INTEGRATION AND TRAUMA HEALING
by Wilfried Ehrmann
A psychological trauma is defined by an emotional injury or a strong shock caused by an extremely stressful event that cannot be processed and integrated. “A trauma is the interrupted breath,” writes Anna Walker. With the breath, the flow of life is abruptly cut off.
In trauma therapy, the concept of integration plays an important role – an integrated trauma is considered to be cured. What had fallen apart in the trauma has now been reunited.
Breath therapy is not a specialized method for trauma healing. There are many therapeutic methods and procedures around that deal explicitly with trauma and its healing. Yet, in a breathing process, trauma memories can emerge as images, thoughts or physical reactions. Sometimes the biographical context becomes clear, i.e. what happened and when; but sometimes there is no trace in the memory. For example, the body may show a strong defensive movement during the breathing process, and the person does not know who she is defending herself against. In these cases, it is important to have a conversation after the breathwork session, in which it can be explored what the origins of the defensive reaction in the past might have been.
The elements of the trauma reaction that arise in the breathing process usually find some form of integration: The traumatizing experience can be consciously experienced, the associated feelings can be felt and processed, and a deeply relaxed state can be achieved at the end. However, in order to heal severe traumatic experiences in a profound way, it is advisable to consult specialized trauma therapists and to check whether the integration experienced in the breathing experience is sustainable and lasting.
Characteristics of Trauma Integration
Integration in trauma therapy involves overcoming the internal splitting and fragmentation that occurs as a result of trauma and restoring the unity of body and psyche. This includes finding a place for the stressful events in one’s own life story and ensuring that one’s entire life has regained a continuous narrative thread, without gaps or blind spots. Even terrible events can be addressed in a conversation without strong emotions. There is an experience of unity both in the moment, in the self-relationship (vertical) and in the biographical perspective, with one’s own life story (horizontal).
In order for the divisions and dissociations resulting from the trauma experience to be reversed, the self-regulation of the autonomic nervous system must function well. The sympathetic nervous system is activated when performance and exertion are required, and the parasympathetic nervous system works when relaxation and regeneration are needed. Traumatic experiences are characterized by a disruption at the neuronal level, which manifests itself in freezing reactions (parasympathetic overreaction) and in excessive and permanent stress (sympathetic overreaction).
As they grow up, children learn to regulate their emotions and thus their nervous system, so that they are not helplessly depended on their feelings, but can modulate themselves if they react too vigorously and violently. This ability in affect regulation gets distorted and weakened by trauma. Only when it has been restored, the traumatized person can relax sufficiently and thus make the best possible use of their resources. Instead of constant tension and anxious alertness in a state of trauma, there is a life with a healthy ebb and flow of high and low arousal. It becomes possible to build balanced and loving relationships with others. A successful integration of traumas can also be seen in the ability to feel one’s own needs without pressure for immediate satisfaction. Memories of the terrible events can be recalled without strong emotional arousal.
At every moment, the breath indicates whether we are in a state of trauma. Then it becomes hectic and shallow or stops abruptly. At the same time, the breath offers the best way to regulate the autonomic nervous system through active inhalation and relaxed exhalation. Practicing breathing exercises, like coherent breathing, is a potent way to improve the self-regulation of the nervous system and to reduce stress levels. As a result, the nervous system increasingly acquires a balanced state by itself, which indicates the integration of the trauma at this level.
Technical Elements of Trauma Healing
A basic element of many methods of trauma therapy is that the client does not immediately deal with the full emotional charge of the trauma situation, but approaches it step by step, repeatedly reconnecting with resources and thus dividing the impact of the trauma load into smaller units that are easier to confront. In this way, the overload of the nervous system that was built up during the experience of the trauma gets slowly reduced.
In breathwork, the breath is the main resource that is always available. The facilitator can repeatedly draw attention to the flow of breath, verbally (“Feel your breath flowing as you experience these strong feelings”) or by simply breathing along with the client. In this way, the attention of the client alternates between the trauma charges and the source of vitality which is the breath. In this way, the process moves closer to integration.
The breath always provides an anchor that connects to the here and now and helps to distinguish the current experience from the past. Anchoring this distinction in the psyche is another important element of trauma therapy: back then, in the trauma situation, there was insecurity; now there is security. With this insight, the conscious cognitive parts in the frontal lobe can calm the aroused trauma memory in the limbic system.
As already mentioned, breathing also serves to strengthen the abilities in affective self-regulation. This ability consists of being able to feel and to hold emotions, i.e. to have free access to one’s inner experience and at the same time to be able to decide to express the emotions or to keep them inside. In the safe environment of a breathing session with a facilitator, the emotional energy bound up in the trauma is released for expression and thus reduced and dissipated. Emotional energies that could not be expressed in the trauma situation are now allowed to come out in all their intensity and then calm down. Often a trauma experience leads to numbness, to paralysis of all emotional impulses and to cutting oneself off from one’s own feelings. During a breathing session, the power of the breath can help to relax the emotional defenses that the body developed during the trauma to protect itself from painful emotions, allowing the repressed feelings to be released. The facilitator should make sure that the emotions are not expressed in too intensely so that the client gets overwhelmed. The therapist makes sure that the client does not completely get absorbed in the feeling by repeatedly bringing back the attention to the breath. This creates a distance between the person and the feeling and between the present and the past. These distinctions are crucial elements that contribute to the integration of past trauma experiences.
The therapy sessions often lead to progress in healing, which is then weakened by old experiences arising during everyday life. In breath therapy, we have an important and obvious recommendation at our disposal to help consolidate new experiences: the recommendation to again and again draw one’s attention to the breath and thus bring the awareness into the moment. With each act of returning to the momentary breath, the distinction between now and then is consolidated and the burden of trauma is further alleviated.
Adequate integration time
After a longer breathing session, the client needs time to come back to normal consciousness. It is advisable that the companion announces the end of the breathing process, e.g. ten or five minutes earlier. This also allows the client’s unconscious to prepare for the end of the session. Afterwards, there should be time and space for a verbal exchange and for feedback from the facilitator.
In order for the experiences to be well integrated, sufficient time is needed before the client can get back to her daily business. What “sufficient” means depends on many factors: the intensity of the breathing process, i.e. the depth of the feelings that were experienced, the length of the relaxation time towards the end of the session, and the personality of the client, to name the most important factors. In particular, after emotionally intense processes, the client should take enough time for herself after the session and after leaving the therapy room. The therapist should give this recommendation in such cases, along with the question of whether there is someone in the social environment to talk about any issues that may arise and to provide support when needed. If, in addition, there is the impression that the client is in a labile state after the session, but the time cannot be extended for practical reasons, the therapist can consider offering the client to contact him by phone or otherwise if she experiences problems with the integration. This offer conveys the security of not being left alone and of having the opportunity for competent support in case of an emergency; however, it should not give the client having the impression that she can call her therapist about every little thing.
The breath as a constant companion, day and night, year in, year out, offers us the chance to get in touch with ourselves and to stay in touch with ourselves by paying attention to it. This is the most important advice that the facilitator can give to her client. She can always take advantage of this offer, which is granted to her by her breath, when she feels that she is losing herself or gets overwhelmed by feelings. The breath will guide her back to her strength and relaxation as soon as she takes time for it.
