In the last five years I've had the privilege of working with clients at the deep, embodied place they increasingly call "trauma". The place contemplative teaching has always called "suffering".
Due to the binary nature of options for treating trauma in Australia - either mainstream, or alternative - Australians are at high risk of carrying unresolved trauma into future generations.
Mainstream options are usually too clinical to access the necessary spiritual aspects of therapy. Alternative options are unregulated, meaning applied policies and practices come down to the exposure and education of the practitioner.
Until the time when mainstream and alternative medicines are genuinely respected as complementary, the Australian public are denied access to a team approach. Institutionalised opinions continue to outweigh patient preferences and outcomes. My research points to this structural barrier as a key leverage point to treating trauma in the collective psyche of Australians, including our original and migrant populations.
Despite this institutional bullying, social media continues to demonstrate the power of group-think.
For those of you on a journey of personal liberation from trauma, I outline the 4-Phases of Trauma Treatment. If you would like to quote or share, please do so by referencing this source. Email me directly, for my Signature Presentation "A More-than-Insta- Approach to Trauma".
Phase 1 is purely contextual.
It includes how your client was referred to you, the blogpost your client read before booking the appointment, the confirmation text on booking, and the reminder the day before.
Even more crucial, phase 1 includes your professional- & personal- integration of Trauma theory and practice, and the structures (institutional, political and cultural and historic) in which your clinical practice is embedded. Those of you with a Public Health background have a strong advantage here.
As an attachment figure (and you may well be the Primary Attachment Figure while clients are seeing you intensively) your Consistency, Availability, Reliability, Responsiveness and Predictability will determine your client's sentiment. Your own attachment style will dictate this part of the process. #healerhealthyself #ouch #tritebuttrue
Phase 1 also includes identifying and affirming your clients adaptive strategies for self-securing, and implicitly offering your own.
Breath-awareness, sensory-grounding and self-touch form a foundation of self-securing. Weeks-to-months may be necessary to draw out symbols of safety such as the earth or experiencing freedom-from-judgment in nature.
The goal of phase 1 is for your client to know you've "got" them, and they've "got" themselves.
Phase 2 is about identifying your client's habituated stress response.
In this phase, you'll draw heavily on your ability to recognise "Posturing" in the body. How are they protecting themselves? Where are their eyes drawn? What are their subtle signs of stress? And how do they respond?
Overall, you'll need to know, does your client tend to fight, flee, freeze or fawn?
The stress response is the KEY INDICATOR of "stuckness" in the body.
Fight. Usually shows as tension in the upper body. Headaches, jaw clenching, neck, shoulder and arm tension are all signs of the tendency to fight. Finger restlessness, fist-clenching and nail-biting* are common tell-tales too. Breath tends to be inhale-dominant. Chest may be puffed up. Accessory breathing muscles ie SCM and scalenes, are often pronounced.
The fight response needs trust in humanity.
2. Flee. Usually shows as tension in the lower body. Quads, glutes, calves, hamstrings, feet. Knee-jiggling*, hyperactivity, restless legs, even night cramps are tell-tale signs of the tendency to flee. Sudden need to empty the bowel is a classic flee response. Breath tends to be "huffy-puffy". Short and ineffectual.
The flee response needs to let be & turn towards.
3. Freeze. Usually..... doesn't show up! Hidden and invisible, the freeze tendency is the hardest of all to identify. Clever, huh? Often shrouded by the intellect, the freeze response is insidiously perpetuated by our mind-revering society.
Signs are usually an attempt to redirect the therapist's attention with logic, and the appearance of having it all together. Don't fall for it! Tell-tale signs include controlling the environment eg sweeping crumbs off the table, coolness, aloofness, judgment and criticism. The tell tale is usually the sense that this is client is a "Hard nut to crack". Often clients with a strong tendency to freeze will cancel or forfeit therapy. Given the structural barriers mentioned above, they are all too often lost in the system. PhD topic, anyone?
The breath may be hard to find and sometimes barely noticeable. Eye contact is uncomfortable. Your client might jump at hearing their name. Speech is jagged, restricted or even silenced. Tension is often in the throat and face. Palpation often reveals rigidity or "wooden-ness" in the body.
The freeze response needs softness, warmth, tenderness and compassion.
4. Fawn. As the term "people-pleasing" enters common vernacular, the fawn response has become better known. Over-use of rapport, romantic or friendly, is the most common sign of the tendency to fawn. Subtle but clearly-definable, fawning often shows as being especially complimentary, or even slightly-smarmy tendency. More subtle body-language includes leaning to capture the therapists gaze, especially-animated facial expression, voice- or hand-gesturing, audible sighing, over-use of humour, or even a kind of exaggerated awkwardness.
The fawn response needs self-connection and respect.
Notice how many of the tell-tales are "over-riding" techniques eg knee-jiggling is an over-riding of the leg-muscles needs to pump, nail-biting is an over-riding of the fingers need to act. This is the first clue of the need to "compassionately embrace" tendencies (phase 3) before they can be transformed.
Phase 3 is Compassionate Embracing.
Once phase 1 (securing) and phase 2 (identifying) are complete, your client is ready to start compassionately "turning towards".
This is a unique practice developed through years of sensory-observation (Vipassana meditation), coupled with psychological language, gifted by my dear friend and colleague Dr Rachel Hannam.
True "felt" compassion comes from the experience of shared humanity. Just like a wounded animal, to connect with pain, we need a trusted someone to "watch over" and protect while we tend to our vulnerability. We need to know we're not alone. That fundamentally, we are all share universal needs ie we are "needy" or vulnerable.
Phase 4 is Integration
Not to be confused with "done, dusted, moving on", integration is the process of leaving the safe womb wrinkly and pink-skinned with a single vernix-layer of protection. In Hypnobirthing terms, "the fourth trimester".
During this time, the client starts to differentiate from the practitioner. If there has been little "closure-work" it can take months of deliberate practice of release, coming-to-terms-with, trust, acceptance and surrender for the client to secure their attachment with themselves (a form of re-parenting). Conscious-uncoupling has a lot to offer in this space, as does the buddhist practice of Taking Refuge (in the Triple Gem).
By returning our client's attachment to us, they can assign it to transition objects, places and people, and ultimately their own ancestral lineage. This is necessary to avoid the "fall from grace" otherwise protectively-constructed.
As you can see, treating trauma requires an appetite for complexity. Those who know only the theory will struggle to access it in your own body. Those who know only the practice will fail to crack the defences of your mind.
You can be liberated from the strong-hold of trauma held deep in the body-mind. You can reset your nervous system to respond gently over time. It will take trust. It will take patience. It will take courage. It will take others. Without doubt.
20-years clinical experience, 10-years corporate experience, 40-years embodiment-practice (classical ballet and yoga) and a 30-year contemplative-discipline (Vipassana Meditation), I graduated Pre-Medicine and post-graduate research (MPH) at The University of Queensland to complete 5-years of client thematic-analysis. I am Alexis Dennehy, Trauma Practitioner. For small-group consulting, please email a.dennehy@uq.net.au