The main therapeutic ingredient for someone who is grappling with childhood trauma, whether repressed or vivid memory, is SAFETY. The safety we refer to in psychotherapy is not only physical safety but emotional and psychological safety as well. People who have been abused or traumatized in childhood were helpless victims because they were young and did not have control over their environment or the relationship with the adults around them. In essence, their nervous systems were built around the trauma and this usually means that dissociation is a central defense mechanism the child used. For some people the dissociation was so strong (a great way to protect themselves!) that the memories of the trauma get lost in very depth of the mind.
Below I share a short case study of a woman who, over the course of psychotherapy, has started to uncover the lost memories and rebuild her life. The purpose here is to give clients insight into the importance of safety in treatment and some of the ways a client can work with a therapist to create a safe container.
CASE STUDY (This is a very condensed synopsis of work that took about a year)
'Freya' was referred to therapy by a local agency and complained that she feels "like something bad happened to me but I don't know what." I explained to Freya that whether or not we find out what happened to her or not, our intention in therapy is to help her deal with the impact of her traumatic past on her present-day life. The very first step in creating safety is stepping away from the trauma and focusing on creating a supportive therapeutic relationship.
After a number of sessions, Freya and I became more and more interested in what helped her feel safe in the therapy room. We discovered that it was helpful if she took 15 minutes before the session to prepare and ground herself in the waiting area and also 15 minutes after the session to reflect and transition back into her day. Extending the session time in this way on her own helped Freya to be ready to go deeper when she was with me.
In the beginning of each session I led a grounding exercise to help Freya connect with a feeling of safety and support. Her favorite one was mindfulness of her feet on the floor and back against the couch. We sat together for about 3 minutes focusing on these sensations and arriving into the session slowly.
We also found that Freya felt more comfortable in the therapy office when after the initial exercise, she lay down on the couch. Most of the time she did not make eye contact with me. Sometimes her eyes were closed when she spoke but other times they were not. She could speak more naturally and freely this way instead of sitting up across from me. Once she began laying down during the session, each session deepened in content.
One week Freya shared that she had been consumed all week with the feeling that there was a child screaming inside her. I interpreted this as the young child self that Freya had left behind. During this session I guided her to close her eyes and encounter the child. After she spent a few moments with the child, I asked her to see herself in a safe place. For Freya the safe place was at the ocean, listening to the ocean sounds and feeling the sun and sand. In our session she alternated between being with the screaming child and returning to the safe place. Eventually without my guidance, Freya felt the urge to return to be with the little girl. The child in her mind was upset and closed off. They did not speak very much since it was hard to communicate with such a child. I asked Freya what she might do to connect and comfort the child. She found herself sitting down next to the little girl and placing a hand on her shoulder. This was all the contact necessary. The two of them sat together in silence like this for a long time.
A few weeks went by and Freya returned to session reporting that she was having memories of her childhood trauma come to the foreground in her memory. She told me this calmly, sitting up across from me as an adult. The memories she shared were very difficult and painful. I remarked to Freya how grounded she seemed to be as she spoke. She said that she herself was surprised by how well she has been doing even as the memories surfaced. She did not expect it to be like this. I explained to Freya that she had been doing a very good job creating safety for herself while connecting with the little traumatized girl inside of her. I reminded her that she is no longer that young girl. She is an adult who is no longer going through those experiences. Her ability to reflect and support herself is a real show of her strength and growing self-acceptance and self-love as an adult.
I believe that it was Freya's willingness to let go of the expectation that the memories would come up that helped free them. She spent most of the first year of therapy focusing on resourcing herself in her day to day life by finding creative activities, support groups and a stable living environment. In therapy she focused on learning tools to use in times of high anxiety and depression. The repressed memories were not the focus of her attention yet when they began to surface, she had access to a whole new set of coping skills she had been building.
Building safety in and out of the therapy room is a very important process for clients dealing with childhood trauma. It can be a lifelong process. It is so valuable because healing can feel like a deep dive; you've gotta have that oxygen tank with you down there. But once you've been to the bottom of the ocean of your mind and come back to the surface, you can take a long walk on the beach.
Yin Yoga is a passive style of yoga developed by Paulie Zink and taught by Sarah Powers and Paul Grilly that integrates yoga poses and knowledge of Chinese meridian theory. Meridians are lines of energy that run through the body and correspond to internal organs. These can be accessed through acupressure, acupuncture, hand-on-healing, and even by your own stretching to activate them.
The Stomach/Spleen meridian pair are the main meridians you can target for benefits relating to disordered eating.
"The stomach meridian is the yang meridian and is paired with the Spleen yin meridian. It helps support physical and emotional nourishment. It functions with the Spleen meridian in the assimilation of Qi from food through digestion and absorption. The Spleen supports self-esteem and open mindedness." (Taken from NaturalHealthZone)
The idea in Yin Yoga is to target the energy lines so it's not as important that you do the exact pose in the exact right way. As long as you feel a stretch, an opening of energy, a deepening of sensation - in the area you're working on.
Here are some tips for your Yin practice:
Here is a list of some poses that correspond to the Stomach/Spleen Meridian:
Being in our bodies is hard. Pain and discomfort are built into our human systems. There are a lot of ways we find to try to escape. Drugs, alcohol, tv, over working, obsessing or distracting in many different ways.
People with eating disorders have found a way to manage the pain. They found out that if you can’t make it stop altogether, you can find a way to have it at least be a familiar entity that feels like something you can control. “Hey you pain… I can handle you. You can’t be in charge of me! I say when, where, and how!”
The better you succeed at controlling, the more you actually reinforce the fear of the pain. Because the more control you have, the safer you feel. So you find yourself in an unending cycle. Having control feels safe. So you need to get control over and over and over.
The problem is that you find out that it’s only an illusion of control. Things will happen in life that throw off your control and so the eating disorder ramps up. Anything can go wrong emotionally, physically, relationally – and you have your “go to” coping tool. Controlling the pain… Until one day, instead of you controlling your pain and your food, it is controlling you. And you are left worse off than where you started. And you realize that you are not in control at all. So you try and try and try to get that control back – to get that safety back.
Recovering from an eating disorder is difficult and scary because you have found something that works for you. You found a way to control the pain and bend it to your will. Until it stopped working…
So now what? The miracle cure for the pain has been hijacked by a whole new set of complications and you are left looking for different answers - for something that will help - but hoping in your heart of hearts that you won’t have to give up the control you think keeps you safe.
The most important thing to keep in mind when you are seeking treatment is this:
Recovery from an eating disorder is not about taking away your control. And it is not about taking away your safety. It is about finding out how you can discover or recover safety in your body, even though you can’t control it all.
But how?? How will you learn to feel safe without control? Practice.
Practice. So the first thing is to practice being in your body. Simple. Just practice. Not perfection.
The first step is to start to cultivate an awareness of yourself in your body. The first step is to practice allowing yourself to be still and follow your impulses. To begin to practice an embodied movement meditation.
I bring the practice of Authentic Movement to a Eating disorder treatment group in Sonoma County. In this group I offer a facilitated form of movement therapy inviting the participants to listen to their bodies and let the impulses lead them.
Our first session was telling. I introduced the practice and they were curious and open to trying it. So we began by me guiding them into their bodies. With closed eyes, each of the participants found a comfortable position to begin. I spoke warmly and slowly, inviting them to allow themselves to follow any urge to move. I repeated time and time again that this was their safe space to learn to give themselves permission. To allow themselves to listen to their own bodies in a new way.
And I sat and witnessed them in silence.
It was difficult to witness these young women. Not because of the movements they were making. But because of their utter stillness. Every so often someone would make a slight adjustment. And I would eagerly watch, hoping that this would lead to a little more…
In reflection, we spoke about the ways in which each participant was afraid of being seen. And how some felt they wanted to rebel against the freedom I was suggesting they allow themselves. We spoke about how they held on so tightly.
This is the way it begins. The noticing of what is. What is true for each of you right now is just as important as the path you will take to recover. You can not get anywhere else before you find out where you are at the beginning.
So if right now your are inhibiting your impulses, or holding tight, or clamping down, or afraid to be seen… That is where you are now. And you have permission to be there.
As you begin to learn to be with yourself and allow your experience, just letting yourself feel your own truth, your truth will continue to emerge. You are cultivating a listening. You are learning to attend to yourself in a different way. You are practicing compassion for yourself. And most of all you are opening up to curiosity. As you continue to pay attention and get curious about your internal landscape – you will find it easier and easier to navigate. And as you learn to navigate your bodily experience, you will find there is so much more richness to discover.
Being in control will start to seem pretty boring in comparison to the adventure of being an embodied human.
Yonat Piva, MA, LMFT
I write about navigating the challenges of prenatal, postpartum, parenting & relationships. I believe we can inhabit our bodies with a renewed sense of fulfillment in being a human woman.