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CAPA 1991-01-02-January_February

The Body as Healer

Pages: 29-38
Year: 1991
Dr. Ida Rolf Institute

ROLF LINES, Vol IXX nº 01 – JAN/FEB 1991

Volume: IXX
This article represents a condensation of the introductory chapter in the author's upcoming book The Substitute Tiger. In this book, the genesis of various traumatic syndromes are examined and the author's treatment approach of Somatic Experiencing developed. These methods are employed in the naturalistic treatment of a variety of anxiety and post-traumatic reactions.

Somatic Experiencing

THE WIND SHIFTS. The grazing impala are poised to a hair trigger of acute alertness. They smell, listen, and look. Danger is in the air. It is in the form of a few molecules of a new, but familiar scent, diluted minutely in millions of parts of air. The impala will flee or-if they find no further clues-turn to their grazing. In this same split second, the cheetah, hid-den and waiting, also knows that the moment must be seized. It leaps from behind the bush. The herd of impala spring together as one organism. They flee for the cover of the thickets at the perimeter of the wadi.

One juvenile, separated from the rest, trips and then recovers it footing, but the critical second has been lost. The cheetah, now a blur, is on top of it. The young impala falls to the ground, appearing to be dead. Remarkably, it is not injured, nor is it “feigning” death. It has so changed in its physiology, though, that it lies motion-less in a profoundly altered state of consciousness. This reaction in almost all(prey) animals, will inhibit predatory aggression. (Gallup, et al. 1977) If the cheetah is not too hungry or has cubs at home to feed, the impala’s life may be temporarily spared. The cheetah may drag its prey back to the lair where it could possibly escape in an unguarded moment. And if the cheetah does make the kill, the young impala in this altered, analgesic state is at least spared the pain of its demise.

An exploration of the relationship between active escape and paralytic freezing in the survival strategies of animal silluminates a neglected key in the understanding and treatment of diverse anxiety reactions as well as certain depressive and psychosomatic conditions. In particular, post traumatic and other panic dissociative reactions show striking similarities to the behaviors and physiology of prey animals when they perceive themselves to be trapped by predators. The significant difference is that with animals in the wild these freezing responses are normally acute, terminating in hours or even minutes. In humans, however, they may persist, often for years or indefinitely, unless treated effectively. The post traumatic Vietnam Vet or the molestation survivor who only relives, understands, reevaluates, or expresses his anger, fear, and sorrow about an event without also terminating residual immobility reactions remains fixated in these primitive evolutionary holdovers. Their constricted behaviors, physiology, and disturbing affects and perceptions continue to reflect these compelling atavistic responses to inescapable threat.

Somatic Experiencing (SE) is a biological, body oriented approach which alters these fixated immobility reactions. It is based upon a study of normal instinctive defensive behaviors as a model for various, traumatic anxiety symptoms and syndromes. As an experiential-educational Body/Mind approach, SE utilizes the transformative value of body awareness(“somatic feeling”) in the healing of posttraumatic impairment in the resolution of various anxiety reactions. It examines the individual’s developmental history of (mal) adaptation to psycho physiologically overwhelming, in escapable events. It “tracks” the neuromuscular, autonomic, and perceptual resources which are necessary to meet potentially life threatening situations. It considers, particularly, the individual’s present defensive resources in relationship to those specific and developmental resources that were missing at the time of traumatic activation. SE is based upon the reworking traumatic responses, from paralytic-maladaptive to active adaptive. It accomplishes this by restoring those (biological) resources, in the form of orientation and defensive responses, that were missing or insufficient at the time of life-threatening activation (and which still exist, latently, in the form of “genetic potential”). Orienting responses involve those sensory motor mechanisms that allow animals to localize the identify novelty (and there for epotential sources of danger or utility) in their environments. Defensive responses include the (survival) mechanisms of fight or flight, of ducking, dodging, retracting, stiffening, contracting, etc.

Treatment Strategies

The various positions taken in the psychological treatment of trauma reflect five different viewpoints:

(1) The individual is considered scarred for life, the damage is irreparable, and the best thing that one can do is offer support, reassurance, drugs, and coping skills.

(2) Unconscious traumas can be un-covered by analytic methods and am re-moved by reliving, by catharsis, and by abreaction.

(3) The patient is exposed and desensitized to elements of a traumatic experience. The approach is behavioral; relaxation and biofeedback training may also be used.

(4) The working through of trauma is a lifelong, psychodynamic process.

(5) Healing is seen to arise through transforming the “meaning” of the traumatic event. In this Ericksonian type approach, the client’s (unconscious) resources are developed.

The first position, essentially a resignation to traumatic impairment, recognizes the importance of support, social networks, and the use of psychoactive drugs for symptom management. The consequences of posttraumatic injuries are seen, in the last analysis, to be permanent. The most that can be hoped for is that the symptoms will abate over time and that there will be a gradual restoration of function. The approach is, unfortunately, too often the last resource of there sourceless. It may be an excuse for non treatment. Position (4) is similar to Position (1) in expressing the belief that the working through of trauma is a life long process. One could add to this that the working through of life is also a life long process. This approach ignores the fundamental differences between trauma, development, and growth.

The second view, that of “uncovering” and catharsis, represents an approach that has its historical roots in Freud’s ear lya work and, before him, the work of Breuer, Charcot, Mesmer, and even further back in the writings of Aristotle. Traumas were seen to be lodged deep within the unconscious mind and exerted their harmful effects because they were repressed. Accordingly, cures were sought by uncovering and releasing these repressed, “dammed up” energies through reliving and catharsis. Although such abreactive, “hydraulic discharge” views have lost favor, abreactive techniques still are significant in the treatment of trauma. In reliving traumatic events, however, patients often find themselves uncovering other traumatic episodes or endlessly reliving a particular event. Thus, rather than “surgically” extirpating their traumas, patients could find themselves in bottomless pits of terror and despair.

SE differs from cathartic approaches in that it examines, specifically, how the(post)traumatic reaction is patterned in the body and perceptual structures. Rather than reliving and releasing so called re pressed affect and ideation, SE seeks to renegotiate the client’s maladaptive w sponses to overwhelming threat. It does this by gradually and progressively destructuring a particular traumatic response, such as chronic freezing, and then restructuring these maladaptive neuromuscular patterns as flexible, defensive, and orient-mg responses.

The approach taken by SE in treating anxiety and posttraumatic responses is most similar to Erickson’s view (5) of “healing through transformation” but is offers a much wider, developmental appreciation of the catalytic role played by motoric responses and body sensations as latent (genetic) potential. SE is a functional approach which charts the pivotal role played by bodily experience, asinnate biological resources, in the restructuring of panic and post traumatic anxiety reactions.

SE also has some apparent relation-ship to behavioral approaches, where exposure is generally milder and deals more with specific phobias and stimuli. In exposure treatment, patients are made to confront related unpleasant situations until their responses have habituated or “extinguished.” Abreaction is less emphasized, though strong autonomic discharge an catharsis can occur. In addition, other behavioral methods such as bio feed back and relaxation training are employed to help deactivate the patient’s high arousal responses. Fundamentally, however, SE is quite different, with its emphasis of drawing on the person’s biological resources to renegotiate his habitual response from that of paralytic freezing to one of active defense. SE also offers some use full insight as to why some exposure paradigms and treatments are more effective than others. In particular, it suggests that exposure is effective to the degree that it evokes restructuring in the form of psycho physiological resources which were not previously available. In addition, because survival homeostatic systems operate complexly through (inter)reaction, traumatic responses are only indirectly addressed with linear methodologies, like bio feedback and relaxation. The maladaptive (biological) organization of paralytic freezing remains essentially unchanged with relaxation procedures that do not address these issues and are primarily ameliorative.

The type of traumatic reactions treated by SE include, but extend beyond, those ordinarily considered by psychological therapists. SE compliments and extends the psychological treatment of abuse and other trauma through a refined use of body awareness in “depotentiating” post traumatic dysfunction. It precisely identifies and restructures the motoric and other psycho physiological patterns underlying a wide variety of traumatic responses. It looks broadly at the individual’s entire development history of severely threatening conditions. These seen The Body As Healer A Continuationsitizing and eliciting stressors include emotional, physical, and sexual abuse, disaster, intrauterine (maternal-fetal) distress, difficult birth, severe abandonment and neglect, surgery, near drowning, ill ness, poisoning, prolonged immobilizations, physical injury (e.g., automobile accidents), physical attack, abduction, extreme physical pain, and mutilation to self and others. All of these occurrences have the potential for initiating, sensitizing, and augmenting posttraumatic (shock)reactions. The seeds of traumatic impairment are sown where an individual’s bio developmental resources are insufficient to resolve a source of (extreme) threat successfully by removing it or by (actively) escaping from it.

The Substitute Tiger

My interest in the essential rD1e played by bodily responses and motoric patterns in the genesis and treatment of anxiety (in contrast to the psychopathological view of anxiety) began quite accidentally about twenty years ago when a young woman was referred to me by a psychiatrist. “Nancy” had been suffering from panic attacks for two years. She had not responded to psychotherapy, while tranquilizers and antidepressant drugs gave her only minimal relief. The referring psychiatrist asked me to do some massage and relaxation training with her. My attempts were equally unsuccessful: she resisted; I tried harder. Since I knew almost nothing about panic attacks and agoraphobia at the time, I asked her, one day (out of frustration), for more detailed information about her attacks. She revealed that the onset of the first attack occurred while she (along with a group of other students) was taking the Graduate Records Examination. Becoming suddenly terrified, she forced herself to complete the test and then ran out, frantically packing the streets for hours, afraid to enter a bus or taxi. Fortunately she met a friend who took her home. During the following two years, her symptoms worsened and became more frequent. She was unable to leave her house alone and could not enter graduate school, even though she had passed the exam and was accepted by a major university.

Nancy recollected the following sequence of events: She felt expectant, but confident, on the bus ride to the exam. As she recalls this, I am surprised to note that her chest elevates and expands in contrast to her habitual collapsed, sunken posture. Arriving early, she went to the canteen to have a coffee and smoke a cigarette. A group of students was already there, talking about how difficult the test was. Nancy became agitated, lit another cigarette, and drank another coffee. She remembers feeling quite jittery upon entering the room. I notice her neck pulse increasing slightlyas she describes this. She remembers that the exam was passed out and that she wrote vigorously. She stops speaking momentarily and becomes quite still. I notice that her neck pulse is increasing rapidly. Her chest collapses. I ask her to lie down and try to relax. Her heart beat accelerated further to almost 130. I had rather unfortunately discovered, some years before it was reported in the literature, the” relaxation induced panic syndrome.” Nancy replies, “I don’t know … I can’t think … I … don’t know.” Her eyes develop a stuporous, drifting gaze. To focus her attention, I ask if she was writing with a pen or pencil. “With a pencil I think …yes, it’s a pencil.” “Can you feel it?” “Yes, I can … it’s a blue pencil… I mean it makes blue marks on the page.” Her breathing and pulse rate start to decrease. I am relieved, but only momentarily. Her pulse continues to drop precipitously to about50 beats per minute. Her face pales and her hands begin to tremble. “I’m real scared … stiff all over … I feel like I am dying…I can’t move…I don’t want to die… help me.” She continues to stiffen, her throat becoming so tight that she can barely talk. She forces the words, “Why can’t I understand this… I feel so interior, like I’m being punished … I must have a character flaw … I feel like I’m going to be killed but there’s nothing … it’s just blank.” “Feel the pencil,” I demand, without knowing why. “I remember now, I re-member what I thought; my life depends on this exam.” Her heart rate increases now, moving up into the 80’s; it continues to increase…

An altered state “dream image” of an attacking tiger jumping though bush flashed before me, as I somewhat disassociated in fear. A fleeting thought about a zoological article I had recently read on tonic immobility or death feigning in predator prey behaviors prompted me to announce loudly: “You are being attacked by a large tiger; see the tiger as it comes at you; run towards that tree, climb it, and escape!” She let out a piercing, blood curdling yell-a scream which brought in a passing police officer (fortunately, my office partner took care of the situation).She began to tremble, shake, and sob in waves of full-body convulsions. I held her for almost an hour while she continued to shake. She recalled a terrifying memory from her childhood: a tonsillectomy with her anesthesia had surfaced in images and feelings. We talked about this and she left feeling “like she had herself again.” We continued relaxation and assertion training for a few more sessions. She was taken off medication and entered graduate school, completing her doctorate in physiology without relapse.

Motivated by my subconscious image process, I had introduced the “substitute tiger” to Nancy as the specific and localized stimulus accounting for her persistent arousal. This previously unexplained arousal (augmented by caffeine, nicotine, and the excitement of taking the exam) The Body As Healer A Continuation had become associated with her perceived inability to survive a “life and death situation” (derivative to an actual earlier one, the tonsillectomy). Being trapped in a closed room had triggered her intense panic reaction. The evoking of running escape in our session, at a (state dependent) level of hyper activation, allowed for some completion of the previously aborted escape response (in the exam and the operating room). By orchestrating an appropriate and critically timed defensive(escape) response, Nancy learned a response which allowed her to alter here arlier freezing response. This “learning” is not a learning in the cognitive sense, but rather a restructuring of primitive brainstem-bodily responses from freezing (like the cornered impala) to an active escape response (from the “substitute tiger”).

When the psychiatrist, astonished by Nancy’s dramatic recovery, asked me what I had done with her, I was without an adequate explanation. I did not, at the time, realize the critical and unitary importance of restructuring activation responses in completing previously thwarted defensive responses. Bridging of somatic resource states (Nancy’s change in body position) from her habitual collapsed-frozen attitude to an open supported expanded one, as she experienced confidence riding to the exam in the bus, was an essential clue that kept repeating itself again and again in my bodywork practice in the early 1970’s. Over the next few years, I was referred several more clients with anxiety and panic symptoms. I began to comprehend that the central axis in the resolution of posttraumatic and various anxiety responses was the (state dependent) bridging of active defensive orienting responses in completing pre-pared, but previously thwarted motor acts. It was a readapting of the body/mind into a less limited way to responding. These mal adaptations could be seen in the client’s habitual postures and movement patterns, and they gave the clues for working through strategies. The abreaction which occurred with Nancy was neither, as I soon came to realize, an essential or even desirable, component in the resolution of anxiety states. While abreaction and catharsis may some times occur, it is the emergence of genetic potential in the form of specific patterns of defensive activation that is the critical catalyst for therapeutic response.

Giving The Body Its Due

Aaron Beck and Gary Emery (1985),in their important book, Anxiety Disorders and Phobias, make the point that to under-stand fear, anxiety, and panic, the per-son’s appraisal of a situation is most important. In the chapter “Turning Anxiety on its Head,” the authors consider cognitive appraisal to be a critical fulcrum in anxiety reactions. They argue that because anxiety has a strong somatic emotional component, the more subtle cognitive processing which occurs may be neglected both in theory and in clinical practice. By focusing on the cognitive aspects of anxiety, however, the fundamental role played by body responses and sensations has also been overlooked. It is also be cause anxiety has such a strong and compelling somatic component that the subtlety and range of somatic sensations are often overshadowed by the urgency and meaning of the experience. In addition to recognizing the importance of cognitive factors, systematic study of bodily reactions, body sensation, and sensate experience is also important; in fact, it is essential. This study must occur conjointly with the recognition and exploration of cognitive and perceptual (head) factors. Appreciating the role of bodily experience illuminates the complex web called anxiety and connects many threads in understanding and modifying its physiological and experiential basis. In addition to “turning anxiety on its head,” the head needs, as well, to be returned to the body in recognition of the intrinsic psycho physiological unity which welds body and mind together.

Cognitive theorists believe that anxiety serves primarily to signal the brain to activate a physical response that will dispel the source of anxiety. The role of anxiety is likened, in this way, to that of pain. The experience of pain (or anxiety)impels us to do something to stop it. The pain is not the disease. It is merely a symptom of a fracture, appendicitis, etc. Similarly, according to Beck (1985), anxiety is not the disease, but only a signal: “Humans are constructed in such a way as to ascribe great significance to the experience of anxiety so that we will be impelled to take measures to reduce it.” He adds: “The most primal response depends on the generation of unpleasant subjective sensations that prompt a volitional intentional action designed to reduce danger. Only one experience of ‘anxiety’ is necessary to do this.” (italics mine) As examples, Beck mentions that the arousal of anxiety when a driver feels he is not incomplete control of the car will prompt him to reduce his speed until he again feels in control. Similarly, a person approaching a high cliff retreats. What is the wisdom of an involuntary, primitive global, somatic, and often immobilizing, brain-stem response calling the individual to make varied and specific voluntary responses? While evolution does not require parsimony, such a nonspecific and inefficient arrangement is highly questionable.

A lack of refinement in appreciating the essential nuances played by bodily responses and sensations in the structure and experience of anxiety is typical of behavioral approaches. Beck (1985, p. 188) for example, flatly states: “A specific combination of autonomic and motor patterns will be used for escape, a different combination for freezing, and a still different pattern for fainting. However, the subjective sensation anxiety will be approximately the same for each strategy.” In the following paragraph of this article he adds: “An active coping set is generally associated with sympathetic nervous system dominance, whereas a passive set, triggered by what is perceived as an overwhelming threat, is often associated with parasympathetic dominance(as in a blood phobic). In either case the subjective experience of anxiety is similar.”

These statements of Beck’s reveal a significant “glitch” in the phenomenology of anxiety and highlights its paradoxical nature. According to Beck’s reasoning, the same body signal is relayed to the brain’s cognitive structures for all forms of threat. The head structures would then somehow, be expected to decide on an appropriate course of action. This top-heavy, Cartesian hold-over goes against the basic biological requirements for an immediate, precise, and unequivocal response to threat. In requiring that distinctly different proprioceptive and autonomic feedback be experienced as the same signal, this behavioral view is strikingly inefficient and confusing. Descartes’ cogito, ergo sum, “I think, therefore I am,” needs to be reassessed. We have tended so much to identify with the “rational mind” that the wide role of instinctive (bodily) responses in orchestrating and propelling behavior and consciousness has been all but ignored (see Gendlin,1990, for a thoughtful and highly reasoned commentary).

Animals possess a variety of (pre-pared) orientation and defensive responses which allow them to respond automatically to different, potentially dangerous situations rapidly and fluidly. The sensations involving escape are profoundly different from those of freezing or collapse. Beck is correct, however, in de-scribing panic and post traumatic anxiety states which have in common the experience of dread with the perception of inescapability. The singular experience of anxiety that Beck talks about occurs only where the normally varied and active defensive responses have been unsuccessful, i.e., when a situation is both dangerous and inescapable. Anxiety, in its pathological panic form (as distinguished from so called “signal anxiety”), represents a profound failure of the organism’s innate defensive structures to escape from threatening situations actively and successfully.

Where escape is possible, however, the organism responds, motorically, with an active pattern of coping. There is the continuous experience of danger, running, and escape. When, in an activated state, escape is successfully completed, anxiety does not occur. Rather a fluid (felt) sense of biological competency is experienced. Where defensive behaviors are unsuccessful in actively resolving severe threat, then anxiety is generated. It is where active forms of defensive response are aborted and incomplete that anxiety states ensue. The monolithic experience of anxiety camouflages a wealth of (incomplete)underlying and identifiable somatic responses, sensations, and bodily feelings. These body sensations represent the individual’s genetic potential (resource) as underlying defensive capability. The recognition that these (instinctive) orientation and defensive behaviors are organized motor patterns, i.e., prepared motor acts, helps to return the head to the body. Anxiety derives, ultimately, from a (motoric) failure to complete successfully these motor acts. Jean Genet, in his auto biographial novel. Thief’s Journal, states this premise in bold prose. “Acts must be carried through to their completion. Whatever their point of departure, the end will be beautiful. It is(only) because an action has not been completed that it is vile.”

Orientations, Defense, and Flight

A scene from an uplands meadow I ilustrates the motor act concept: In an open meadow where you are strolling leisurely, a shadow suddenly moves in the periphery of your vision. Instinctively, all movement is arrested; reflexively, you crouch in a flexed posture; them is autonomic nervous system activation. After this momentary arrest response, eyes open wide and the head turns, automatically, in the disction of the shadow (or sound) in an attempt to localize and identify it. Muscles in the neck, back, legs and feet coordinate so that the whole body turns and now ex-tends. Eyes narrow somewhat, while the pelvis shifts horizontally, giving an optimal view of the surround and an ability to focus panoramically. This initial two phase action pattern is an instinctive orientation preparing us to respond flexibly to many possible contingencies. The initial arrest-crouch flexion esponse minimizes detection by possible predators and offers some protection from falling objects. Primarily, thought, it provides a “convulsive jerk “that interrupts any motor patterns already in execution and then prepares us, through scanning, for the fine tuned behaviors of exploration or defense.

If the shadow was cast by an eagle taking flight, a further orientation of tracking pursuit occurs. Adjustment of postural and facial muscles occur spontaneously, and this new “attitude,” when integrated with the contour of the rising eagle (image), is perceived as the feeling of excitement and pleasure with the meaning of enjoyment. This aesthetically pleasing sense is affected by past experience, but it is also one of the many powerful, archetypal predispositions or undercurrents that each species has developed over the millennia of evolutionary time. Most Native Americans have a very special, spiritual, mythic relationship with the eagle. Is this a coincidence, or is there something imprinted deep within structures of the brain, body, and soul of the human species that responds intrinsically to the image of the eagle with (the attitudes of) awe and respect? All organisms possess dispositions, if not specific approach-avoidance response to (moving) contours. A baby chick, with out learning from its mother, flees from the moving contour of hawk. If the direction of movement of this silhouette is reversed, however, to simulate a goose, its hows no such avoidance response. Males of our species also exhibit tendencies where they are drawn to appreciate, approach, and mate by particular female contours.

If the initial shadow in the meadow had been from a raging grizzly bear rather than from a rising eagle, a very different preparedness reaction would have been evoked: the preparation to flee! This is not because we “think bear” and then evaluate it as dangerous and then prepare to run. It is because the contours and features of the large, looming, approaching animal cast a particular light pattern upon the retina of the eye. This stimulates a pattern of neural firing which is registered in phylo genetically primitive brain regions. Pattern recognition and defensive response derive from an undercurrent of genetic predispositions as well as from the registration of the outcomes of previous experiences with similar large animals. Non conscious circuits are activated, triggering preset patterns or tendencies of defensive posturing. Muscles, viscera, and autonomic nervous system activation cooperate in preparing for escape. This preparation is sensed kinesthetically and internally joined to the image1 of the bear. As a gestalt-whole, movement and image are perceived together, fused, as the feeling of danger. Motivated by this feeling, we continue to scan for more information: a grove of trees, some rocks, all impinging on our ancestral and personal memory banks. Probabilities are non consciously computed, based on such encounters over millions of years of historical evolution as well as our own personal experiences. We prepare for the next phase in this unfolding drama. With out rational thinking, we orient towards a large tree with low branches. An urge is experienced, from this organization of preparedness, to flee and climb. If we run, freely oriented towards the tree, it is with the feeling of directed running. The urge to run is experienced as the feeling of danger, while successful running is experienced as escape (and not anxiety!).

However, chancing upon the staring or wounded bear and finding our-selves surrounded on all sides by she evoked walls, i.e., trapped, then the (defensive) preparedness for flight (with the feeling of danger) is thwarted and will change abruptly to the fixated emotional states of anxiety. (The word fear, interestingly, comes from the Old English term for danger, while anxious derives from the G mek root meaning to “pass tight” or strangle. Edward Munch’s compelling painting Angst a graphic portrayal of anxiety.) Our entire physiology and psyche becomes precipitously constricted in anxiety. Response is restricted to non directed (desperate) flight, to rage, to counter-attack, or to freeze-collapse. The lateral fords the possibility of diminishing the beads urge to attack. (Similarly, but from the bear’s point of view and in contradiction to common propaganda, if the bear is not cornered or hurt and is able to clearly identify the approaching human being, it usually will not attack the intruder. It may even remain and go on with business as usual.)

Emotional reflexes, the thwarted pre-cursors of anxiety, involve maximal activation of the individual in non directed global response or in paralysis. They are evoked, in the last analysis, when the normal orientation and defensive escape resources have failed to resolve the situation. Life hangs in the balance with non directed flight, rage, freezing, or collapse. Rage and terror panic are the secondary emotional anxiety states which are evoked when the preparatory orientation processes (feelings) of danger orientation and preparedness to flee are not successful, when they are blocked, or when they are inhibited. It is this which results in freezing!

Tonic Immobility-Freezing

Anxiety has often been linked to the physiology and experience of flight or fight. Ethological analyses of distress behaviors are brightly relevant here in suggesting that this maybe quite misleading. Ethology points to the thwarting of escape as the roots of distress anxiety. (Morris, 1967; Salzen, 1978) When an antelope is attacked by a tiger on the plains, it will first attempt to escape through directed (oriented) running. If, however, the fleeing animal is cornered so that escape is diminished, it may run blindly, without direction (orientation), or it may attempt to fight wildly and desperately against enormous odds. Abruptly, when trapped, or at the moment of physical contact, or often before injury is actually inflicted the antelope then appears to godead. It not only appears dead, but its autonomic physiology also undergoes awidespread alteration and reorganization. Generally, the antelope is highly activated even though outward movement is al-most nonexistent. The prey animal is immobilized in a sustained (cataleptic-catatonic) pattern of neuromuscular activity and high autonomic and brain wave activity. (Gallup, et al..,1977) Sympathetic and parasympathetic responses are also concurrently activated, like brake and accelerator, working against each other. (Gel-horn, 1967) Nancy, as she (re)experienced the examination room, exhibited this pattern when her heart rate increased sharply and then plummeted abruptly to a very low rate. In tonic immobility, the animal is either frozen “stiff” in heightened contraction of agonist and antagonist groups or in a continuously balanced, hypotonic, muscular state exhibiting “waxy flexibility.” In the hypotonic state, body positions can be molded like clay, as is seen in catatonic schizophrenics. There is also analgesic numbing. (Gallup, et al.,1977) Nancy describes many of these behaviors as they are happening to her. She is however, not aware of her physical sensations, but rather of her self deprecating and critical judgments about these behaviors. It is as though some explanation must be found for these profoundly disorganizing forces, even one’s own perceived inadequacy. Zimbardo (1977)has gone so far as to propose: “Mostmental illness represents, not a cognitive impairment, but an (attempted) interpretation of discontinuous or inexplicable internal states.” Tonic immobility, murderous rage, and non directed flight am such examples.

Ethologists have found wide adaptive value in these immobility responses: freezing makes prey less visible and non-movement in prey appears also to be a potent inhibition of aggression in padators, often aborting attack-kill response sentirely. (Gallup, et al., 1977) The park service, for example, advises campers that if they are unable to escape an attacking bear (such as by climbing a tall, sturdy tree), they should lie prone and not move. Such a response was dramatically portrayed in the recent and wonderful film, The Bear.

The family cat, seemingly “on to” nature’s game, bats a captured, frozen mouse with its paws, “hoping” it will come out of shock and continue in the game. Immobility can buy time for prey. The predator may drag the frozen prey to its den (or lair) for later consumption, giving it a second chance to escape. In addition to these aggression-inhibiting responses, the freezing of prey animals nearer to a predator may provide a signaling and decoy effect, thus allowing co-specifics farther away a better chance for escape in certain situations. Loss of blood pressure may also help prevent bleeding when injured. The various functions of inhibitory freezing have a remarkably strong influence on increasing the gene pool, and analgesia is “humane” and parsimonious where most animals are, at different times, both predator and prey. An immobile (prey)animal is, in summary, less likely to be detected by a predator; and if detected, it is less likely to be attacked. Further, if attacked, it is less likely to be killed and eaten, increasing its chances of escape and reproduction.

Tonic immobility demonstrates that anxiety can, at one and the same time, be both self-perpetuating and self defeating. Freezing is the last ditch, cul-de-sac, bodily response where (active) escape is not possible. Where flight and fight escape have been (or are perceived to be) blocked, the nervous system reorganizes to tonic immobility. Both flight or fight and escape or immobility are adaptive responses, but only in respective situations. Where fligh or fight is appropriate, freezing will be relatively maladaptive; and where freezing is appropriate, attempts to flee or figh tare likely to be maladaptive. Biologically, immobility is a potent adaptive strategy where active escape is prevented. When, however, it becomes a preferred response pattern in situations of activation in general, it is profoundly debilitating. It be-comes the crippling, fixating experience of traumatic and panic anxiety reactions. Underlying the freezing response, however, are both the fight or flight and the other defensive and orientational preparations which were activated just prior to the onset of freezing. The depotentiation of anxiety, in SE, is accomplished by precisely and sequentially restoring the latent flight or fight and other (prepared) active defensive responses that occurred at the moment(s) before escape was thwarted and relinquished.

Uncoupling Fear Potentiated Immobility: An Example

The key in treating various anxiety and posttraumatic reactions is, in principle, quite simple: to uncouple the (normally acute) time-limited, freezing response from fear (re)activation. This is accomplished by progressively and state dependently reestablishing the pre traumatic, defensive, and orienting response, i.e., the responses which were in execution just prior to the initiation of immobility. In practice, there are many possible strategies that may be utilized to accomplish this uncoupling of the immobility fear(panic) reaction. These are discussed in my book, The Substitute Tiger. An ex-ample follows:

Marius is a native Eskimo, born and raised in a remote village in Greenland. When I asked Marius (a year after working with him) whether I could transcribe his session for a book assuring him I would disguise his name and identity, his eyes opened wide. “No, please…it would be an honor,” he said, “but would you please use my last name too, so if family and friends from my village read your book, they will know it is me you are talking about.” So this is Marius’ story:

Marius Invusttog is a slight, intelligent, boyish-looking young man in his mid twenties. He is shy, but unusually open and available. As a participant in the training class in Copenhagen, Denmark, he asks to work on his tendency towards anxiety and panic particularly when he is with a man he admires and whose approval he wants. This is experienced somatically, in probing, as a weakening in his legs and a stabbing ache on the lateral mid line of the leg. There are also waves of nausea moving from his stomach to his threat, where it becomes stuck. His head and face feel very warm, and he is sweating with a notable flush. After talking with him and using some exploratory images, we come to an event that occurred at age eight. While returning from a walk alone in the mountains, he was attacked by three wild dogs and badly bitten on his leg. He only remembers seeing the dogs come at him and then waking up in the arms of a neighbor. His father came to the door and was annoyed with Marius. Marius felt bitterly angry and hurt at this rejection. He remembers also that his leg was hurting badly and that his new pants were ripped and covered by blood. Saying this, he is visibly upset. I ask him to tell me more about the pants. He tells me that they were a surprise from his mother that morning. She had made them especially for him. He is in a transparent moment experiencing pleasure, pride, and excitement similar to that other day seventeen years ago. The memory of the blood allows (state dependent) experiential recall of the positive association with his new pants. Marius holds his arms in front of himself, feeling the fur and feasting on his “magic” polar bear fur pants. “I feel like I want to jump up and down.” (He is approaching, now, the traumatic event peripherally.)”Marius,” I ask “are these the same kind of pants that the men of the village, the hunters, wear?” “Yes,” he responds. “Do they wear them when they go out to hunt? “I ask. “Yes.” He is more excited. He describes seeing them with eidetic detail and aliveness. I have him feel the pants now with his hand and then also feel them on his legs. (I am beginning to build, as are source, a somatic bridge, utilizing neuromuscular patterns of the leg.) “Now, Marius, can you feel your legs inside the pants?” “Yes,” he responds, ” I can feel my legs, they feel very strong, like the men when they are hunting.” The mirroring of the men, in evoking social and animalistic predator responses, is the first step of the somatic process which will eventually bridge to previously thwarted resource states- to the traumatic event. We are working, most peripherally, to-wards center.

This walk into the mountains is an initiation, a rite of passage for Marius; his pants are power objects on this “walk about.” I have him describe the sensations and images of walking up into the mountains. His descriptions are bright, embodied with awareness of detail. The experience he describes is clearly authentic and present. He is also aware of being in the group, though without self consciousness. I would call this primarily a state of “presence” and “retrogression” rather than “regression.” As images and kinesthetic perceptions unfold, he sees an expanse of rocks. I ask him to feel his pants and then look at the rocks again. “My legs want to jump; they feel light, not tight like they usually do. They are like springs, light and strong.” He reports seeing a long stick that is lying by a rock and picks it up. “What is it?” I ask. “A spear,” he responds. “What is it for?” I ask. “What do the men do when they see bear tracks?” I am hoping that this “play” in “dreamtime” will help stimulate predatory and counterattack behaviors that were thwarted when being overwhelmed by the attacking dogs. This successive bridging is helping to prime required (defensive) responses that could eventually neutralize the tonic immobility freeze collapse which occurred at the time of the attack.

He goes on, “I am following a large polar bear. I am with the men, but I will make the kill.” Flexor and extensor micro movements can be seen in his thigh, pelvic, and truck muscles, indicating that he is jumping from rock to rock in following the trail. “I can see him now. I stop and aim my spear.” “Yes, feel that in your whole body, feel your whole body, feel your feet on the rocks, the strength in your legs, and the arching in your back and arms, feel all that power.” “I see the spear flying.” Again micro postural adjustments can readily be seen in Marius’ body; he is trembling lightly now in his legs and arms. I encourage him to feel these sensations. He reports waves of excitement and pleasure. “I did it. I hit him with my spear!” “What do the men do now?” I ask. “They cut the belly open and take out the inside and then cut the fur off…to…make pants and coats. The other men will carry the meat down for the village.” “Feel your pants, Marius, with your hands and on you legs.” Tears form in his eyes. “Can you do this?” “Yes…No…I don’t know…I’m scared.” “Feel your legs, feel your pants.””…Yes, I cut the belly open, there is lots of blood…I take out the organs. Now I cut the skin, I rip it off, there is glistening and shimmering. It is a beautiful fur thick and soft. It will be very warm.” Marius’ body is shaking and trembling with excitement, strength and conquest. The activation/arousal is quite intense and is approaching a level similar to that during the dogs’ attack on him. “How do you feel Marius?” “I’m a little scared…I don’t know if I’ve ever felt this much strong feeling…I think it’s okay,…really, I feel very powerful and filled with an energy, I think I can trust this…I don’t know…it’s strong.” “That’s good, Marius. Feel your legs, feel your feet, touching the pants with your hands.” “Yes, I feel calmer now, not so much rush,..it’s more like strength now.” “Okay, yes, good,” I say, “now start walking down, back towards the village.”

A few minutes pass; then Marius’ trunk flexes and his movements hold as in “still frame” (arrest). His heart rate accelerates, and his face pales. “I see the dogs…they’re coming at me.” “Feel your legs, Marius. Touch the pants.” Again bridging the positive supportive leg sensations toward the critical state dependent traumatic com event, I sharply demand, “Feel your legs and look. What is happening?” “I am turning, turning away from the dogs. I see a pole, an electricity pole. I am turning towards it.” (All of this is new to Marius’ recall. Previously, he had not “remembered” these state dependent aspects of the attack; they had been deleted and constricted.) His pulse starts to drop rapidly, characteristic of freezing. “I’m getting weak,” he responds. “Feel the pants, Marius,” I command. “Feel the pants with your hands.” “I’m running.” His heart rate increases. “I can feel my legs…they’re strong, like on the rocks…” Again he pales. He yells out, “Agh…my leg it burns like fire…I can’t move I’m trying, but I can’t move…I can’t move…I can’t move-it’s numb now…my leg is numb, I can’t feel it.” “Turn, Marius, turn to the dog, look at it…” This is the critical point. I hand Marius a roll of paper towels that has been left in the mom. If ,Marius freezes, he will be retraumatized. He has grabbed the roll and is strangling it, as the other members, myself included, look on with utter amazement at his strength, as he twists it and tears it in two.(I have asked weight-lifting friends to replicate this, and they have barely been able to.) “Now the other one, look right at it.” This time he lets out screams of rage and triumph. I have him settle with his bodily sensations for a few minutes, integrating this intensity. I then ask him again to look. “What do you see?” “I see them…they’re all bloody and dead.” “Okay, look in the other direction. What do you see?” “I see the pole…there are bolts in it.” “Okay, feel your legs, feel your pants.” I am about to say “run” (in order to complete the running response which, in contrast to the rage counterattack, is a primary orienting response). Before I do, he reports, “I am running…I can feel my legs. They’re strong like springs.” Rhythmic extensor-flexor undulations are now visible through his pants, and his entire body is trembling and vibrating. “I’m climbing…climbing…I see them below…they’re dead and I’m safe.” He starts to sob softly, and we wait a few minutes.

“What do you experience now?” “It feels like I’m being carried by big arms. I feel safe.” Marius reports now a series of images of fences and houses in the village. (Again soft, gentle sobbing.) “He’s knocking at the door of my family’s house. The door opens…my father…he’s very up set, he runs to get a towel…my leg is bleeding badly…he’s very upset…he’s not mad at me, he’s very worried. It hurts. The so aphurts.” Marius sobs now in waves. “I thurts but I’m crying cause he’s not angry at me…I can see he was upset and scared.” “What do you feel in your body now?” “I feel very peaceful now; I feel vibration and tingling all over, it is even and warm. I can feel that he loves me.” Again Marius begins to sob, and I ask what happens if you feel that in your body, if you feel that the loves you. There is a silence. ” I feel warm, very warm and peaceful. I don’t need to cry now. I’m okay, and he was just scared.” A year later, I returned to Denmark and was able to find out that his anxiety reactions were no longer a problem.

Initially, the only images (memory)that Marius has of the event are the bloody pants, torn flesh, and his father’s rejection. Yet here also is the positive seed of the emerging healing nucleus. As the pants are central to the (traumatic) episode, it was essential that their positive valence be elicited early in the sequence. The experience of the pants is the thread (no pun intended) by which the altered states related to the traumatic event were experienced and progressively renegotiated. In working with several hundred clients, I have never found an instance where there was not a dual aspect of critical image. (Akhter Ahsen, 1973, refers to this, phenomenologically, as the “law of bipolarity.”)

Within this initial image are the first stirrings of the motoric plan that he will develop. Toward destructuring of the particular anxiety response (thwarting pattern) and restructuring of the underlying defensive and orienting responses, this “renegotiation” process must occur step wise, from periphery towards center.

The image of the ripped and bloodied pants are amusing to Marius, but so is the happiness (his legs wanting to jump for joy) he experiences when he sees the same pants for the first time earlier that morning. He is joyful when presented with the first possibility of manhood. In wanting, literally, to “jump for joy,” Marius activates motoric patterns that will be essential in the progressive renegotiation of the freezing which occurred at the moment he was bitten by the dogs. It was necessary to build adaptive motor patterns successively with increasing activation, in moving from the periphery of the(entire) experience to the “shock core. “Because of state dependency, maladaptive neuromuscular patterns can only be neutralized by adaptive, flexible ones at similar levels of activation.

In moving from the initial (positive)pants experience, gradually, towards the traumatic, freezing “shock core,” suggested to Marius the image of the hunters from the village. This links the positive pants experience to a seed of support, aggression, competency (through motoric mirroring and social identification). In seeing the image of the rock field, the seed begins to sprout as he begins to jump from rock to rock. In finding and picking up the stick, Marius’ dynamic unconsciousness propels the motor plan sharply a head. Through identification and mirroring, he is now preparing to meet the impending challenge. In picking up the stick and pretending that it is a hunting spear, he takes the offensive and moves toward mastery of this previously thwarted situation. Like the hunters, he tracks the polar bear as I track his autonomic and motoric responses. Supported by the pants and the hunters, he makes the find and the kill. And while I encouraged him, “And what would the men do? ” Marius, in a high of activation approaching ecstasy, eviscerates the bear with an (imagined) knife and now stands victorious. His genetic, motoric potential is creatively expressed in this form.

In the next sequence of events, the true test will be made. Excited and empowered, he heads back down towards the village. He describes the road and then sees (for the first time) the dogs. He experiences the images of the dogs coming towards the electric pole. All of this was completely absent (amnesic) earlier in the session. He now feel his legs moving. This can be seen in micro movement. At this moment, the inhibitory freezing response is no longer the exclusive channel of somatic-autonomic response. The experiencing of running-escape is now I highly activated and pleasurable. The ecstatic trembling from the kill and evisceration is bridged into the running. It is, how ever, only partial; he begins to run, but does not escape! He is asked to turn and face his attackers; his response is less thwarted. This time he counter attacks: first momentarily-with rage; and then, with the same ecstasy of victory that he experienced in the previous sequence of killing and eviscerating the bear. The “motor plan” has succeeded. Marius is now victorious, whereas in the “original-real” event he was the defeated victim. His response shave been progressively, state-dependently, creatively and mythically renegotiated.

The event, however, is not yet complete. As the sensations and autonomic responses shift from highly activated sympathetic (ergo trophic) to a parasympathetic (trophotrophic) resolution, the more primary orienting responses come into play. (Gellhorn, 1967) Marius not only “sees” the pole, but he orients to-wards the pole and prepares to run as he had prepared for in the original event, even though it was not executed. He consummates this preparation now with the act of running. And while this does not make “left brain,” linear sense (he has al-ready killed his attackers), it is completely logical in the biological reptile (“body”)brain language of defense, preparation, and orientation.

Traumatic reactions are addressed by a wide variety of strategies. These strategies can be quite diverse, raging from directed touching and gentle manipulation to the use of images, movements patterns, and hypnoidal states. What unifies all of these approaches, however, is that they are used in destructuring the thwarted anxiety response and in restoring defensive and orienting resources. This is accomplished through the unitary processes of titration, expansion, and completion that are also described in The Substitute Tiger. The overall picture show each individual’s needs and resources call for the unique, creatively adapted solution. Some of the strategies are more linear, while others are more richly mythic: It is the weaving together of both. It is here that the resolution occurs in creative transformation.

The renegotiation of trauma is an integrated, psycho physiological process. It is also a profoundly creative and mythic one. The elements of the experience are cohesive and organized in their movements toward integration and resolution. My role seems to be more that of a tracker, teacher, and midwife, rather than a “therapist.” That is, I hold the position of a guide allowing each sensate (body) gestalt to unfold in its “ripe” moment. This allows the client identification with his own bodily sense of self-discovery and mastery. Timing is critical in allowing the client’s body to express itself as “genetic potential.” This occurs creatively, in the form of instinctive motoric forces and (eidetic) images(Ahsen, 1972).

“My belief,” wrote D.H. Lawrence,” is in the blood and flesh as being wiser than intellect. The body-unconscious is where life bubbles up in us. It is how we know that we are alive, alive to the depths of our souls and in touch somewhere with the vivid reaches of the cosmos.” Gendlin (1990) also speaks of this innate wisdom in his development of focusing. The inter-weaving of linear and mythic is not at all peculiar to Marius because he is an aboriginal. It occurs with all people and in all the cultures where I have worked. All of us grow and develop in the mythic somatic as well as the linear-rational world. Joseph Campbell, one of our wise elders, has fortunately left us with an appreciation of this giftin his books and (visually) in marvelous interviews with Bill Moyers. From The Power of Myth, Campbell directs us to the very mystery of reality and existence of the body:

People say what we’re all seeking is a meaning for life. I don’t think that’s what we’re really seeking. I think that what we’re really seeking is an experience of being alive, so that our life experiences on the purely physical plane will have resonances within our inner-most being and reality, so that we actually feel the rapture of being alive in our bodies.

“Posttraumatic reactions show striking similarities to the behaviors of prey animals trapped.”

“SE is based upon the reworking of traumatic responses.”

“The approach taken by SE is similar to Erickson’s view of ‘healing through transformation.'”

“The seeds of traumatic impairment are sown where resources are In suficient to resolve a threat.”

“A zoological article on tonic immobility or death feigning in predator prey behaviors prompted me.”

“Systematic study of bodily reactions, body sensation, and sensate experience is essential.”

“A lack of refinement in appreciating the essential nuances played by bodily responses and sensations in the structure and experience of anxiety is typical of behavioral approaches.”

“Anxiety derives, ultimately, from a failure to complete successfully motor acts.”

“Muscles, viscera, and autonomic nervous system activation cooperate in preparing for escape.”

“Ethologists have found wide adaptive value in these immobility responses.”

“Tonic immobility demonstrates that anxiety can be both self-perpetuating and self-defeating.”

“The key is to uncouple the freezing response from fear(re)activation.”

“I can feel my legs, they feel very strong, like the men when they are hunting.”

“He has grabbed the roll and is strangling it, as the other members look on with utter amazement.

“This time he lets out screams of rage and triumph.

“My role seems to be more that of a tracker, teacher, and mid-wife, rather than a ‘therapist'”.

REFERENCES

Ahsen, Akhter. Basic Concepts in Eidetic Psycho-therapy, Brandon House Press, 1972.

Beck, T. Aaron. “Theoretical Perspectives on Clinical Anxiety,” in Anxiety and the Anxiety Disorders, eds. Tuma, A.H. and Maser, Jack. (Hillsdale, N.J.: Lawrence Erlbaum Associated Publishers, 1985).

Beck, T. Aaron and Emery, Gary. Anxiety Disorders and Phobias: A Cognitive Perspective, New York: Basic Books, Inc., 1985.

Gallup, G. Cordon and Maser, Jack D. “Human Catalepsy and Catatonia,” in Psycho pathology: Experimental Models, eds. Masser, J.D. and Seligman, M.E.D. (New York W.H. Freeman, 1977), pp. 334-357.

Gellhorn, Ernst. Autonomic-Somatic Integrations: Physiological Basis and Clinical Implications. Minneapolis: University of Minnesota Press, 1967.

Gendlin, E.T. “On Emotion In Therapy,” in Emotions and the Process of Therapeutic Change, eds. Safran, J.D. and Greenberg, L.S. (New York Academic Press, 1990).

Morris, D., Ed. Primate Ethology. London: Weidenfield and Nicolson, 1967.

Salzen, A. Eric. “Social Attachment and a Sense of Security,” Social Sciences Information 12.(4/5, 1978), pp. 555-627.

Zimbardo, P.C. “Understanding madness: A cognitive-social model of Psycho pathology.” Invited address at the annual meeting of the Canadian Psychological Association, Vancouver, June, 1977.The Body as Healer

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