Body and Soul Retrieval: Process-Oriented Trauma Approach Focusing on Body and Mindfulness

A Final Project Submitted in Partial Fulfillment of the Requirements for the Diploma Program and Master’s Degree in Process Work

by Ken Matsumura Process Work Institute, Portland, OR February, 2013

Copyright © Ken Matsumura 2013 All Rights Reserved

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Table of Contents Chapter 1: Introduction .................................................................................................. 1 Chapter 2: Literature Review: Introduction to Body-Oriented Trauma Theories ......... 4 Why Body? And What Does Body Mean? ........................................................ 6 A Brief History of Dreambody .......................................................................... 7 Body-Oriented Trauma Therapy ...................................................................... 10 Process-Oriented Trauma Approach ................................................................ 13 Contribution to the Field, Comparison Between Process Work and Others.... 15 Chapter 3: Psychotherapy and Trauma Now ............................................................... 18 Brief History of Therapy for Trauma............................................................... 18 Trauma Therapy Goes Through a Transition................................................... 19 New Approaches .............................................................................................. 21 Chapter 4: Trauma and the Body ................................................................................. 23 What Does Trauma Do to Our Physiological Body? ....................................... 23 Somatic Memory and Neurological System .................................................... 24 Autonomic Nervous System ............................................................................ 25 Somatic Nervous System: Muscles, Movement, and Kinesthetic Memory..... 26 Emotions and Body .......................................................................................... 27 Chapter 5: Trauma and Mindfulness............................................................................ 28 What Is Mindfulness? ...................................................................................... 28 Why Mindfulness? ........................................................................................... 29 Mindfulness and Body ..................................................................................... 29 iii

Chapter 6: Somatic Trauma Approach ........................................................................ 31 Safety ............................................................................................................... 31 Body-Oriented or Somatic Trauma Approaches.............................................. 32 Body Awareness .............................................................................................. 32 Chapter 7: Basic Theory of Process Work ................................................................... 40 Dreambody to Process Work ........................................................................... 40 Primary and Secondary Process, and Edge ...................................................... 40 Deeper Awareness to Sentient ......................................................................... 43 Field and Role .................................................................................................. 43 Chapter 8: Body in Process Work: What Is Dreambody? ........................................... 45 Dreambody Into Channels ............................................................................... 45 Body in Double Signal and Role ..................................................................... 47 Three Different Levels of the Body ................................................................. 48 Body and Mindfulness ..................................................................................... 50 Chapter 9: Safety in Process Work .............................................................................. 53 Feedback Oriented ........................................................................................... 53 Facilitator / Therapist’s Awareness ................................................................. 53 Pacing Primary Process.................................................................................... 54 Spaciousness .................................................................................................... 55 Brake in Process Work..................................................................................... 55 Dreaming Up .................................................................................................... 56 Awareness of the Field and Roles .................................................................... 58 iv

Chapter 10: Trauma and Field, Roles and Body .......................................................... 59 Victim .............................................................................................................. 59 Perpetrator ........................................................................................................ 60 Bystander and Witness ..................................................................................... 62 Protector ........................................................................................................... 63 Deep Democracy to All Roles in the Trauma Field and Body ........................ 64 Chapter 11: Process-Oriented Somatic Trauma Approach .......................................... 66 Before Process-Oriented .................................................................................. 66 Process-Oriented Safety Principle ................................................................... 67 3 Stages ............................................................................................................ 68 Body Awareness in Process Work ................................................................... 70 Mindfulness...................................................................................................... 71 Primary, Secondary, and Edge in Trauma ....................................................... 72 Body and Roles in Trauma .............................................................................. 72 Using Therapist’s Body ................................................................................... 75 Chapter 12: Deeper Meaning in Trauma and Spirituality ............................................ 76 Doorway to Dreaming...................................................................................... 77 Community Process: Dreambody as a Field .................................................... 78 Eldership .......................................................................................................... 79 Life Myth ......................................................................................................... 80 Chapter 13: Conclusion................................................................................................ 82 References .................................................................................................................... 84 v

1 Chapter 1: Introduction There are several reasons why I wrote this paper for my final project. First, it is about myself and without knowing it consciously, I suffered from trauma. I realize I needed to somehow heal myself, and my recovery process or retrieval of my soul led me to the place where I am now. On the way of this process, I began to know Process Work and had some sessions, yoga, vipassana meditation, and eventually became a clinical psychologist. My master’s thesis was about “Roles of Body and Mindfulness in Clinical Psychology.” The second reason is that nowadays it seems the body has increased attention in psychotherapy and trauma. Somatic and mindful approaches seem to be close to what Process Work does. I will discuss somatic and mindful trauma approaches in chapters 3, 4, and 5, and I explore in detail about somatic and mindful parts of Process Work in chapters 9, 10, and 11. Cognitive behavior therapy (CBT) has had much influence worldwide as a psychotherapeutic modality. Somatic and Mindfulness approaches are now integrated in CBT, such as Mindfulness Based Cognitive Therapy (MBCT) (Crane, 2008). In Jon Kabat-Zin’s (1990) Mindfulness Based Stress Reduction (MBSR), the body plays an important role. One of the leading experts in trauma, Bessel van der Kolk, addresses how the body plays an important role in trauma and its therapy and recovery (van der Kolk, 2006, 2011). Third, I had a question to myself of how does Process Work link to those other somatic or mindful approaches? Although Process Work has developed to go beyond

2 being just psychotherapy, I felt it was also important to think about both connection and difference with other modalities. I believe here there must be some contribution from what Process Work does and can offer to other approaches. We could learn a lot from cutting edge research from other modalities, too. So, my paper poses a few questions. What is special about Process Work when it approaches trauma? What does “body” mean in the context of Process Work? How can we see mindfulness from a Process Work perspective? Trauma is, I believe, not just a tragedy. For those traumatized, though it looks like a tragedy, from the perspective of Process Work there must be some deeper meaning in it. There would be many ways to heal trauma, and healing the trauma itself is good thing. However, if one traumatized person has a question of “why did it really happen to me?” nobody could give a great answer to it. This is an existential question. We need to know why, but especially in trauma, we need a larger perspective, and Process Work could help the person to integrate this existential deeper meaning. In chapter 12, I explore the deeper meaning of trauma in more detail. Trauma could be the doorway to entering into a mysterious but exciting spiritual journey for our soul. Writing this paper forced me to stay in the present moment, which brought me to my edge, which is where a critical part of me was very activated, and part of me started not to trust myself. The writing process itself was facing my trauma, as some critical part of me said, “What do you know about trauma and the body? What is your point? You’re not good enough to write an academic paper . . . .” I still do not know where exactly it

3 came from, but those words were coming from trauma inside of me which I received in my personal history. Could be my father’s voice, or a teacher’s, or it could be more collective and cultural. I tried to notice when I got to the point of this edge, and worked on it a little bit by myself. I noticed that part of me was very much a perfectionist and could not see where I actually am in the moment. I noticed my attachment to perfectionism and let go of it, and continued. Writing in English adds another layer of stress. However, on the other hand, it was exciting learning, about myself and my trauma, how it effects my body, thinking about the body in Process Work, and thinking about Process Work theory. What made this possible was much support from faculty in PWI, my great study committee and supervisor, and my therapist. I deeply appreciated their support.

4 Chapter 2: Literature Review: Introduction to Body-Oriented Trauma Theories In mainstream psychotherapy, a body-oriented approach to trauma has become more popular than ever before. Many healthcare practitioners admit that historically, traditional trauma approaches are more focused on a cognitive and emotional perspective. It is well-known that trauma impacts one’s body and symptoms manifest physically, but it was not directly approached by most therapists (Emerson, Hopper, & van der Kolk, 2011). Bessel van der Kolk, a leading authority on trauma, said that the cutting edge approach to trauma is beyond therapy through words alone, and requires a more holistic medical approach (Emerson, Hopper, & van der Kolk, 2011). Traditional talk therapy activates trauma connected experience and brings difficult emotions forward. When that happens, victims of trauma feel that having a relationship with trauma is not yet safe (van der Kolk, 2006, p. 26). Traditional therapy has been cognitive, a top-down approach. The term top-down comes from theory about how the brain processes information. The cognitive approach works from the top of the brain, brain cortex at first, and then the limbic system for feeling and emotion, and then the brain stem. On the other hand, body-oriented psychotherapies including yoga are bottom-up approaches, which means they work from the brain stem and then the limbic system, then at the same time integrating cognitions of the brain cortex. These approaches are based on physical experience and can go further into psychological experience (Emerson, Hopper, & van der Kolk, 2011).

5 Arnold Mindell became interested in the connection between body and psychology many years ago. As a traditional depth psychologist, and more specifically as a Jungian Analyst, Mindell tried to include the body into the Jungian approach. In 1982, Mindell published his first book, Dreambody, and there he coined a body-mind connected concept, Dreambody. The Dreambody approach eventually developed into the Process-Oriented approach or Process Work (Mindell, 1982/1998). Process Work has integrated the body into its modality for nearly 40 years, and now it seems other psychotherapeutic approaches finally acknowledge the necessity and effectiveness of integrating body into their modalities. As some approaches in cognitive behavioral therapy are integrating mindfulness, such as MBCT (Crane, 2008), I felt like mainstream psychotherapy is nowadays coming closer to Process Work. The body’s role has a lot more importance in other trauma psychotherapy approaches, and I discuss more details in chapter 6. My main focus in this thesis is to find common ground in some of the mainstream body-oriented trauma approaches and the Process-Oriented trauma approach, which is based on Process Work. Also, I wish to find the differences between those approaches. Then my inquiry will support mainstream approaches to have a new perspective which does not contradict their approach but rather adds to it. For the Process Work field, it would contribute to deepen its concept especially around the body, finding a bridge between Process Work and other modalities, and having a chance to learn other modalities’ knowledge and information around trauma in order to deepen their practice.

6 There have been many aspects of trauma that have been researched. In this thesis, I narrow my focus to the body’s role in trauma approaches. Given my chosen limitations, my main references are the works of Babbete Rothchild (2000), Peter Levine (1997), David Emerson, Elizabeth Hopper, and Bessell van der Kolk (2006, 2011), as well as Arnold Mindell (1989, 1982/1998). Why Body? And What Does Body Mean? In 1994, van der Kolk and his colleagues published an article called “The Body Keeps the Score.” Rothchild (2000) states that this was the first article wherein mainstream psychiatry recognized a connection between body and mind. As Rothchild (2000) mentioned, after that there was much research in related fields that helped in understanding how trauma damages the nervous system such that an individual develops PTSD. As Levine (1997) said, trauma is physiology. It seems obvious that trauma is connected to both psychology and physiology. For example, when one is traumatized, it directly affects the autonomic nervous system, and creates symptoms. I discuss more about the details in chapter 4. In thinking about how the body is recognized in body-oriented approaches, Babbete Rothchild’s (2000) work serves as a useful reference. She regards somatic awareness as a practical tool for therapy in trauma and PTSD. She defines body awareness as sophisticated subjective consciousness of body sensations which may be stimulated from inside and/or outside of the body. Body awareness comes from an external receptive sense which is responsive to stimulus emerging from outside of one’s

7 body. An internal receptive sense is structured by sensations emerging from inside of one’s body. In the traditional trauma approach, before Rothchild, sensation and movement were not often suggested for use in psychotherapeutic practice. Often connecting oneself to her or his feelings is important but difficult in traumatized people, and Rothchild helped them to cultivate body sensation. It is like a mindful practice, in that she asks one to notice their breath and how it comes in and out, which part of their body is moving, and how it feels, what does one feel in the stomach area . . . and so on. Focusing on the body, movement in the body, and body sensations helps one to increase body awareness (Rothchild, 2000, p. 60). Rothchild also talks about somatic memory, which is usually connected to trauma memory, as well as concurrently to other positive feelings. Somatic memory could be a super highway to connect past experiences. Sometimes positive somatic memory could help to resolve problems without facing terrible traumatic memories. For example, one would remember how safe and comfortable it felt to sit in the kitchen of one’s grandmother, while also noticing one’s body awareness of relaxing. When one decides to face and work on trauma, positive somatic memory is a very useful resource (Rothchild, 2000). A Brief History of Dreambody Arnold Mindell coined the body-mind connected concept of Dreambody. Process Work began when Arnold Mindell created the idea of Dreambody. As a Jungian psychologist, he was interested in dreams, and found their connection with the body

8 through his own case. The dreambody concept was developed when Mindell himself suffered from his own health problem. Although he started to study and experiment more about the body from western medical and bodywork perspectives, it did not satisfy him. As he was a Jungian psychologist, he knew and experienced that there is a meaning in life, especially though dreams, from the perspective of teleology, or the philosophical understanding of thinking there is a meaning in and behind phenomena. Mindell (1998) said, “ Since I’ve always considered my dreams meaningful, I thought that maybe what was happening in my body was meaningful too, not pathological or wrong” (p. 99). When he was struggling with this idea, his clients and their work helped him to discover the concept of Dreambody. The client was dying from stomach cancer. Before this patient went into the hospital, he saw a dream that he had an incurable disease and the medicine for it was like a bomb. When Mindell visited him in the hospital, he was suffering from pain in the stomach, and Mindell thought they should focus on proprioception and suggested it. The patient knew how he could amplify the pain and said something in his stomach wants to break out. As he exaggerated feeling of the pain, he shouted out to Mindell, “Oh, Arny, I just want to explode, I’ve never been really able to explode!” Mindell (2002) found the vital link between dreams and body symptoms. Mindell (1992) said, It was his lost expression trying to come out and finding no way out it came out in his body as cancer, and in his dream as the bomb. His everyday experience of the bomb was his cancer; his body was literally exploding with pent up expression. In this way his pain became his own medicine, just like the dream stated, curing his onesided lack of expression. (p. 8) This is the story of his discovery of the concept of Dreambody. Mindell named

9 this mirroring of physical experiences in dreams the Dreambody, and described it as a dreamlike, unifying field that gives expression to body symptoms and dreams alike (Diamond & Jones, 2002). He suggests that the Dreambody is floating between somatic sensation and mythical imagination. He refers to physics and says that the actual body itself is no longer an absolute something, as a physical particle is no longer recognized as being a sphere in space. When a symptom is strong enough and arouses some experience, then the Dreambody activates and expresses itself through somatic experience and dream. In medicine, several symptoms in one body might be explained as having several different causes. However, in the eyes of dream or body work, any physical change is emerging from oneness or the dreaming process. If we want to reach the roots of individual somatic process, we need to observe changing body experiences (Mindell, 1989, p. 19). From the perspective of the Dreambody, the physical world and actual body might seem to function as psychological structures, which sometimes could even create repression and unhappiness. On the other hand, from the perspective of ordinary consciousness, Dreambody departs from reality, and it seems a phantomlike subtle body, which threatens consensus reality. Dreambody is an experience which doesn’t have a defined space or time dimension, and shows up for a patient through the experience of a symptom. It comes from dream, body, or movement, or sometimes through synchronicity or accident.

10 Dreambody swings in the intermediate space between spirit and matter. Mindell noticed that over time, the difference between Dreambody and physical body is integrated, creating a more holistic personality, and their separation is no longer so obvious. One’s actual body starts glowing when Dreambody unfolds its personality. It appears that Mindell’s concept of Dreambody has a much broader meaning than what Rothchild explains as body awareness. It may include body awareness and offers more, to be further explored in later chapter 6. Body-Oriented Trauma Therapy There are many approaches in body-oriented trauma therapy. Here are some details about the approaches of Rothchild (2000), Levine (1997), and Emerson, Hopper, and van der Kolk (2011). Rothchild. Babbet Rothchild emphasizes safety in therapy for trauma and introduces 10 fundamental points to create it in trauma therapy, which I discuss in detail in later chapter 6 (Rothchild, 2000, p. 98). Rothchild (2000) emphasizes that using body as a resource in trauma and PTSD therapy is very useful in any approach, because as we discussed already, trauma impacts the individual not only psychologically but also physically. More specifically, strategies are used to develop body awareness, and here I give some examples. It is useful to befriend one’s body sensation for traumatized people. They often feel some kind of body sensation is not safe because the sensation reminds them of a traumatic memory. Rothchild helps them to understand that body sensation in the moment is safe and not

11 connected to the traumatic memory. It will help them to use body sensation for anchoring, help them to use sensation as a scale. If we do not have body sensation as a scale, how do we know that we are tired? How do we sense that being alone in a dark dangerous street is unsafe? We actually know it by feeling and catching information from our body sensation as a scale. Anchoring in the body means that as long as people are aware about their body sensation, they are in the present moment. That means as long as they are in the present moment, people would not have the space for getting lost in traumatic memory of the past (Rothchild, 2000, p. 107). Using the body as a brake is one of the strategies. When traumatized people talk more about trauma in detail, the risk of being in a hypervigilant state is higher. If client’s psychological, and physical condition is not good to talk about it, it needs to be slowed down, and body and body sensation could be used as a brake here. If clients learn enough about body sensation in the moment, asking about what they feel in body in the moment is always helpful to them to get back to present moment. Or it helps them to differentiate the moment and the past experience (Rothchild, 2000, p. 115). Rothchild (2000) also added a few somatic techniques for increased safety. She talks about tension and relaxation, and that sometimes when people suffer from trauma and PTSD, relaxation would make people react to their trauma, since maintaining tension could be one part of their boundary-making defense system. Building muscle, one kind of tension, would be helpful to feel safe and comfortable in their body, and it supports in holding emotions connected to hyper-vigilance (Rothchild, 2000, p. 135). She also added

12 an interesting point of view about one’s physical boundary. Interpersonal boundary is very important in trauma therapy, and it connects to therapeutic distance. Knowing and respecting this boundary is very important, and when the client learns enough body awareness, they would know the boundary of the point in between comfort and discomfort. Boundary at the skin level is important as traumatized people often use expression of “thin-skinned.” To make a concrete boundary at the skin level, Rothchild suggests muscle building, a practice of how to make a boundary on the physical level, for example, like a therapist puts hands on a client’s shoulder, and then the client tries to put that hand just aside to make a positive action in order to make a boundary by oneself. For establishing a sense of boundary at the skin level, rubbing firmly all over one’s body by oneself is suggested (Rothchild, 2000, p. 146). Emerson and Hopper. Emerson, Hopper, and van der Kolk (2011) write about trauma sensitive yoga, which is trauma-oriented yoga, using the body, and in the background there is psychotherapeutic knowledge about trauma. It has been researched and developed at the Trauma Center in Boston, where van der Kolk holds the position of president. There are four main themes in trauma sensitive yoga: experience here and now, make a choice, take effective action, and make a rhythm. I discuss these in more detail in a section of chapter 6. Levine. Peter Levine has his own body-oriented trauma approach called Somatic Experience (1992/1997). In his approach, felt sense is emphasized, which is a combination of somatic experience and awareness. I explain about felt sense in depth

13 later in chapter 6. Felt sense is a tool to experience overall sensation. According to Levine, in using our instinct to heal trauma, we need to catch the signs of trauma through the experience of felt sense, and then use it. Felt sense includes inner and outer environment and atmosphere. Somatic visual sensation, auditory sensation, and sensations of smell, touch, and taste are only part of the information of felt sense. Other data is coming from internal awareness such as posture, tension, movement, body temperature, and so forth. Emotions are just part of felt sense. It increases sensual joy, and it is a doorway to spiritual awakening. However, we need to remember that for victims of trauma, it is sometimes difficult to work on felt sense, as dissociating ourselves from our own internal experience is one of the dynamics of trauma (Levine, 1997). Process-Oriented Trauma Approach The Dreambody work began from the connection between dreams and somatic awareness. As Mindell (1989) states, we can use dreams and also somatic experiences to support individual growth. Further, he notes that pathology and symptom are balanced when having the perspective that a symptom may also be a life-changing dream. Dreambody can express itself through six channels of perception, which are: proprioception, movement, visual, auditory, relationship, and world. Visual and auditory are more like imagination connected to dream, and maybe flashback comes from these channels, and proprioception and movement are connected to somatic experience. Mindell (1982/1998) framed relationship as a channel, as well. He brought somatic

14 awareness into relationship, and discovered that a double signal (an unintentional signal) is also part of the Dreambody. There is also world connected somatic experience. No symptom emerges from anything, rather that it is a part of the field it is connected to, and is an expression of world tension and joy. Dreambody comes from individual deep sensation, but is connected to the world, too. The message we get from our dream or body is in part, a message from the world (Mindell, 1982/1998). In this essay, I focus especially on how the body is considered in Process Work when thinking about its trauma approach. A prior MACF thesis by Corina B. Baumgartner (2011) about the Process-Oriented trauma approach has been very helpful. She adopts Mindell’s (2004) idea that the Process-Oriented perspective of perceiving and experiencing the world is comprised of three different levels: consensus reality, dreamland, and essence level. On the consensus reality level, Baumgartner talks about identification of victim in trauma. In the dreamland level, she talks about dream figures and roles. Important roles in the experience of trauma are victim, the perpetrator, the (noninvolved) bystander, the (involved) witness, and the protector. She also wrote about the Process-Oriented view of trauma symptoms such as dissociation, intrusion, freezing, and how these symptoms could be seen in Process Work. I will discuss them in detail later in chapters 8, 9, 10, and 11. Baumgartner also references Emetchi, faculty at the Process Work Institute, in talking about three stages of trauma transformation. More details are in a later section in chapter 11.

15 Contribution to the Field, Comparison Between Process Work and Others Process Work is using body awareness and body signals as important part of the psychotherapeutic process. I could see much connection in other approaches such as Rothchild, Emerson and Hopper, and Levine. However, even though we understand that other body-oriented psychologies found much connection to Process Work, I could not find any references to Process Work in those approaches. This is one of my motivations to write this paper, to find out why there is no reference or connection, and I wanted this paper to contribute to knowledge of trauma-related bodywork. I explore further what the body means in Process Work, especially in chapter 8. Keywords are awareness, mindfulness, body sensation, and body awareness, which are all keywords from other approaches. I introduce other body-oriented approaches to trauma, and explore in later chapters, especially chapter 11, how these keywords are already included in Process Work. What are Process Work’s original contributions to this domain? Perhaps, they may be the three levels of awareness, channel theory, holistic and integral process structure, creating a safe environment thorough the interaction of here and now relationship, respecting an individual’s process, and so on. These are further explored in chapters 7, 8, 9, 10, and 11. There are several merits I see emerging. For example, it would place Process Work as a more in the mainstream of body-oriented trauma approaches, and help to deepen dialogue with other approaches. Process Work’s body concept has a unique sense

16 and is different from what body means in other modalities. Dreambody has much more to offer than what body means in others’ approaches. There is more to come on both body and Dreambody in later chapters, and especially chapter 8. The traditional body-oriented trauma approach would have a chance to share a great idea of Process Work here. For example, as Rothchild (2000) mentions, the best fitting trauma approach is not in the same manual for everyone, and varies for each individual. Process Work’s idea is following process and that means finding the original way for each individual. As Rothchild (2000) and others stress safety, the Process Work approach has many ways of creating safety, especially by following process through signals of an individual client, relationship, and the field itself. It could be a new model for working with trauma in these ways, serving as a useful addition to mainstream approaches. Trusting the body is an interesting idea in Process Work. While Rothchild (2000) emphasizes using brakes in trauma therapy sessions, Process Work places trust in following the process and where it goes. I introduce basic Process Work ideas later in chapter 7. The essential idea is that a symptom is not merely something to get rid of, and that Process Work sees the symptom itself as having some meaningful message. This idea might be usefully integrated with other approaches in the future, and this process may in turn prompt additional new ideas. Levine (1997) mentioned shamanism and its healing rituals in his book, and saw trauma as a community problem. In their rituals, community itself witnesses the

17 shamanistic healing process of retrieval of body and soul, which contributes to integrating trauma (Levine, 1997). This is understood in Process Work as the Dreambody healing effect and its connection to community through the world channel. Process Work sees one’s process not only as individual, but connected to community and the world around. So it is not mere individual trauma and suffering, but at the same time society or the community itself is also suffering from trauma. Then, recovery from trauma is not just healing of a traumatized person, but also and at the same time, people around that person and the community itself would gain more awareness of how trauma plays out in community and in the world, possibly changing the pattern for the future. There is a question raised, “Is trauma just a symptom which should be treated?” How you approach this question depends on what lens you use to explore it. This can also be a question of paradigm, spirituality, or understanding of spiritual tradition. Today, as body, awareness, and spirituality seem more integrated into psychotherapy, and body itself is, in a way, a doorway to the mystery of life, Process Work might have some answers to contribute. From the perspective of Process Work, trauma could be seen in larger picture. I discuss more about the deeper meaning in trauma and spirituality in chapter 12.

18 Chapter 3: Psychotherapy and Trauma Now In this chapter, I offer a brief history about trauma and psychotherapy. Especially in the most recent 10 years or so, a somatic approach for psychotherapy around trauma has received much interest. One of the reasons is that more scientific studies are coming out about mindfulness and body approaches these days. In the US, an institute like the Trauma Center has been studying and practicing much about somatic and mindfulness approaches to trauma. In years of studies around trauma, so-called talk therapy had more mainstream approaches for trauma, and many studies contributed to the field, but it seems that there are big changes happening around and within this field today. Brief History of Therapy for Trauma Hippocrates, the most famous doctor in human history already knew of the connection between body and mind and emotion, and 500 years later, Galenos differentiated between symptoms which stemmed from biological reasons and which from emotional reasons. In the 19th century, Jean-Martin Charcot, famous as father of modern neurology, studied hysteria, and suggested that before the symptoms of hysteria happened, there might be an incident of traumatic stress as a trigger. Sigmund Freud was once a student of Charcot, studied much about trauma in his career and used the phrase, traumatic neurosis. Pierre Janet, also a student of Charcot, psychologist and psychiatrist in the early 20th century, made a tremendous contribution to the field. He is said to have coined the term trauma, and he studied the role of “dissociation” in traumatic hysteria. He set a precedent for today’s medical model for trauma, and his three stages for treatment of

19 trauma are still useful today. His three steps are: first, stabilization and reduction of symptoms; second, recognition of traumatic memory and its revision; and third, re-integration and recovery (Emerson & Hopper, 2011). After World Wars 1 and 2, posttraumatic stress was seen in returned soldiers and veterans, or survivors of the holocaust. Finally in 1980, Diagnostic and Statistical Manual of Mental Health, so called DSM-4 included PTSD, or posttraumatic stress disorder. In the 1980s the definition of term trauma expanded to war trauma, domestic violence, sexual abuse issues, and so on. In the 1980s and 1990s, many of the biological foundations of PTSD had been studied, and researchers tried to connect them to general reactions to trauma. Therefore, many different therapy approaches to trauma and PTSD came out (Emerson & Hopper, 2011, p. 9). Trauma Therapy Goes Through a Transition In the 1970s and 1980s, the treatment model of trauma was much about catharsis, in which every emotion and memory coming from traumatic incidents should be released. Cognitive behavioral therapy like Exposure therapy and Cognitive Processing Therapy are interested in modern PTSD effective studies (Emerson & Hopper, 2011, p. 14). In the 1980s and 1990s, exposure therapy became the most general approach to PTSD. In this approach, the client is exposed to traumatic memories which evoke emotions, and if exposed for a long time, the client’s intensity of anxiety and avoidance would reduce. Goal of this kind of treatment is, that clients themselves come to recognize their thoughts about self and others and society, and are supported to change their cognitive scheme

20 connected to their trauma symptoms. Nowadays the psychopharmacologic approach is well-known, and antidepressive medications like SSRI and SNRI are used (Emerson & Hopper, 2011, p. 15). A recent meta-analysis shows every treatment which focuses on trauma is somehow evenly effective and better than traditional approaches not focused on addressing trauma (Emerson & Hopper, 2011, p. 15). As trauma approaches refined, pioneers of PTSD and trauma like Judith Harman (1997) and Bessel van der Kolk (2011) struggled with the more difficult types of trauma. They found people suffered from chronic relational trauma, especially if it happened in their infant stages, and that the impacts of trauma are deeper and wider than that which is scripted in DSM. It seemed clients’ whole being, or body, mind, and spirit are influenced deeply. Describing the severe effects of trauma, van der Kolk (2011) coined the phrase combined-type trauma, and Harman (1997) coined the phrase complex trauma. Symptoms of complex trauma include dysfunction of emotional control, dissociation, confusion of physical sense, negative self-image, disorder in ability of starting and sustaining new relationships, disruption of semantics and basic trust, and so on. Exposure therapy is known for its effectiveness but it is not an almighty therapy and people suffering complex trauma cannot stand for its approaches (Emerson & Hopper, 2011). They need inner and outer resources to hold their biological and emotional experience when exposed to trauma, but exposure therapy cannot meet such criteria. Much of complex trauma is cut off from researchers, but as its quantity is not small, new approaches are needed.

21 New Approaches In coping with complex trauma, new treatment models developed. Some of them are focused on coping skills requisite prior to working with traumatic memories. Dialectial behavior therapy (DBT), founded by Marsha M. Linehan, was not at first meant for trauma therapy, but focuses on development of important mental ability and skills such as mindfulness, emotional control, and so on. These skills are often lost or not developed enough in many chronic trauma survivors. EMDR is known for its effective trauma approach today, and the most recent EMDR approach focuses more on one’s ability to recover from trauma (Emerson & Hopper, 2011, p. 17). The front line of trauma treatment these days seems to go beyond traditional talk therapy, and toward a more integral and holistic approach. Van der Kolk once said that traditional talk therapy tends to activate covered memories of trauma, which then activates physical sensations, biological hyper-arousal or low arousal, and emotions like helplessness, fear, shame, or anger come out. If this happens, typically the survivor of trauma feels it is not safe yet to work on trauma (Emerson & Hopper, 2011). Many of the new approaches today try to include development of resources, and combining the body to focus on a so-called “Bottom up” approach. Sensory-motor psychotherapy, founded by Pat Ogden (2006), uses the body as a channel to get into a client’s resources and unprocessed trauma memory. Van der Kolk’s trauma center developed trauma sensitive yoga with D. Emerson and Elizabeth Hopper, using yoga, body, and mindfulness. Somatic Experience by Peter Levine focuses on what we

22 experience in the moment as our body sensations, felt sense, and has many body-oriented exercises for recovery from trauma. Body-oriented approaches or Bottom up approaches often work with awareness, so called mindfulness. Jon Kabat-Zinn, one of the famous figures in the mindfulness approach, applied mindfulness in hospitals with a variety of patients, and through his research, found much effectiveness of his program, called mindfulness based stress reduction, or MBSR. Kabat-Zinn (1990) describes his program and mindfulness. . . . based on rigorous and systemic training in mindfulness, a form of meditation originally developed in the Buddhist tradition of Asia. Simply put, mindfulness is moment-to-moment awareness. . . . It is a systemic approach to developing new kinds of control and wisdom in our lives, based on our inner capacities for relaxation, paying attention, awareness, and insight. (p. 17) When we think about the body as a therapeutic tool, it seems mindfulness is something we cannot avoid talking about these days. Especially in the field of trauma therapy, mindfulness is an increasingly popular approach worldwide. Trauma Center in Justice Resource Institute in the US is one of the leading trauma research centers in the world, and the director of the center, Bessel van der Kolk, is an internationally known figure in this field. He now talks much about mindfulness and the body, and its need of integration into trauma therapy. Also, John Briere (2012) is one of the leading figures in this field today, who focuses much upon mindfulness, and its many useful applications in working with trauma.

23 Chapter 4: Trauma and the Body What Does Trauma Do to Our Physiological Body? Babbete Rothchild (2000), one of the authorities in somatic psychology, stated, “Trauma is psychophysical experience, even when the traumatic event causes no direct bodily harm” (p. 5). In DSM-IV-TR (2000), a major category in the symptom list of PTSD is “persistent symptoms of increased arousal” in the autonomic nervous system (ANS). Three major symptoms of PTSD are flashback, avoidance, and hyper arousal in ANS. Somatic disturbance which people suffered from PTSD experience is coming from this hyper-arousal of ANS. Hyper-arousal is connected to the limbic system in our brain, and there are increasing research reports these days that the hippocampus and amygdala are very connected with traumatic memory. Traumatic threat represses the hippocampus, and when it happens, traumatic event is out from an individual’s history, or dissociated from one’s consciousness, but continues to invade the present, as trauma is actually there to affect traumatized person even unconsciously (Rothchild, 2000, p. 12). As we can see, trauma has a very physiological impact on us, and not only in psychological matters. Scientific research in brain function and neurology has made a quantum leap in these recent several years. Going into more detail about this quantum leap is beyond the scope of this thesis, however, it is helpful to note that the introduction of quantum thinking might be a causative factor in bringing the worlds of psychology and somatic therapy closer together.

24 Somatic Memory and Neurological System Rothchild (2000) speaks of somatic memory. She suggests that a basic understanding of the organization of the nervous system would help in understanding the phenomena of somatic memory. Rothchild (2000) states that three nervous system divisions are the most relevant with regard to trauma: sensory, autonomic, and somatic. Within the sensory system are two main subsystems: exteroceptive and interoceptive. Exteroceptors are nerves that receive and transmit information from the environment outside of the body by way of the eyes, ears, tongue, nose, and skin. Interoceptors are nerves that receive and transmit information from the inside of the body, from the viscera, muscle, and connective tissue. Within interoception, there are two major types: Propreoception and the vestibular sense. Proprioception is further comprised of the kinesthetic sense, which enables one to locate all the parts of her body in space, and the internal sense, which gives feedback on body states such as heart rate, respiration, internal temperature, muscular tension, and visceral discomfort. The vestibular sense helps the body sustain a balanced posture and maintain a comfortable relationship with gravity (Rothchild, 2000, p. 40). Sensory memory and somatic memory are connected, and trauma keeps the score (van der Kolk, 1994). Many somatic symptoms, or body sensations are often connected to implicit memories of trauma. A flashback can be triggered through either or both extroceptive and interoceptive systems (Rothchild, 2000, p. 45). For example, if I drink

25 coffee and its caffeine effect accelerates my heart rate, only that could bring up memories of trauma, because it could be a connecting factor to a traumatic event and experience. Autonomic Nervous System The limbic system could be called “survival central” (Rothchild, 2000, p. 46). This part of our brain is very connected to what happens in people having PTSD. The hypothalamus activates the sympathetic branch (SNS) of the autonomic nervous system (ANS). Under this system, cortisol, an antistress hormone, halts the alarm response, but in the case of PTSD, cortisol secretion is not adequate to halt the response. What happen then is, “The limbic system continues to command the hypothalmus to activate the ANS, persisting in preparing the body for fight/flight or going freezing, even though the actual traumatic event has ended—perhaps years ago” (Rothchild, 2000, p. 49). Protective reactions evolve into the distressing symptoms of disability. In the case of trauma, neutral stimuli like sound, colors, movement, and so forth become associated through classical conditioning to the traumatic incident, causing traumatic hyper-arousal. “Under normal circumstances, the PNS and SNS branches of the ANS function in balance with each other”(Rothchild, 2000, p. 47). In the case of PTSD, however, it is different. “First the limbic system commands the SNS to prepare the body to fight or flee. But if that is not possible—there is not time, strength, and/or stamina to succeed—the limbic system commands the body to freeze” (Rothchild, 2000, p. 49). A good example of an instance of freezing is the mouse that “goes dead” when caught by a cat. According to Peter Levine (1992, 1997), the likely mechanism

26 underlying this hypotonic response, tonic immobility, is an unusual imbalance in the ANS. In this extreme circumstance the SNS will remain activated, while the PNS simultaneously becomes highly activated, masking the SNS activity, causing the mouse to “go dead” (Rothchild, 2000). PTSD is characterized, in part, by chronic ANS hyper-arousal. Understanding the functioning of the ANS helps in explaining the vulnerability to stress of those with PTSD (Rothchild, 2000, p. 50). Understanding the limbic system, ANS, PNS, and SNS, and also how this pattern of freezing often happens in PTSD is fundamental knowledge in therapy. As Rothchild (2000) continuously stated, it is important as a therapist to know information about the mechanism of PTSD. Somatic Nervous System: Muscles, Movement, and Kinesthetic Memory According to Rothchild, the somatic nervous system (SomNS) is responsible for voluntary movement executed through the contraction of skeletal muscles. SomNS is connected to muscles, movement, and kinesthetic perception, which often have much connection to trauma. The SomNS has many roles in the experience of trauma. It carries out the trauma defensive responses of fight, flight, and freeze through simple and complex combinations of muscular contractions that result in specific positions, movements, and behaviors (Rothchild, 2000, p. 56).

27 Emotions and Body Rothchild (2000) said, “Emotions, though interpreted and named by the mind, are integrally an experience of body” (p. 5). This reality nowadays is shared in many different body-oriented therapy approaches. We can see every emotion through the face and in body posture, or somatic nervous system. Each emotion is felt differently in every body through the internal sense and proprioceptive nerves. “How an emotion feels on the inside of the body communicates it to others in our environment. How an emotion feels on the inside of the body communicates it to the self” (Rothchild, 2000, p. 56). Here I share what Rothchild (2000) says about emotions which look connected to trauma. Anger or rage might be connected to self-protection, to prevent injury, or to specify a boundary. Anxiety, fear, or terror may be alerts of potential harm, and both fear and anxiety are common emotions for those with PTS and PTSD. Shame is a difficult emotion to deal with, and individuals with PTSD often have a large component of shame involved in the disorder. Grief is a response to loss or change, but according to Rothchild (2000), it is also a great resource in the treatment of trauma and PTSD.

28 Chapter 5: Trauma and Mindfulness What Is Mindfulness? Mindfulness means bringing your attention here and now in the moment. The background of mindfulness is in Buddhist meditation, and some of the teachers such as Thich Nat Han are introducing awareness as conceptualized in Buddhism, by using this word mindfulness. A Buddhist meditation technique called vipassana meditation is in the background and it actually is the mindfulness practice. Although Buddha himself never thought about Buddhism as a religion, today it could be seen as a religion. As a vipassana meditator himself and one of the most famous mindfulness teachers, Jon Kabat-Zinn used the word mindfulness, and applied this ancient technique in medical situations. He created an 8-week stress reduction program, which now is called Mindfulness Based Stress Reduction (MBSR). He ran this program in the Medical Center in Massachusetts University and applied it with people suffering from a variety of physical and mental diseases. In this clinic, participants are taught to practice mindfulness meditation, such as sitting while noticing one’s breath, and watching body sensations without judging, body scanning techniques, and also mindful yoga practice. This program cultivated mindful awareness and body awareness which eventually led participants to healing and bringing their wellness back (Kabat-Zinn, 1999). Mindfulness is now studied in many fields such as neuroscience, brain science, psychology, and so on. According to Kabat-Zinn (1999), research about mindfulness has now increased explosively in the world (Mindfulness Research Guide). Trauma is one of

29 the increasing fields of research about mindfulness, and it is actually casting a new perspective in seeing trauma today. Why Mindfulness? Bessel van der Kolk, founder and medical director of the Trauma Center, often refers to trauma as “a disease of not being able to be present” (Emerson & Hopper, 2010, p. xxii). For people suffering from trauma or PTSD, it is difficult to be in the present moment. Because of one’s natural and biological survival systems, those people are forced to face traumatic memories, such as flashbacks, which take them totally away from the present. So, for this reason, it is understandable that when those people notice that their psychology is caught in traumatic memories and away from the experience of here and now, that coming back to the present moment is helpful. Mindfulness practice could help to just focus on the present through breath or body awareness. Mindfulness is a very important and useful skill when we think about symptoms of dissociation in PTSD or PTS. “We are inclined to trust such a simple practice as being aware of one’s breath as a legitimate present-moment experience that may be very useful as a coping tool to manage dissociation” (Emerson & Hopper, 2010, p. xviii). Mindfulness and Body When we think about mindfulness, it is impossible not to think about our body. Breath or body sensations are objects of the mindful awareness and without those, we could not cultivate our mindfulness. Emerson and Hopper (2010) wrote that, “We

30 consider present-moment experience to be physical and body-based, not intellectual or theoretical” (p. 42). In the MBSR program, body and mindfulness have a lot of links. Why body? I think because it is coming from Buddhist tradition. In Buddhism, there is a scripture called Satipatthana, which means four foundations of mindfulness. They are mindfulness of Kaya, or body, Vedana, or body sensation and feeling, Citta, or mind, Dhamma, or mental phenomena (Wikipedia). Therefore cultivating mindfulness itself is very connected to body and its awareness. Today, neuroscientists are also finding out how important the body is in one’s consciousness. Van der Kolk (2011) states that, “The neuroscientist, Antonio Damasio has shown that an area of the brain called the insula is the place that transmits bodily sensations into conscious awareness” (p. xxiii). He continues to very important words, “This means that consciousness is fundamentally a product of how we interpret the physical sensations that we experience” (van der Kolk, 2011, p. xxiii). More, what’s important is, “Brain imaging studies of traumatized people repeatedly show decreased activation in the insula and other areas related to self-awareness” (van der Kolk, 2011, p. xxiii). As we saw, mindfulness is an awareness technique used in therapeutic situations, and its connection to the body has an important role in trauma. This idea will be further unfolded as we continue.

31 Chapter 6: Somatic Trauma Approach Safety Whether it is body-oriented or talk-oriented therapy, in working on trauma, the first thing we need to know and care about is safety. As a somatic psychotherapist, Rothchild talks about the foundation for safe trauma therapy, and I think it is useful that many different approaches can also synchronize with this. I later compare this with the Process Work point of view on safety. Here are those 10 principles. 1. First and foremost: Establish safety for the client within and outside the therapy. 2. Develop good contact between therapist and client as a prerequisite to addressing traumatic memories or applying any techniques—even if that takes months or years. 3. Client and therapist must be confident in applying the “brake” before they use the “accelerator.” 4. Identify and build on the client’s internal and external resources. 5. Regard defenses as resources. Never “get rid of” coping strategies/defenses; instead, create more choices. 6. View the trauma system as a “pressure cooker.” Always work to reduce—never to increase—the pressure.

32 7. Adapt the therapy to the client, rather than expecting the client to adapt to the therapy. This requires that therapist be familiar with several theories and treatment models. 8. Have a broad knowledge of theory—both psychology and physiology of trauma and PTSD. This reduces error and allows the therapist to create techniques tailored to a particular client’s needs. 9. Regard the client with his/her individual differences, and do not judge her noncompliance or for the failure of an intervention. Never expect one intervention to have the same result with two clients. 10. The therapist must be prepared, at times—or even for a whole course of therapy—to put aside any and all techniques and just talk with the client. (Rothchild, 2000, p. 99) Body-Oriented or Somatic Trauma Approaches Here I’d like to show some different approaches to illustrate and compare how different body-oriented approaches work on trauma. I consider the work of Rothchild, Levine, and Emerson and Hopper. Body Awareness The definition of body awareness from Rothchild (2000) is “Body awareness implies the precise, subjective consciousness of body sensation arising from stimuli that originate both outside of and inside the body” (p. 101). It is an awareness which connects us to the sensations here and now, and connects us to our feelings. It is a great tool in

33 trauma therapy as it works to notice hyper-arousal, works as a brake, and it supports in separating our past memory from what we experience now. Most body-oriented therapies more or less make use of body-awareness in their work. Rothchild. In her work, she talks about developing body awareness. Many clients already have a good idea of what they sense in their bodies and will be able to communicate this to therapist. This process itself is, I think, awareness training and develops the sense of body awareness. However, some clients could not even express about what they sense, and Rothchild (2000) shows her way of how to practice this awareness with a client in a session. There are many questions, and here are a few examples. •

First, do not move. Notice the position you are sitting in right now.

•

How do you know you’re comfortable or not? Which sensations indicate comfort/discomfort?

•

Do you have an impulse to change your position? Do not do it yet, just notice the impulse.

•

Now follow the impulse and change position. What changes have occurred in your body? Do you breathe easier? Is a pain or area of tension relieved? Are you more alert?

Body as Anchor. This way of thinking is, I personally believe, very important and useful when you work on trauma. As Rothchild (2000) wrote, “Awareness of current body sensations can anchor one in the present, here and now, facilitating separation of

34 past from present” (p. 107). When we are aware of body sensation, we are easily connected to the present, not the past. However, traumatic memory has a strong effect to bring one to the past, so be aware that body sensation is a crucial tool and important to anchor to. Emerson and Hopper. Emerson and Hopper (2011) invented trauma sensitive yoga with trauma professionals in the trauma center at JRI. This approach is beautifully integrating body awareness and knowledge from the ancient technique of yoga into the psychological experience of trauma. Much about technique and how it was invented, and even information about the psychology of trauma is contained in their book, Overcoming Trauma Through Yoga, which I highly recommend. Here, I mention four key themes of Trauma-Sensitive Yoga, which seems very useful to everyone who works with trauma. First theme is “experiencing the present moment.” As van der Kolk mentioned (Emerson & Hopper, 2011, p. 1), trauma is a symptom of not being able to stay in the present moment. Trauma-Sensitive Yoga is very sensitive about how to make a safe environment at first, and then support survivors to get in touch with the present moment through their body, yoga, breath, and other mindfulness practices. Second theme is “making choices.” One of the tragedies that happens after trauma is that because the traumatic event takes away every option to be safe, survivors and their body started to learn there is no choice. It is deprivation of one’s subjective existence, which has bad results in one’s psychology. Even though this approach teaches yoga to trauma survivors, they are very sensitive about the theme, and their teaching is not to

35 teach or lead students to some expectation, but let them have space and time to feel themselves in order to really choose what they want to do in the moment. Third theme is “taking effective action.” If trauma’s impact deeply rooted in their body, mind, and their brain, it is difficult to get out of its traumatic effect. Knowing that if they could not make a change when they feel bad about a situation, for example like a relationship or environment, they need to try to take effective action. Trauma-Sensitive Yoga integrates this theme in asking students to make any effective action before class starts. For example changing the temperature by themselves, having more clothes, going to the bathroom, changing the light’s effect. All those little actions mean something to the students. Fourth theme is “creating rhythm.” As Herman and other authors mention, trauma actually disconnects people from the body, relationship, work, family, and everything. One of the themes for a survivor is to get the connection back. Connection to the body is a big thing, and this approach helps people to connect to their body especially through breath and movement. When breathing rhythm and body movement go along, we could discover more connection to our body, which then becomes the foundation for other connections. Levine. Levine is a long-term researcher and therapist for trauma, and one of the authorities around body-oriented trauma approach in the world. Levine (2008) said, “Trauma is primarily physiological” (p. 26), and his findings about how animals or humans respond to a traumatic event were a huge contribution to this field. He researched

36 animals, especially in a traumatic situation like an impala almost caught by a cheetah. As we discussed in chapter 3, in such an event of trauma, animals as well as humans respond with fight or flight or freeze. Levine studied and found that even though human beings sometimes repress the greater energy of fight or flight response or freezing which contributes to make traumatic stress, animals seem never to have traumatic stress or PTSD. He found the answer in the particular type of spontaneous shaking, trembling, and breathing that many animals do after being in shock or traumatized in the moment. So his approach has developed based on this observation. When we can discharge our residual survival energy, we feel less threatened and overwhelmed by life. We are no longer frozen in fear . . . . As we move from fixity to flow, we begin to experience a sense of coherency. We begin to feel reconnected to life. (Levine, 2008, p. 31) Levine invented the “Twelve-Phase Healing Trauma Program.” I introduce his approach just a bit here. Phase 1 Safety and Containment Exercises. It includes exercises in finding body boundaries, using tapping one’s body, or using a shower to be aware of a physical boundary, or a very simple muscle exercise. Phase 2 Grounding and Centering. This includes the feeling of grounding of the body through being aware of your feet on the ground, or connecting oneself to an animal to center. Phase 3 Building Resources. Here, thinking about, and writing internal and external resources. Phase 4 From “Felt Sense” to Tracking Specific Sensations. Here, Levine emphasizes importance of felt sense, a term coined by Eugene Gendlin (1982). Felt sense,

37 in Gendlin’s (1982) definition, “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 subject at a given time” (p. 46). I think the reason why Levine emphasized this is that felt sense connects people to their feeling and body awareness, and what actually happens and experience in the moment. Phase 5 Tracking Activation: Sensations, Images, Thoughts, and Emotions. It is like mindful training of what is happening inside of oneself. One is being mindful and aware about sensations, images, thoughts, and emotions. Phase 6 Tracking Your Rhythms of Expansion and Contraction. Here there are some exercises to change the traumatic pattern to a new situation. Traumatized people tend to be riveted on their traumas; new situations are connected to that past event. The key to dissolve this constriction is learning to stay with the sensation until it begins to change. Phase 7 Fight Response: Natural Aggression Versus Violence. Levine (2008) explains, “Aggression is an innate natural resource that protects us when we are threatened” (p. 59). Traumatized people often lack the healthy aggression that they need to carry out their lives effectively. Exercises here are like pushing hands with someone to feel power, and back pushing exercise with someone to feel their strength. Phase 8 Flight Response: Natural Escape Versus Anxiety. One of the reasons people are traumatized is they found themselves in a situation from which they could not escape. In this phase and exercise, one could practice letting them escape and complete

38 the experience of running away and feeling safe using imagination and guided meditation. Phase 9 Strength and Resiliency Versus Collapse and Defeat. Here Levine sees that the feeling of collapse that traumatized people often experience is coming from an incomplete response to threat. Going into, and then out of it fully, strength and resiliency are coming back. There is a guided practice to imagine fully going into the feeling of collapse, allowing oneself to really let go. Phase 10 Uncoupling Fear From the Immobility Response. The key here is “to uncouple fear from the biological immobility response so that the response can complete itself” (Levine, 2008, p. 65). Also there is an exercise here for returning back to equilibrium, since traumatized people often get used to an immobility response for so many years that to allow themselves to return to equilibrium seems strange sometimes. Phase 11 Orientation: Moving From Internal to External Environment and Social Engagement. Until this phase, the focus of the exercise was more internal, such as body awareness and sensing. Here Levine suggests to people to come out of the exercise and their internal state, and just look around with curiosity, or make connection with the environment or relationship to other people. When one has such an outer orientation, one cannot be traumatized at the same time. Phase 12 Settling and Integrating. “As you come out of the trauma response, you’ll need tools to help draw you into a new sense of presence and calm” (Levine, 2008, p. 68). Here Levine adds a little practice to calm down when being aroused and as a way

39 to integrate the new presence. (See all phases and exercises in “Healing Trauma” by Levine, 2008.)

40 Chapter 7: Basic Theory of Process Work Dreambody to Process Work The founder of Process Work, Arnold Mindell, was first studying Physics at MIT, and went to Zurich to study in graduate school. In Zurich, he coincidently came across Jungian psychology, and having analysis himself changed his direction to become a Jungian psychologist. He worked as an analyst, and then became a training analyst at the Jung Institute. When he suffered from his symptom, he discovered the limitation of his dream analytical approach to the body. Being a Jungian analyst, Mindell was committed to Jung’s teleological approach, the idea that dreams had a meaning or purpose. He thought that body symptoms, like dreams, must contain meaning and purpose for the individual (Diamond & Jones, 2004, p. 3). He applied a teleological approach to the body, and found the concept of dreambody. Mindell named the mirroring of physical experiences in dreams the “Dreambody” and I discuss more about it in the next chapter. Dreambody was a dream experience as well as a body experience. It also applied to relationship and group, and then the concept grew into channel theory. Dreambody now manifests itself in six main channels: visual, auditory, proprioceptive, movement, relationship, and the world. Primary and Secondary Process, and Edge “Practicing Process Work involves understanding ‘process’ as the flow of experience in oneself and in the environment and following this flow in a differentiated way” (Diamond & Jones, 2004, p. 17). Understanding process, we need to know what is

41 our primary process, and what is our secondary process. According to Diamond and Jones (2004), “Primary process refers to those experiences that are better known and closer to a person’s sense of identity. Secondary process refers to those experiences that are further from a person’s sense of identity” (p. 20). Primary process and secondary process are both part of the whole process, and in between, there is an edge. The edge represents the limit of the known identity as well as a point of contact with unknown experiences or identities. An edge is often felt as discomfort, nervousness, or excitement because it is an encounter with something new or unfamiliar. (Diamond & Jones, 2004, p. 20) These concepts are helpful to map the process of where the person, relationship, or group is. As Process Work follows teleology, in the work, we try to find which way the process wants to go, and follow the process itself. Where is the process happening, which is secondary process, and how we could get into to the secondary process by dealing with the edge, which separates secondary from primary? It starts with signal awareness and we follow that signal or amplify that signal that might get us to the edge. Then we have an idea of what the secondary aspect is. Whether we cross the edge and get into the secondary or not, it is a process of unfolding. Diamond and Jones (2004) describe this process as, “Unfolding a process involves noticing a secondary or NCR experience in the initial description of a problem, amplifying its expression until a new meaning or aspect of identity emerges, and then integrating the new experience in unfolding process” (Diamond & Jones, 2004, p. 23). As mentioned before, amplification is one of the techniques that focuses on a channel experience and brings more awareness to it. Often when we amplify the secondary signal, you learn more about the unknown secondary process. For example, if my secondary

42 process was tension in my hands, then I will amplify a hand’s tension in the proprioceptive channel. I start to feel the tension more and making a fist and move a little bit. Then further amplification is to be aware of the fist more, make the movement bigger. There might be an edge, however, if I could really get into the experience, I might start to move like knocking on the door. In my deeper experience is that I have much deep passion to say something into the world. I would have insight from this work of amplification that I have much passion to bring to the world, which has remained secondary, and I could think about how I could connect and use this energy, and how I could bring this passion to my life in the moment. This would be the integration process. This is example of unfolding the process with amplification, which eventually leads to some insight of unknown secondary. In this example, I might always have some tension in my body in communication with others, which could be a sign that some communication wants to emerge. However, it is likely that there is an edge present that could be connected to my family trauma. The emphasis was on maintaining family harmony by withholding personal expression. However, by unfolding the process of my secondary and having awareness of my passion inside, I could change this pattern. Noticing my body tension could be an alert to notice some voice inside of me, and then say and express my opinion or what I feel in the moment.

43

Deeper Awareness to Sentient In the late 1990s, Mindell extended his theory, and added the sentient dreaming reality called “Dreaming” (capitalized to denote the realm of undifferentiated experience), or essence level, which is a dream-like reality that permeates everything (Diamond & Jones, 2004). Mindell differentiated this level from two other realities, and the model of three different levels of reality was created. They are Consensus Reality level, Dreamland, and Essence or dreaming level. I talk more about this concept in the next chapter in connecting to the body, and please see those sections for more information. Field and Role As Process Work developed its applications to a group or world problem, it started to see groups of people and their atmosphere as a field. Field is a dream-like concept, and when we see a group as a field, we can think about people in the field as a time spirit or exchangeable roles. Mindell was a physics student and continues to have an interest in quantum physics, where the term field is originally from. In the field, there are several roles there to be played. If we notice it or not, we somewhat play roles in everyday life. For example, if I feel rebellious in the working place, and it created trouble in relationship with my colleagues, and I do not know why it happened, it could be because of some rebellious role in the field. It could be a rebellious feeling towards the company or larger system, and this role could be noticed and understood. The following explanation about field from Julie Diamond (2006) is helpful

44 to explain the concepts of field and role: A role can be defined as a unit of behavior with social meaning. Further, Process Work theory does not distinguish theoretically between a role in a group and a role in an individual’s inner world, such as a dream figure. While roles are found in groups and relationship, dream figures are found in nighttime dreams, body experiences, projections, complexes, and other subjective experiences. Both roles and dream figures are understood as part of a larger field, as functional sub-sets of behaviors and identities, arising out of deep feelings and experiences. (Diamond, 2006, p. 7) What is important is that when we think about trauma, we think about the field of trauma. In this field there can be many roles and these roles will be embraced by different people in the trauma process. There might be roles played in this field such as perpetrator, victim, protector, or witness.

45 Chapter 8: Body in Process Work: What Is Dreambody? Dreambody Into Channels In the development of Process Work, there was a quantum leap in the Dreambody work (Diamond & Jones, 2002). Mindell started to design a signal-based method of following process, or the flow of experience, as he developed detailed technology for tracking how experience manifests through multiple “channels” or modes of representation (Diamond, 2002, p. 6). Channels are signal vehicles, which convey intended and unintended communication. As we saw in the prior chapters, body awareness is often referred to as body sensation, movement, and how they sit or stand. Through this channel development in Process Work, we know the body or Dreambody in Process Work has more to say than only somatic awareness. This is a very critical point to understand the body’s role in Process Work theory. Simply, Dreambody or the body in Process Work is much broader and deeper in meaning than so called somatic awareness. It is a body sensation, feeling and movement, at the same time imaginal vision and auditory sensation. It is much more that Dreambody manifests in relationship or interaction between others, and also in the family, organization, and social contexts. In Process Work terminology proprioception refers to felt sensations such as temperature, weight, and pressure. This is very close to the feeling of felt sense, and how

46 people feel their body from inside subjectively. It is like a subjective body feeling and sensation. Movement is a kinesthetic mode of experience and expression. The movement channel is evident in nonverbal signals such as jiggling feet, hand movements, shifting around in a chair, or rocking. This kinesthetic movement experience is one of the main somatic experiences, which are not always in one’s consciousness but when there is a strong signal, we get into this body through the movement channel. In Process Work, visual and auditory channels are also part of Dreambody. Much of dreams is also experienced in the visual and auditory channels, as we know ourselves. Since the body and a dream have a similar pattern in Dreambody, then the visual channel and auditory channel are also parts of the body in the Process Work paradigm. It seems to have a much deeper history in it, since Mindell is a Jungian psychologist. C. G. Jung had studied a lot about the subtle body (Oimatsu, 2001). Subtle body is not physical body but more like an imagination, and subjective experience connected to body. In Jungian psychology, the subtle body is seen in dreams or active imagination (Oimatsu, 2001). World channel is also part of the dreambody, as dreambody is connected to our deeper personal experience, but it is also connected to the world. Every symptom is not emerging from nothing, but rather, it is part of collective field, and is also a representation of tension and joy in our world. What we get from our body or dream are in a way, a message to the world around us, too (Mindell, 1998, pp. 7-8).

47 Body in Double Signal and Role In the field theory in Process Work, there are many possible roles. As we discussed in chapter 7, there could be some roles in the trauma field. Each role could have its own body experience if it is unfolded or played out. I would like to mention two things. First, secondary process in the body could be seen in a double signal, such as jittering feet while talking. Mindell found that to integrate dreambody experience more into relationship, he needed to study more about body experience connected to the signals around human relationship. He found that a double signal, which is an unintended body signal, is also part of the dreambody experience. Double signals have dream like foundation in themselves (Mindell, 1998). For example, someone thinks of himself as humble, and what he says in words is very humble. However, he might have a body posture which seems to look down on somebody as a double signal. The double signal is present as a signal in communication but very secondary, or unconscious for himself and even others. He expresses a double message that one is humble, and at the same time is looking down on others. It creates difficulty in communication, because people who talk with him get a double message and would likely be confused. Second, if we start to pay attention to that double signal, and unfold and identify its process, possibility is that there is some secondary role in it. As each role has a body experience in it, Process Work suggests that clients get fully into the role in order to integrate that part of ourselves. In trauma, this secondary role could be a protector, or it

48 could also be a perpetrator. It depends on feedback and timing of the client, whether they could integrate the secondary role in their body, but the direction of the therapy is integration to the whole. One day in my own therapy session, I was talking about my traumatic memory, and also found tension in my body while talking as double signal, and I didn’t know why it happened. It was very secondary, but that tension holds much energy in my body. Since it was a very obvious signal, with the support of my therapist, I focused on and amplified it. As I did so, it suddenly connected to a traumatic experience as a teenager, when I couldn’t stop myself from being violent, and I was afraid of myself for that energy. Many emotions were coming back at the same time. However, staying in traumatic memory and emotions, kept me more to my primary position, probably victim role. I needed to focus more on the secondary body sensation and movement which happened throughout my body. I stood up, and opened my heart while feeling much power and energy was going through my body, and feeling stable. I got insight that I needed this energy to really protect myself from an environment in which I felt not safe in that moment. I could find the protector role of my traumatic experience. Three Different Levels of the Body As Mindell entered into the sentient level, Process Work started to see reality in three different levels, which are consensus reality, dreamland, and essence. In his book Quantum Mind and Healing, Mindell (2004) talks about three different levels of the body in what he calls rainbow medicine. Mindell (2004) said,

49 Rainbow Medicine includes components of classical medicine such as anatomy, diagnosis, medication, surgery, biophysics, etc., as well as alternative medical procedures involving subjective experience, dream patterns, and all levels of consciousness. Rainbow Medicine deals with at least the following three levels of reality, each of which is linked to a particular form of awareness. (p. 17) Mindell (2004) talks about how the body could be seen in three different levels, but to notice this difference requires different awareness. Below are three different levels and how the body is seen in each one. 1. Consensus reality: observations of time, space, weight, and repeatable measurements. 2. Dreamland: experiences of fantasies, subjective feelings, dreams, and dreamlike figures. 3. Essence: perception of subtle tendencies and a lucid sense of the force of silence from which dreams arise. (Mindell, 2004, p. 17) Mindell calls any medicine that deals with only one of these levels, “one-color medicine,” and its body is seen in the consensus reality level. “In this reality, the ‘normal body’ has a head, two arms, two legs, a heart, and so forth, and it is seen as an object located in time and space” (Mindell, 2004, p. 17). Rainbow Medicine includes all levels of awareness and dreaming body. Body has dreamlike dimensions that cannot be easily measured and located in time and space. Body in the essence level could not be directly measured or located, but could be seen in the subtle feeling or tendency that a given body may be having. There is an example of body in the essence level in Mindell’s (2004) book Quantum Mind and Healing. Mindell’s client was worried about death, and he did the

50 work of following subtle tendency of the body. When this client followed the subtle tendency of his body, he noticed that his jaw wanted to drop. After he let his jaw down, he got a sudden fantasy, in which his head fell off his body, leaving an image of his body breathing freely and totally open to the wind. For this client, “The meaning was obvious: Drop my head, my inner programs, and open up.” He got a message from the essence part of his body, and it was to integrate (Mindell, 2004, p. 8). Body and Mindfulness Here, I want to discuss mindfulness in Process Work and how it is connected to other mindfulness approaches. Much of the work in Process Work is about awareness, for example to be aware of what is happening in the body’s experience. Mindell already used the word mindfulness in the early 80s and talked a lot about mindfulness and meditation. In his book Working on Yourself Alone (Mindell, 1985), he talks about Process Work’s way of mindfulness and meditation, which later was called inner work. In Chapter 11 of this book, Mindell talks about two different kinds of awareness. One is the awareness of here and now, which I believe means the same thing as mindfulness. Mindell (1985) explains, “Preference is not given to any particular state, either stressful or peaceful, but to the ability to live completely in the moment, in everyway possible” (p. 7). In order to use this awareness, you could find in which channel you are experiencing. As Mindell (1985) mentioned, “ . . . the awareness principle ensures that only those visual, auditory, movement, proprioceptive, relationship, and world processes

51 occur to you which press you to become aware of your secondary process as quickly as possible” (p. 115). Being aware of the dreambody comes through being aware of in which channel process is happening. Dreambody awareness itself is like a meditation and mindfulness practice. The second type of awareness which Mindell discussed here is deeper awareness. It is an insight of the awareness process itself and connected to this is the question, “Who is it that meditates?” It is connected to Buddha mind in Buddhism (Mindell, 1985) or later on, Mindell (2010) talks about this awareness as Processmind. Also Mindell talks about one aspect of Process Work meditation that goes beyond causality and judgment of good or bad. He said one of the fundamental and sometimes unconscious tenets found in many psychologies and meditation procedures is that a human being is undisciplined, unaware . . . and somehow wrong. Mindell (1985) continues, “We need to add a new dimension to our belief about being human. This new dimension sounds like an ancient one, which states: ‘The world is perfect the way it is’” (p. 14). We could find the purpose behind events, which is teleology. Mindfulness as Kabat-Zin describes it is awareness of here and now and is nonjudgmental, and I believe I can say that Process Work has many aspects of mindfulness practice in itself. In the mindfulness approach, awareness is focused on here and now and anything happening in the moment, while in Process Work, awareness is also used to focus on what is happening in the moment. In mindfulness, everything happening in the moment is seen without judgment, with awareness to watch the

52 experience happening just as it is. Process Work’s teleological aspect, in which not judging things good or bad, and finding purpose behind the event is also an aspect of nonjudgment. Mindell talks about three different personalities about mindfulness. First is like ego, who is doing something? Second is some part of us within which reacts to what one has done. Third one is a neutral observer which holds both sides (Mindell, 1989, p. 17). He said ego itself is on the way to transformation, and ego is one of the stages to become the neutral observer (Mindell, 1985, p. 19). Mindell continuously talks about this neutral observer. This position is also free from judgment of good or bad, right and wrong. Compassion is also mentioned in conjunction with this observer. For Mindell (1985), “Compassion is a crucial element of process work because it lovingly tolerates and accepts potential growth in ourselves” (p. 15). Pure awareness and compassion discussed here are key concepts in mindfulness, and Mindell himself discussed their connection. “‘Loving kindness’ and other types of spiritual feelings for others thus transform in process work into accepting and processing all of those events which reach our awareness” (Mindell, 1985, p. 15).

53 Chapter 9: Safety in Process Work In most trauma oriented therapy, the emphasis is on safety on many levels. As we discussed the 10 principles around safety in trauma therapy from Rothchild, where could we find the aspects of safety in Process Work? In Process Work, we are focused on feedback, and emphasize that following feedback is very important. I think safety is a different concept from the Process Work perspective, but following feedback is one of the Process Work characteristics of safety in therapy. When I interviewed Emetchi, faculty and researcher of trauma, at the Process Work Institute, she told me how much safety is always important when she works with a trauma client. Feedback Oriented Process Work is feedback oriented, which I believe, creates much safety in therapy. If a therapist does not follow a client’s process, this means that the therapist does not take feedback from the client. Then therapy itself does not continue. Therapy only starts when rapport is made between therapist and client. When Mindell talks about applying the work of the dreambody, I think he talks about creating safety. Neverthless, despite good results, I do not recommend attempting this work without training in near-death situations or in cases of frail health. Besides learning to notice negative feedback, body signals indicating hesitations, and body shyness; training includes, at least, a working knowledge of relationship work. (Mindell, 1998, p. viii) Facilitator / Therapist’s Awareness Process Work has lots of potential to apply to different situations, but for safety, especially working on trauma, some sort of serious training is needed. Personally, I have been studying Process Work about 10 years, and while in this diploma training for 4

54 years, I intensely worked on myself and in the training group and with lots of individual supervision. Here is another point about safety. It also depends on the facilitator / therapist’s awareness and that rests on their own inner work practice. Subtle signals and negative feedback, which Mindell (1998) spoke of, are something we have intensely focused on and learned to truly understand as being essential to what it means to really follow process. Watching feedback and noticing it about to change is the way to intervene with the client, it seems to me, and is a necessary attitude for the therapist regarding safety. If we forget about this, and our intention is to just apply a technique which is said to work for trauma patients in general, it could create harm for the client. If we really follow a client’s feedback, it creates a good enough rapport between therapist and client. If we learn how to follow feedback from a client, and especially working on trauma, we would know how much we sometimes need to have some distance from working on the trauma itself and create space for safety. Pacing Primary Process As we discussed about basic Process Work concepts in chapter 7, we see phenomena as process, and structure this process as primary, secondary, and edge. Primary process is so-called ego or person’s usual identity, and though our intention is unfolding secondary process, we see the feedback and sometimes really stay with the primary process. This is what I named here as pacing the primary process and it is important in order to create safety.

55 What Rothchild (2000) said in safety principle #2 implied this as well. “Develop good contact between therapist and client as a prerequisite to addressing traumatic memories or applying any techniques—even if that takes months or years” (p. 98). One’s primary identity might not want to go into traumatic memories, and it is also quite natural to dissociate ourselves from memories. We need to support and pace this primary process. If we really follow the feedback of the process, the secondary process we need to follow first might be dissociation itself. Spaciousness When Stephen Schuitevoerder, president and faculty at the Process Work Institute, came to Japan after the March 11th earthquake 2011, he led a seminar about trauma. Schuitevoerder (Seminar, 2012) said that when people experience the kind of disaster that had happened in Tokyo, even talking about it is difficult. Safety is critical, and for that safety, what he calls spaciousness is important. Spaciousness is kind of mindful awareness practice to find a larger part of ourselves. Dissociation is sometimes connected to a natural process to find spaciousness inside of ourselves. Brake in Process Work What is a brake, as Rothchild calls it, in the Process Work context? Following feedback and pacing the primary process are brakes. Body could be another, and when victimized and wondering how to get out, spaciousness is a good brake. Essence level awareness could be a brake, too. As Rothchild (2000) talks about imaging nature as a brake in her book, so does Process Work have the idea of earth-based work. We could

56 find the deepest part of ourselves in our body, then connect it to a favorite place on earth, nowadays called Process Mind (Mindell, 2010). Process Mind is also a brake, and could have the potential for increased usage as people want to work on their trauma. Similarly, Rothchild (2000) uses nature images as a brake when a traumatized person gets lost in traumatic memory or flashback. It is used to displace their identity from a victimized place and connect one’s awareness to imagination as resource. If we use Process Mind, we could identify ourselves not with the victim role, but to the state of the essence level, and from that state, even the victimized role or other roles could be held as part of a whole. Personally, it happens a lot to me. When I have been in my traumatized state, I realized that it is really difficult to get out of the victimized state. Then when I use a Process Mind exercise, it helps me to shift out of that identity, and I found peace and a safe place in myself and body, which definitely works as a brake. Dreaming Up Dreaming up happens when people send a double signal, and dream up the other person to play some role (Mindell, 2002). For example, if somebody says yes to me but with another signal is saying no at the same time, then I become caught in the situation and felt tension in my body. Then I might become aggressive or difficult in communication with this person, which could be the cause of dreaming up. Dreaming up could be found from a double signal or a person’s dream. If this person dreamed of somebody very rigid and sending same quality of double signal, my response could be coming from dreaming up, and it affects our relationship.

57 The concept of dreaming up in Process Work could be useful in trauma. The trauma process constellates not only in the client’s psychology, but it could also constellate at any time in the therapist-client relationship in the moment. As Rothchild (2000) emphasized how important relationship and trust towards it is for those really suffering from complex trauma (p. 82), there might be a danger of a retraumatizing process happening in the therapeutic relationship. Probably we could talk about this process also from the framing of transference and counter transference, but here we think about it from the dreaming up concept. There is always danger in a trauma process, that a client could easily project abusive power onto the therapist. Then the clear danger there is that a therapist could be dreamed up as the abuser, and take the role and actualize it in some way in therapy. For example, if a person is traumatized from maltreatment, the first trauma happened in the relationship channel. Symptom could be seen in the body, and we could work on it, however, we could also guess that the same process could happen in the relationship channel between therapist and client. Therapist then suddenly could feel violent towards the client, and if the therapist is alert and cautious enough to be aware of it happening, we could use this experience in therapy like just telling what happened in the moment to the therapist. It is like a dream experience, and it is called dreaming up in Process Work. If a therapist is not aware enough of the dreaming up experience, there could be a danger that therapist unconsciously takes the role of abuser while in the session.

58 Awareness of the Field and Roles When working on trauma in Process Work, we see the process as in the field, too. We discuss more about roles in the trauma field in chapter 10. However, awareness of the field and roles would create safety, too, in that we would be cautious with an abuser or perpetrator role already in the session room. Process Work has a principle of deep democracy, in which every role is important. Whether a client is identified with a victim role or not, every part of the field is important, and because roles are not paid much attention to consciously, that could make the client’s psychology feel unsafe. Therefore awareness of the field and roles are essential for safety in the session.

59 Chapter 10: Trauma and Field, Roles and Body In this chapter, I talk about field and the roles around trauma. Already, Baumgartner has written about this area in her master’s thesis in 2011, and I mostly follow her ideas, so that some of the discussion is coming from her paper. As my intention is around the concept of body, I’d like to connect body to field and body. When I interviewed a few faculty members about how to work on trauma in Process Work, everybody talked about roles in the traumatic field. Here, I follow the definition of roles and field from Bumgartner (2011), which are not so different from what I heard from faculty at PWI. The roles I have defined are outer roles in society, and they are roles in the inner theatre of every victim (and perpetrator). No one role is attached to one person. Process Work goes even further in saying that all these roles can be found as an intrapersonal part of each of us, because we are humans and because we live on this planet and cocreate the reality we live in. (Baumgartner, 2011, p. 45) Baumgartner defined five main roles in the trauma field. These are Perpetrator, Victim, Bystander (non-involved), Witness (involved), and Protector. Victim When there is a traumatic event that happened, there might be a perpetrator or sometimes it could be natural disaster, and there also would be a victim of the event. Victim is someone who suffers from a traumatic event. We could be a victim. However, from the field perspective, there is a part of us that feels victim is a role. Victim is a more primary part of a trauma survivor. However as Baumgartner describes, if this role is not fully owned, it is a bit secondary process. There might be an edge to this sort of primary process.

60 Knowing that one is a victim of a trauma incident is, as Baumgartner says, the first stage of trauma recovery. Whether people know that they are victim, or whether they do not identify themselves as a victim, if trauma happens and it is not worked out yet, there is a victim role in the field. If this role is more secondary, the victim role could be shown in their body symptom or signals. Typical symptom like hyper vigilance could be a signal of the victim role. Accepting or identifying oneself as a victim is a very edgy thing, as I know for myself. However, it is a first step to really enter into a healing journey. What makes it difficult to accept this role is the edge to the feeling, which one avoids seeing for their survival. Really owning the victim role means that we might face the feeling that we had had in the moment of trauma, which is difficult and creates symptoms. As Baumgartner explained, we could only identify with our victim role fully when we feel safe enough to hold these feelings. She also explains, “Acknowledging and identifying with the victim part can be accompanied by strong feelings and regression” (Baumgartner, 2011, p. 61). One needs one’s own timing and also needs much support and a safe environment, just to face the role of victim inside oneself. Perpetrator Perpetrator is someone or something which becomes the cause of a traumatic event, and makes the victim suffer. In the interpersonal level of trauma, the perpetrator role is most present, but it is also very secondary in the scene of trauma. I could understand from my experience, too, that a survivor or a victim of trauma, though

61 consciously or not, could find this role in disturbances and symptoms in everyday life. The perpetrator role is a frozen energy in the trauma experience. If a survivor could not well integrate the energy of this role or potential power, it will linger in secondary processes and cause troubles in one’s body, personal psychology, relationships, and so on. This is the core issue when we think about the recovery process. As Baumgartner (2011) put it, “To unfreeze that power and to make it useful again for the person who experiences it only as something that happened to her, is one of the core goals of trauma transformation, and one of the most delicate tasks” (p. 46). Nobody likes a perpetrator. However, if one is traumatized, a perpetrator is there in the field. It is a delicate thing to say, but as a perpetrator anyway exists in one’s psychology and dreams, which means they exist in their body, so that eventually the task in recovery from trauma is how to integrate this role. Otherwise this role remains in the field, coming into one’s body as a double signal. There need to be very gentle steps to this point, but integration is one of the goals of recovery. For example, the perpetrator role might be found somewhere in the body, as a body symptom or double signal. If we could unfold that secondary signal enough to get some message, or deepen enough to the essence level, then the perpetrator role is not just threatening something, but is some energy to be used skillfully. When I worked with my perpetrator energy, I found some neutral coldness in the essence, which is actually useful in my relationship skills to have healthy distance with people. The other time, I found that the putting down energy of the perpetrator was very useful to really connect to a

62 deeper authority inside of me. People could find their own perpetrator role in their body, and could then find some message and essence behind that role, which could be useful. Bystander and Witness These two roles are close in definition, but here I follow Baumgartner’s framing. Bystander is somebody there when a traumatic incident happened but was not involved. Baumgartner (2011) explains, “One could say this role is created by dissociation. The role of the bystander is to be transformed into the role of the witness” (p. 46). I was impressed with this perspective, that the bystander might be connected to dissociation. Although a trauma survivor needs survival skills to dissociate themselves from trauma experiences, it means that they somewhat dissociate from themselves, and here we could assume the existence of a bystander in their psychology. Baumgartner (2011) continues, “Developing the role of the witness frees the trauma survivor from the trauma consequences of constriction and disconnection” (p. 47). Bystander needs to be transformed into witness. It is like a practice of mindful awareness and involvement in oneself. Therapist could be a first role model of the witness of the trauma. Therapist would commit to the trauma and traumatized people deeply with awareness and with compassion, which in turn helps traumatized people to develop the role in themselves. From my survival of trauma, and from my experience of mindfulness practice, I think dissociation happens with unconsciousness. If we could consciously dissociate, we would see ourselves or what we experience from a useful distance. It is like seeing ourselves without judging outside, and it would be just like mindfulness

63 practice. It is a place to see oneself with commitment, even though it seems distant, and it is also the place to develop compassion. A survivor would develop this witness, with the support of the therapist, therapy sessions, and their own efforts to be mindful in whatever happens in the moment though the therapy session. As we saw, the bystander could be found in one’s experience of dissociation and the witness could be cultivated through paying mindful attention in the emerging processes. Connected to the experience of one’s body, I think if a survivor had enough courage to face what is going on in the moment in his or her body, it would cultivate the witness. The more we could perceive what is going on in our body in the moment, the more the witness would be cultivated. In this way, what Rothchild (2000) calls body awareness in itself, cultivates the role of witness. Protector This is the role missing in the trauma field. It is a ghost role, as there is often no protector role in the trauma event. If there is a protector in the moment of trauma, experience of trauma and recovery from trauma could be very different. However often because a protector is not there, that trauma happens and symptoms like PTSD also happen eventually. If there is no protector in the dreaming trauma field, it is just like a nightmare. In the survivors’ inner psychology, a perpetrator is always there and without protection, that one could feel tension and fear all the time in turn creates lots of PTSD symptoms. I agree with Baumgartner. The protector role is one to be nourished in the process of trauma transformation. It is closely connected to establishing safety, finding inner and outer resources to cope with the challenges of life and relationships, and beginning to trust again. (Baumgartner, 2011, p. 48)

64 Establishing safety constellates a protector in the field in many ways. The therapeutic relationship is connected to a protector role, and the therapist might even take this protector role consciously in order to constellate it in the field. My question here is where is the protector in the body? Thinking and imagining about a protector in the session, and playing the role, and find out what do they feel in the moment as a protector, is one of the ways to find the body. Also my guess is that if we follow the process, like tension in the body, sometimes we could discover our power or authority inside of that symptom, which has the potential to turn out to be a protector role. Trauma happens when one could not have any boundary to enormous power, and making a boundary is the great task on the way to recovery. Boundary is connected to power, authority, saying no . . . and so forth. My idea is that we need to think about boundary being connected to a protector role in the field. For example, if a traumatized person has a weak boundary, but wanted to say no to somebody or something, it could be difficult work. Her body might be squeezed and have some tension. However, there might be a protector role in her body, for instance like her tension. If she follows her tension in the body, she might connect to her own power found within the tension to say no from that tension. Deep Democracy to All Roles in the Trauma Field and Body As Process Work always tries to be deeply democratic, all the roles in the trauma field, even the perpetrator role, are important in some way to the other roles. Deep democracy is a concept and feeling attitude towards life that all levels, consensus reality,

65 dreamland figures (roles and ghosts), and essence that connects everything, are equally important. Every role has its own body, and those bodies could be constellated to a survivor’s body. On the way to recovery, when we focus on body, we pay attention to every part of the body, or the body’s diversity. In the process of recovery, each role needs to be paid attention to, and some roles need to be heard by each other in making dialogue. The process of recovery from trauma is perhaps like making a story. There is no linear way, but the process directs us as to which role needs to be paid attention to. If those roles in the body are held in one’s body, there is a beautiful community in it. Body has the potential to hold tension, and diversity in itself.

66 Chapter 11: Process-Oriented Somatic Trauma Approach Before Process-Oriented First, I want to mention a little bit about what we, as Process Work, could learn from other mainstream modalities. When I interviewed Emetchi about what is most important when working with trauma, she said, safety. Rothchild already wrote much about how safety is important, and we have also addressed it in previous chapters. As Rothchild mentioned about trauma theory, knowledge is important for safety, too. As Process Work follows process, as long as we follow process we could use tools and thoughts from other modalities. Today, brain science is increasingly progressing, and we can learn from scientific research, too. We know from therapy experience that body is also mind, and more than that, however such knowledge helps us to integrate our approaches to a much broader field. Connected to that, I personally am very impressed by the research of Peter Levine. His research and studies show that the phenomena of shaking is very connected to trauma, especially freezing or frozen state (Levine, 2008, p. 2). Levine found that prey animals in the wild, though routinely threatened, are rarely traumatized. He studied footage of wild prey animals, and understood it was reflected in their shaking, trembling, and spontaneous breathing. He at the same time found almost the same process in his work with traumatized clients. He gave an example of a wild polar bear coming out of the shock of a tranquilizer dart for biologists’ study. It begins to tremble lightly, then trembling intensifies steadily, then peaks into a near convulsive shaking—its limbs flail

67 seemingly at random. In this process, this animal tries to complete its escape by actively finishing the running movements which were interrupted. Then it shakes off the “frozen energy” as it surrenders in spontaneous, full-bodied breaths. He also mentioned observing the same kind of shaking in many shamanic healing rituals performed throughout the world. I knew about and saw the experience of shaking happening in the therapy process, but had not known about this information. Shaking is not a special shamanic something, but is a very understandable phenomenon when people have come to the moment of releasing long time held traumatic energy. People know about it, I believe, but to really know it as embodied knowledge is very different. Process-Oriented Safety Principle Process Work could contribute safety in a unique way, in that it is feedback oriented, caring much about primary process, seeing disconnection as a natural process which should be followed, and seeing altered states such as hyper vigilance or dissociation as part of the larger range of consciousness. Thinking about dreaming up, assessing the structure of the process, and having awareness of a perpetrator role in the moment also contributes. Pacing the primary identity is important when working on trauma, and not going too quickly into secondary material works as a brake here. Also, Process Mind inner work or finding an earth spot are also brakes for the trauma process. Interestingly, Rothchild uses images of nature as brake, and also uses it as connecting to a resource.

68 3 Stages Herman (1997) talks about three stages of recovering from trauma, which are as follows: 1. Safety 2. Rememberance and Mourning 3. Reconnection This is still a typical recovery process from trauma, and we need to know about it as therapists. Thinking about the trauma process, dissociation or avoidance are natural survival processes from the effects of trauma. Some people might just recover from it naturally, while others suffer from PTSD. In the first step, even safety is a secondary process for a survivor, because safety gave space for him or her to connect with their victimhood. When the time has come and a safe environment or therapy situation is organized, a closer secondary process is really recognizing oneself as a victim. In the first place, victim is also secondary. In this way, Emetchi spoke of the first step as, “Knowing the primary process of trauma” (personal communication, Emetchi, 2012). This step overlaps with Herman’s second stage, rememberance and mourning. When we really know the primary process of trauma, what we are avoiding comes closer, which means secondary feeling, or rememberance and mourning, come back. Emetchi’s first step brings one to the edge of trauma. Unfolding and following this process, the next step of reconnecting would start.

69 Feelings like loss, sadness, or mourning are some of the difficult emotions we could face, but they also have lots of healing potential. Feeling connects us to the part of ourselves, or our soul, that we lost or dissociated from for a while because of trauma. It is a retrieval process. Reconnection of the body, and even deeper meaning as dreambody, happens. This is the actual healing process. However, as Herman (1997) said, the recovery process is never finished. It is a serious comment, but since we have a teleological concept, I believe we could go further. What Emetchi mentioned is encouraging: “Does growth ever finish?” These days there are concepts called PTG, which means posttraumatic growth (Wikipedia, 2012). We know from our human history that Gandhi, Mandela, and Victor Frankel did survive their respective traumatic histories and events, and also showed significant humanistic growth. Emetchi’s second and third steps show the Process-Oriented way and growth with trauma. Second step is, “Moving towards the secondary process of perpetrator.” It takes time to work on the process of perpetrator role. Emetchi is talking about not an actual perpetrator but rather work on the energy which the role holds. As we have seen, perpetrator could be seen as one of the roles in the field, and in Process Work, we see the role’s energy is something that could be integrated. For example, if somebody sees a perpetrator in a night dream, she could feel the perpetrator’s energy in the moment in her dreambody. If she could work on the figure as her secondary process, and worked on it to get some meaning in it, she has possibility that perpetrator role could transform into something less harmful. For example, if someone suffered from trauma of domestic

70 violence, perpetrator role is who hits this person. This person might have deeper passion which needs to be expressed, however could not express it and suffer from depression. If we could work sentiently with this hitting energy, then she could use this energy to bring her deeper passion of expression out to the world in more creative ways. The third step shows Process Work potential with the perspective of sentient reality, namely through developing eldership and integrating the victim and perpetrator energy. In the sentient reality and its paradigm, perpetrator role and victim role both could be held. Baumgartner (2011) explains, “We have a broader inner perspective because we have access to the essence level of our reality. From this perspective we can see that there has been transformative power all along the way” (p. 59). Body Awareness in Process Work As we saw, body in other modalities has several meanings. They are compared to body in Process Work. Anatomical and physiological body is one aspect of the body we care for in the CR level. Body awareness is closer in definition to awareness in Process Work channels, especially proprioception and movement. Body in Process Work has broader meaning because of dream or dreaming body. Other channels are also body in Process Work concepts. Process Work’s idea has a deeper body concept which is body in sentient and essence levels. This body is more than a dream, it is like the root of a dream and everything, and these days it is called Process Mind.

71 Mindfulness As mindfulness is related to trauma and the body, it is already in Process Work, too. Process Work is said to be a psychology of awareness, or awareness is everything. However, I personally had a question when we say awareness because of its diversity. From my experience, a Buddhist approach or mindfulness approach could help us to train the pure awareness. I found the book Working on Yourself Alone: Inner Dreambody Work (Mindell, 1985) also very useful about this. In this book, Mindell talks about awareness, especially in comparison with Buddhism and other spiritual traditions. Process Work sometimes talks all about awareness, but I here would like to emphasize, awareness of the body has an important role especially in trauma, and much work we do as Process Workers is cultivating this awareness, or mindfulness. In a way, a Process Work session itself is a mindful practice both for therapist and client. Every intervention therapists make must be followed by conscious choice and thinking, and therapist uses his physical and dreaming body while in the session mindfully. As Rothchild talked about the practice of body awareness, when a Process Work intervention focuses on body signals, and amplifies proprioceptive and movement channels, a client has a chance in the moment to cultivate their awareness of the body, which is mindfulness practice. I believe that Process Work could be described as a mindfulness approach for trauma, and has much more to offer.

72 Primary, Secondary, and Edge in Trauma Between the primary and secondary process is where freezing or dissociation could happen. As van der Kolk and other trauma therapists mentioned, trauma takes one away from the moment, or here and now. When people who suffer from trauma try to be present in the moment, memory and feeling would come back. Flashbacks might happen as if trauma is happening in the moment. It is in a way between primary and secondary process, and primary process recognizes that what happened in the moment of the experience is dangerous. The primary process, closer to our rational mind, considers that energy as dangerous and thus interrupts the natural impulse to complete the process and release that energy (Levine, 1998). Thus we could say that at the edge between the primary and the secondary process, we freeze again. (Levine, 1998, as cited in Baumgartner, 2011, p. 53) As she mentioned, freezing happens at the edge. One is no longer here in the moment. What we do in Process Work when we discover the edge is to go back to the moment before it happens, which is using a brake. I agree with how Baumgartner continues. Process Work theory says that if we slow down the process of freezing, going back to the last moment of energy, exploring thoroughly what happens, slowly the edge can be moved. In slowing down the process we get a chance to find the missing information that leads to the meaning of what is happening. (Baumgartner, 2011, p. 53) I see this awareness and attention to edges and emerging secondary processes as a Process-Oriented trauma attitude. Body and Roles in Trauma Each role has a related body experience. When in therapy, every role in a trauma field might come up in the moment, and probably at the same time. For example, a

73 traumatized person might identify more with a victim role, but her double signal could hold a perpetrator role in it, or if we follow tension in the body, we might find a protector role. Bystander could be coming up on the surface, like not caring much about one’s own feeling, or witness could come up on the surface by focusing attention on oneself. It is also dependent on a client’s story and how they talk in the narrative: Which role is on the surface in the moment, and between which roles is there some conflict, and so on. Mindell (2007) said that it is natural that roles switch from one polarity to the other, so awareness of where we are in the moment is the key. For instance, when much feeling is naturally coming up, I would think that a victim role is more on the surface. When a double signal in the body is very strong, a perpetrator role might be in the body signal which attracts our attention. Thinking about the roles in the field of trauma would be very useful, however we have to be careful not to forget trauma is unique in each individual, and each individual has its own recovering story from trauma. Here I explain about five roles and emphasize their connection to the body in a trauma field. Bystander. Could be seen in a cold attitude towards oneself or others. It could also show as apathy, helplessness, or dissociation. As each individual finds him or herself in the bystander position in a different way, the way it is experienced could be unique to that person. From my personal experience, I could at times find my bystander in my expression of face, or cold eyes. Witness. Probably with support from a therapist, this role came up as a sort of altered but conscious state like spaciousness. It could be connected to dissociation or

74 avoidance, but when those processes and states are handled with conscious awareness, it could turn into a witness. This role could be seen as beyond a physical body. This body is like pure mindfulness itself, pure observer, and pure witness. Victim. It is a role and body at the edge, showing flashback, dissociation, and freezing. Thinking about trauma recovery, this primary body is very important. This body and role is where lots of feeling comes through. Finding this role and body is the first step in the therapy. This role often has a deep inner process when unfolded. Protector. It could be found in body signals, especially double signals. I have experience from myself and with my clients, that some double signals help to connect a protector role and the body. When someone is in remembering mourning process, one might be crying at the same time as holding the body by oneself. In this double signal, mother role as protector is emerging. We could consciously connect this part of the body, which is very useful in the scene. Or when one is crying of his weakness, we might find strong fist at the same time. Here inside the fist might be hidden power. This type of protection is like a father role as protector. Mother and father who could protect them in the trauma scene, actually many times do emerge in the movement of one’s body. Perpetrator. This role and body could be seen in a double signal, and relationship channel in which it originally happened. This is a difficult process, but when one could feel safe enough to work on this role, it might be the time. We could try this role and its body with much awareness, and we could only work on dreamland and essence level, to really understand its role, body, and energy.

75 Using Therapist’s Body From Process Work theory, a therapist’s body is also one of the roles in the field. Body of a therapist, then is as important as a client’s. How a therapist could be aware of what he or she experiences in the moment could be connected to the whole process. For example, if I listen to a trauma story from a client who hasn’t recovered enough from it and still is suffering a lot, I might start to notice much compassionate feeling coming through my heart area, and almost tears coming through my eyes. I might be dreamed up then to be the missing role of protector as a mothering role. I could feel into my body sensation and connect to this role and share how I feel or consciously use this as a role of protector. My experience could be also that of a victim role in a client’s story and trauma field. Then it gives me a chance as a therapist to have deeper understanding of how the client suffers as a victim. It is connected to dreaming up theory. However, sometimes a trauma from a client could activate the therapist’s own trauma. For example, if I feel triggered by a client’s story, or if I couldn’t get out of cloudy feeling at a client’s edge, I could also be at the edge of my own trauma. Then I need to work on myself more around my own trauma. Client’s trauma and its process, in a way helps the therapist to be aware of unfolding the therapist’s process, too. In this way, trauma is not just a tragedy that the therapist should heal, but it also offers an opportunity for the therapist to grow.

76 Chapter 12: Deeper Meaning in Trauma and Spirituality Is trauma just a tragedy to overcome and recover from? I do not think so, and I believe it is a path of humanistic and spiritual growth. Herman (1997) says the recovery process would never finish. However, I agree with what Emetchi said, “Is growth ever finished?” If the recovery process never finishes, it is already not a recovery process, but it is growth. Levine (2008) states, “In order to heal trauma, we need to learn to trust the messages our bodies are giving us. The symptoms of trauma are internal wake-up calls” (p. 24). I believe trauma is a chance for us to wake up! As Levine (2008) continues, trauma is not just an irritating symptom, but, “You might, instead, be grateful that your body is sending you messages that healing needs to happen” (p. ??). Before really facing the suffering inside of us, who could listen to our body message? Who could really trust the messages from the body? As Levine (2008) explains, “virtually in every spiritual tradition, suffering is seen as a doorway to awakening” (p. 4), it is a spiritual path with heart. I am happy that mainstream psychotherapy is now coming closer to spiritual traditions and / or including mindfulness and the body into their therapy. However, when we differentiate a therapist, who heals someone, and a client, who should be healed, it creates a complicated situation. Reason is that person who heals might be the client. I explain here that therapist is also part of the field and that this role needs the client role. Both are roles in the dreaming field, and people are also connected with each other as a

77 community. If a client’s trauma is healed, it means he healed the field itself, or part of the field. As a therapist, I have experienced this many times. When my client recovers from their trauma, it somewhat affects me, and I feel that I am also healed. Who does not have suffering as a human being? Levine talks about Buddha’s teaching of four noble truths. First truth seems very important to listen to as a therapist, too. “The first truth, Buddha taught his disciples, is that suffering is part of the human condition. If we simply try to avoid confronting painful experiences, there is no way to begin the healing process” (Levine, 2008, p. 5). We need to know, Buddha is not talking to a patient or a survivor of trauma, but to every human being. People facing trauma might walk the spiritual path on their own, and people around them, even therapists, might come along on their spiritual path with them. Doorway to Dreaming As I have discussed, the body plays an important role in healing trauma. From the perspective of Process Work, then, trauma is a doorway to the dreambody, or dreaming. Mindell (1998) writes in Dreambody, “The basic message of dreambody work is that a symptom is not only a pathological defect in normal health, but a ‘big dream,’ a huge opportunity and opening to life never experienced before” (p. xxi). This body is not just a body to heal trauma or the body felt as subjective experience. It is more, that doorway to a larger space, possibility, dreambody. One starts to find connection to body,

78 oneself, and dreambody, which means finding a connection to relationship and world, as well. Community Process: Dreambody as a Field Dreambody connects us to a field. As Mindell (2010) says, everyone is connected to every relationship in the field. From a deeper Process Mind or dreambody perspective, even a perpetrator in a trauma field is a part of the role, and every role played there, and the field itself leads us to grow. Dreambody here expresses the energy of the world. Everything is interconnected in dreambody. It is a body, and at the same time, our world. Mindell (1995) states: In the new politics, social awareness relieves health issues. Many illnesses are not curable now because modern medicine is based on pathology—cause, effect and cure . . . . They are not only enemies but potential allies. They are expressions of world energies, timespirits, processes. . . . Your body reacts to the world. You need to know the body from the inside out. Then you realize it is like the world, full of trouble and timespirits asking for interaction. (p. 236). Working on the body and trauma is not just an individual healing process, but it is also connected to the world and its community process. I saw and experienced this connection many times from my experience in Process Work. For example, when I worked on my trauma from childhood in front of my classmates in Process Work training, I got great feedback from others. They told me that I worked for them, or that their own trauma had a great impact from my work, and many thanked me. It was at first very surprising, but it felt for me that trauma connected me deeply to others and outside in the world. I felt the same way when I saw others who worked on their trauma, and saw the community healing process happen.

79 Eldership The concept of Process Mind has another layer of possibility when I think about recovery from trauma. Discussing in depth about Process Mind is beyond this paper’s capacity, but I just want to mention a possibility. Safety is the most important aspect when working with trauma, and PM could help us to connect with this safe place inside of us. When we work on the field level of trauma, roles could have tension and conflict. Then connecting to the PM state could help to have detachment to work from PM perspective on the roles. It even helps to integrate the energy of a perpetrator. When one could integrate roles in the trauma field from the PM perspective, it would be not only great healing and development of one’s trauma, but could be meaningful to our community and world, since one’s body is not only individual, but really connected to the world. In his book, Mindell (2007) called our whole self as “big U,” and explained its somatic experience is coming in the form of dreambody. For most purposes, however, it would be a help if even one person in a hundred could actualize the U. Because of the U’s power, that one person, even without much social rank, can be helpful. Think, for example, of Joan of Arc. That young maid of Orleans listened to the voice of St. Michael and led France to survive impossible situations. (Mindell, 2007, p. 216) Working on the deeper part of our body, the many dimensions of the body, and trying to live in one’s body in a deeply democratic way, I believe, could bring great healing to the world.

80 Life Myth Process Work has an idea about one’s process to find our life myth, which is influenced by Jung. “Jung originally coined the term ‘life myth’ to describe a patterning for life-long personal development” (Diamond & Jones, 2004, p. 148). Jung found that dreams people had in their childhood revealed an archetypal or mythical pattern for a person’s life. Mindell extended this idea and suggested that pattern also could be seen in long-term experiences, such as chronic symptoms, illness, addictions, and relationship patterns. “A person can work with a life myth consciously and creatively, instead of being unconsciously propelled by it” (Diamond & Jones, 2004, p. 148). Since trauma impacts one’s life very deeply and stays there for the length of our life, from this perspective we could also see a trauma event and its impact as a pattern of one’s personal myth. It not only locates personal history in the context of a broader archetypal drama, but also adds a spiritual dimension to self-exploration by addressing questions such as: “Why I am here? What am I meant to learn or do? What is my purpose in life?” Viewing experience as part of a mythic pattern can relieve feelings of stuckness or failure that often accompany chronic problems. (Diamond & Jones, 2004, p. 149) If we could see trauma in this deeper and more spiritual perspective, trauma could be seen in different way. I am still on the way of exploring my own life myth, but it was definitely helpful for me to see my own trauma as a part of my life myth. Seeing it from this perspective, I am freer from the perspective of a victim of the event, and have a wider and larger view of myself. I offer a bit of my experience, for example. When I was a child, I continuously saw a terrible dream that I awoke in a coffin in a dream and became aware. I was not

81 dead, but nobody knew and I cried for help and fear. It is interesting for me that I could find the same pattern in my traumatic experience or my life itself. Part of me woke up in my life, that I became aware of feeling as if in the coffin in my own reality. In the training of Process Work, working on myself helped me to develop my own personal myth. I worked on really getting into the coffin and being buried consciously that could eventually connect me to a deeper meditative state or connect me to the earth, which helped me to come out of the coffin in a way. I also worked on a perpetrator like figure in the dream who buried me. It was a powerful experience, and I felt connection also with Japanese collective culture which sometimes buries an individual. Trauma is beyond our limitations, but because of this we could also expand our imagination to a larger thing, such as religion or any kind of spirituality. What makes trauma happen? It is not an easy way and sometimes it seems like a tragedy, but I believe having that kind of question to life is opening a doorway to spirituality.

82 Chapter 13: Conclusion Though writing this paper, I felt the mainstream of psychotherapy seems to really be coming closer to Process Work. I believe there are many perspectives that Process Work can contribute to other modalities. At the same time, though writing and researching, I learned a lot about trauma and other approaches that contribute to my ability and knowledge as a therapist. Process Work could also come closer to mainstream psychotherapy and learn from it. First motivation for writing this paper was that I wanted to compare Process Work and other approaches and find difference and connection to bridge those two sides, which are probably inside of myself, too. In the process of writing this paper, however, I discovered more about differences between Process Work and other approaches. I felt it is coming from Process Work theory that is in turn coming from different perspectives, especially on how to see the body, or seeing reality on three different levels. I found many useful resources when working on trauma and the body from other approaches like Rothchild, Levine, van der Kolk, Emerson, and Hopper. They talk about the body in the consensus reality level as physiology, and subjective experience. Process Work could share these ideas and I think we should learn more from them. Other approaches seem to me to be sharing the same field, and because of that, they could exchange their knowledge easily, which is probably difficult with Process Work. Part of me was reluctant to make that connection. Probably that is because Process Work went beyond so called psychotherapy, and developed into a broader

83 approach to groups, organization, world problems, extreme states of consciousness, and spirituality. I was tired of seeing trauma as just a symptom or tragedy to be healed and not to see a deeper meaning in it. This awareness helped me to not marginalize parts of myself. I learned a lot more about trauma which is important for me and needed. I also learned from what I wrote about where I am. I somewhat freed myself from my tendency of “should.” I “should” make some great academic paper, or I should research more to finish this program, and so on. I suffered a lot from this “should,” or inner critic, which is connected to my own trauma. Working on myself, I’m freer than before, and here is where I am in the moment. My history and my trauma led me here. The healing process for myself connects me to a deeper part of myself. Still, I am on the way of my process, and I do not want to lose this connection to myself.

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