivor of trauma is left with a mind and body that now function better under conditions of threat than conditions of calm, peacefulness, or pleasure.

 “In traditional psychotherapy models, it has always been assumed that, as a consequence of re-telling the story and re-experiencing the feelings connected to what happened, these trauma responses would remit naturally on their own. Clinical experience and recent neurobiological research tell a different story: the human mind and nervous system will always have a tendency to respond to a reminder of past threat as if it too were a threat unless the brain's frontal cortex is “on line” and therefore able to discriminate a real threat from the reminder.

 “To actually desensitize or transform a traumatic memory, we need to change the mind-body responses to that memory: to reinstate activity in the frontal lobes so we can interpret the responses differently or react to them differently. We need to counteract the habitual responses by calling attention to them, providing psychoeducation about how and why they are symptoms, encouraging mindfulness and curiosity in place of reactivity, pacing the exploration of the past so that the autonomic nervous system can be better regulated instead of dysregulated by the recovery process, and by encouraging the developing of new responses to triggers or memories that compete with the old habitual responses. We need to challenge the subjective perception of traumatized (individuals) that the symptoms are just “who they are.”

 “…The model takes the essential ingredients of a trauma recovery program and breaks them down into small, achievable steps. Practice in mindful observation is needed, for instance, to challenge the automatic unthinking instinctual responses to traumatic triggers… Cultivating the ability to step back from overwhelming experience to study its components (thoughts, feelings and body sensations) is essential to the skill of modulating autonomic activation. Identifying facts versus feelings and learning how to be “present in the present” help cultivate past-present differentiation. Without the ability to make those discriminations, (survivors) continue to feel a sense of unending subjection to threat for decades after the traumatic events are over. Finally, learning to deliberately choose new responses or deliberately change one's perspective challenges beliefs that nothing will ever change, that the survivor is helpless in the face of the intense activation, overwhelming emotions, and beliefs that she is damaged and defective… allowing access to another world of possibilities.”

~ Janina Fisher Ph.D., from the Forward in Becoming Safely Embodied.

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Goals of Treatment: Core Capacities

Your journey through the transformation of life trauma draws upon supportive conditions, practical transformative tools, and mind-body practices as you develop core capacities that include:

1. Mindful Awareness
Cultivate a pure awareness of your moment-to-moment internal and external experience. You will be guided to:

•  Develop a neutral witnessing of body sensations, emotions, and thoughts, in a calm, non-judging, spacious awareness.

•  Learn to approach the here-and-now experience with curiosity, openness, acceptance, and love. (Daniel Siegel M.D.)

•  Cultivate a self-observing state, increased body-mind awareness, and a sense of well-being independent of life circumstances.

•  Develop an internal and external safe and secure base, as well as self-care and stabilization practices, as a ground for the exploration and transformation of traumatic memory.

•  Use mindful awareness of sensations, feelings, and memory as a way to loosen the self-identity defined by the trauma and achieve more emotional freedom.

2. Emotional Regulation: Self-regulation & Interpersonal-regulation
Cultivate emotional self-regulation skills, as well as co-regulation with another, that enable you to experience strong emotions, sensations, or stressful life circumstances without dissociating – either flooding with emotion (hyper-arousal) or shutting down and going numb (hypo-arousal). You will be guided to:

•  Learn to use self-reflection, stabilization and self care practices to create the physical and emotional conditions for personal and interpersonal safety.

•  Learn to recognize the early signs of becoming physically and emotionally hyper- or hypo-aroused, and choose to return your “optimal arousal zone”.

•  Build practical skills to manage anxiety, contain emotional reactivity, identify and create external and internal boundaries, and stay present in the moment, without dissociating or being reactive.

•  Develop authentic connection in order to practice self-regulation, interpersonal attunement, and emotional co-regulation.

•  Learn to recognize and develop internal and external resources.

3. Processing & Integration
Cultivate mind-emotion-body integration – the ability to be aware of your in-the-moment experience and stay with it as a focus of attention long enough to make sense of it, which allows choice and change. (Daniel Siegel M.D.) You will be supported to:

•  Recognize and relate with traumatic memory in a safe collaborative environment, and at a pace that is manageable, in order for it to be acknowledged, discharged, transformed, and integrated.

•  Explore the relationship between earlier traumatic experiences and current triggers, including distinguishing between past and present threat, and choosing adaptive responses in the present.

•  Place the traumatic event(s) in perspective, in order to understand that remembering the trauma is not the same as experiencing it again.

4. Earned Secure Attachment
Cultivate “earned secure attachment” – the parallel experience of a secure attachment between a parent and a child. You will be supported to develop the nine functions of well-being:

“There are nine functions that support personal and relational well-being: the first seven are the outcomes of secure attachment, and all nine functions are the outcome of mindful awareness practice.

•  Body Regulation : capacity to attend to bodily states, as well as coordinate and balance the “brakes” and “accelerator” of the nervous system.

•  Attuned Communication (emotional attunement): capacity to coordinate the input from another mind with the activity of one's own.

•  Emotional Balance : capacity to monitor and affect the emotional response to fight-flight-freeze.

•  Response Flexibility : capacity to pause before action.

•  Empathy : capacity to perceive another's signals and imagine what might be going on inside someone else.

•  Self-knowing Awareness : capacity to link the past, present, and future and give emotional texture to the emerging themes of your present awareness and life story.

•  Fear Modulation : capacity to calm down, breathe, and let go.

•  Intuition : capacity to keep the channel open to information from the intestine and the heart that have “peripheral brains,” as well as from every cell in your body.

•  Morality : capacity to imagine what is best for the whole not just oneself, even when alone.”

~ Daniel Siegel M.D., The Mindful Brain

5. Personal and Interpersonal Well-being Independent of Life Circumstances
Transform your relationship to past trauma and create the conditions for optimal personal and relational health and well-being. You will be supported to develop:

•  Stability and inner calm: …the surface processes of chaos and rigidity, of dys-regulation and defensive exclusion of lived experience, can melt away as they are recognized as habits of mind, equanimity can be created, and true transformation can begin. ~ Daniel Siegel M.D.

•  True happiness: …an enduring feeling of contentment, capability and centeredness... It's a rich sense of well-being that comes from knowing you can deal productively and creatively with all that life offers – both the good and the bad. And it's a deep sense of engagement – living in the moment and enjoying life's bounty. ~ Rick Foster & Greg Hicks, How We Choose to Be Happy: The 9 Choices of Extremely Happy People

•  Well-being of body, mind, and relationship: … the capacity to be flexible, adaptive, coherent, energized, and stable, with connection, openness, healing, empathy, receptivity, resonance, engagement, deep knowing, compassion, and an emerging sense of freshness. ~ Daniel Siegel M.D.

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The Bardos of Transformation

The process of transforming trauma can be seen as a series of transitional realities known in Tibetan Buddhism as bardos . The word “ bardo ” is commonly used to denote the intermediate state between death and rebirth. A bardo can also be seen as a space between realms – the gap of sleep, phases of life, between thoughts, between breaths, or other transitional realities.

“In reality bardos are occurring continuously throughout both life and death, and are junctures when the possibility of liberation, or enlightenment, is heightened… Certain moments are much more powerful than others and much more charged with potential, when whatever you do has a crucial and far-reaching effect.”
~ Sogyal Rinpoche, The Tibetan Book of Living and Dying


There are four phases of the bardo :

•  The natural bardo of this life as we know it and preparing for the death of an old way that no longer serves us.

•  The painful bardo of letting go and dying to the old ways of being.

•  After death, the luminous bardo of seeing clearly the essence of things as they are.

•  The bardo of becoming, in which the mind is no longer limited and obstructed, and the possibilities are infinite for emerging in a new form.

Each person's unique transformational process of healing involves a death of the old way of being, and emerging into a new relationship with oneself, with others, and with one's life. The ancient teachings say that we wait in the bardo until we can make a connection to our future form, in the same way that we remain frozen with past trauma until we begin to sense the possibility of transforming it into a larger perspective of our selves and our life.

“Transformation requires change. One of the things that must change is the relationship that we have with our memories.”
~ Peter Levine Ph.D., Walking the Tiger: Healing Trauma

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Transformation Groups:
Awareness & Skills to Transform Trauma


Download the flyer Transformation Groups:
Awareness & Skill to Transform Trauma
pdf

Download the handout Wellbeing Tool Kit
Download the handout Self Care Daily Reflection


“I can feel very alone in this journey, but I don't have to take this journey in isolation. We are conditioned by our society and culture not to talk about our pain. But if we don't talk, if we don't create a language to express our feelings, healing will not take place. We will continue to store up and re-create the cycles of suffering. What is helpful and necessary in this process is a safe container such as a therapeutic environment or a community of like-minded people who can assist, help, support, and encourage each other in this process of waking up.”

~ Claude Anshin Thomas, “At Hell's Gate: A Soldier's Journey from War to Peace”

“Coming out of isolation and separation is, in and of itself, healing. One of the most inspiring parts of group sessions is being part of a larger emerging wisdom. When people practice with others who have similar backgrounds, they discover they are not alone. They experience kinship. Over the duration of the group, participants learn from each other, and contribute to each other through both their struggles and their triumphs. And by holding strong common intentions, the group becomes a community of support and authentic inquiry.”
~ Dierdre Fay MSW, “Becoming Safely Embodied Skills Manual”

 

Trauma arises from your unique experience of an event or enduring circumstance that is markedly distressing and overwhelms your ability to cope with a perceived threat to your physical, mental, emotional, or spiritual well being. The traces of big and small trauma that remain in your nervous system and mind can be released, freeing a new relationship with your self and your life.

Transformation Groups focus on the development of new capacities to transform past traumatic experience. Because revealing much of one's “story” can trigger yourself or others, this group's focus is not on talking about our history. Instead, the group is dedicated to helping you develop the awareness and practical skills to create safety, stability, and support; develop internal and external resources; transform your relationship to past trauma; promote mind-body-emotion regulation and integration; and create the conditions for optimal personal and relational health and well-being. This group may be a valuable adjunct to individual therapy or a first step toward exploring your relationship with your past.

I strive to create a safe, peaceful, and fun group environment that supports stability and well being during the group and in your life. Each week will draw upon practical tools of mindful awareness, self inquiry, mind-body awareness, conscious boundaries, and empowered choice to allow you to safely enter your internal world; begin to transform your mind and body into safe places for rest, reflection, and well being; and, take steps toward the life you want to live…

Week 1: Setting the Foundation
Practices that support safety, stability, and choice. Set intentions and group boundaries. Experiment with curiosity and fresh discovery.

Week 2: Belonging
Offset isolation and alienation, reconnect with the self, discover the threads of connection to others and the larger world.

Week 3: Mindful Awareness
Observe and notice without judgment, stay in the present, dis-identify from what is arising and triggers, develop the capacity to focus and direct attention, increase tolerance for internal kindness.

Week 4: Internal Information Flow: Thoughts/Feelings/Body Sensations
Build distinctions between thoughts, feelings, and body sensations, sustain awareness, notice habitual associations and deconstruct triggers.

Week 5: Separating Facts from Feelings
Separate facts from interpretations, evaluations, and habitual beliefs. Experience more calm if over-aroused and more energy if under-aroused, stay within your "window of tolerance."

Week 6: Addressing Parallel Lives
Separate the past from what is happening in the present. Discern between the adult/wise part of the self and those parts of the self that are triggered. Tools to actively notice triggers and choose adaptive responses.

Week 7: Working with Internal Parts
Stay centered in the neutral observing witness. Experiment with awareness and choice, support communication between different parts of the self, calm internal dys-regulation. Self-soothing strategies.

Week 8: Carving Out a New Path
Step-by-step means to change experience and choose new directions. Anticipate resistance. Identify small steps, support for success, and choices for the life you want to live.

Week 9: Telling & Retelling
Letting go of the old and developing new perspectives to observe your life. Discover empowered approaches to painful and entrenched life situations.

Week 10: Finding Guidance from an Older, Wiser Self
Access the inner wisdom that guides you through the challenges of healing from trauma. Listen more deeply to your inner “knowing” of your path and direction.

Week 11: Conscious Closure
Support for internal and external resources. Experience ending in a supportive, nurturing way. Integration and beyond.

(Concept inspired by The Becoming Safely Embodied Skills Manual: Skills Building Groups for Trauma & Dissociation , by Dierdre Fay MSW)

Registration: Groups of 6-8 participants meet weekly for 1½ hours, for an on-going 11-week series - day, evening, or Saturday. Groups are available for women, men, military, and others with shared experiences. Initial consultation prior to beginning the group. Individual therapy available by appointment. Contact Marilynne at (415) 492-1042 to discuss your interests and questions.

Fee: $440. Insurance accepted, including Blue Cross, Aetna , Health Net, and Humana.

Cancellation Policy: Refund up to first session, credit thereafter.


May all that suffer find peace
May pain give rise to kindness and equanimity
May our intimate contact with suffering bring forth
A world of compassion and joy.

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Trauma Healing Resources

Visit the Trauma Healing Resources section
for the following information:


•  Where to Get Trauma/PTSD Assistance • Resources for Veterans
•  Domestic Violence Resources
•  Sexual Assault Crisis Centers
•  Psychotherapy Referrals
•  Mental Health Information
•  Healing Trauma Audio Support
•  Healing Trauma Books
•  Healing Trauma Handouts

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Weathered Travel Guide

Your guide for this journey of transformation of trauma is a seasoned explorer. Like all of us, I have traveled through unbearable sorrows and pain and loss that come with taking birth in a human body with a human heart. My journey is any man's or woman's journey – some of us just seem to get dealt a bit more than others. I have found the guides when I needed them and, out of necessity, learned to harness inner and outer resources to take me through the transformational fires again and again to the other side.

And as a therapist and teacher, I have drawn upon my own body and heart's experience of trauma, as well as the teachings I have received from countless clients and students through the years, to support the sacred and healing journey of those who consider me a guide. The alchemical process that reveals the gold is available to each of us if we courageously embark, trust the beacon of our deepest inner truth and knowing, and remain open to the wisdom and compassion that comes with the territory of transformation.

In my life, has there been great loss, pain, and hardship? Yes. Has that been a problem? No. The repeated trauma has been transformed through ancient practices of meditation, body-mind practices, breath, self-care, and modern psychological approaches that are available to us all.

Transformation has also come from welcoming, not resisting, what life has dealt me and my loved ones, with acceptance and surrender. It has been the fertile ground of unbearable pain and loss that has grown unbearable compassion. It has been from receiving life with humility and deepening wisdom, with all the opportunities to practice patience, empathy, kindness, letting go of how I think it should be, and opening my heart to how it is. It has taken me through the alchemical fires of transformation that burn through all that is not true, and break me open again and again to that which we truly are, beyond all the form that changes. It has been from nurturing connections with “journey buddies” and learning the lessons of giving and receiving love well. It has been from embracing this precious human birth amidst all the pain and loss, and savoring the moment with an open heart through the grit and joys of life. And from gratitude. It is not the destination, it's the journey. I would do it all over again.

The fact of the matter is there is pain in life.
The suffering is in the resistance.
Surrender, transform… evolve.

I bow before you with the honor of being a travel guide along your journey of transforming past trauma and healing into your inherent wholeness.

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Words to Inspire the Journey


Trauma can be healed. We must realize that it is neither necessary nor possible to change past events. The past doesn't matter when we learn how to be present; every moment becomes new and creative. We have only to heal our present symptoms and proceed.
~ Peter Levine Ph.D., Walking the Tiger: Healing Trauma ~ 

 
There is a brokenness out of which comes the unbroken,
A shatteredness out of which blooms the unshatterable.
There is a sorrow beyond all grief which leads to joy,
And a fragility out of whose depths emerges strength.
There is a hollow space too vast for words
Through which we pass with each loss,
Out of whose darkness we are sanctioned into being.
There is a cry deeper than all sound
Whose serrated edges cut the heart as we break open
To the place inside which is unbreakable and whole,
While learning to sing.
~ Rashani ~


We may not have been able to control the trauma we have experienced, but we can take an active role in its healing. Thich Nhat Hanh said to us, “You veterans are the light at the tip of the candle. You burn hot and bright. You understand deeply the nature of suffering.” He told us that the only way to heal, to transform suffering, is to stand face-to-face with suffering, to realize the intimate details of suffering and how our life in the present is affected by it. He encouraged us to talk about our experiences and told us that we deserved to be listened to, deserved to be understood.
He said we represented a powerful force for healing in the world.”
~ Claude Anshin Thomas, “At Hell's Gate: A Soldier's Journey from War to Peace” ~


Nature always lovely, invincible, glad,
Whatever is done and suffered by her creatures.
All scars she heals,
Whether in rocks, or water or sky
Or hearts.
~ John Muir ~


We have to face the pain we have been running from.
In fact, we need to rest in it and let it transform us.
~ Charlotte Joko Beck, Zen Teacher ~


Real heroism comes from having the courage to openly acknowledge one's experiences, not from suppressing or denying them. You initiate your own healing by re-integrating lost or fragmented portions of your essential self. In order to accomplish this task, you need a strong desire to become whole again. This desire will serve as an anchor through which your soul can reconnect to your body. Healing will take place as formerly frozen elements of your experience (in the form of symptoms) are released from their trauma-serving tasks, enabling you to gradually thaw. When you thaw, you have the possibility to become more fluid and functional.
~ Peter Levine Ph.D., Walking the Tiger: Healing Trauma ~


For Courage

For everything under the sun there is a time.
This is the season of your awkward harvesting.
When pain takes you where you would rather not go,
Through the white curtain of yesterdays to a place
You had forgotten you knew from the inside out;
And a time when the bitter tree was planted
That has grown always invisibly beside you
And whose branches your awakened hands
Now long to disentangle from your heart.

You are coming to see how your looking often darkened
When you should have felt safe enough to fall toward love,
How deep down your eyes were always owned by something
That faced them through a dark fester of thorns
Converting whoever came, into a further figure of the wrong;
You could only see what touched you as already torn.

Now the act of seeing begins your work of mourning.
And your memory is ready to show you everything,
Having waited all these years for you to return and know.
Only you know where the casket of pain is interred.
You will have to scrape through all the layers of covering
And according to your readiness, everything will open.

May you be blessed with a wise and compassionate guide
Who can accompany you through the fear and grief
Until your heart has wept its way to your true self.
As your tears fall over that wounded place,
May they wash away your hurt and free your heart.
May your forgiveness still the hunger of the wound
So that for the first time you can walk away from that place,
Reunited with your banished heart, now healed and freed,
And feel the clear, free air bless your new face. 
~John O'Donohue ~


The non-violent path of love does not immediately change the heart of the oppressor. It first does something more radical to the hearts and souls of those committed to it. It gives them new self respect. It calls up resources of strength and courage that they did not know they had. And finally, finally, it reaches their opponent and so stirs their conscience that reconciliation becomes a reality. I still believe that standing up for the truth is the greatest thing in this world. This is the aim of life. The aim of life is not to be happy. The aim of life is not to achieve pleasure and avoid pain. The aim of life is to live in a sacred way, come what may.
 
~ Martin Luther King ~


You carry in yourself all the obstacles necessary to make your realization perfect. Always you will see that within you the shadow and the light are equal: you have an ability, you have also the negation of this ability. But if you discover a very black hole, a thick shadow, be sure there is somewhere in you a great light. It is up to you to know how to use the one to realize the other.
 
~ Sri Aurobindo ~

 
 
The Way of Transformation 

Only to the extent that you expose yourself over and over again to annihilation, can that which is indestructible arise within you. In this lies the dignity of daring. Thus the aim of practice is not to develop an attitude which allows you to acquire a state of harmony and peace wherein nothing can bother you. On the contrary, practice should teach you to let yourself be assaulted, perturbed, moved, insulted, broken and battered – that is to say, it should enable you to dare to let go of your futile hankering for harmony, surcease from pain, and a comfortable life in order that you may discover, in doing battle with the forces that oppose you, that which awaits you beyond the world of opposites. Only if we venture repeatedly through zones of annihilation, can our contact with Divine Being, which is beyond annihilation, become firm and stable. The more you learn wholeheartedly to confront the world that threatens you with isolation, the more are the depths of the Ground of Being revealed and the possibilities of new life and Becoming opened.
~ Karlfried von Durkheim, from The Way of Transformation ~


There are still times when my experiences of the war are right here in the present moment. As these thoughts, feelings, and perceptions enter strongly into my consciousness, I concentrate on neither attaching to what comes up nor rejecting it. Instead I focus on just breathing, and at the same time working to establish a different relationship, a more harmonious relationship with this suffering. This does not mean that these thoughts, feelings, and perceptions go away, because they do not. Healing is not the absence of suffering. What happens is that through this process of being more present to my own life, I stop attempting to reject suffering. This is healing and transformation. Mindfulness meditation practice supports me in becoming present to the reality of my life without judgment….

I've come to understand that healing doesn't mean that our pain and suffering go away. Healing is learning to live in a different relationship with our pain and suffering so it does not control us. 
~ Claude Anshin Thomas, “At Hell's Gate: A Soldier's Journey from War to Peace” ~

  
Once an affliction of the mind has been conquered, it cannot return.
~ Thrangu Rinpoche ~

  
You will not grow if you sit in a beautiful flower garden,
but you will grow if you are sick, if you are in pain, if you experience losses,
and if you do not put your head in the sand, but take the pain and learn to accept it,
not as a curse or punishment but as a gift to you with a very, very specific purpose. 
~ Elizabeth Kübler-Ross ~

 
The ultimate weakness of violence is that it is a descending spiral, begetting the very thing it seeks to destroy. Instead of diminishing evil, it multiplies it. Through violence you may murder the liar, but you cannot murder the lie, nor establish the truth. Through violence you may murder the hater, but you do not murder hate. In fact, violence merely increases hate. So it goes. Returning violence for violence multiplies violence, adding deeper darkness to a night already devoid of stars. Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that.
~ Martin Luther King, Jr. ~


When you open yourself to the continually changing, impermanent, dynamic nature of your own being and of reality, you increase your capacity to love and care about other people and your capacity to not be afraid. You're able to keep your eyes open, your heart open, and your mind open. And you notice when you get caught up in prejudice, bias, and aggression. You develop an enthusiasm for no longer watering those negative seeds, from now until the day you die. And you begin to think of your life as offering endless opportunities to start to do things differently, endless opportunities to dissolve the seeds of war where they originate – in the hearts and minds of individuals like you and me.
~ Pema Chödron ~

 
I played with great happiness against the monsters.
~ Argentine basketball player against the Dream Team, Olympics 1992 ~

 
 
Courage

It is in the small things we see it.
The child's first step,
as awesome as an earthquake.
The first time you rode a bike,
wallowing up the sidewalk.
The first spanking when your heart
went on a journey all alone.
When they called you crybaby
or poor or fatty or crazy
and made you into an alien,
you drank their acid
and concealed it. 

Later,
if you faced the death of bombs and bullets
you did not do it with a banner,
you did it with only a hat to
cover your heart.
You did not fondle the weakness inside you
though it was there.
Your courage was a small coal
that you kept swallowing.
If your buddy saved you
and died himself in so doing,
then his courage was not courage,
it was love; love as simple as shaving soap.

Later,
if you have endured a great despair,
then you did it alone,
getting a transfusion from the fire,
picking the scabs off your heart,
then wringing it out like a sock.
Next, my kinsman, you powdered your sorrow,
you gave it a back rub
and then you covered it with a blanket
and after it had slept a while
it woke to the wings of the roses
and was transformed. 

Later,
when you face old age and its natural conclusion
your courage will still be shown in the little ways,
each spring will be a sword you'll sharpen,
those you love will live in a fever of love,
and you'll bargain with the calendar
and at the last moment
when death opens the back door
you'll put on your carpet slippers
and stride out. 
~ Anne Sexton ~

 
For the raindrop, joy is entering the river - -
Unbearable pain becomes its own cure.
Travel far enough into sorrow, tears turn into sighing;
In this way we learn how water can die into air.
When, after heavy rain, the storm clouds disperse,
Is it not that they've wept themselves clean to the end?
If you want to know the miracle, how wind can polish a mirror,
Look: the shining glass grows green in spring.
It's the rose unfolding that creates the desire to see.
In every color and circumstance,
May the eyes be open for what comes. 
~ Ghalib ~



I know God will not give me more than I can handle.
I just wish that he didn't trust me so much.
~ Mother Teresa ~


Give us courage, gaiety and the quiet mind.
Spare us to our friends, soften to us our enemies.
Bless us, if it may be, in all our innocent endeavors.
If it may not, give us the strength to encounter
that which is to come, that we be brave in peril,
constant in tribulation, temperate in wrath,
and in all changes of fortune and down to the gates
of death, loyal and loving to one another.
  ~ Robert Louis Steven son ~


Power is not arms to conquer; power is arms to hold and comfort and work together for peace.
~ Claude Anshin Thomas, “At Hell's Gate: A Soldier's Journey from War to Peace” ~


Chickpea to Cook
 

A chickpea leaps almost over the rim of the pot
where it's being boiled.
"Why are you doing this to me?"
The cook knocks him down with the ladle.
"Don't you try to jump out.
You think I'm torturing you.
I'm giving you flavor,
so you can mix with the spices and rice
and be the lovely vitality of a human being.
Remember when you drank rain in the garden.
That was for this."
Grace first. Sexual pleasure,
then a boiling new life begins,
and the Friend has something good to eat. 

Eventually the chickpea
will say to the cook,
"Boil me some more.
Hit me with the skimming spoon.
I can't do this by myself.
I'm like an elephant that dreams of gardens
back in Hindustan and doesn't pay attention
to his driver. You're my Cook, my Driver,
my Way into Existence. I love your cooking." 

The cook says,
"I was once like you,
fresh from the ground. Then I boiled in Time,
and boiled in the Body, two fierce boilings.
My animal-soul grew powerful.
I controlled it with practices,
and boiled some more, and boiled
once beyond that,
and became your Teacher."
~ Rumi ~


Those who would give light must endure burning.
~ Author Unknown ~


For Courage
 

When the light around you lessens
And your thoughts darken until
Your body feels fear turn
Cold as a stone inside, 

When you find yourself bereft
Of any belief in yourself
And all you unknowingly leaned on has fallen,

When one voice commands
Your whole heart,
And it is raven dark, 

Steady yourself and see
That it is your own thinking
That darkens your world,

Search and you will find
A diamond-thought of light,
Know that you are not alone
And that this darkness has purpose;
Gradually it will school your eyes
To find the one gift your life requires
Hidden within this night-corner. 

Invoke the learning
Of every suffering
You have suffered.
Close you eyes.
Gather all the kindling
About your heart
To create one spark.
That is all you need
To nourish the flame
That will cleanse the dark
Of its weight of festered fear. 

A new confidence will come alive
To urge you toward higher ground
Where your imagination
Will learn to engage difficulty
As its most rewarding threshold! 
~ John O'Donohue ~


The deeper we carve the well of sorrow, the more we can contain.
~ Kahil Gibran ~


The Well of Grief
 

Those who will not slip beneath
The still surface on the well of grief
Turning downward thorough its black water
To the place we cannot breath
Will never know the source from which we drink,
The secret water, cold and clear,
Nor find in the darkness glimmering,
The small round coins
Thrown by those who wished for something else. 
~ David Whyte ~


Climb the mountains and get their good tidings.
Nature's peace will flow into you as sunshine flows into trees.
The winds will blow their own freshness into you,
And the storms their energy,
While cares will drop off like autumn leaves. 
~ John Muir ~


There is a vitality, a life force, an energy, a quickening
That is translated through you into action.
And because there is only one you in all time,
This expression is unique.
And if you block it,
It will never exist through any other medium…
The world will not have it.
It is not your business to determine how good it is,
Nor how valuable,
Nor how it compares with other expressions.
It is your business to keep it yours clearly and directly,
To keep the channel open. 
~ Martha Graham ~


When a young tree is injured it grows around that injury. As the tree continues to develop, the wound becomes realitively small in proportion to the size of the tree. Gnarly burls and misshapen limbs speak of injuries and obstacles encountered through time and overcome. The way a tree grows around its past contributes to its exquisite individuality, character, and beauty. The image of the mature tree, full of character and beauty, will serve us better than denying the traumatic experience or identifying ourselves as victims and survivors.
~ Peter Levine Ph.D., Walking the Tiger: Healing Trauma ~


Autobiography in Five Short Chapters

I
I walk down the street.
There is a deep hole in the sidewalk.
I fall in.
I am lost… I am helpless.
It isn't my fault.
It takes forever to find my way out.

II
I walk down the same street.
There is a deep hole in the sidewalk.
I pretend that I don't see it.
I fall in again.
I can't believe that I am in this same place.
But it isn't my fault.
It still takes a long time to get out.

III
I walk down the same street.
There is a deep hole in the sidewalk.
I see it is there.
I still fall in… it is habit…
But, my eyes are open.
I know where I am.
I take full responsibility.
I get out immediately.

IV
I walk down the same street.
There is a deep hole in the sidewalk.
I walk around it. 

V
I walk down another street. 

~ Author Unknown ~


Until one is committed, there is hesitancy,
the chance to draw back, always ineffectiveness.
Concerning all acts of initiative (and creation),
there is one elementary truth that ignorance of which
kills countless ideas and splendid plans:
that the moment one definitely commits oneself,
then Providence moves too.
All sorts of things occur to help one
that would never otherwise have occurred.
A whole stream of events issues from the decision,
raising in one's favor all manner of unforeseen incidents
and meetings and material assistance,
which no man could have dreamed would have come his way.
Whatever you can do, or dream you can do, begin it.
Boldness has genius, power, and magic in it. 
~ Goethe ~


When despair for the world grows in me
And I wake in the night at the least sound
In fear of what my life and my children's lives may be,
I go and lie down where the wood drake
Rests in his beauty on the water, and the great heron feeds.
I come into the peace of wild things
Who do not tax their lives with forethought
Of grief. I come into the presence of still water.
And I feel above me the day-blind stars
Waiting for their light. For a time
I rest in the grace of the world, and am free. 
~ Wendell Berry ~


Serenity is yours.
When chaos looms seek the sweet
Surrender of simplicity.
Gaze above at the glassy sky,
Feel each blade of green
Beneath your feet,
Listen to the sound of faith
Like a reed flute playing
Inside your chest.
Breathe.
Stand in witness of
Your true nature.
Remember the compassion
Of the lover's eyes,
The calm wisdom of
The elder's voice.
Go within. Be at rest without.
Fall to your knees in gratitude.
You have all you need.
Turn from the riot of distraction.
Let it roll over and beyond you.
Serenity is yours.
It lives within your reach. 
~ Ching Qu Lam ~

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