Somatic Awareness

Vicarious Trauma and Dissociation

    Compassion fatigue is often the result of repeated vicarious trauma. One of the most consistent symptoms of compassion fatigue (and PTSD) is the tendency to dissociate – chronically and unconsciously. In Trauma and the Therapist, Pearlman and Saakvitne state: “Equally basic to one’s identity is one’s sense of his body. It is all too easy to move into one’s head, to become a thinking rather than a sensing creature, in order to manage the onslaught of emotions connected to trauma therapy material. It is not uncommon for trauma therapists to withdraw from their own sensitivity as an unconscious way of protecting themselves from their sexuality or from strong feelings. Therapists can dissociate from their bodily experience within and outside of sessions.” (P. 284).

    Dissociation is the automatic, often unconscious tendency to remove our awareness from our in-the-body, here and now physical experience. It is usually experienced as being intensely preoccupied by our thoughts, internal dialog and fantasies; very often in anger or regret about something that has happened in the past, anxiety about something that may happen in the future, persistent (escape) day dreaming and ruminative conversations with unseen others.

    One of the key features to this internal preoccupation is its reactive and repetitive nature. This is not creative problem solving that is productive and time limited. It is usually not a specific line of internal investigation that produces solutions. Instead, it is repetitive and circular. It is often highly emotional replaying a specific scenario over and over again.

    Another key feature to dissociation is it removes our awareness from the here and now, in the body reality. A question that I routinely ask in my seminars on compassion fatigue is; “What percentage of the time do you believe you are focused in the here and now, in the body reality?” After some thought, most social workers will admit that it is probably less than 10 percent. In fact, research show that it is usually between 5 and 10 percent. Then I’ll ask; “What percentage of the time is your body in there here and now reality?” Of course when you think about it the body is in there here and now reality 100 percent of the time. Which part of us has more (true) information?

The Body’s Mind

    Does the body actually have a mind of its own? According to Dr. Candice Pert, author of Molecules of Emotion the body is actually a manifestation of the mind itself. She states: “Mind doesn’t dominate the body, it becomes the body, body and mind are one! I see the process of communication we have demonstrated, the flow of information throughout the whole organism as evidence that the body is the actual outward manifestation of the mind.”

    The realization that the body is the outward manifestation of the mind has some far-reaching implications – one of the most interesting is the truth is in the body. While it is sometimes very easy to entertain perceptions, thoughts and fantasies about ourselves that may not be fully grounded in truth, what occurs in the body is indisputable. It is the foundation of your personal reality. When we embrace the reality of the body as the foundation for personal truth we begin to accept and integrate rather than disown and dissociate our physical here and now experience.

    Another implication of realizing the body is a manifestation of the mind is – we can have direct access to our mental and emotional functioning through body awareness. We can bypass the automatic filtering mechanism that sifts and strains our perception through unconscious belief systems and access personal reality directly by becoming aware of our own internal body sensations. Dr. Pert states: “The body is the unconscious mind! Repressed trauma caused by overwhelming emotion can be stored in a body part, thereafter affecting our ability to feel that part of even move it. The new work suggests there are almost infinite pathways for the conscious mind to access – and modify – the unconscious mind and the body, and also provide an explanation for a number of phenomena that the emotional theorists have been considering.”

The Felt-Sense

    The first step to access and modify the body’s mind is to increase your body awareness by utilizing the “felt sense,” a term coined by Eugene Gendlin and utilized in trauma work by Dr. Peter Levine in his book Waking the Tiger, Healing Trauma.” He states: “As we begin the healing process we use what is known as the ‘felt sense,’ or internal body sensations. These sensations serve as a portal through which we find the symptoms or reflections of trauma. In directing our attention to these internal body sensations, rather than attacking the trauma head-on, (my italics) we can unbind and free the energies that have been held in check.”

    Utilizing the ‘felt-sense” will take practice because dissociation is often so chronic and automatic. It is sometimes necessary to first consciously create an experience of heightened body awareness to contrast the chronic dissociative experience that we have come to accept as “normal.” Over time, with practice, being in touch and grounded in your body will become more normative and dissociation will not feel as “normal.” In my experience it is best to regularly practice this exercise in the morning. Once you become grounded in the experience you may find yourself automatically doing the exercise each time you begin to dissociate.

Body Awareness Exercise

    Close your eyes and allow your breath to deepen and slow down. Begin to breathe from your diaphragm. Allow your abdomen to open up as you breathe in to a count of five. Allow the energy of your breath to draw your conscious awareness into your body as you breathe in. As you breathe out to a count of five, breathe your awareness through, in, and around your entire body. Without judging, just allow your felt sense impressions to enter your awareness. Trust your intuitive consciousness.

    Slowly begin to pull your shoulders up and in toward your ears as you inhale. What do you notice? Can you feel tension in the muscles that connect your shoulders and neck as you pull your shoulders up and in? What images come to mind as you sit with your shoulders pulled up to your ears? How does this body position affect your emotions, your sense of self? Notice how you’re breathing at this moment.  Are you holding your breath in?

    Now rotate your shoulders back and down. As you let your shoulders ease down, slowly exhale through your mouth in harmony with your movements. Be as conscious as you can of the transitioning of body movement and sensations as you bring your shoulders back with the releasing of your breath. How does this movement make you feel? Can you feel a contrast with the first movement? What sensations and/or emotions are triggered by this movement?

    Repeat the movement several times. As you breathe in from your diaphragm to a count of five, pull your shoulders up and in toward your ears. Continue breathing in as you rotate your shoulders up, in, and back by extending your chest and arching your back. As your in-breath transitions to out-breath, allow your shoulders to sink slowly and easily back to their original positions to a count of four.

    With each breath allow every part of the movement to be an extension of your awareness. Breathe movement and awareness into your neck and shoulders. Allow your awareness to sink into the muscles and tissues with each motion. Sense the physical tension and “frozen” emotional energy that is locked into the tissues of your muscles, nerves, and tendons. Allow your awareness to penetrate every muscle, nerve and tissue in your neck, shoulders and back.

    After you have repeated the motion at least four or five times, allow your awareness to sink into your core center. Place your left hand over your stomach and your right hand over your heart. Focus on you left palm. Breathe long, slow, deep even breaths from your diaphragm. Feel the warmth and support of your palm against your stomach as you gently hold yourself. The stomach is often where you hold fear and tension by tightening and restricting your breath. Allow your stomach to loosen and let go of fear, anxiety, worry and stress – breathe.

    Allow the warmth and energy in your palm to surround your stomach. As you breathe allow the sensation of safety and security to replace fear and anxiety. With each breath allow safety and security to grow and take root in your very center.

    Now focus on your right palm. Allow the energy and awareness in your right palm to surround your heart. The heart is often where we store hurt, pain and disappointment causing us to close our hearts. Allow the warmth and energy from your palm to open your heart. As you breathe allow the energy of acceptance and appreciation flow into your heart. Sense and feel the warmth of acceptance and appreciation replace hurt, pain, and disappointment.

    Allow the sensation of safety, security, acceptance and appreciation to fill your entire body. With each breath sense and feel the energy of safety, security, acceptance and appreciation enter into every muscle, tissue and nerve in your body. Circulate this energy and awareness throughout your entire body as you feel lighter and lighter, fulfilled with energy and awareness.