At Holina, we understand that that when it comes to a long-term successful recovery, addiction treatment in residential rehab is only the beginning. But it’s such an important beginning!.
It’s time to get back to yourself.
The spontaneous movement in all of us is toward connection, health, and aliveness.
No matter how withdrawn and isolated we have become, or how serious the harm we did to ourselves, on the deepest level, just as a plant spontaneously moves toward sunlight, there is in each of us an impulse moving toward connection, natural health and full aliveness.
This organic impulse is the fuel of the therapy at HOLINA. (adapted and modified from Laurence Heller, the founder of NARM)
What is trauma?
Trauma occurs when we experience situations or events that we perceive as a threat to our survival or a threat to the safety of our lives that overwhelm our capacity to cope. We talk about “trauma” when the body holds on to the survival stress, even long after the situation has passed and factual safety has been re-established. This causes chronic nervous system dysregulation, expressing itself either as a chronic hyper-arousal (flight/flight response) or hypo-arousal (freeze or fawn response). So, trauma is not about what happened to us, not about a specific event. It’s about stored survival stress that’s held within the nervous system and all its many associated systems. It’s a psychobiological process of unresolved FEAR that disrupts both, regulatory functioning and our capacity to be present and embodied in the here and now.
Shock Trauma (PTSD)
When we experience overwhelming events that last only a short amount of time, and our nervous system keeps this survival stress in the body, we talk about “shock trauma”.
Example: a truck comes at you, and you barely survive. Typical long-term symptoms of shock trauma are a re-experiencing of the event an avoiding behaviour a chronic sense of threat, anxiety or panic attacks.
Childhood or developmental trauma (Complex-PTSD)
When we experience events that regularly overwhelm our ability to cope over a longer period, and especially during childhood, when our nervous system and brain capacity are just about to be formed, we speak of “developmental” or “childhood trauma”. When the “truck” that comes at you (see the example above) is one of your main caregivers attacking you as a vulnerable child, then you will do anything to not lose your parents’ love. This way, the child faces an impossible bind. Typical symptoms of developmental trauma are the same as with shock trauma: re-
experiencing, avoiding and a sense of threat. Additional to that: affect dysregulation, disrupted capacity for self-regulation negative self-concept, feelings of being wrong, unworthy etc. interpersonal disturbances, disrupted capacity for relationship.
Trauma: often the driving force for addiction
Almost all clients that come into treatment with active addictions have experienced childhood mistreatment to some degree. The most common adverse childhood experiences are:
(* Out of those, it’s sexual or physical abuse as well as the witnessing of inter-parental violence, the & ”Terrible Three” (Martin Teicher, Harvard Medical Center), that has the most harmful effect on the brain and nervous system.)
Addiction begins as a solution, not a problem
Addiction often begins as a solution to medicate or numb feelings that are often typical signs and symptoms of trauma:
As these very challenging internal states can feel threatening, their “medication” or numbing gets linked with survival in the reward centre of the brain. That explains why the power of choice gets completely lost, and the importance of the substance or behaviour gets over-emphasised. The substance or process gets hard-wired with survival.
TRAUMA RECOVERY AND ADDICTION TREATMENT SERVICES
Healing trauma alone won’t keep an individual sober. A solid program of 12-step addiction recovery supports sobriety at HOLINA. The additional offer of trauma resolution services and therapies helps address the underlying root causes of addictive and other maladaptive behaviours. It supports clients to improve their capacity for embodiment, and emotional and physical self-regulation shifts their shame-based identifications grow their ability for creating and maintaining healthy and safe relationships and connects them more with their authentic self. As a result of this, the need to numb or self-medicate intolerable internal states decreases.
PRINCIPLES OF HEALING SHOCK TRAUMA (PTSD)
For the resolution of shock trauma (PTSD), we are using mainly somatic (body-oriented) modalities. Somatic approaches for the healing of trauma apply a deep understanding of the nervous system, its functions and possible states of disregulation. Together with clients we explore how different states of the nervous system express themselves in terms of associated bodily functions (e.g. sweating, sleeping, hyper-agitation, digestion problems or blanking out), muscular tension or belts of tension, emotions, thought patterns and psychobiological trauma reflexes (fight, flight, freeze and fawn). These somatic models, best used to help heal shock trauma, can support the healing of childhood or developmental trauma (C-PTSD) when integrated into other psychotherapy modalities. All models of somatic trauma therapy used at HOLINA support clients in more embodiment of the development of a stronger felt sense and the capacity for self-regulation avoiding dissociation (checking out) avoiding re-traumatisation or emotional flooding (overwhelm) nervous system regulation through the release of accumulated stress and tension from the body a movement away from catharsis and towards more capacity for containment of physical or emotional intensities.
Some of the somatic modalities used at HOLINA are Somato-Emotional Processing & Integration, TRE (Tension, Stress & Trauma Releasing Exercises), and Rebirthing Breathwork.
Psychosomatic Sensing helps clients identify, process and release the held-back somato- emotional tension and/or activated trauma energy that is being held in their body. Using a blend of pressure (bodywork), vocal guidance, breath, movement and expression, clients are supported in building their capacity to stay present in the body (interoception) and observe what is happening inside of themselves. Using a neurophysiological, psychodynamic and energetic foundation to understand and identify the precise root cause of symptoms in the body, the client can address the emotions directly and build enough safety in the body to fully witness and express themselves without becoming overwhelmed, resistant or re-traumatised by the experience.
This guidance supports a person in being able to tap into his or her inner healing intelligence, which in turn allows them to recognise and embody their wholeness. With time, this practice allows the nervous system to withstand greater levels of discomfort (greater “window of tolerance”) which then supports a greater level of regulation. A better-regulated nervous system changes the connection between body and mind, which in turn supports the rewiring of neural pathways. Clients can revisit their traumatic events and build a different relationship/perspective with the past, so that the past is no longer playing out old patterns, thus impacting their day-to-day life. Clients experiencing PTSD can witness, process and integrate past events so that the body and mind no longer re-experience them as being a present threat. This can reduce and/or fully stop symptoms such as emotional flashbacks that may inhibit a person’s ability to experience life to the fullest. Clients re-experiencing any shame or fear-based protective mechanisms stemming from complex trauma are also supported in being able to build the capacity to explore, observe and build new relationships with their past so that they can build healthier relationships with themselves and others moving forward.
TRE® – Tension, Stress & Trauma Releasing Exercises
TRE® helps clients to shake off accumulated tension, stress & trauma that keep them stuck and to restore natural balance and well-being. This generally feels pleasant and soothing. After doing TRE®, many people report feelings of peace and well-being. This deep work with the nervous system consists of a simple yet innovative series of exercises that invite the activation of a voluntary neurogenic tremor reflex. This natural tremor / shaking assists the body in releasing deep muscular patterns of stress, tension & trauma in a safe environment. TRE® calms down the nervous system and brings aliveness to frozen/disconnected parts of the body. When this muscular shaking/vibrating mechanism is activated in a safe and controlled environment, the body is encouraged to return to a state of natural balance.
Breathwork is not for everybody. It can be highly triggering and needs to be done in a trauma-informed way.
Once clients can hold for themself higher states of activation, breathwork can provide great shifts in connection to body, mind, heart or spirit.
Rebirthing Breathwork is a technique that uses breath as a highly transformative tool. Through associated circular use of the breath – circular breathing without a pause between inhaling and exhaling – a higher flow of energy is generated, and trance-like internal states are induced naturally. Through this process, we achieve an altered state of consciousness that allows us to access suppressed emotions, memories or traumatic experiences from childhood or other challenging emotional memories that are stored in the subconscious mind. The breath takes us to the root of our holding patterns, allowing us to bypass our mind’s natural defences and penetrate our & cellular memory & where all information is stored. By breathing through these blockages and releasing them bit by bit, we can reach states of deeper joy, love and full aliveness. New attitudes, new insights, and a new self can be realised and personal transformation can be experienced. The powerful technique of Rebirthing Breathwork works on our physical, mental, emotional, energetic and spiritual bodies. It is a holistic process that can bring deep inner healing.
PRINCIPLES OF RESOLVING COMPLEX TRAUMA (C-PTSD)
EXAMPLE: NARM – THE NEUROAFFECTIVE RELATIONAL MODEL 1
NARM – the NeuroAffective Relational Model – is developed out of somatic trauma therapy models, especially Peter Levine’s Somatic Experiencing (SE) and Wilhelm Reich’s
BioEnergetics. It’s based on the observation that body-oriented approaches only help so far when it comes to complex personality dynamics that are rooted in childhood trauma. Some of the basic principles of NARM, a model developed specifically for the recovery from Complex-PTSD (developmental trauma) are:
The first step in therapy is to clarify a “therapeutic contract”. This is an intervention that supports the client to set an intention for their healing process: “What is it that you most want out of your time here in treatment and out of your therapy process?” By inviting the client to connect to what they most want for themself, we can begin to support a process of exploration, which is built upon client intent and relational consent. This deepens Step 1 in the 12 Steps program. What clients want for themselves is not attainable or possible if they continue using substances or act out addictive behaviours.
1 Taken from Heller, Laurence; Kammer, Brad J: The Practical Guide for Healing Developmental Trauma
In the second step, we explore together with the client what’s in the way for them to get what their heart desires. This inquiry-driven process supports us as therapists, and invites our clients, to reflect on and gather information about their internal processes. We bring curiosity to the ways clients organize their experiences. Most clients have spent their lives running away from their inner worlds. This causes repeating patterns of disconnection, disorganization and suffering. We help clients connect with disconnected parts of themselves, which provides them with an opportunity for greater organization and freedom from suffering. Having someone that is authentically curious about our internal experience and processes is something that many of us have sadly missed from our caregivers when growing up.
The agency is a “game-changer.” It refers to the degree that clients are in the “driver’s seat” of their own life. With reinforcing agency we support clients in shifting focus away from specific traumatic events and toward how they have learned to adapt to (early) traumatic experiences and carried this adaptive survival or coping strategies into adulthood. Identifying with childhood trauma often leaves individuals feeling helpless, hopeless and stuck. However, embodying a sense of agency supports an increased capacity for healing, growth and change. This goes back to the definition that trauma is not what happened to us, but the way we’ve learned to relate to and cope with what happened to us. Understanding how clients are relating to and organizing their life experiences is the essence of supporting agency. Clients can learn new, more healthy and growth-oriented ways of relating to themselves.
The NARM Emotional Completion Model
NAMR offers a new perspective on emotions and the role unresolved emotions play in complex trauma. In therapy, we are working with effect in a way that allows clients to shift complex trauma patterns. We use an important differentiation between “primary emotions” (rooted in adult consciousness) and “default emotions” (rooted in child consciousness). We highlight the focus on containment, as opposed to cathartic expression or discharge of emotional responses. The Emotional Completion Model supports connection to primary emotions and embodiment of deep and nourishing emotional states. “Humans are wired for emotional connection. Emotions shape our internal world. Emotions are the building blocks of the Self. People who can stay connected to their emotions will be informed by the full spectrum of emotions. There are no “good” or “bad” emotions. Emotions such as anger, grief, and fear coexist with other emotions such as love, joy, and gratitude. A person’s ability to experience a full range of emotions reflects their capacity for affect regulation and affect tolerance.” (Heller, Laurence;
Kammer, Brad J: The Practical Guide for Healing Developmental Trauma; emphasis added) The healing happens when people stop running from themselves and start owning and allowing their emotions.
Tracking Connection and Disconnection
As clients begin to connect to their primary emotions, they will often begin using old strategies to disconnect. In these situations, we might say something like, “So as you’re being present with your anger, you begin telling yourself that anger is a waste of time and you just need to focus on being positive. What’s it like for you to notice both, your anger and the impulse to move away from it?” Even if a client is only able to stay with the emotional energy for a brief moment, we view these moments as opportunities for building increasing capacity to be present with their life energy. Connection is our natural state. Only when the connection becomes a threat do we have to employ strategies of disconnection to survive? Early protective mechanisms like dissociation, splitting or fragmentation – all various forms of disconnection – are attempts to reduce the traumatic impact.
Reflecting Psychobiological Shifts
Real change in therapy, or any personal growth work, is often challenging to reach. While cognitive and behavioural changes are certainly important in people’s lives, NARM focuses on the underlying psychobiological patterns of dysregulation and disorganization that are driving cognitive and behavioural symptoms. As a neurobiologically-informed and somatic-oriented model, NARM supports psychobiological shifts that lead to the greater organization, health, and well-being of our clients. Clients are supported to notice shifts on all levels of their experience – including the physical, emotional, cognitive, relational or spiritual.
The focus on healing trauma supports addiction treatment by gently addressing the core wounds and beginning to resolve the underlying emotional conflicts that drive addictive behaviour as an unnatural obsessing and unmanageable compulsion. This way, the journey of addressing trauma in different therapeutic ways is a gateway for addiction recovery at the HOLINA Rehab in Thailand.