Aller au contenu principal

Articles Tagués ‘stress’


Happiness isn’t the only emotion that can help you stay healthy as you age. Feeling excited, amused, proud, euphoric, strong, cheerful you feel on a regular basis matters, too. First-of-its-kind studies are being revealed over the years demonstrating that experiencing a broad spectrum of different positive emotions on a day-to-day basis actually signals lower systemic inflammation. Meaning, that allowing all kinds of euphoric, inspired, happy and relaxed feelings actually contribute to lowering inflammation. This study reveals that the simple acknowledgement of positivity “is related to lower biomarkers of systemic inflammation— which reduces the risk of chronic disease and premature death.” (R)

Previous research has identified many correlations between negative emotions and inflammation, but researchers believe this is the first study of many to come to identify that people who experience a diversity of 16 different positive emotions appear to have lower levels of systemic inflammation. This could be for many reasons, for example, a regular state of joy or happiness is known to produce dopamine, melatonin and serotonin, including its precursor tryptophan. These can all be called the « neurochemicals of happiness », as the secretion of these chemicals is what enables the neural pathway to experience happiness, positivity and well-being.

“Notably, researchers found that experiencing a limited diversity of positive emotions did not down regulate inflammation. Therefore, they coined the term “emodiversity” to emphasize the vitality of promoting various positive emotions on a daily basis. » (R)

16 different positive emotions. . . .You might be asking yourself, what are the 16 different positive emotions?!

There’s a lot more to just “happiness” and “joy”; there are many more positive emotions that can trigger the anti-inflammatory response. Some are: being active, alert, amused, at ease, attentive, calm, cheerful, determined, enthusiastic, excited, happy, inspired, interested, proud, relaxed, and strong.In a study to determine emotional diversity, researchers enlisted 175 participants to self-report their experience of the 16 different positive emotions at the end of each day. They also had the participants rate their experience of 16 negative emotions which included feeling afraid, ashamed, blue, distressed, drowsy, guilty, hostile, irritable, jittery, nervous, sad, scared, sleepy, sluggish, tired, and upset. The degree that someone had experienced any of the 32 positive or negative day-to-day emotions was rated on a scale of « not at all » to 1 (very slightly) up to 5 (extremely). Emodiversity was measured over a 30-day period and categorized by the number of times and degree to which each emotion was experienced. After the experiment was completed, blood samples were taken and tested for three biomarkers of inflammation: IL-6, CRP, and fibrinogen. Researchers concluded that greater diversity of day-to-day positive emotions was correlated with significantly lower systemic inflammation. As for the negative emotions, it was evident that stress and inflammation greatly increased.Anthony Ong, professor of Human Development and Gerontology at Cornell University says, « There is growing evidence that inflammatory responses may help explain how certain emotions get under the skin, so to speak, and contribute to disease susceptibility. Our findings suggest that having a rich, spontaneous, and diverse positive emotional life may benefit health by lower circulating levels of inflammation.” (R)A somewhat recent systematic analysis of over a decade’s worth of mind-body interventions (MBIs) found that practices such as yoga and meditation reduce pro-inflammatory cytokines (in other words, they become like anti-cancerous practices!) and down-regulate inflammation-related genes. This analysis was published several years ago in the journal, Frontiers in Immunology. The systematic review of 18 different MBI studies by researchers at Coventry University concluded that mind-body practices such as mindfulness, meditation, yoga, and tai-chi all appear to have the similar effect of reversing the molecular signature caused by chronic stress and the expression of pro-inflammatory genes.

Emotions as a Map to Yourself. . . .Think for a moment, which emotions or situations trigger you the most?

Emotions signal key location as to where inflammation lies within the body. Happiness and love sparks chemistry across the entire body, while depression has the opposite effect, it tends to dampen feelings in the body, generate rigidity, lock the legs and head, and essentially withholding circulation. Danger and fear, for example, triggers strong sensations in the chest area, while anger was one of the few emotions that activated particularly the arms.

*according to Traditional Chinese Medicine
Anger =  Liver
Envy = Liver + Gallbladder
Sadness = Heart + Stomach
Anxiety = Stomach + Kidneys
Jealousy = Thyroid + Heart

How to Avoid Destroying Emotions when Tracking Body Sensations?

How to Avoid Destroying Emotions when Tracking Body Sensations?


Summary: The paper explains how tracking of body sensations can eliminate emerging emotions and then offers  ways of working more effectively with emotions in the body to improve not just emotional outcomes but also cognitive, behavioral, relational, and spiritual outcomes in all therapeutic modalities.

1. The Problem

1.1 How tracking body sensations can be helpful in body psychotherapy

Tracking of body sensations is becoming a popular tool for working with the body in psychotherapy.  It is indeed a powerful technique. When the brain consciously tracks the body in great detail, two things happen at the same time. The brain receives more information about what is happening in the body and the brain allocates more higher-brain neurological resources to regulate the body. Therefore, conscious tracking of body sensations can be extremely effective in regulating the physiology. Given that clinical populations show increasing levels of physiological dysregulation, tools such as tracking of body sensations that promote regulation can be very useful in therapy.

Tracking of body sensations, because it regulates the body, can also undo the defenses in the body against emotions and make the emotions more available. And it can provide emotional regulation by stabilizing the body experiencing an overwhelming emotion. Therefore, tracking of body sensations can also be a useful tool in working with emotions.

1.2 How tracking body sensations can be hurtful in body psychotherapy

The more detailed the tracking of the body, the more the body gets regulated down to states of rest and relaxation. While these outcomes might be desirable for those who chronically suffer from high levels of arousal or other kinds of extreme dysregulation, they can destroy emerging emotions; and compromise the formation of relevant cognitions and behaviors in relation to those emotions. Approaches that use detailed tracking of body sensations as the primary tool appear to be unaware of this downside of the technique for a good reason: The scientific knowledge that sheds light on why detailed tracking of body sensations can destroy emerging emotions and compromise the formation of relevant cognitions and behaviors does not appear to be widely known even in body psychotherapy circles.

1.3 How emotions are generated in the body

According to the science of the physiology of emotions, pleasant emotions in the body are generated from placing different systems in the body (such as the muscular system and the autonomic nervous system) into states of regulation; and unpleasant emotions in the body are generated from placing them into varying states of dysregulation and stress (Damasio, 2003; Sapolsky, 1994). If you have trouble imagining this, think of the last time you fell in love and of the heartache you experienced from the subsequent breakup.

1.4 How emotions and sensations are related in the body

In the body, emotions are meaningful patterns of sensations. They can be likened to the picture of a woman carrying an umbrella in an impressionistic painting. The thousands of dots that make up the woman’s image can be likened to the individual sensations that are aggregated and mapped on a higher level in the brain (as the image of the woman with the umbrella). The brain constantly maps the body at different levels of detail (Damasio, 2004). In general, higher order maps such as emotions are theoretically easier to sense in the body than the lower order maps of individual sensations from which they are aggregated. However, it is psychologically harder to make emotions conscious than the sensations that make them up because emotional experiences need much inner and outer support.

1.5 How tracking sensations can interfere with emotions in the body

Detailed tracking of body sensations in a mindful (non-reactive) manner leads to the down regulation of the body. But unpleasant emotions in the body are by definition states of stress and dysregulation in the body. Therefore, it can be understood that resorting to tracking body sensations when difficult emotions arise can compromise, if not destroy, the very emotions as they are forming.  This is akin to going so close to the impressionistic painting that one can see only the dots. The woman with an umbrella is no longer there. At times this is often misunderstood as having completed one’s work with emotions just because they are no longer there and the body is peaceful.

For the same reasons, the strategy of alternating the tracking of emotions and sensations and the strategy of tracking them both at the same time in the body can compromise work with emotions. It is akin to trying to turn up a flame and to turn it down at the same time while cooking something. In addition, our working memory capacity is rather limited. To appreciate the neurological difficulties involved in these strategies, just imagine holding the image of the woman with the umbrella and all the dots that make her up at the same time or quickly alternating between the two in your awareness.

1.6 How tracking sensations can damage sensorimotor emotions in particular?

Emotions have been classified into primary emotions such as happiness and sadness, secondary emotions that are combinations of primary emotions (such fear and shame mixing to form guilt), and sensorimotor emotions, psychologically meaningful body states such as feeling good and bad or attraction and revulsion psychologically in a situation. Sensorimotor affect states are more common than primary and secondary emotions. They can be likened to the trunk of the tree of affect with primary and secondary emotions likened to the leaves and the flowers. But sensorimotor affect states have been neglected in psychotherapy because psychotherapists have historically paid little attention to what is happening in the bodies of their clients.

Sensorimotor emotions require the tracking of body states in a meaningful way in relation to a situation. Detailed tracking of body sensations without attending to the meanings embedded in the form of sensorimotor emotions neglects important and more common aspects of emotional experience; and can destroy sensorimotor emotions even more than primary or secondary emotions because the latter are more understood and attended to in therapy. The loss of sensorimotor emotions is not only a significant loss of an important aspect of every emotional experience, its very base or trunk,  but also carries the risk of the loss of primary and secondary emotions.

And, over time, detailed tracking of body sensations can become automatic response patterns to thwart the formation of emotions especially unpleasant ones. Detailed tracking can even become a learned defense against emotions as observed in systems that use detailed tracking of body sensations as a primary tool for working with the body. This, by the way, is also true of other tools that are used to regulate the body such as looking for good places in the body to soften bad experiences in other places. In fact, any tool for working with the body, such as touch, breath, tracking energy in and out of the body, voluntary or involuntary movement, and positive imagery or memory, will have the same effect if the intent behind their use is one of down regulation of the physiology.

Unfortunately, psychology appears to be increasingly in the grip of the psychiatric point of view that the resolution of psychological problems lies primarily in the regulation of the physiology. This tendency has also increased the use of tools such as detailed tracking of body sensations more for regulation (especially down-regulation) than for other purposes such as undoing defenses, accessing and supporting unconscious content, and developing a capacity in a person for the ups and downs of life, to resolve current symptoms as well as to develop resilience for the long run.

2. The Solution

2.1 How are emotions, body, and psychophysiological symptoms related?

Overwhelming emotions can shut the body down and lead to physical, cognitive, affective, behavioral, relational, and spiritual symptoms. And they can stress and dysregulate it towards psychophysiological (psychosomatic) symptoms. This is particularly true for unpleasant emotions that are, by definition, states of dysregulation and stress to begin with. It is often the inability to tolerate unpleasant emotions that shuts the body down or further stresses and dysregulates the body to cause psychosomatic (psychophysiological) symptoms, even serious ones such a chronic fatigue and fibromyalgia. The Psychophysiologic Disorders Association in the US estimates that as many as two-thirds of symptoms for which people seek medical help are psychological in origin.

Psychologically, it is the ability to experience and tolerate an emotion that allows it to heal. It is when one can get to a place of sensing a heartache as something that one can live through that it becomes possible to keep one’s heart open for engaging others more fully in the future. It is when one can tolerate an emotion that one can stay with the information in the form of emotion long enough to process it cognitively and behaviorally. Otherwise, one might resort quickly to meaning making or acting out behaviorally as a defense against emotions.

The basic problem in psychotherapy, psychoneuroimmunology, and psychopathology is the lack of affect tolerance (Stolorow et al, 1995; Pert, 1999). The primary determinant of the outcomes of a person’s attempts to separate, differentiate, and individuate as well as an individual’s ability to relate to others and to the collective levels of one’s psyche is the capacity to tolerate opposites in one’s experience (Jung, 1960). The ability to grow personally as well as spiritually is constrained by a person’s inability to tolerate opposites in one’s experience. (Dayananda, 2002). And what often makes any psychological experience unbearable is the emotion associated with it.

2.2 How can the body be used as a container for emotions and for building affect tolerance?

The experience of an emotion can potentially involve the entirety of one’s brain and body physiology (Damasio, 2003; Pert, 1999). The whole body can therefore be used as a container for creating a greater capacity for experiencing and tolerating emotions over a longer period of time to heal them; and for generating more cognitive and behavioral information from the greater emotional information available for a longer period.

Some therapeutic and spiritual approaches do recommend ‘staying with’ uncomfortable experiences till they ‘transform’ as a strategy for healing. But just staying with an emotion wherever it shows up in the body does not necessarily lead to a greater quantity of it or a greater capacity for it. In fact, it can stress and dysregulate the body further and create psychophysiological symptoms. For example, one can develop respiratory or cardiovascular symptoms from ‘just staying with’ grief or heartache in the heart and lung areas where they often show up first. To avoid such risks, one needs to know how to increase, deepen, and expand the emotion in the body and, at the same time, regulate the body in such a way that the body does not get too dysregulated from the emotion or too regulated that the emotion is destroyed.

2.3 What is needed to work more effectively with emotions, cognitions, and behaviors through the body?

What is needed is a better way to work with emotions in the body. Emotions have to be supported psychologically on the inside and more importantly from the outside while the body is worked with in relation to them. Work with the body during an emotional experience has to able to undo the body’s defenses against emotions and make them easier to access for processing. It also has to be able to manage the extreme stress and dysregulation in the body so that the emotional experience is more bearable. At the same time, it has to ensure that the body is not excessively regulated so that the very emotional experience one is working with is not destroyed. Tools such as detailed tracking of body sensations that tend to regulate the physiology quickly either have to be avoided or used with due diligence so that they are not used at cross purposes when one is working with emotions.

Also, to work effectively with emotions through the body, one has to understand how emotions are generated and defended against in different layers (muscle, organ, and nervous system) of the body; how emotions are related to cognitions and behaviors; and what has to happen in a person’s process and body for emotions to heal and for emotions to be of further use in forming relevant cognitions and behaviors.

2.4 What do emotions have to do with cognition and behavior?

Availability of emotion improves a person’s behavior. Research shows that a person who has access to emotion is not only able to generate more relevant behavioral alternatives but is also better at choosing the best course of action to deal with a situation (Damasio, 1994).

Research also shows that embodiment of emotion, defined as expansion of emotion in the physiology, improves a person’s cognition about a situation (Niedenthal, 2007). That is, a person with emotions is better able to name the emotion and makes sense of the emotion by associating it to the appropriate context for it.

Longitudinal research in the UK has shown that children who are better at managing emotions do better as adults not only in their personal lives but also in their professional lives.

2.5 How can Integral Somatic Psychology (ISP) help in working with emotions, cognitions, and behaviors?

Integral Somatic Psychology™ (ISP™) is based on affect theory, the science of the physiology of emotions, the science of the physiology of regulation, and principles of energy psychology. ISP offers a complementary approach for working with emotions using the body as a container to improve cognitive, emotional, and behavioral outcomes in any therapeutic modality.

The core strategy in ISP is embodiment of emotional experiences. And, rather than rely on a more complex tool of detailed tracking of body sensations with its attendant problems, ISP uses simpler tools of self-touch by client, breath, and voluntary movement that are easier for both therapists and clients to adapt to across therapy settings.

2.6 How is embodiment of emotion defined in Integral Somatic Psychology (ISP)? 

In the Integral Somatic Psychology (ISP) approach, the ability to experience different emotions  (primary, secondary, and sensorimotor) in as much of the body as possible and the ability to tolerate them as long as possible are defined as the two most important aspects of embodying emotions (with the ability to make sense of them and the ability to express them as its third and fourth aspects).  Expanding and tolerating emotions in the body is a missing piece even in traditional body-oriented Reichian and Neo-Reichian psychotherapies. To learn more details about the theory and practice of this effective paradigm-shifting complementary approach, please visit



Damasio, A. (1994). Descartes’ error: Emotion, reason, and the human brain. New York: Penguin Books.

Damasio, A. (2003). Looking for Spinoza: Joy, sorrow, and the feeling brain.  Orlando, FL:Harcourt, Inc.

Dayananda, S. (2002). The teaching of the Bhagvad Gita. New Delhi: Vision Books.

Jung, C. G. (1960). The structure and dynamics of the psyche. Princeton, NJ: Princeton University Press.

Pert, C. (1999). Molecules of Emotion: The science behind mind-body medicine. New York: Simon & Schuster, Inc.

Niedenthal, P. (2007). Embodying emotion. Science (316), 1002-1005.

Sapolsky, R. M. (1994). Why Zebra’s don’t get ulcers. New York: Holt Paperbacks.

Stolorow, R., Brandchaft, B., & Atwood, G. E. (1995). The psychoanalytic treatment: An intersubjective approach. New York, NY: Routledge.

Nature is Medicine — Even in a Prison Cell

Trees are the earth’s endless effort to speak to the listening heaven.
–Rabindranath Tagore

by Nalini Nadkarn

The “Moss-in-Prison” project helped me bring my love for trees and forest to men and women in the deepest windowless reaches of the prison system.

“We learned that the inmates who viewed nature videos committed twenty-six percent fewer violent infractions than those who did not view them, a convincing result for the prison officers and administrators—and for ourselves.” Photo by Samuel Zeller/Unsplash

When one is in love—especially with something as huge and beautiful and complex as trees—there is an urge to share this emotion with everyone, especially to those who have no opportunity to experience such feelings themselves. As my love of trees and canopy biota expanded, I sought to share my connections to nature with people who live in places where it is absent, just as a new bride might urge those sitting on the sideline of her wedding party to find a dancing partner. It occurred to me that the people who live in venues that epitomize the most severe endpoint of environments without nature are those who are incarcerated in prisons and jails, the spaces where nature is not.

In 2003, I started a research project that brought together plants and prisoners. I realized that it would be unrealistic to bring trees to inmates, but I could bring canopy-dwelling mosses inside the concrete walls to connect convicts with living, growing things that need their care. This “Moss-in-Prisons” project included prisoners in a combination research/conservation effort to counteract the destructive effects of collecting wild-grown moss from old-growth forests for the floral trade. Florists, who use moss for their flower arrangements and to pack bulbs for shipment, have created a growing market for mosses harvested from old-growth forests in the Pacific Northwest. Since 2005, the moss-harvesting industry reached an economic value of nearly $260 million each year.

Ecologists have raised concerns about this expansion of this “‘secondary forest product”‘ because they have documented that these moss communities fill important ecosystem roles. They take over three decades to regenerate, far longer than what would make for sustainable harvest at present removal rates from these ancient forests. No protocols exist for growing mosses commercially, or in large quantities. If I could learn how best to grow commercially usable moss, perhaps I could create a more sustainable source of moss and relieve the pressure of wild-collecting from old-growth forests. To do so, I needed help from people who have long periods of time available to observe and measure the growing mosses, access to extensive space; and, most important, fresh eyes and minds to put forward innovative solutions. These qualities, I thought, might be shared by many people in prison.

The biology of mosses also makes them suitable for novice botanists, because mosses possess “poikilohydric” foliage, which means their thin foliage wet and dry rapidly, allowing them to survive drying without damage and to resume growth quickly after rewetting. Some mosses that have lain in herbarium drawers for over one hundred years have been revived by simply applying a little water and bringing them into the light, reawakened after a century of dormancy in the dark. They therefore tend to be resilient, a characteristic that increased the probability that the prisoners would succeed in nurturing living things.


After scouting prisons in my region, I found the Cedar Creek Correctional Center in Littlerock, Washington, directed by Superintendent Dan Pacholke, open to the program. From the beginning, he facilitated all aspects of the project, forging pathways through the Department of Corrections administration. We wished to know which species grow the fastest, and the inmates learned how to distinguish the different types of mosses, built a small greenhouse with recycled lumber, and took notes with the notebooks and pencils I distributed. After eighteen months, we all shared the excitement of knowing which mosses grew fastest.

There were other rewards that I had not foreseen, small and individual, but real. One of the prisoners, Inmate Hunter, joined the horticulture program at the local community college after his release, with a career goal of opening his own plant nursery. “I don’t want to just mow lawns and trim hedges anymore,” he said firmly. “I want to grow real plants.” Another, Inmate Juarez, told me he had taken an extra mesh bag of moss from the greenhouse and placed it inside the drawer of his bedside night table. Each morning, he told me, he opened the drawer to see if the moss was still alive. “And though it’s been shut up in a dark place for so long, it’s still alive and growing this morning,” he said, grinning. And then, more quietly, “Like me.”

This “Moss-in-Prisons” project answered the scientific question I posed, which I valued from the standpoint of a researcher. However, the activities also resulted in better social interactions among the inmates, which was viewed positively by the administrators. The work also provided stimulation and a strong sense of contributing to the Earth, which proved to be of value for the inmates themselves. The superintendent requested other projects, so we brought in faculty to provide science lectures and initiate other conservation projects. These included captive rearing of the endangered Oregon Spotted Frog, the Taylor Checkerspot Butterfly, and seventeen species of rare prairie plants for ecological restoration projects around the state. The practice of inviting incarcerated men and women to actively participate in conservation has now spread across the country to many state prisons and county jails.

Although I felt strong satisfaction in sharing the love of practicing natural history with the inmates we were able to reach in the minimum- and medium-security portions of these prisons, I also felt compelled to find ways to bring nature to those in the deepest reaches of the prison system—men and women in the cellblocks of solitary confinement, where they are held in concrete windowless cells the size of a parking space for twenty-three hours a day, with one hour in a slightly larger concrete exercise room. We could not bring endangered animals and plants—or even lecturers—to these locales because of the high security protocols.

The human environment of hospitals is in many ways similar to those of prisons. The “inmates” of both prisons and hospital wards experience extreme stress and anxiety, as their activities and fate are no longer under their own control. Interior spaces are stark and sterile—for punitive and security reasons for prisoners; for health reasons for patients. Their webs of social interactions are entirely dependent on who might choose to visit them; often these individuals are islands in a frightening sea. Behavioral psychologists have documented that the view of nature outside a window or portrayed on backlit panels can reduce stress and speed recovery. In 2013, I found a maximum security prison in Oregon that was open to the idea of showing nature videos to men in their solitary confinement cellblocks to explore whether this might reduce agitation, anxiety, and the violent infractions that cause injury to inmates and officers. We installed a projector in the exercise room of one of the cellblocks and provided inmates with the opportunity to view the videos during their exercise time—one hour a day, three days a week.

After a year, our surveys and interviews of staff and inmates revealed that they felt lower stress, agitation, and irritability, and were able to carry a “sense of calmness” from seeing the nature video when they returned to their individual cells. Most significantly, we learned that the inmates who viewed nature videos committed twenty-six percent fewer violent infractions than those who did not view them, a convincing result for the prison officers and administrators—and for ourselves. Further work is now needed to learn how this “nature intervention” might work in other prisons, and to understand which elements of nature were most effective in bringing light to the darkest parts of our prison system.

I have been intimate with trees—through the curious eyes of a tree-climbing child, the number-filled notebooks of an academic scientist, the borrowed lenses from people of diverse disciplines and experiences, and most importantly, moving the shuttle of a loom that brings together the intersecting threads of nature and the multiple ways that society comes to perceive and communicate insights about our world. Practicing natural history—and the love that grows organically from that action—is a critical thread in the tapestry that makes up our world, an entity that is complex, connected, useful, strong, fragile, and beautiful.

Nalini Nadkarni is a forest ecologist who pioneered techniques for studying tree canopy communities in tropical and temperate forests, and the author of Between Earth and Sky: Our Intimate Connections to Trees, and other books. She is a professor of biology at the University of Utah. 

Peter Levine on Freedom from Pain

Tami Simon speaks with Dr. Peter Levine and Dr. Maggie Phillips. Dr. Phillips is the director of the California Institute of Clinical Hypnosis and is author of Finding the Energy to Heal and Reversing Chronic Pain. Dr. Levine is the developer of the groundbreaking Somatic Experiencing® approach to healing trauma. With Sounds True, they have coauthored a book and accompanying CD called Freedom from Pain. In this episode, Tami speaks with Maggie and Peter about the prevalence of chronic pain today, how physical pain may relate to past trauma, and the stages that pain sufferers commonly experience. They also offer inspiring real-world examples and insights about the keys for solving “the puzzle of pain.” (59 minutes) 

The paradox of trauma is that it has both the power to transform and resurrect. –Peter A. Levine

Tami Simon: You’re listening to Insights at the Edge. Today I speak with Peter Levine and Maggie Phillips. Maggie Phillips is a licensed psychologist and currently serves as director at the California Institute of Clinical Hypnosis. She has authored numerous papers and articles as well as the books Finding the Energy to Heal: How EMDR, Hypnosis, TFT, Imagery, and Body-Focused Therapy Can Help Restore Mindbody Health and Reversing Chronic Pain: A 10-Point All-Natural Plan for Lasting Relief.

Peter Levine has spent 45 years studying and treating stress and trauma; is the developer of somatic experiencing, a naturalistic approach to healing trauma; and has practiced and taught at treatment centers, hospitals, and pain clinics throughout the world. With Sounds True, Peter Levine and Maggie Phillips have released a new book and an accompanying CD called Freedom from Pain: Discover Your Body’s Power to Overcome Physical Pain.

In this episode of Insights at the Edge, Peter, Maggie, and I spoke about the prevalence of chronic pain in modern society and how physical pain may relate to past trauma. We also talked about the stages that pain sufferers commonly experience, and we talked about bracing patterns and a subsequent progression into what they refer to as the “pain trap.” Peter and Maggie explained the concept of self-regulation in dealing with physical pain and shared real world examples of its effectiveness. Finally, they discussed the primary keys to solving what they call the “puzzle of pain.” Here’s my very helpful conversation with Peter Levine and Maggie Phillips.

In reading your book Freedom From Pain, one of the things I discovered was how many people are actually in chronic pain, and it made me think of all the people I interact with during the day and questioning how many of them might actually be in pain. The grumpiness that I sometimes sense in people—maybe they’re suffering from back pain or something like that. So how prevalent is chronic pain in our society today?

Peter Levine: To give you an idea of the scope of the problem, more people are suffering from chronic pain than from diabetes, cancer, and heart disease combined. So if you’re going through your day at a checkout line, at an [car] mechanics—and some of the people that are your coworkers, your colleagues, that you know—a significant proportion of those people are suffering, usually silently, from chronic pain. And unfortunately, most doctors don’t really have much education or an understanding of where to refer people who are seeking help from chronic pain.

So every day we’re meeting—a fair percentage of the people that we come into contact with are suffering from chronic pain.

TS: Now, you talk about chronic pain as a puzzle, “the puzzle of pain,” that it’s not easy to understand as we might think. Can you help me understand that? Why is chronic pain so puzzling?

Maggie Phillips: Well, I would say that chronic pain is puzzling because it’s so complex. There’s no one source of pain. In fact, there are multiple factors that contribute to it. So we look at chronic pain from the standpoint of trauma because in our clinical practice, [our] combined practice over many years, we have found that [when] people are not responding to the usual treatments, it’s almost always because they have some type of unresolved trauma that is being held in the body.

And so the key, what we found really works for people, is to help identify the source of trauma, to help them find ways to release it for themselves that are safe and comfortable and helps them to expand their body experience. We’ve been very successful [in helping] those people move out of pain, or at least to a place where it’s manageable and they can live a good life.

TS: Help me understand how physical pain relates to past trauma. That’s not obvious to me.

PL: Well first, I want to add one other thing: pain in itself becomes traumatic. And anybody who’s suffered from chronic pain of any kind is also experiencing trauma. But in trauma, what happens is our body stiffens to protect ourselves. Our shoulders get tight, our back stiffens, or alternatively, we collapse in helpless defeat. Trauma is something that happens in the body. And tension is one of the main causes of pain, one of the main consequences of trauma.

So the body has become locked in a protective encasement to protect itself from an external threat, from an emotional conflict, which is terrible. Then that tension that gets locked in our body actually generates the pain, and then the pain generates further bracing because we brace against the pain. And that bracing causes further pain, further trauma, more pain. So it’s a feedback loop. You could say it’s a positive feedback loop with negative consequences. So that trauma leads to pain, the pain leads to trauma, pain leads to fear, and fear leads to more bracing, which leads to more trauma.

There are many ways in which the trauma could have arisen in the first place. Often people—sometimes when they’ve had a relatively minor car accident—somebody comes and hits them from behind—the body is thrown into a state of paralyzed bracing because at that moment, you don’t know how serious that impact is. So your body is protecting yourself from being splattered. And we forget how to undo that. As a matter of fact, after an accident, we get a lot of adrenaline, so we feel really high, we feel really good, and we go on not even resting, and then we maybe find it difficult to sleep that night. Then, over the next few days, the pain starts to lock in.

So this is one of the very, very common causes of pain, but it’s not necessarily, or even likely, [due] to an actual physical injury. The minor impacts are generally not due to any injury to the spine or any injury to the soft tissue, but to the bracing pattern. All trauma involves the bracing pattern. So in this program, we help people learn to identify in their bodies those bracing patterns so that they can undo them. You can say that trauma is something that happens in the body and the mind—the body and the brain and the mind—that doesn’t unhappen. And so in this series, in this program, we help people to learn to release those bracing patterns and to not stiffen against the pain—therefore not causing the pain to recycle.

MP: I want to address what you said, Tami, about it being counterintuitive. It’s not obvious, and that’s true of many people that we see. Generally, people will come in many months, and sometimes years, after the accident or injury that really might have started the pain problem. So they don’t—what they’re involved with is what’s going on with them now. And stress, of course, makes anything or everything worse. It can exacerbate any kind of medical condition.

So lots of times they’re thinking, “Well, I must have had trouble with repetitive injury at work. Maybe that’s why my shoulder’s hurting—it’s that I’ve been doing more computing than usual. And yet I don’t understand. I’ve gone to all of the doctors. I’m doing everything they’ve told me to do, and I’m not getting better. And the doctors don’t understand either. They don’t know what to make of why I’m not recovering.” That would be a situation where we would start talking to the person about the role of trauma. We might not even use that word, but we might say, “Let’s talk about this part of your body.” If it’s a shoulder injury or a shoulder pain that the person has: “Let’s talk about as far back as you can remember any type of injury that happened to your shoulder.” It’s in more of a conversational way [that] we will usually help people uncover the earlier sources of the injury.

As Peter was saying, anytime there’s an injury or a threat, the threat, of course, is one of danger, but because we’re animals, the threat is to our survival. That’s how the body experiences it. The body can’t discriminate between, “Oh, well, I’m not really hurt in this accident because I can still move. I can still walk around, so I must be OK.” The body is going to feel the impact as a threat, and then, as Peter was saying, is going to respond with complex bracing patterns. When those are held in the body and not released over time—and then, of course, we encounter other stresses, so it’s not just maybe one trauma; it may be cumulative trauma that’s built up over time. The good news about what we’re doing is that it doesn’t really matter how many traumas or when the trauma started. It’s really about working with the person’s body experience to the point where they can experience release and relief.

PL: Yes. Exactly. So they are perpetuating the pain cycle unconsciously. And as people become aware of that pattern, then they’re able to release it. Also—and there’s considerable research on this—that people who have early trauma and abuse, trauma issues, are much more likely to develop pain later in life. So that’s one of the reasons that make it complicated: because it can come in any number of different directions. But the key is: the final common pathway is in the body, and how the body braces against what was originally a threat, but now becomes bracing against itself. It’s, again, recycling and reactivating that stress and maintaining it as chronic pain.

TS: Let’s talk a little bit more about the bracing pattern because I’m imagining that most people can relate to that. That’s something that they can feel to some degree inside of themselves, how they brace themselves in different situations. So why do we brace ourselves? I mean, I get it in terms of a car accident because I don’t want to get hurt. But it sounds like what you’re describing is a response that happens in all kinds of traumatic situations.

MP: Yes, that’s right. For example, if you take, as Peter was saying, early childhood trauma. Let’s just go with physical, emotional, or sexual abuse, or some combination of all three. What happens is that in our young bodies, we don’t have enough cognition to be able to mitigate what’s going on or to understand it. So we’re just thrown into these primitive states where we have what we can think of as reflexive responses, where there’s no thinking mind involved.

So if we’re being hit or assaulted or threatened in some cases, then what will happen is that the body just automatically, reflexively responds. And it responds by bracing, because that is just the way animals [of all kinds] respond. They’re going to form this kind of constriction as a way of protection. As one of my clients was saying the other day, it’s like a coat of armor. And it’s their [sense of] “I know I’m trying to protect myself, but this time I don’t really have anything to protect myself from. I have a good life, I’ve lowered my stress, I’m using the tools that I’ve learned from you. So why do I keep protecting myself, keep bracing?”

And that’s where the second level of bracing comes in, if you want to look at it that way—which is that after a while, we get so frightened of what comes up inside of us, when we’re reminded of a danger or threat, that we react, again, protectively and reflexively. So again, we’re not thinking about, “Well, there’s really no danger here.” We’re just reacting. So we initially brace against what we perceive as being real danger and what the body certainly identifies that way. And then later on, it’s self-perpetuating, because the person becomes scared of their inner experience or the constriction and pain in their body, and so they’ll brace again.

PL: So let me give an example with an emotion. Let’s just say somebody was molested, abused as a child. The natural response is that of the anger. And so when the anger may begin to arise, even before the person is consciously aware of it, they push the anger down because of the fear of the anger, the fear that they might hurt themselves or hurt somebody because that’s what anger is. It’s about the impulse to strike out. So they push down on the anger. But then what happens, of course, is the anger pushes up even more, and then the person pushes down on the anger, and how do we do that? Again, we do that with our muscles. So whether it’s the bracing pattern or whether it’s emotions, such as anger or fear or sorrow that we’re frightened about, we brace against those equally.

So again, it doesn’t matter whether it’s emotional or physical. The net response is to brace, is to suppress and hold and check. And the more we do that, the more it pushes, and the more we resist, what we resist persists. Again, this is perpetuating the pain, and again, the pain is perpetuating more fear, and more fear is perpetuating more tension or more collapse and more pain, and on and on and on.

The key is in breaking this cycle whenever we can, so even if something has been chronic for years and it comes from very early trauma, still, through the tools and awareness that we’ve developed through the program, people learn to touch into these sensations, to touch into these feelings and befriend them, really, not to suppress them, not to be overwhelmed with them, not to mindlessly express it, but to touch them, to become more in tune with our natural instincts. And this is what frees us, ultimately, from it, and it’s what the last chapter of the book [and] CD are about. It’s about coming back to wholeness, which is really, in a way, the surprising gift that trauma does give us—because when we’re able to transform it, we are gifted with things we wouldn’t have access to had we not had these challenges to deal with in our lives.

TS: Now, there are many things you’re saying here that I think are quite radical. I’m just going to start with the first layer, which is that our physical chronic pain is not necessarily just physical. I know someone, for example, who has very, very bad chronic back pain. His approach is to, you know, get different kinds of injections, etc. I don’t think he’s looking at early trauma in his life as an aspect of what might be going on with his back pain. He thinks it’s a physical problem.

MP: Let me just give you an example, maybe, of one of the people we talk about in the book, a client that we talk about in the book. This is a man who had 27 knee surgeries before he even came in for treatment. And he, before that, had been very physically fit. In fact, he was a fitness trainer. He was certified in that. And then later on, he drove a truck as a manager, supervising people in the field to install air-conditioning devices. He had two car accidents while he was driving in that job. But the problem started when he, at the age of 18, had a terrible motorcycle accident and almost lost one of his legs.

He convinced the doctor not to take it off. And that was where the multiple surgeries came in. They tried to repair his leg, but when I saw him, he wasn’t talking about that experience at all. It took two or three sessions before I could even find out that there was this important event that was back in his youth. This was 30 or 40 years later, when he had had already two knee replacements. Both of them had failed. He came in because he had absolutely unbearable pain. And it was the first time in all those 27 procedures he had been able to manage his pain somehow. A lot of it was heavy, heavy narcotics. But it wasn’t working because—and I was able to explain this to him later—because of how much trauma you’ve had, your dissociative protection, the walls that protect you from feeling everything that’s happening in your body, have broken down. They can no longer protect you.

So once we started exploring—and of course, you have to do this very carefully with somebody who has multiple traumas. And to be honest with you, that is most of us—have more than one traumatic event in our lives. It’s pretty rare if we don’t. That includes physical, but as Peter was saying, emotional, psychological, sometimes spiritual—there are many, many different kinds of trauma. We also look at everyday trauma that keeps getting repeated for people. He had some of that. He had some childhood abuse that he had not told anyone about, and that came to light. Also, his mother, who had MS, had died when he was about nine years old, and that loss was very heavy for him.

So as we were able to explore these different kinds of experiences and helped him find where they were stored in his body, but also—and this is very important—we don’t just help people get in touch with trauma. That would be overwhelming and retraumatizing. The last thing anybody needs in chronic pain is more trauma. So what we want to do is touch into the trauma as it’s held in the body today and at the same time find resources in the body that can heal the trauma as it’s being held. But it’s helping the body experience expand so that, as Peter was saying, ultimately it’s that sense of wholeness, when we’re able to claim and experience and feel all our experience at the same time. That’s how we find wholeness. So it has to be resources that help the person recover and rebound from the trauma. At the same time, they’re also touching into these wounds from the past.

PL: And getting back to the question that you asked, Tami, some people, they have back problems, and of course they think there’s something physically wrong with their back. For example, they may go to see an orthopedic surgeon, and they may look at the X-rays or the MRIs or the CT scans, and the doctor says, “Well, look. We can see where this problem is coming from.” And that is a possibility. But some studies were done where people who had identical radiographic findings—so in other words, the two backs look exactly the same—one person was in severe pain, and the other person had no pain at all. Why is that? Well, again, these are the things we address in this program.

There are times when you have to have surgery. You know—when the legs are going numb, you’ve gone past where other methods can help, most likely. So it’s important to be working with a physician as well as working psychologically or working with the body to enlist its own healing responses. So you do want to, of course, have advice from a physician. But again, at the same time, I think people—very often, the doctor says, “Look, do you see the X-rays? Your back is a mess.” Then [the idea] that that is the cause becomes locked into the person’s mind. Unfortunately, many times, when surgeries are done when it wasn’t really necessary, it actually leads to more pain.

So in the program, we do try to help lead people through these questions, to be able to ask questions of the physicians, and to get second, maybe sometimes even third, opinions to separate what the possibilities are. Because when you’re in pain, people will do almost anything to get out of pain. And if surgery is suggested, maybe the person will go right to surgery when there really is breathing room to explore other possibilities, such as what we describe in the program.

TS: Now Peter, you said something very interesting. You said two different people with the same basic X-rays—one could be in pain, and one could not be in pain. How do you explain that?

PL: Well, again, we don’t know all the reasons for that, but it’s very likely—but I don’t believe studies were done specifically on this hypothesis—that the people with the higher pain are the ones who have the greater trauma histories or the greater bracing patterns. But again, remember the bracing pattern, no matter what causes it, it causes more pain. So again, there are certain indications where surgery is absolutely necessary. But my experience, and those of many orthopedic surgeons that I have spoken to—really feel that that is a minority of the people who see them for pain. So we try to get a dialogue, an effective dialogue, a positive dialogue between physicians and patients.

TS: It sounds like that’s the place where the pain is made worse. It’s amplified because of this bracing pattern. And Maggie, you were talking about how in the somatic experiencing method that you and Peter teach, there’s a way to interrupt this pattern right here in the present. So talk to me about that. How do we do that?

MP: Right, OK. Let me give you an example, and then I’ll talk from that. You mentioned back pain, and it’s so common, so I’ll use that as an example. Working with a—I think he’s probably about 38 years old now—and he has had back surgery before he worked with me. The reason he got in touch with me is because the back surgery made him worse. Basically, it caused more pain, and of course, Peter and I know, more bracing. And I’ll get to that in a moment. So that’s why he said, “I need help. I don’t understand what is going on. Other people that have had this same surgery and went to the same physical therapist that I did, they’re doing fine. Why is it that I am struggling like this?” After talking to him, I assured him that he was not malingering. It wasn’t all in his head. In fact, there were probably some very good reasons as to why he wasn’t recovering—and that we needed to look at them together so we could help him recover from those.

Well, as we begin to work together, it turns out that what he did after the surgery was that he braced against the pain and the fear of the surgery itself in ways that other people don’t always brace. Now, why is that? This is where we had to get a little bit creative and help him be willing. The main word that Peter and I use is “curious.” We try to help people develop curiosity about what could explain this. It doesn’t mean that something is wrong with me. It means that maybe something is right with me, that my body is simply trying to help me in ways that I don’t recognize, and it can be sometimes that the mind is fighting back against what the body is trying to do.

So that was true in his case. What he would do is sort of beat himself up internally that he wasn’t working hard enough in physical therapy, or he wasn’t exercising enough; he was getting lazy. He had this kind of inner critical pattern that went on that really further kept him bracing against himself. So he began to recognize—as we unfolded some of this—that his body was tense when he would have these onslaughts of criticism or when he would push himself further. He happened to be a surfer, and he was a competitive surfer before all of this started happening. So he was used to pushing his body, and he didn’t recognize that now, when he pushes after he’s been traumatized by the surgery as well as the injury before that, that he’s getting a third layer of bracing and constriction. And so what he’s learning to do now is to recognize it.

So part of our approach really is a mindful one. That is, we train people how to get curious about their experience, how to accept it, and how to connect with it. So he has learned some of those skills, and now, when he gets scared, he goes back to his surgeon. The last time this happened, he called me up in a panic and said, “The surgeon told me I might need more surgery, and maybe I should just go ahead and do that because maybe I’m just not progressing enough.” I said, “OK, wait a minute. Stop right now, and tell me what’s happening inside you as you tell me about your visit to the surgeon.”

And he was able, because he’d learned the skills and been practicing them, he was able to say, “Wow. I’m just really tight, really tense. I feel like I’m really wound up tight, and also I have this pain.” And he not only had pain in the core of his body, which is sometimes related to internal fear, then he also had the increase of fear in his back—fear and therefore pain in his back, just from talking about the visit to the surgeon. So as he was able to recognize that, he’s learned some ways of breathing, which we include in the program. Just focusing on his breath in a very neutral way, he was able to slow down and calm down. After about two minutes, he said, “You know, I think that was just my fear working against me.”

He said, “I know it’s not a good idea for me to think about having another surgery. I need to do a lot more homework and a lot more work on myself before I make those kinds of decisions.” So that’s just an example of how you can work with somebody who’s going through that kind of bracing, double-bracing, triple-bracing, pain trap that we then can help them out of by learning to work with their body in a different way.

PL: And in this pain trap, self-blame is a hook. What we try to do, and I think we have done, is really help people understand that this is not due to a mental weakness, that there are reasons for that, and that as they can identify what the reasons are and work with them, then they get freedom from the pain. So what we do is—people who are in chronic pain are in the pain trap. What we try to do is help them find where they are trapped and then help them find ways to find the exit from that trap.

TS: It seems that part of the trap is that when you’re feeling terrible in your body, the last place you want to go is to your body. You don’t want to pay attention to your body; you want to escape from it. So how do you help people cross that divide?

PL: Well, Maggie was talking about curiosity. You know the expression about curiosity and the cat, right? At least in Kansas, they say that. “Let the cat [come] to realization of its own highest potential.” As we get people to be curious, truly to be able to explore these things, that in itself reduces the fear and a lot of the tension because a lot of the fear is the kind of “Oh my God,” the kind of catastrophic thinking. So as people are able to explore and find the roots of the problem and to deal with them, well, then that’s when the pain reduces or even resolves.

MP: And we also find it helpful to explain sometimes what’s going on in the body in terms of animal behavior because it helps them normalize what’s happening. So most people have had pets, for example. Even if they haven’t been lucky enough to be in the wilds of Africa and to see animals in their habitats, they’ve seen their pets become threatened.

So we talk about it in terms of “Have you ever seen your dog or cat stiffen up at times when maybe you didn’t understand what was going on?” And they stop everything—the animal stops everything. They’re completely frozen, completely still. And it takes them a while before they can ascertain that it’s a garbage truck, or that whatever it is they’re responding to isn’t really life-threatening. Then they will move automatically, and the key there is “move.” They will move their bodies through and past the fear and the bracing to the other side of that. As Peter was saying, they’re free at that point.

So most people can understand that, and we tell them, “Well, and that’s what’s going on sometimes in you” and that your main enemy may be fear, and at a primitive level, just like my dog is afraid that she may get completely overwhelmed by a garbage truck, the fear is—at the deepest level—is that I won’t survive. Something is so terrible that it will kill me, or it will ruin me and overwhelm me and destroy me. And so once we can help people understand where those really deep survival fears come from, and they are curious about their bodies and how their bodies can help them through this, then we can get them into a place of more hope—because I think that’s where the hope comes from.

PL: And you know, animals are doing things all the time to relieve tension and stress. Dogs, cats—the way they stretch, the way they yawn. What they’re doing, essentially, is dissolving the stress that may have occurred in a threatening situation, such as being frightened by a loud sound. And again, they go through the whole day regulating their level of tension through stretching and through other similar kinds of movements, gentle shaking and trembling, and again, people don’t know that this is actually helping them come back into equilibrium, come back into inner balance. They fight against it. And guiding people through this, they get to say, “Oh my gosh, the thing that I was frightened about is exactly the thing that’s making the tension and the pain disappear.”

TS: Now, you introduce a term in the Freedom from Pain approach that I think is really interesting: the term “self-regulation.” And in the book, it states, “Self-regulation is the cornerstone of our approach.” So can you explain to me what you mean?

PL: What goes up will come down. Animals are threatened on a routine basis in the wild. A predator is always stalking prey, and prey is always trying to get away from a predator to not be eaten. And what happens is after an encounter—well, in a successful encounter—the prey animal, let’s say a rabbit, runs away and escapes from the coyote. But another thing is possible, and you see this, for example, with an opossum, because the opossum doesn’t really have the speed to escape, so what it does is it “plays opossum.”

Well, it’s not playing opossum. It’s a profound physiological response that actually inhibits the aggression and the eating behavior of a predator. So in other words, instead of running, this charge, this energy, this arousal, it goes into this shock response, this immobility response. But the nervous system is still supercharged. It’s sort of like our brake and our accelerator. Our accelerator is going on at a hundred miles an hour, and we have the brake put on at the same time, so it keeps us paralyzed.

But underneath the stillness of the coyote, of the opossum, underneath this stillness is this tremendous arousal of the fight-flight fear, sympathetic adrenal response. And so the animal has an innate ability—and so do we because really, ultimately, we are animals—to discharge that aroused state and to bring us back to equilibrium so that we don’t take that into the next day or even to the next moment. So we always go back to neutral; we always go back to balance. This is built in; it’s innate. That’s what self-regulation is about. And, as I said before, many people have learned to not trust that. We help people learn to re-gather trust for these mechanisms, which will take them back into healing.

MP: Right. And the example I gave earlier about the young man with the back problem—one of the things that he learned to do was to regulate not only his fear, but also the kinds of movements that he was doing. I asked him to show me some of the movements. For example, you learn a lot by asking someone, “Well, have you been given exercises for recovering from this surgery?” or whatever they’re dealing with. I asked him to show me what are some of the exercises, “Show me one exercise that you usually do.”

And he showed me, and he was moving so quickly, and with jerky motions, that I knew there was no way that the exercise was really doing him much of any good because he wasn’t really connected to his body experience. So I helped him learn. I said, “Let’s see if we can find a feeling of balance in your body as you’re doing the exercise, even if you just do one little part of it. Let’s find out what difference it makes.” So I had him slow down his movement and make it very intentional instead of like a reflex, like being afraid to touch a hot stove, and you draw back quickly. That was the kind of movement he was making.

As he slowed down, and we added in some breathing, and some rhythmic breathing, that helped the movement become more smooth and easy. After about two or three minutes, he says, “I haven’t felt like this in months.” He says, “I certainly haven’t felt like this since the surgery.” I said, “Well, what are you learning right now that may explain that?” He said, “Well, I can see I am not connected with my body. I’m not working with my body at all. I’m not even in my body.” So that’s what we found that a lot of people need help with is the simple practice—and it’s an early exercise in our program—of reclaiming and reinhabiting our body.

TS: Have you ever encountered people who were in such dire chronic pain that you couldn’t help them at all—that they were beyond help?

PL: I can’t think of any that were beyond help. No. I mean, in over 40 years, there have been cases where a surgery had to be done. Even when surgery is necessary, you still can help reduce the pain somewhat and also help increase their recovery after the surgery. But especially when there wasn’t a tissue damage site, not everybody is completely free of pain, but I can’t think of anybody that was in such pain that they weren’t able to get some significant relief.

MP: Yes. I would agree. First of all, I just categorically don’t believe that anyone is beyond help. They can always learn something from what we are offering them. Why? Because it makes sense to them once they understand what’s going on. And understanding what’s going on, as we’ve been explaining in this interview, gives them a sense of empowerment. It gives them a sense of choice. So, they may decide to go on with the surgery with the understanding that they can use the tools that we’re teaching to help them recover from it if that’s what the best choice is for them.

Now, there are a couple of people that I have found very difficult to work with. That’s a different issue. There are some people who really, I believe, have had attachment or relational trauma very early, so their problem is they can’t trust anyone to help them. They want desperately to believe that someone can give them some tools that will really make a difference or that somebody cares enough about them that they want to try to help them out of pain. But for their own good reasons, in being traumatized and abused, it’s very hard for them to persist long enough against the fear that they have about trusting you, that you’re not going to be one more person that lets them down or manipulates or exploits them in some way.

And so when we get into cases like that, it’s much more complex. But I don’t ever believe that anyone is beyond help, and it’s very important, I believe, to keep trying to repair the relationship that you’re forming with the person at the same time you are offering them tools. You can’t just be a mechanic. Neither Peter nor I believe in that at all. We put as much thought and care into the relationship as we do into the tools we’re teaching.

PL: And we’ve tried to convey some of that feeling in the program itself. So even though obviously we’re not seeing each person individually, we try to convey that kind of openness and invitation to people because, like we said at the beginning, people with early trauma can tend to have higher instances of chronic pain. And these are people who have not been understood, or not been cared about, or [have] people who have given up on them in the past. Obviously, this doesn’t in any way substitute for individual therapy, but it certainly can be a very helpful adjunct. It can be something that both clients and therapists can use to help continue the therapy outside of the individual session work.

TS: Now, I’m going to take this just a little bit further because I have personally known people who have really suffered from chronic pain, and I’m imagining one of those people listening to our conversation and feeling, “You know, I just feel like my situation is hopeless. I’ve tried for so long, and now a book-and-CD is going to help me? A series of exercises are going to help me? I just don’t buy it. I’m just in pain.” What would you say to such a person?

PL: Well, helplessness is a characteristic of trauma. And so when we help people begin to—and we have a chapter on depression—to move out of helplessness and depression, then, you know, it’s kind of like, “OK, if it’s a cloudy, rainy day, there’s nothing you can do, if you want sun, except to wait for it to change.” And so we have this mood of resignation and depression.

Well, actually, if we can do something that can change the depression, then the light on the problem will be different. Now, look, I don’t think anyone who has had chronic pain doesn’t at some time feel, myself included, “I’m never going to get better. This is going to go on forever.” It’s a normal part of the process. But again, if we can help people deal with the resignation, then they have a brighter light to shine on the problem and on the tools that might be able to help them. Now, some of the tools—and we’re very clear about this—won’t work for you.

But we have given, hopefully, a number of tools that—at least some of them will work for most people. Hopefully, something will work for everybody. The only thing we could say is, “Look, we hope you give this a try. Of course, it’s not a guarantee.” And it’s something that—in our total 80 years of clinical experience, we’ve found that these kinds of tools are helpful. And we sincerely believe that they will be helpful as we present them here, not for every single person, as much as everybody would want, but I think that most people can get something out of the program.

MP: Yes. I tell people that my job is to help them find at least one tool that they haven’t been able to find or to use successfully before that really makes a significant difference in their pain. And I take that really seriously as a challenge with each person that I work with. And that’s our challenge with people who are going to consider the Freedom from Pain program—is that we believe that we have put together the best of our thinking, the best result of 80 years of combined clinical practice of things that have worked with people that have never had hope before in many cases. We teach people to try something once. The very first possibility and invitation is “Are you willing to try this one tool to see if it can make a difference?” And if it doesn’t, move on, because there are at least probably 40 more tools in this program, and one of them is going to work for you.

So it really is a question of helping people feel empowered and also teaching people that a lot of this is about choice. The choice is not about being in pain. That’s not what we’re saying. We’ve had a lot of people that have had terrible things happen to them, and it’s amazing that they’re still alive. Their suffering is overwhelming, and we have great empathy with that. However, it is a question of choice about what they are willing to try, about what they’re willing to experiment with. And on the basis of those experiments, we are able to learn, as they learn, what happens as they encounter the tool or work with the tool, and then we can modify it. We can modify it so that the tool begins to work in a more and more effective way.

And so really, we’re not telling people that we’re miracle workers. Far from it. We’re just saying we believe in the tools, and we believe in the method, and we want you to find one thing that will work for you.

TS: Now, Peter, you said something very interesting: that hopelessness, depression is actually part—is intrinsic to the trauma experience. Can you explain that?

PL: Yes. Well, look at the opossum. The opossum goes in this immobility response where it’s motionless. Then when the coyote goes off and goes away, it comes out of this and goes off to finish its day. Now, humans go into this immobility response, but we sometimes find it more difficult to come out of it. And the experience of this immobility response is of helplessness. It is of helplessness.

So as people learn to actually complete this and to come back into life, then the helplessness is reduced. So helplessness, you could say, is a psychological component or a psychological aspect of the biological immobility response, which we share with all mammals. Actually, we share it even with many insects. This is a very powerful survival response.

But if we get stuck in it, we don’t come out of it. Instead of perceiving that we feel immobile and that that’s a physical thing in the body and that it can change, we tend to psychologize it as feeling helpless. When we can change the physiology, then the psychology will follow.

MP: Just another word about this is that I think most people are familiar with “fight, flight, and freeze.” They know that these are the three survival responses that we have inherited as animals on this earth. One of the things that we do is to educate them as to which symptoms, so to speak, are connected to each of those incompleted or thwarted responses. In other words, unlike the animals in the wild, we can’t keep running and running and running away from a danger. I mean, how do you run away from a car accident if you’re involved in it? You can’t. How do you run away from somebody who’s trying to abuse you? Fight back? You can’t complete the fight response because of the same kinds of issues. But freeze—like Peter was saying about the opossum—that is the only avenue that’s left open to human beings in many cases.

And so we educate people about this, and we tell them that if you’ve been in the freeze response for a long time, and it’s been held in your body as this huge constriction and immobility, then you are going to go into a state of collapse and frozenness at the emotional level that takes the form of depression. At the physical level, it can take the form of massive constriction that creates terrible pain that you don’t get relief from. So I think that education is really, really important for people to understand that.

PL: Yes. Because out of education comes self-compassion because when you see that there’s a reason, you first of all have more compassion—there’s less self-blame, and second, it gives you a clear pathway or some pathways to explore to come out of this and to return to reregulate, to find our inner balance again.

TS: We started by talking about the puzzle of pain and how it’s a lot more complicated than somebody might think at first. It’s not just, “I’m in physical pain, and I need someone to fix my body.” I think this conversation has helped underscore, highlight, and show the complexity of the puzzle of pain. So here, as we’re coming to a conclusion, if you had to summarize what you think the keys are to solving this puzzle for an individual, if you could just give them a small key ring of the most important keys to solving the puzzle of pain, what would be the keys on that key ring?

PL: First would be that one size doesn’t fit all. The tools that work with one person may not work with another. And to be open to explore different possibilities.

MP: The second key might be healing through the body, that we understand that you’ve disconnected from your body—for good reason—as an attempt to regulate the suffering you’ve had that just feels unbearable. And yet, the challenge is to find out how a connection with your body can make all the difference, can bring you into contact with resources that you’ve never found before.

PL: And that there are tools that can help us befriend, re-friend, our bodies and begin to come out of the pattern, the body patterns, the tension patterns that are actually generating a significant portion of the pain, if not the entire pain.

TS: Wonderful. Maggie Phillips and Peter Levine summarizing solving the puzzle of pain with three keys. Thank you so much for that terrific summary and mostly for the important work you’re doing and for the program you’ve put together: Freedom from Pain: Discover Your Body’s Power to Overcome Physical Pain. It’s a book and a CD of guided practices, a self-guided program that people can work with in their own way to overcome physical pain. Thank you both so much.

PL: By the way, thank you, Tami, for [helping] us until we finally did it.

TS: Wonderful. That was a great conversation. Peter Levine has also created a series of audio programs with Sounds True on Sexual Healing: Transforming the Sacred Wound, and a program for guiding your children through trauma called It Won’t Hurt Forever. He’s also written a book that also has an accompanying CD, Healing Trauma: A Pioneering Program for Restoring the Wisdom of Your Body.

Stress : Mais pourquoi est-il si contagieux ? Cette étude explique comment le stress est contagieux : c’est-à-dire comment le stress de l’autre va jusqu’à modifier notre cerveau au niveau cellulaire, de manière similaire à notre propre stress.

Cette étude de l’Université de Calgary (Canada) explique comment le stress est contagieux : c’est-à-dire comment le stress de l’autre va jusqu’à modifier notre cerveau au niveau cellulaire, de manière similaire à notre propre stress. Ces travaux, menés chez l’animal, montrent également une moindre sensibilité des femelles aux effets du stress de l’autre.

Alors que les changements cérébraux associés au stress peuvent déclencher de nombreuses maladies mentales, dont le syndrome de stress post-traumatique (SSPT), les troubles anxieux et la dépression, cette « idée » que le stress peut être « contagieux » incite à regarder si une exposition au stress de l’autre a également des effets durables sur le cerveau.

L’équipe étudie ici les effets du stress chez des paires de souris mâles ou femelles. Une souris de chaque paire est exposée à un léger stress puis est renvoyée à son partenaire. Les chercheurs examinent ensuite les réponses d’une population spécifique de cellules, les neurones CRH qui contrôlent la réponse du cerveau au stress, chez chaque souris et constatent que les réseaux dans le cerveau de la souris stressée et les réseaux dans le cerveau du partenaire sont modifiés de la même manière. Ainsi, les neurones CRH des partenaires, qui n’ont pas été exposés à un stress réel, présentent des changements identiques aux neurones des souris directement soumises au stress.

Activer les neurones « du stress » de l’un, active les neurones « du stress » de l’autre : par optogénétique, les chercheurs peuvent activer ou éteindre ces neurones « du stress ». Lorsque l’équipe éteint ces neurones pendant le stress, ils empêchent les changements dans le cerveau « normalement » liés au stress. Lorsqu’ils éteignent ces mêmes neurones chez le partenaire lors de son interaction avec son partenaire stressé, le stress n’est pas non plus transféré au partenaire. Lorsqu’ils activent ces neurones même en l’absence de stress chez la souris, à la fois la souris stressée et son partenaire présentent les changements associés à un stress réel.

Le stress contagieux, mais par quel processus ? Ces neurones CRH « du stress » libèrent un signal chimique, une sorte de « phéromone d’alarme », qui alerte le partenaire. Le partenaire qui détecte le signal peut à son tour alerter d’autres membres du groupe. Cette propagation de signaux de stress révèle ainsi un mécanisme clé pour la transmission de l’information.

Les femelles amortissent mieux le stress : ainsi, chez les souris femelles non exposées, l’effet du stress du partenaire est à terme réduit de moitié. Le même phénomène n’est pas constaté chez les mâles.

Des résultats qui pourraient s’appliquer aux humains, concluent les auteurs : « Nous communiquons facilement notre stress aux autres, parfois sans même le savoir, et il est même prouvé que certains symptômes de stress peuvent persister dans la famille et les proches des personnes souffrant du SSPT ».

Source : Nature Neuroscience 2018

La connexion esprit-corps, bien plus dense qu’on ne le pensait, par Elena Sender

Des neuroscientifiques de l’université de Pittsburgh viennent d’identifier les connexions anatomiques entre de multiples zones du cerveau et la partie du corps qui gère le stress.  »Cela vient apporter une nouvelle lumière sur la manière dont le stress, la dépression et les autres états mentaux peuvent altérer la fonction des organes, et montre qu’il y a une réelle base anatomique pour les maladies psychosomatiques ». 

NEURONES. « L’axe du stress » est une notion connue depuis longtemps. On sait qu’en cas de situation d’urgence, le cerveau envoie un signal vers les glandes surrénales – petites structures coiffant les reins – qui sécrètent alors du cortisol. Celui-ci va provoquer des réactions physiques, accélération du rythme cardiaque, dilatation des pupilles, sudation, comportement d’attaque ou de fuite, etc. jusqu’à ce que le cerveau le freine, une fois le danger passé. On soupçonnait jusqu’à présent qu’une seule, voire deux régions du cortex cérébral, à la localisation incertaine, contrôlaient la glande surrénale. Aujourd’hui, grâce à une nouvelle méthode de traçage qui révèle les longues chaines de neurones interconnectés, une équipe de l’université de Pittsburgh (Etats-Unis) affirme, dans une étude publiée dans les PNAS, qu’elle a découvert de multiples zones corticales liées anatomiquement aux glandes surrénales.

« Une réelle base anatomique pour les maladies psychosomatiques »

« Cela vient apporter une nouvelle lumière sur la manière dont le stress, la dépression et les autres états mentaux peuvent altérer la fonction des organes, et montre qu’il y a une réelle base anatomique pour les maladies psychosomatiques », indique le communiqué de presse.

On découvre ainsi que les plus grandes zones de connexions « esprit-corps » sont celles impliquées dans la cognition et l’affect. Ce qui expliquerait notre mode de fonctionnement : grâce à ces connexions multiples, le cortex nous donnerait la possibilité de répondre au stress de façon un peu plus subtile (combattre ou fuir) qu’une créature primaire. « Comme nous avons un cortex, nous avons des options, résume Dr Peter Strick, co-auteur de l’étude. Si quelqu’un vous insulte, vous n’avez pas à attaquer ou à fuir. Vous pouvez avoir des réponses plus nuancées et ignorer l’insulte ou trouver une répartie spirituelle. Ces options sont une partie de ce que le cortex nous donne. »

« Nous avons peut-être découvert le connectome du stress et de la dépression. »
Autre surprise : certaines zones du cortex moteur (bande de cortex qui contrôle nos mouvements) sont aussi connectées aux glandes surrénales. Entre autres, une portion du cortex moteur primaire impliquée dans le contrôle de l’axe du corps et de la posture. Ce qui pourrait expliquer, selon les auteurs, pourquoi les exercices de recentrage du corps (Pilates, yoga, Taï-chi…) sont si efficaces dans la gestion du stress. 
Enfin, lorsque nous ressentons un conflit, ou lorsque nous avons commis une erreur, certaines zones cérébrales s’activent. Et bien, l’étude des PNAS démontre, que ces zones influencent également la glande surrénale. Il serait donc possible que se remémorer une erreur, ou se culpabiliser, réactivent ces zones qui, via un un signal descendant, génère de nouveau un stress, comme l’événement initial. Cela pourrait ouvrir de nouvelles pistes pour les thérapies du stress post traumatique. La méditation, notamment, est un bon remède anti stress. « Peut-être parce que la connexion anatomique avec la glande surrénale et cortex apparaît active ». 

Et Peter Strick de conclure : « Une façon de résumer nos résultats est que nous avons peut-être découvert le connectome du stress et de la dépression.