When we talk of “healing” it often conjures up many preconceptions– from the most practical (e.g. a cut), to the most esoteric (e.g. a deep psychological scar). When it comes to “trauma”, the healing process encompasses the whole range, from the deepest spiritual recesses to the most obvious physical aspects. In the deepest and most profound trauma, the body, mind and spirit all suffer.
Jean-Pierre Baral and Alain Crobier. TRAUMA – An Osteopathic Approach, 1997 pp.92-93
R. PAUL LEE DO, INTERFACE – Mechanisms of Spirit in Osteopathy pp.211-212
The Eight Steps of Healing
“Trauma can be defined as an injury or wound, whether physical or psychic, caused by an extrinsic agent.”
(Baral et al TRAUMA.An Osteopathic Approach pp.5).
An inherent property of this dynamic interaction is the capacity of the individual for the maintenance of health and the recovery from disease.
Many forces, both intrinsic and extrinsic, can challenge this inherent capacity and contribute to the onset of illness.
The musculoskeletal system significantly influences the individual’s ability to restore this inherent capacity and therefore to resist disease processes.
American Osteopathic Association
When we speak of “trauma” it is generally associated with circumstances which are beyond the person’s control (unexpected), that tend to be violent in nature (a blow, an accident), that are not circumscribed by time (can occur from an instant to an eternity). When these align the result is pain and suffering. Without the resolution of “what has happened”, there can be no resolution of trauma, no healing process. So what are the eight steps of healing?
“Belief” is the beginning of healing. Without the fundamental belief in one’s self (I can heal), the process and the practitioner there is simply no where to go. What has been damaged without the belief to heal, will remain damaged.
As difficult a place as this is for the traumatised person, without being able to envision a place other than their pain and suffering, this leaves them without recourse.
STANLEY KELEMAN, Your Body Speaks Its Mind pp.170
Healing requires a commitment to the very idea that one can and will get better. It also requires a commitment to the process of what it takes to get well. This is not easy to ask of someone who has suffered a deep trauma, but without this the person comes to a place where they will “try” to get better. “Try” is a potential precursor for failure in that should the going get tough (and it will), the idea of quitting is all right in that “I tried”.
“Trust” is related to “belief” in that it involves a faith in self as well as the process. “Trust” is not easily attained but is earned through the practitioner and what they do, as well as the impact this has upon the victim.
“Knowledge” occurs on many levels. The deepest knowing is that place we come to, where we have an understanding of what has occurred, what has changed, what we have lost (or gained). This is a profound place for it reflects an understanding of “spirit” rather than that of “intellect”. In a nutshell, trauma changes us. When someone talks of nightmares, or night terrors, or panic attacks, or some fundamental change after having sustained trauma, that person needs to come to an understanding of what has occurred. Without this place there is no healing process. Here, “knowledge is power” has never been more true.
Another aspect of” knowledge” is the knowledge of the practitioner. From this perspective, the starting point is always to identify what one is really looking at. What happened? What do we see in the physical plane—how do they move? What is obvious? Where do they have pain? What assymmetries do they have? How do they communicate? How do they sound? The whole point here is that we have to create a rapport and “safe place” for the trauma victim. No healing will ever occur if the person who, having sustained a profound hurt and trauma, finds themselves in a place of “no confidence”. This is a journey and the practitioner is the guide as well as the catalyst.
5. Love and Compassion
This is probably the most articulated perspective. Still it remains one of the fundamental truths. Often, we find that after a profound trauma, people can sustain a loss of such magnitude that the very idea of there being such a thing as “love”, and that it might still be available to them , is completely foreign.
For example, “Jack”, after bidding a fond and loving farewell to his four year old daughter and expecting wife, went to work, as usual, one morning. All was normal and as usual, he was entertaining all sorts of ideas as to the forth- coming babies. The kind we all indulge in- the colour of the walls of the new room, where the cribs would go—the mundane and happy thoughts we all have from time-to-time. What occurred that morning would shatter Jack’s life forever. His pregnant wife, babies-to-be and little daughter were all killed in a freak accident on their way to the grocer. Jack was left bereft and such pain that all he could do for some time was to “scream at God”. Combined with this he was left with many “what ifs”—“if I had done this” or rather have “done that”, “why did I not say this or that?” The guilt and recriminations were all enormous. He was inconsolable.
The work with Jack has been, and continues to be, some of the hardest we have ever experienced. How do you console the inconsolable? How do you start the process of healing in someone so bereft as to be locked in a terrible anger and rage? A rage so consuming that just the sheer act of getting out of bed in the morning is a major act of courage? As a practitioner the answer for us has always been, and will always be, “love and compassion”. In essence you have to like people and be prepared to do whatever it takes to move them from pain, suffering and trauma to a place of healing. Yes, we need the expertise to identify what is wrong in body, mind and spirit, and have the further expertise (or access to it) in order to facilitate the process. However without being able to “place” that person in a space of safety, love and compassion, there is no ability on that person’s part to heal. One has to realise that when people have been severely traumatised (soldiers with post traumatic stress syndrome, for example), they are hyper-aware and hyper-responsive to an unsafe environment, even those who initially present little or no reaction. The whole point of the process is to allow the person to let their guard down so that they might begin to allow their pain and suffering out.
“A psychic reaction to trauma affects the deepest part of the victim’s person, while an emotional reaction is merely a manifestation in response to the problem. In serious cases, the emotions and the psyche interact.” Baral et al pp.159.
So what of “Jack”? To understand what happened to him is to understand the depth to which trauma goes. Physically there was no assault upon his person, emotionally or spiritually, however, the trauma was immense. What Jack experienced was a loss so great that it divided him from himself, as well as from his perceived Maker. No Jack was not by nature a religious person. The kind of separation we are talking of is a spiritual one. We see this time and again in the sustaining of trauma. In Jack’s case he experienced his loss as a senseless, inexplicable, and vindictive act. He continually asked ‘Why? Why? Why? He continually directed his rage at what he perceived to be his Maker. He continually screamed his rage at the top of his lungs demanding of God an answer. Given Jack’s circumstances, he is no different from anyone of us. The loss of love is by far the most traumatic thing we can experience. Truly, there are no atheists in a foxhole.
The human being has need of explanation. Whether this comes in form of a “spiritual kick to the head”, an epiphany so profound as to change one’s life, or whether we have to delve into some learned tomes looking for an answer. Either way, we are looking for an answer, some kind of an explanation as to what has happened. Trauma is a puzzle, both for the victim, as well as for the practitioner.
For example: “Brian” was a carpenter who fell some two stories onto the sidewalk, sustaining injuries that were almost beyond belief. The very first question he was asked-
“How are your nightmares?”
“How did you know I was having nightmares?”
Inadvertently, he had just been asked the question. It seems in Brian’s case, of all the injuries he had sustained, it was not the broken bones (and there were many), it was not the torn tissue or ruptured tendons (and there were many), it was the fact that he was terrified to go to sleep at night. Of course, this lack of sleep exacerbated everything. Without sleep pain is that much worse.
“I know, this sounds like a stupid question, but why do you think you are having nightmares?”
“Man I don’t know, but it’s like I’m going to die, you know.”
“Do you ever die in your nightmares?”
“No, shit, I always wake up screaming”
What Brian had just articulated was something we have come to see often in trauma. The specter of death. That people survive tremendous trauma always leaves an indelible stamp on them. The very fact that they have survived against all the odds, leaves them, at the deepest level, in a limbo of the spirit. It is almost as if they have experienced this death that they should have had, without actually physically doing so. In a sense they are caught in that space between life and death, in a space between what “was” and “is”. There is a continuous feedback between the unconscious and the conscious- an ongoing dialogue that never stops. It is only when they come to understand this, that this traumatic schism can be healed. In Brian’s case we were fortunate in that we asked the question that went to the core of his problem. In doing so, immediately a rapport was struck and we were able to move rapidly from this point. We are not always so astute or lucky and sometimes (as in the case of Jane) it takes a long and rough time in coming to that understanding.
In passing, when we talk of “understanding”, it is not enough for the person to “get it” at an intellectual level. This “spiritual tear” can only be repaired at the level at which it has occurred. In other words, the healing required has to occur at the appropriate level.
So what does this mean?
Well, firstly, when John Upledger talks of a traumatic injury as an “injection of energy”(SomatoEmotional Release, pp.25), people who have experienced trauma instinctively know this. Many times we have been told by the victim that “I have not been the same since…” Secondly, knowing this, the traumatically instilled energy has to be released. And that means, in turn, they have to, in some way, relive this trauma. What goes in, has to come out. Herein is the crux of the matter. All that “chaotic and disruptive” energy that has been incorporated in the body, in the mind, and in the spirit- all have to be released.
Yes, we know that this has been written about until the cows have come home, but it is and will always remain one of the major aspects of healing. “Forgiveness” is a very peculiar thing. People go through their lives without the realisation that the act of forgiveness is not simply an act of contrition but a condition of “release”, so to speak. This is especially true for trauma. In Jane’s case it was not only the forgiveness of mother, but the forgiveness of self that was part and parcel of her healing. So too with Jack. It is a strange and terrible thing to have something so powerful happen to you that your life becomes a painful parody of what it used to be. That there needs to be a reconciliation with what has happened, as well as with who and what you have become, is non-negotiable. No forgiveness, no movement. No movement, no release. No release, no healing.
8. Practice and Application
When it comes to the actual work of dealing with trauma, we use a number of modalities, ranging from naturopathy to neuromuscular therapy to osteopathy. Quite candidly, “trauma” demands an ever evolving practice and we continually are questioning what we do. Bear in mind that each human is an accumulation of unique experiences and when trauma enters the picture it confounds that particular person.
So… What do we do?
In our clinic we have a long passageway through which a person has to walk down. This allows us to evaluate a lot of variables. For example- How do they move? Is there anything blatantly obvious? Is there something they are not doing? What is their pallor? Is there anything that strikes us on an intuitive level? This is all before we sit down and interview them. The tool of observation is always the beginning of any process. Often, once we begin the interview, we find that the person provides “meat” to the “bones” that we have already discovered. Also do not underestimate your other senses as a practitioner. Abigail (a nurse with many years of emergency practice) once trusted her sense of smell in detecting a septicemia in a post- birth woman. Left undetected the consequences would have been rapid and dire.
Once we have completed the “detective” stage, in the case of trauma, all things being equal, the person is on our table. Generally, the body is the place to begin for, within and without, it is the sole repository of all that has happened. It is the only source and access to that person. It sounds ridiculous to say this but what someone brings into the clinic is all that they are – the hidden and the obvious – it is all there.
Palpation and Communication
Fundamentally these are the same things in that we are talking to the person and at the same time listening to what the body has to say. A communication that is both verbal and non-verbal. Finding out what the body is doing. Finding out what moves and what does not. Finding out what should move and does not. Finding out what does move and should not. Finding out where there is pain. The list is endless but it is always an ongoing balance between what is presented against a template of what ought to be. In other words- What is going on and what to do about it? Above all, learn to palpate. Learn to listen.
The scope of this paper does not allow an in- depth look at the techniques we use, but when it comes to trauma, we can never know or learn enough. However, one of the fundamentals is learning how to palpate the Primary Respiratory Mechanism (PRM).
What is this?
This all begins with an osteopath by the name of William Garner Sutherland who whilst being a student in the late 19th century, had an epiphany whist examining some cranial bones. In looking he found beveled articular surfaces in the sphenoid bone. In an instant he concluded that these bevels “indicated [an] articular mobility for a respiratory mechanism”.
( Sutherland , A. With Thinking Fingers, quoted in R. Paul Lee, op cit pp.128)
Bear in mind, what we are talking about is the concept of “bony motion”. Mobility in the skull! Such a revolutionary idea! Even today this is still an heretical statement. According to the mainstream, our craniums are solidified, almost immobile masses. How cerebrospinal fluid is supposed to move against gravity is relegated to the province of…?
What Sutherland did was to define “ five aspects of the primary respiratory system, or the craniosacral system. These are 1)the inherent fluctuation of cerebrospinal fluid, 2) the motility of the central nervous system, 3) the “reciprocal tension membrane”, 4) the mobility of the cranial bones at the sutures, and 5) the involuntary movement of the sacrum between the ilia.”
(Roger Gilchrist. Craniosacral Therapy and the Energetic Body, pp. 24 – 25)
As one can see this is a respiratory system not of air, but of liquid – the cerebrospinal fluid. Why Sutherland called it respiratory refers more to its action of inhalation/exhalation – indeed – this is sometimes referred to as the “tide”. More so, Sutherland pointed to something far more profound when he spoke of this as also being the “breath of life”. Now for him this carried extensive implications, which covered from the most spiritual to the most practical. In practice what we know is that when one palpates this rhythm, one is also able to discern how strong or weak it is. It provides us with information as to how healthy this person is, or is not. In a sense we are feeling the “potency”. Do not forget, this system encompasses the brain and the central nervous system, so, it does not take much imagination to see that anything that would affect such a system must, and does, produce profound effects and changes. When huge and unexpected amounts of energy explode into the body (e.g. a motor vehicular accident), we are talking of a liquid medium that conveys shock very well (e.g. hydraulic brakes). This impact on very fine and delicate membranes (the brain and spinal cord) is horrifying even in what are considered “mild accidents”. This is what we are, in essence, palpating. It is a starting point to something that is deep within us. What we are palpating is trauma.
As mentioned above, we practice many modalities. Our experience has shown the use of osteopathy, John Upledger’s CranioSacral Therapy, Paul St. John’s Neuromuscular Therapy, and Naturopathy, have all proven invaluable in resolving trauma. This is not to say that other therapies and modalities are not effective. Regularly we refer to psychiatrist and psychologists and various others, however trauma is as much about the physical , as it is about the mind, as it is about the spirit. The eight steps of healing is a small part of what we do, however we cannot emphasise enough that trauma requires a global approach without which our current paradigm is doomed to stagnate and fail.
- BARAL, Jean-Pierre & Lain Crobier. TRAUMA – A Osteopathic Approach. Eastland Press 1999.
- DiGIOVANNA, Eileen L. & Stanley Schiowitz. An Osteopathic Approach to Diagnosis and Treatment, 2nd Edition. Lipponcott – Raven 1997.
- GILCHRIST, Roger. Craniosacral Therapy and the Energetic Body. An Overview of Craniosacral Biodynamics. North Atlantic Books 2006.
- KELEMAN, Stanley. Your Body Speaks Its Mind. Center Press 1981.
- LEE, R. Paul. INTERFACE– Mechanisms of Spirit in Osteopathy.Stillness Press 2005.
- MAGOUN, Harold I., Osteopathy in the Cranial Field, 3rd Edition. The Journal Printing Company 1976.
- UPLEDGER, John E. & Jon D. Vredevoogd. Craniosacral Therapy. Eastland Press 1983.
- UPLEDGER, John E. SomataEmotional Release Deciphering the Language of Life. North Atlantic Books 2002