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Our Mental Health IOP offers the resources and support to Learn to trust the body's wisdom to heal from trauma, anxiety, depression, PTSD, addiction, eating disorders, body image issues, chronic pain and other suffering.
Our programs are uniquely designed with:
Please call (805) 987-3162 or email info@thenewbeginningscenter.com for more information.
Our programs are uniquely designed with:
- Somatic-Based and Evidence Supported Approach to Treatment
- Customized Treatment Adapting to each Client's Needs for Healing
- Balance of One-on-One and Group Modalities
- Multi-Disciplinary Team of Caring and Skilled Licensed Professionals
- Collaboration with Client's Outside Treatment Professionals
Please call (805) 987-3162 or email info@thenewbeginningscenter.com for more information.
The Nine-Step Method for Transforming Trauma
Dr. Buczynski: Let’s go through briefly your Nine-Step Method for transforming trauma.
Dr. Levine: The first thing is that you have to create a sense of relative safety. Remember we talked about the social engagement system – you have to help the person feel just safe enough to begin to go into their bodies.
“...From that sense of relative safety created by the therapist and the environment, we help the person to support initial exploration and acceptance of sensations...”
Then, from that sense of relative safety created by the therapist and the environment, we help the person support initial exploration and acceptance of sensations. And we do it only a little bit at a time, so they “touch into their sensations” then come back into the room, into themselves.
The third step is a process I call “pendulation.” That’s a word I made up – what it means is that when people first begin to experience their body sensations, they actually feel worse for a moment. It is probably largely because they have avoided their sensations. So when they feel them, they feel worse.
This is like a contraction. But what I have discovered is when you help support people, they discover that with every contraction there is an expansion. So if they learn just to stay with these sensations just momentarily long enough, it will contract but then it will expand. And the rhythm between contraction and expansion, that really gives people the sense, “Oh my God, I’m going to be able to master this!”
So, again, when they get the sense or rhythm, of contraction/expansion, it needn’t become threatening. It just becomes, “Oh, okay, I’m contracting, and now I’m expanding.”
The fourth step, which is really the first, and the second, and the third, and the fourth, fifth, sixth, seventh and eighth, is what I call “titration.” And by titrating, by just dosing one small amount of experience at a time, this creates an increase in stability, resilience, and reorganization of the nervous system. So titration is about carefully touching into the smallest drop of survival-based arousal…
“Pendulation is the rhythm between contraction and expansion...and titration is about carefully touching into the smallest drop of survival-based arousal.”
Dr. Buczynski: So sort of like a homeopathic approach to trauma? A homeopathic dose level of approaching…
Dr. Levine: Yes! Yes, that’s it! Yes, that is exactly a really good analogy – and it may be more than just an analogy. You know, we have a number of homeopaths, particularly in the European and South American trainings – and, you know, they get it – the idea of the smallest amount of stimulus that gets the body engaged in its own self-defense mechanisms.
Then the fifth step is to provide corrective experiences by helping them have active experience that supplants or contradicts the passive response of collapse and helplessness. So as they recover active responses, they can feel empowered – active defensive responses.
“By helping them supplant the passive response of collapse and helplessnes, they recover active defense responses; they can feel empowered.”
When people are in the immobility response, when they are in the shut-down state, what happens is that normally in animals, it’s time-limited. I was out on the beach the other day and some of the kids on the beach do this for fun – they will take one of the pigeons and hold it. They will come up very quietly behind the pigeon, hold around its wings so it can’t move, and then turn it over and it goes into this complete immobility response. It doesn’t move. It looks like it is dead – it is so-called “playing possum.” But then, if they [the kids] leave it for a moment upside-down there on the sand, after a few seconds, it pops out of this immobility state and flies off as though nothing had happened.
But if you frighten the animal when it is coming up or if you frighten it when it is coming in, it stays in that immobility a longer amount of time, a much longer amount of time – particularly if you re-frighten it.
So the thing is, we frighten ourselves. Normally the exiting out of immobility is time-limited – you go in and you go out. When people are coming out of immobility, if they are frightened of those sensations, that fear then puts them into immobility.
So I call it “fear-potentiated immobility.”
“...we uncouple the fear from the immobility and the person comes out of the immobility, back into life.”
In this step, we uncouple the fear from the immobility and the person comes out of the immobility, back into life. And, again, when they come out, there is usually a lot of activation, a lot of arousal. So when the person comes out, we have to be prepared to help them contain that sensation of arousal and then move through that, back into homeostasis, balance and social engagement. So that is the sixth step.
And the seventh step is to help them discharge and regulate the high arousal states, and they redistribute the mass of the vital energy mobilized for life-preserving action, while freeing that energy to support higher-level brain functions.
Step eight is engaging self-regulation to restore dynamic equilibrium and relaxed alertness. I like that word better than “homeostasis” because homeostasis implies a static state, and this dynamic equilibrium is always shifting. So we go into a high level of arousal, but dynamically we turn to a balanced equilibrium.
And then the ninth step is to help the person reorient in the here and now; contact the environment, the room, wherever they are - the emergency room if it is the emergency room, the recovery room if it is the recovery room – and reestablish the capacity for social engagement.
Dr. Levine: The first thing is that you have to create a sense of relative safety. Remember we talked about the social engagement system – you have to help the person feel just safe enough to begin to go into their bodies.
“...From that sense of relative safety created by the therapist and the environment, we help the person to support initial exploration and acceptance of sensations...”
Then, from that sense of relative safety created by the therapist and the environment, we help the person support initial exploration and acceptance of sensations. And we do it only a little bit at a time, so they “touch into their sensations” then come back into the room, into themselves.
The third step is a process I call “pendulation.” That’s a word I made up – what it means is that when people first begin to experience their body sensations, they actually feel worse for a moment. It is probably largely because they have avoided their sensations. So when they feel them, they feel worse.
This is like a contraction. But what I have discovered is when you help support people, they discover that with every contraction there is an expansion. So if they learn just to stay with these sensations just momentarily long enough, it will contract but then it will expand. And the rhythm between contraction and expansion, that really gives people the sense, “Oh my God, I’m going to be able to master this!”
So, again, when they get the sense or rhythm, of contraction/expansion, it needn’t become threatening. It just becomes, “Oh, okay, I’m contracting, and now I’m expanding.”
The fourth step, which is really the first, and the second, and the third, and the fourth, fifth, sixth, seventh and eighth, is what I call “titration.” And by titrating, by just dosing one small amount of experience at a time, this creates an increase in stability, resilience, and reorganization of the nervous system. So titration is about carefully touching into the smallest drop of survival-based arousal…
“Pendulation is the rhythm between contraction and expansion...and titration is about carefully touching into the smallest drop of survival-based arousal.”
Dr. Buczynski: So sort of like a homeopathic approach to trauma? A homeopathic dose level of approaching…
Dr. Levine: Yes! Yes, that’s it! Yes, that is exactly a really good analogy – and it may be more than just an analogy. You know, we have a number of homeopaths, particularly in the European and South American trainings – and, you know, they get it – the idea of the smallest amount of stimulus that gets the body engaged in its own self-defense mechanisms.
Then the fifth step is to provide corrective experiences by helping them have active experience that supplants or contradicts the passive response of collapse and helplessness. So as they recover active responses, they can feel empowered – active defensive responses.
“By helping them supplant the passive response of collapse and helplessnes, they recover active defense responses; they can feel empowered.”
When people are in the immobility response, when they are in the shut-down state, what happens is that normally in animals, it’s time-limited. I was out on the beach the other day and some of the kids on the beach do this for fun – they will take one of the pigeons and hold it. They will come up very quietly behind the pigeon, hold around its wings so it can’t move, and then turn it over and it goes into this complete immobility response. It doesn’t move. It looks like it is dead – it is so-called “playing possum.” But then, if they [the kids] leave it for a moment upside-down there on the sand, after a few seconds, it pops out of this immobility state and flies off as though nothing had happened.
But if you frighten the animal when it is coming up or if you frighten it when it is coming in, it stays in that immobility a longer amount of time, a much longer amount of time – particularly if you re-frighten it.
So the thing is, we frighten ourselves. Normally the exiting out of immobility is time-limited – you go in and you go out. When people are coming out of immobility, if they are frightened of those sensations, that fear then puts them into immobility.
So I call it “fear-potentiated immobility.”
“...we uncouple the fear from the immobility and the person comes out of the immobility, back into life.”
In this step, we uncouple the fear from the immobility and the person comes out of the immobility, back into life. And, again, when they come out, there is usually a lot of activation, a lot of arousal. So when the person comes out, we have to be prepared to help them contain that sensation of arousal and then move through that, back into homeostasis, balance and social engagement. So that is the sixth step.
And the seventh step is to help them discharge and regulate the high arousal states, and they redistribute the mass of the vital energy mobilized for life-preserving action, while freeing that energy to support higher-level brain functions.
Step eight is engaging self-regulation to restore dynamic equilibrium and relaxed alertness. I like that word better than “homeostasis” because homeostasis implies a static state, and this dynamic equilibrium is always shifting. So we go into a high level of arousal, but dynamically we turn to a balanced equilibrium.
And then the ninth step is to help the person reorient in the here and now; contact the environment, the room, wherever they are - the emergency room if it is the emergency room, the recovery room if it is the recovery room – and reestablish the capacity for social engagement.