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When The Past Is Always Present

When the Past is Always Present

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100% found this document useful (2 votes)
1K views20 pages

When The Past Is Always Present

When the Past is Always Present

Uploaded by

Ecaterina Stan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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This book is part of the Psychosocial Stress Series, edited by Charles R. Figley.

Routledge Routledge
Taylor & Francis Group Taylor & Francis Group
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New York, NY 10016 Hove, East Sussex BN3 2FA
2011 by Taylor and Francis Group, LLC
Routledge is an imprint of Taylor & Francis Group, an Informa business

Printed in the United States of America on acid-free paper


10 9 8 7 6 5 4 3 2 1

International Standard Book Number: 978-0-415-87564-6 (Hardback)

For permission to photocopy or use material electronically from this work, please access www.
copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc.
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Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and
are used only for identification and explanation without intent to infringe.

Library of Congress Cataloging-in-Publication Data

Ruden, Ronald A.
When the past is always present : emotional traumatization, causes, and cures
/ Ronald A. Ruden. -- 1st ed.
p. cm. -- (Psychosocial stress series)
Includes bibliographical references and index.
ISBN 978-0-415-87564-6 (hardcover : alk. paper)
1. Psychic trauma. I. Title.

BF175.5.P75R83 2010
616.8521--dc22 2010007844

Visit the Taylor & Francis Web site at


http://www.taylorandfrancis.com
and the Routledge Web site at
http://www.routledgementalhealth.com

http://www.routledgementalhealth.com/when-the-past-is-always-present-9780415875646
Contents

S e r i e s E d i t o r s Fo r e w o r d xv
Fo re wo rd xvii
P r e fa c e xxi
Acknowledgments xxv
Au t h o rs N o t e xxvii

C h a p t e r 1 A Th i r d P i l l a r 1
Traumatization Appears to Produce Immutable Feelings,
Thoughts, and Behaviors as if Written in Stone 1
Traumatization Always Involves Intense Emotions 2
The First Pillar: The Psychotherapies 2
The Second Pillar: The Psychopharmacologies 4
The Third Pillar: The Psychosensory Therapies 5
References 7

C h a p t e r 2 Th e R o l e E m o t i o n s P l ay 9
Types of Emotions 9
Emotions Are Stressors 10
The Relationship Between the Aversive and Appetitive
Survival Systems 11
Emotional Awareness 13
Emotions Are Motivating and Aid With Decisions 13
Emotions as Physical Forms of Communication 13
Emotions Involved With Social Bonding 14
Emotions and Memory 14
References 15

ix
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x C o n t en t s

Chapter 3 Ancient Emotions and S u r v i va l 17


Fear and Survival 17
Fear Is Relayed by Our Senses 20
Species Have Specific Alarm Systems That Activate Fear 22
Fear Activates Physiological Changes 22
The Limbic System 23
Input Into the Amygdala From Senses 25
Outflow From the Amygdala 26
Hardwired Fears: Unconditioned Fear Stimuli (UFS)
Directly Enter the Amygdala 27
Avoiding Threats to Survival 28
Amygdala Activation 30
Plan B: Defensive Rage 31
References 34

C h a p te r 4 M e m o ry and Emotion 35
Memory Systems 36
The Role of Norepinephrine 38
Norepinephrine in the BLC 38
The Role of Cortisol 39
What Else Is Needed for Traumatization? 39
References 40

Chapter 5 Encoding a Tr au m at i c M e m o r y 41
Requirements for Traumatization 41
The Event 41
Meaning 43
Landscape Needed for Traumatization 45
Neuromodulators and Neurotransmitters 46
A Vulnerable Landscape 47
A Resilient Landscape 48
Inescapability 48
Traumatization 53
Dissociated Traumatic Memories 55
Sensory Input and Emotion 56
Modulation of Response to an Emotional but
Nontraumatizing Event 57
The Traumatization of an Event 58
The Timing of Traumatization 59
References 59

C h a p t e r 6 C au s e s a n d C o n s e q u e n c e s of

Tr au m at i z at i o n 61
Early Events 61
Later-in-Life Causes 65
Cultural Sources 66

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C o n t en t s xi

Consequences of Traumatization 67
Why? 67
Phobias 68
Phobia Generation and Generalization 69
Pattern Recognition and Generalizability 69
Panic Attacks 71
Posttraumatic Stress Disorder (PTSD) 72
Repetition Compulsion 73
Chronic Pain 74
On the Origin of Chronic Psychogenic Pain 75
Pathological Emotions 77
Somatization 78
Other Consequences of Traumatization 78
The Absence of Forgetting 79
References 80

Chap ter 7 Disrup ting a Tr au m at i z at i o n 81


Avoiding the Encoding of a Traumatic Memory 81
Disrupting an Encoded Trauma 82
Preventing the Passage of a Retrieved Component From
Working Memory to the Amygdala 82
Displacing From Working Memory a Stimulus That
Activates the BLC 83
Activating Traumatic Components So They Can Be Treated 85
Early Successful Trauma Treatments 86
Disrupting the Amygdala Component of a Traumatic
Event: A Neurobiological Mechanism 88
The Extrasensory Response to Touch 89
References 92

C h a p t e r 8 H av e n i n g 95
A New Approach 95
Case Study 98
Andrades Research 100
Rating of 1: Much Better Results Than With
OtherMethods 101
Rating of 2: Better Results Than With Other Methods 101
Rating of 3: Results Similar to Those Expected With
Other Methods 102
Rating of 4: Worse Results Than Expected With Other
Methods 102
Rating of 5: No Clinical Improvement or
Contraindicated 102
Havening 103
Mechanism of Havening 104

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x ii C o n t en t s

Details of Havening 106


Recall and Activate the Emotional Core 106
Distraction and Other Sensory Input 108
Havening Touch 109
Havening: A Summary 112
Self-Havening 113
Post-Havening 114
Postscript 116
References 117

Chapter 9 A Brief Introduction to P s yc h o s e n s o r y


Th e r a p i e s 119
Extrasensory Responses 119
Intrinsic and Conditioned Extrasensory Responses 121
Psychosensory Therapy 121
Nonspecific Psychosensory Therapies 122
Touch 123
Posture (Position Sense)/Kinesthetic 124
Vision 124
Sound 125
Taste and Smell 126
Event-Specific Psychosensory Therapies 127
References 128

C h a p t e r 10 Tr au m a S t o r i e s and Tr au m a C u r e s 131
Loss of a Loved One 131
Loss of a Loved One 132
September 11, 2001 132
Medical Trauma 133
Public Speaking 134
Fear of Snakes 134
Grief Reduction 135
PTSD 135
Back Pain 135
Back Pain 136
Carrying a Chicken 136
Claustrophobia and Elevators 137
Rats 137
Fear of Falling 138
Nasal Congestion 138

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C o n t en t s xiii

A pp e n d i x A: N o n t o u c h H av e n i n g 139
A pp e n d i x B: C u lt i vat i n g R e s i l i e n c e 141
A pp e n d i x C: A n A n a ly s i s of Fe a r of F ly i n g 145
A pp e n d i x D: N i g h t m a r e s , N i g h t Te r r o r s , J u s t B a d
D r e a m s , a n d H av e n i n g 151
A pp e n d i x E: S u g g e s t i o n s for Tr e at m e n t 155
A pp e n d i x F: Tr a n s d u c t i o n , D e p o t e n t i at i o n , and the

Electrochemical Br ain 159


A pp e n d i x G: H av e n i n g To u c h : C l i n i c a l G u i d e l i n e s 161
A pp e n d i x H: Th e D o w n s i d e of Re m ovi n g a Tr au m at i c
M e m o ry 165
A pp e n d i x I: N o t e s and Additional References 167
A pp e n d i x J: G l o ss a r y 187

Inde x 195

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7
D isrupting a Traumatization

Traumatization can be avoided if, during a potentially traumatizing


moment, an escape is perceived. If an event is encoded as a trau-
matic memory, upon recall of the event, providing the individual
with a safe haven should disrupt the trauma-induced linkages and
erase the emotional response to related stimuli.

Avoiding the Encoding of a Traumatic Memory

A gang of thugs is chasing you after you inadvertently insulted the


leaders girlfriend. They are going to beat you to a pulp after they catch
you and you are literally running for your life. You are getting tired
and there is no place to hide. The thugs are gaining and your heart
is racing as fast as it can to keep you going. They are just about to
catch you and all of a sudden you wake up. Sweating, eyes wide open,
and heart pumping, you realize it was just a dream and you laugh to
yourself, but its a little hard getting back to sleep. Awakening just in
time from a scary dream is a great way to escape the danger and avoid
traumatization. Escape is when the danger has permanently passed.
Hollywood understands this concept. How many endings of scary
movies have you seen where the predator, thought to be killed, some-
how manages to survive and look the audience in the face? Just when
you thought you were safe, that you escapedit is the stuff night-
mares and traumatizations are made of.
At the beginning of a potentially traumatizing event, when specific
pathways are being created, it is unclear whether the criteria for ines-
capability will be met. At this moment, dopamine, norepinephrine,
and cortisol are elevated, preparing us to do what needs to be done
to survive. If we survive and find a haven we calm down. To calm
down, we need to inhibit the release of norepinephrine from the locus

81
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8 2 W hen t he Pa s t is A lways p re sen t

coeruleus (LC) and inhibit the central nucleus (Ce) from further acti-
vating our physiology. In the LC, serotonin via its effect on GABA
neurons prevents the release of norepinephrine.1 The prefrontal cor-
tex, on perceiving the threat has passed, inhibits the Ce via GABA
interneurons. The amygdala is now quiet and the event fades. But
things are different if an event is encoded as a trauma.

Disrupting an Encoded Trauma

Once an event has been encoded as a traumatization, the subsequent


finding of a haven does not disrupt the pathways. How, then, do
we de-encode a traumatic memory? The answer is to disrupt the
synaptically encoded glutamate-specific pathways in the basolat-
eral complex (BLC). To do so, we must seek the event that leads
to their activation, for as we have mentioned earlier, once activated,
the glutamate receptors become vulnerable to disruption. Then, once
activated, fool the brain into thinking a haven has been found. To
promote this, we must also inhibit the cognitive component from
further activating the amygdala. The path to a cure is outlined
below:
Retrieval of emotional component Working memory
Hippocampus Activate BLC Sensory input of the
event to the amygdala by distraction Havening Disrupt the
encoded emotional BLC pathway by depotentiation of glutamate
receptors De-link the components of the traumatization
Traumatizationcured

Preventing the Passage of a Retrieved Component


From Working Memory to the Amygdala

Conscious/subconscious retrieval of a traumatized component en route


to the amygdala passes through a system known as working memory
(WM) (Figure7.1). The working memory system (generally consid-
ered to be part of the prefrontal cortex) receives the stored memories
and sends this information to the hippocampus. If this information
has been encoded as part of a traumatization, it is forwarded to the

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D isru p tin g a T r aum atiz ati o n 83

Working Memory

Phonological Loop Visual-spatial Sketchpad

Central Executive

Figure 7.1 Working memory. (Courtesy of Ronald Ruden and Steve Lampasona.)

amygdala. The WM system is a limited-capacity store for retrieving


and retaining information over the short term that allows for per-
forming mental operations on the contents of the store. According
to Baddeley, 2 working memory has, at minimum, two components, a
phonological loop that is concerned with auditory and speech-based
information, and the visual-spatial sketchpad that maintains and
manipulates visual and spatial information. His model also postulates
a central executive that directs what working memory pays attention
to and supervises these two components. The central executives role
is to regulate attention, and it does not readily allow working memory
to hold dissimilar items simultaneously.

Displacing From Working Memory a Stimulus That Activates the BLC

Working memory is the system to which retrieved components of


the traumatic memory are first brought. In order to keep the com-
ponent in working memory, it must be rehearsed or augmented by
an emotional feeling. The ability of an emotion-producing stimulus
to sustain the item in working memory is the reason feelings can
overwhelm rational thought. However, even emotion-producing
stimuli that enter the working memory system can be displaced if the
mind is distracted. Displacement can be accomplished by simultane-
ously attending to other cognitive or physical tasks. Using Baddeleys
model, after entry into the working memory, having the individual
attend to verbal commands that activate the visual-spatial sketch-
pad (having them imagine walking downstairs while counting the
steps) or the auditory loop (hum Take Me Out to the Ball Game)
can displace the component. It is nearly impossible for the mind to
sustain two different items in working memory. Try for yourself

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8 4 W hen t he Pa s t is A lways p re sen t

by adding two 3-digit numbers in your head while humming the


Star Spangled Banner. For the moment, this displacement stops
the retrieved traumatic memory from activating the amygdala and
producing a response. However, it requires a concentrated effort to
do so.

Working memory can only hold one item.


Traumatic component in WM Displacement from WM
/////// Hippocampus ////// BLC activation No response
The displacement of the traumatic component from working
memory temporarily extinguishes the response.
If the working memory is holding an event that activates the
emotional component, it is difficult to dislodge it, and even if dis-
lodged, it returns at another time. Nonetheless, if one can displace
the event, activation of the BLC will cease. Thus, for example, for
someone who is snake phobic, bringing into working memory an
image of a slithering, sliding snake will cause the release of norepi-
nephrine and a fear response. Distraction by thinking of something
else stops this conscious activation of the BLC. However, bringing
another snake to WM will reactivate the BLC and cause the person
to reexperience the fear response.
Shakespeare expressed the idea that retrieval of traumatic mem-
ories causes us to reexperience the feelings as if for the first time,
and that we can alter these feelings by displacement from working
memory:

Sonnet 30
When to the sessions of sweet silent thought
I summon up remembrance of things past,
I sigh the lack of many a thing I sought,
And with old woes new wail my dear times waste:
Then can I drown an eye, unused to flow,
For precious friends hid in deaths dateless night,
And weep afresh loves long since cancelled woe,
And moan the expense of many a vanished sight.
Then can I grieve at grievances foregone,

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D isru p tin g a T r aum atiz ati o n 85

And heavily from woe to woe tell oer


The sad account of fore-bemoand moan,
Which I new pay as if not paid before.
But if the while I think on thee, dear friend,
All losses are restored and sorrows end.

Activating Traumatic Components So They Can Be Treated

In order to disrupt a traumatic memory, it must first be retrieved


and brought into working memory. Then it must activate the BLC.
This activation corresponds to the release of glutamate in the BLC-
specific pathway that was produced during encoding. It is this ability
of stimuli to activate the BLC pathway that must be de-encoded. This
prevents a signal from being sent to the Ce (which in turn activates
the locus coeruleus and releases norepinephrine) and the other areas
of the brain where the linkages are stored. In the case of subconscious
stimuli that activate somatosensory and autonomic symptoms, bring-
ing the symptom into working memory followed by havening may rid
the individual of the symptoms, but it will not eliminate the synaptic
pathway through the BLC that encodes the emotional response. The
ability to reencode these nonemotional components exists and relapse
remains possible. Sarno3 has observed this in many of his patients,
symptoms returning or appearing elsewhere if the emotional core was
not disrupted.
To de-traumatize an event we must search for its emotional origin
so that it can be activated. A diagnosis of an amygdala-based disor-
der should make us seek the encoding event. Chronic pain and other
somatic symptoms should cause us to search for a traumatizing event
or unresolved anger. PTSD has both cognitive and subconscious
stimuli that activate the emotions, and all should be sought. Phobias
directly enter into working memory by cognitive processes and activate
a fear response. Trying to recall the first time it happened is helpful.
Pathological emotions arising from distressing events can be directly
activated by conscious effort. If no origin can be found, such as in
panic attacks, one can still generate emotions for panic disorder by
thinking about the last time it occurred and how fearful we are that it
will happen again. Even events that are not cognitively stored, such as

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8 6 W hen t he Pa s t is A lways p re sen t

those from early childhood, can be de-traumatized if we can recreate


the felt sense, the emotion and/or some sensory feeling. If the trauma-
tizing event can be found and activated, this affords an opportunity to
alter the BLC pathway. How can this be accomplished?

Early Successful Trauma Treatments

Early attempts at treating the consequences of a traumatization by


talk therapy were generally unsuccessful. Most researchers felt that
a traumatization permanently encoded the event, and that cognitive
cues or subconscious triggers of the event caused emotional, soma-
tosensory, and visceral responses derived from the original trauma.
Professionals in this field thought that a cure was not possible. As we
shall see, this has proved to be wrong.
Dr. Roger Callahan first described his tapping approach to cure
trauma in 1985.4 This was followed by eye movement desensitization
and reprocessing (EMDR), described by Dr. Francine Shapiro.5 Both
therapies involve imaginal reexposure to the event and followed by
various forms of sensory input. Dr. Callahans approach was to evoke
the memory of the trauma, then tap on various acupuncture points.
This would be interspersed with a distracting process called a Gamut
procedure. EMDR has eight phases. These phases include reexpo-
sure and maintenance of the images while attending to other forms of
stimulation in the form of repeated sets of eye movements, tones, and
taps. The goal is to focus on the information, as it is currently stored.
In well-controlled trials, EMDR was shown to cure PTSD in a sig-
nificant percentage of patients.
Somatic experiencing is a method for the treatment of trauma
described by Dr. Peter Levine.5 He focused his therapeutic efforts
on the moments when a traumatizing event is encoded and uses an
escape metaphor to describe his theory. It is of interest here because
he recognizes that finding an escape is critical for the resolution of a
traumatized event. According to Levine,6 Traumatic symptoms are
not caused by the triggering event itself. They stem from the frozen
residue of energy that has not been resolved and discharged; this resi-
due remains trapped in the nervous system where it can wreck havoc
on our bodies and spirit. It occurs because we cannot complete the

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D isru p tin g a T r aum atiz ati o n 87

process of moving in, through and out of the immobility or freezing


state. (Dr.Levineand Dr. Scaer (see below) use the term freeze state
to denote flaccidity.) He uses the animal model of freeze discharge
to free the individual from the traumatic event. After attempting
escape and being caught, an animal becomes flaccid. If somehow the
animal survives, it begins to move its legs as if it were running. This is
the freeze discharge. After a few moments, the animal is then able to
get up and walk away.
Traumatization occurred when the animal could not experience a
freeze discharge. For Levine, the animal is psychologically and physi-
cally frozen in time. How does one escape from this state? Levine says
this is possible by accessing the felt sense, that which is stored in
the procedural memory system. This can be done by a variety of ways,
not always requiring the recall of the event. Just sensing the ines-
capability may be sufficient. Levine7 uses Eugene Gendlins term felt
sense, which is not a mental experience but a physical one. Physical.
A bodily awareness of a situation or person or event. An internal aura
that encompasses everything you feel and know about the given sub-
ject at a given timeencompasses it and communicates it to you all
at once.
This felt sense is the gut feeling, the knowing without knowledge,
the experience of correctness or incorrectness; it is somatosensory
information without interpretation. It is the physical aspects of emo-
tion without cognition. The same pathway that is activated by cogni-
tive generation of emotions is also activated and experienced as a felt
sense.
The first step in somatic experiencing is to retrieve the feeling
aspect of the event. The next step is to complete an escape that liber-
ates the undischarged energy. In his seminal story, Levine encourages
the patient to run when fear arises. This completes the escape, a freeze
discharge has occurred, albeit in the clients imagination, and the per-
son is cured. His discovery story is wonderfully instructive8:
As I began with this patient she began to relax. Suddenly, without warn-
ing, she panicked. Terrified, and with no notion of what to do, I had a
fleeting image of a tiger jumping towards us. It appeared dreamlike, and
at the time, I had no idea where it had come from.

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8 8 W hen t he Pa s t is A lways p re sen t

There is a tiger coming after you, Nancy, Run toward that tree;
climb it and escape. To my amazement, Nancys body began to shake
and tremble. Her legs started making running movements. After sev-
eral minutes, she took a few spontaneous breaths. This response, which
was scary for both of us, washed over her in waves for almost an hour.
At the end she experienced a profound calm, saying she felt held in
warm tingly waves.
Nancy reported to me that during this hour she saw mental pictures
of herself at the age of three being held down and given ether anesthesia
for a tonsillectomy. The fear of suffocation she experienced as a child
and that she remembered and revisited during her session with me was-
terrifying. As a child she felt overwhelmed and helpless. After this one
session with me, a whole host of debilitating symptoms improved dra-
matically, and she felt like had herself again.

Another mind-body exposure approach is called the sensorimo-


tor approach to psychotherapy. Here the somatosensory component
is brought to awareness and then treated. Pat Ogden and colleagues9
describe this process in their book Trauma and the Body. In this ther-
apy, talking is not of importance. Neither are the associations, fan-
tasies, narratives, and defenses the individual has. Rather, it is the
unregulated body experiences that are the focus of this therapy. For
traumatized individuals, although the narrative of the event may be
dissociated, the somatic experience is available. Using this approach,
the memory can be safely reevoked and empowering actions are exe-
cuted. These exposure methods use emotions and body sensations to
activate the specific glutamate-encoded pathways, causing them to be
subject to disruption.
Are there other ways that we can disrupt this encoding?

Disrupting the Amygdala Component of a Traumatic


Event: A Neurobiological Mechanism

Early researchers such as Janet and Freud10 felt that traumatization


caused their victims to become fixed in the past, in some cases becom-
ing obsessed with the trauma. Janet observed behaviors and feelings
that included nightmares, intense reactions to benign stimuli, terror
without reason, and grief without relief to reminder cues arising from

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D isru p tin g a T r aum atiz ati o n 89

the original event. These are people stuck in their past with no escape,
for whom the past is always present. These memories do not decrease
over time and they elicit responses decades after the event.
Sonia, the daughter of an employee of Homeland Security, heard fright-
ening stories about terrorists and potential threats to the country as she grew
up. After getting married, Sonias husband would be awakened in the night
by her screaming. He would find her curled in a fetal position in a corner
of the room screaming, yet she was asleep. These are called night terrors (see
Appendix D). He couldnt awaken her, and the episode could last several
frightening minutes. She didnt recall those moments. Sonia also found that
she didnt like to leave the house. She would only go for a walk with her new
and very large bulldog. Her life was becoming more and more constricted.
It was clear from her history that she could not find a safe place; chased, she
could not escape.
A potential model for the disrupting an encoded glutamate path-
way comes from Rasolkhani-Kalhorn, Harper, and Drozd, on the
mechanism for the efficacy of EMDR and amygdala de-potentiation
(see Appendix F). These researchers believed that EMDR disrupted
the activated glutamate receptors by a mechanism called de-potenti-
ation. The principal mechanism for depotentiation is the removal, by
internalization, of activated glutamate receptors by the production of
a low-frequency signal produced by eye movement. These receptors,
now internalized within the neuron, cannot transmit a signal and the
pathway is disrupted.
Activated BLC glutamate receptor Eye movements Induction
of low-frequency signal Depotentiation and internalization
of BLC glutamate receptor Inability to transmit a signal
Traumatic memory disrupted
Are there other forms of sensory input that can accomplish this?

The Extrasensory Response to Touch

The first experiences we have with fear, especially abandonment, seem


to respond to touch. What does this touch do? In addition to temper-
ature, vibration, consistency, shape, texture, pressure, and of course
pain, touch provides comfort, sensuality, relaxation, and experiences

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9 0 W hen t he Pa s t is A lways p re sen t

that have nothing to do with the classic neurobiology of ascending


pathways. The consequences of the sensation of touch in mammals
must therefore affect pathways that involve cognition and emotion.11
These are the extrasensory properties of touch.
For example, if I stroke the bottom of my foot, or I have a friend
stroke the bottom of my foot, the ticklish response is much more
intense when my friend strokes it. If someone you hated stroked your
head, the response would be much different than someone you loved
doing the same thing. So the context of the touching matters, but in
the beginning, right after birth, a gentle soothing touch feels good no
matter who is doing it because the context doesnt matter; this touch
means we are not abandoned. Studies have demonstrated that infants
who were stroked smiled, vocalized more, and cried less than infants
who were tickled or poked.12 Infants preferred stroking to tickling
and poking. Positive touch includes stroking, holding, hugging, kiss-
ing, hand-holding, and care giving. Lack of positive touch negatively
affects growth, development, and emotional well-being. Conversely,
soothing massage therapy with preterm infants enhanced weight gain.
The areas of the body where massage was found to be most effective
were the forehead, the scalp, the back of the head, the upper arms,
and the hands.
Touch has meaning not just for humans but for other animals as
well. Cats purr when petted. Dogs roll on their backs, I suspect, to
get their tummies rubbed. All animals are quieter when held. Touch
clearly gives pleasure, and it affects the stress axis. It is not just the
individual who is touched that benefits; under most circumstances,
the person who touches also benefits. See how good it feels to pet a
dog.
There are many ways we touch in our culture. The most common
is the handshake. The handshake has many meanings, from every-
thing is all right, to we have a deal, to goodbye. The point is that
touch bonds individuals. Its intent is contextual, but its meaning is
personal; it creates an attachment. Shaking hands with an enemy is
not done until peace is accepted on both sides. Comparisons between
preschool-aged children in the United States and France revealed that
French children were aggressive to their peers on playgrounds only
1% of the time, compared to 29% for American children. This finding

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D isru p tin g a T r aum atiz ati o n 91

correlated with the amount of time parents touched their children:


the French, 35%, and the Americans, 11%.13 Our current legal system
in this country actively discourages unsolicited touch in this culture.
It is impossible to determine what an individuals response is to some-
one elses touch, so we refrain from touching anybody.
Touch is reputed to have many healing qualities, and these have
been organized into therapies. The most commonly used touch ther-
apies include chiropractic, osteopath, cranial sacral therapies and
acupressure, massage, Reiki, Rolfing, and so on. Some of these are
discussed in more detail later. What is interesting is that when we
touch and are touched, we experience sensations that are not directly
assigned to the physical act. Even more remarkably, watching some-
one being touched can be relaxing.
What is the neurobiology of soothing touch? How does this sooth-
ing touch, what we call havening touch, produce a feeling of safety
and allow us to escape from the inescapable? The technique that most
resembles havening is Swedish massage. Swedish massage techniques
include long strokes, kneading, friction, tapping, percussion, vibra-
tion, effleurage, and shaking motions:
EffleurageGliding strokes with the palms, thumbs, or
fingertips.
PetrissageKneading movements with the hands, thumbs, or
fingers.
FrictionCircular pressures with the palms of hands, thumbs,
or fingers.
VibrationOscillatory movements that shake or vibrate the
body.
PercussionBrisk hacking or tapping.
Studies from the Touch Research Institute in Miami, Florida,
have shown14 that massage therapy enhances attentiveness, allevi-
ates depressive symptoms, reduces pain, and improves immune func-
tion. Patients in the intensive care units of hospitals describe touch
as critical to their feeling safe. There are measurable physiological
changes associated with touch. Cortisol secretion, the stress hor-
mone, is diminished with a soothing touch such as massage. There
is an increase in dopamine (thought by some to also act as a reward

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9 2 W hen t he Pa s t is A lways p re sen t

c hemical) and serotonin, as well as a decrease in norepinephrine, dur-


ing massage. While these studies looked at peripheral concentrations
of these chemicals, it is not unreasonable to assume that they are also
altered centrally in the brain. If, as described earlier, depotentation
occurs because of the production of a low frequency wave, is there
a relationship between the neurochemicals released and the electri-
cal activity in the brain? There is an abundance of data to support
that serotonergic modulation of GABA neurons15,18 and increased
GABA release is associated with an increase in low-frequency (delta)
waves in the amygdala.16,17
Can havening touch, the touch that tells us we are safe, be used to
create a neurobiological equivalent of a haven, and also produce a de-
potentiating signal? If so, then we will have found a powerful method
for treating a traumatization.

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