Uncovering the Truth About Your Codependence: A Review of Facing Codependence by Pia Mellody

The words “codependency” and “codependent” are becoming more commonly used to describe a person who has an intense drive toward people-pleasing, often to their own detriment.  Increasing numbers of therapists are advertising themselves as experts on codependence, and individuals are self-identifying with the team more readily.  But what does this term mean? 

Pia Mellody, the author of Facing Codependence, defines codependence as a series of symptoms that indicate an intense focus on controlling relationships and a lack of awareness of the self, both of which have likely been perpetuated by abusive situations in the past.  These symptoms include difficulties with, “experiencing appropriate levels of self-esteem, setting functional boundaries, owning and expressing their own reality, taking care of their adult needs and wants, and experiencing and expressing their reality moderately.”

While codependence is a common topic in addiction recovery circles, I believe that many people, including addicts, recovering partners, and those without an addiction history may struggle with some forms of codependency perpetuated by their experiences in family-of-origin or even in our culture as a whole.

In Betrayed Partners

Codependence has been used synonymously with “co-addiction,” proposed to be the illness partners of addicts experienced as an addiction to their addicted partner.  Fortunately, there has been a movement away from this labeling, as it can inadvertently blame the betrayed partner for the addict’s behavior.  Yet for many individuals whose behaviors led them to be labeled as “co-addicts,” more subtle forms of codependence were likely at play.  Codependence symptoms such as low self-esteem, difficulty moderating emotions, and trouble maintaining appropriate boundaries can all show up in traumatized partners.

While not all betrayed partners are also codependents, the symptoms associated with codependence can exacerbate the experience of pain and trauma of being betrayed.  The origins of codependence symptoms originate in family-of-origin trauma and painful experiences in childhood.  It may be helpful for partners to explore the symptoms of codependence and discern whether or not they occur and/or have roots in family-of-origin trauma.

In Addicts

Addicts are likely to have codependence as a factor that led them to addiction in the first place.  Often addicts have a history of abuse or trauma, which leads to maladaptive coping through addiction.  In order to deal with the pain of the past trauma, addicts turn to their drug of choice, masking the intolerable reality of the abuse they experienced.  In sex addiction, for example, sexual connection is used to manage this emotional state, which inhibits true intimacy and creates an unhealthy dependence on sexual experiences to feel “okay.” 

Symptoms of codependence that are relevant to addicts include difficulty setting boundaries, inability to meet needs and wants in healthy ways, and difficulty owning and expressing their own reality.  These can show up in deception and denial.  Boundarylessness leads to justification of their actions.  Sometimes self-esteem issues can show up as arrogance or grandiosity instead of low self-esteem, which fuels addictive behavior through entitlement and minimization.

What about you?

Do you struggle with codependency?  Whether you are an addict or betrayed partner, it may be beneficial to review common symptoms of codependency in a codependency assessment or through reading Pia Mellody’s book Facing Codependence. 

Facing Codependence

Pia Mellody’s extensive research in treating codependency, as well as her own experience recovering from it, has equipped her well to share information about codependence and the first steps toward healing.  Facing Codependence includes practical information about the disease and wraps up with where to start in recovery.  It incorporates awareness of how codependence correlates with addictive behaviors, and how recovery programs can help.  She normalizes the experience of codependency through many examples, both personal and clinical.

Often one of the hardest tasks for codependents is facing up to their past.  One element that they find challenging is labeling parents’ or others’ behaviors as “good” or “bad.”  However, Mellody’s facilitates this exploration through encouraging the label of “functional” and “dysfunctional” behaviors instead.  She also addresses misgivings people have about calling their parents to account for their mistakes because they need to defend or minimize their own mistakes with their children.  Instead, Mellody tells codependents that the best gift they can give their children is working their own personal recovery, and that without acknowledging their own hurt, they will be unable to create lasting change in their families.

“In a functional family the members know that EVERYBODY is imperfect.”

— Pia Mellody

While this book doesn’t get into a full recovery program, it does offer some beginning steps and points toward an additional resource Mellody has put out, a companion workbook called Breaking Free.

Why I Recommend This Book

More comprehensive review of symptoms of codependence

As listed earlier, the symptoms of codependence include difficulty with appropriate levels of self-esteem, setting boundaries, owning your own reality, meeting wants and needs appropriately, and expressing reality moderately.  Mellody gives deeper descriptions of these symptoms with in-depth explorations of their consequences and origins.  She also explores experiences that hint at these symptoms, such as high intensity of emotion or complete lack of emotion, as signs of codependence.

Understanding these symptoms can be incredibly normalizing for you, as you explore how they developed and know that you are not alone in facing them.

Includes less-than-nurturing experiences

To further normalize your experience, Mellody broadens the definition of abuse to include any “less-than-nurturing” behavior your family or others may have displayed.  This helps those who haven’t had any serious or extreme abuse understand the presence of their codependence symptoms.  Mellody includes not only signs of overt abuse, but also neglect or other covert abuse behaviors that may have been at play.

For many people, taking a critical look at their family-of-origin and harm they may have experienced is nearly impossible, as they prefer to believe they had a “normal” or “good” childhood.  This is where the language of functional and dysfunctional behaviors comes in handy, rather than labeling them as “good vs. bad” behaviors. 

“...looking at our histories, identifying the specific incidents about which we had our original overwhelming feelings, and finding a way to own and release those feelings can bring freedom from the sabotaging cycle that makes our lives so unmanageable and painful.”

— Pia Mellody

Prepares you to explore your own history

In advance of outlining various types and examples of abuse, Mellody warns the reader about defense mechanisms that arise to protect against facing up to the reality of what happened to us.  Exploring these defense mechanisms first encourages more openness to understanding where your story fits within these categories. 

She names and defines such defenses as denial, minimization, repression, and dissociation and expresses how they protect you from facing the realities of your past.  This prepares you to delve into your own history with awareness of how you might protect yourself against looking at the truth.

Encourages exploration of your story

Mellody describes five different categories of abuse: physical, sexual, emotional, intellectual, and spiritual abuse.  In these chapters, she gives a variety of examples and invites you to consider your own experience in comparison.  She emphasizes the need to explore this history, not as a way to dump all the blame onto your past, but to allow parents or caregivers to be accountable for their actions, as well as encouraging your own accountability for present-day behaviors.

Mellody identifies how these less-than-nurturing experiences have influenced your feelings of shame, motivated by what she calls the “shame core.”  Shame can be helpful in that it reminds us of our imperfections and fallibility.  But when caregivers act in shameful or abusive ways toward children and don’t take accountability for those actions, they can pass along that shame as “carried shame” into children, leading to repetition of abusive patterns.

An interesting claim Mellody asserts is that all abuse is spiritual abuse because of the impact it has on relationship with God, or a Higher Power.  For those who are Christian, this can be an eye-opening experience of why it has been difficult to trust God or believe certain truths about Him.  Also, for those in recovery, it can explain why surrendering to a Higher Power feels impossible.

First steps to recovery

In the last chapter of the book, Mellody lays out some basic, practical tools to get started in your recovery journey.  These early steps include such actions as getting involved in a 12 Step group, finding a sponsor, working the 12 Steps, and finding a counselor with an understanding of codependence.  While this isn’t a comprehensive recovery plan, she does point to the companion workbook Breaking Free to provide a more in-depth approach.

Getting involved in a supportive recovery community and using resources to work through the 12 Steps can help you put action steps into practice that will actually change your experience.  This will allow you to begin to set healthy boundaries, which are essential to recovery from codependency.  Your work in these groups will also encourage and help you to look for ways to re-parent yourself so that you can change the ingrained patterns of thought and behavior from the trauma.

Pia Mellody’s Facing Codependence is a great starting point that I would recommend to identify and begin to explore your own codependence, as well as point you in the direction of some tools and resources to continue on your journey of healing.

The ACT Matrix: A Map to Awareness and Empowerment for Change

Imagine you wake up in the morning full of energy, looking forward to what you have planned for the day.  As you step into the kitchen to make your coffee, you think of the big presentation you have coming up for work.  Suddenly, you start feeling afraid and nervous as you imagine everything that could go wrong.  Thoughts of insecurity begin to flood your mind: “I can’t do this.  I don’t know enough to give this presentation.  This is going to be a disaster.”

The energy you felt getting out of bed is draining fast.  After pouring yourself a cup of coffee, instead of tackling your emails or the tasks you had planned to complete in the morning, you end up sitting on the couch and scrolling through Instagram.  Maybe you give up on the coffee altogether and go back to bed.  Or you pick a fight with your spouse when they walk into the kitchen to let out some of the stress and anxiety you’re feeling.

Later in the day, you think back and wonder, “How in the world did that happen?  My morning was going great, and then everything fell apart so quickly.  Why does this happen to me?”

Oftentimes, we find ourselves in frustrating patterns of behavior that make us unhappy, but we’re not quite sure how to change them.  Often these concerns lead people to seek out counseling.  They know there’s something wrong, but they just aren’t sure how to fix it.

Luckily, there is a tool for making sense of these thoughts, behaviors, and feelings: the ACT matrix.  It is a guide to seeing your behavior within the framework of what inner and outer experiences move you toward or away from what really matters to you.

The ACT Matrix

The ACT Matrix was developed out of Acceptance and Commitment Therapy (ACT), which emphasizes the balance between acceptance of your current reality (supported by mindfulness and self-soothing strategies) and commitment to change what is within your control (supported by behavior change strategies and skill-building).  The goal of this framework is to move toward change with compassion and self-understanding, integrating nonjudgmental awareness and making peace with challenging emotions and experiences.

The ACT matrix tool was developed as a way to visually represent this framework.  It was created by Kevin Polk, Jerold Hambright, and Mark Webster for use with trauma and addictions.

Credit: Dr. Kevin Polk

The matrix helps you see the function of your behaviors, or how and why they work (or don’t work) for you.  Understanding these foundations can help you take a more holistic, compassionate, and long-lasting approach to change.

The Horizontal Axis: Moving Toward vs. Away

Looking at the diagram above, you’ll notice a horizontal line with the labels “toward” and “away.”  This axis represents how we move in each of these two directions.  We have hard-wired biological responses that move us toward things that feel important to us and away from potential threats or what we do not want.  Consider the instincts of animals in the wild: they move toward things that provide something they need (food, shelter, other animals of their kind) and away from threats (predators, wildfires, humans). 

The Vertical Axis: Inner vs. Outer Experience

As humans, however, we don’t live our lives purely on instinct.  We can observe and respond to stimuli that are outside of ourselves, but we also have a vibrant inner world that influences and shapes our responses.  We can use reason, control impulses, make decisions, and weigh options.

The vertical axis on the diagram represents this shift between our inner and outer worlds.  Our outer experiences are things we do that other people could observe, including behaviors or actions.  Our inner experiences are what happens inside our mind and body: thoughts, feelings, sensations, decisions, etc.

In every moment of our lives, we exist somewhere on this vertical line.  Either we are more connected to our internal world, absorbed by the thoughts and feelings associated with it.  Or we are more connected to the outer experience, what we’re doing or what’s happening around us.

The Matrix as a Road Map

Consider that each of these axes are a continuum.  Rather than living in all-or-nothing, this matrix provides a road map to identify what can move you closer to one side or the other.  There are a range of possibilities to explore along each of these lines.

Creating Your Matrix Map

Now, let’s consider how you can reflect on your personal values to fill out this road map and identify what patterns are keeping you stuck.  We do this through a series of four questions that guide you to identify how you are moving toward or away from your goals, and how your internal experience as well as your behavior play a role in that dynamic.  Let’s start with the bottom right quadrant.

Quadrant 1 (bottom right - moving toward, inner experience)

What matters to me?  What is important to me?  What values do I hold?

Write a list in this quadrant of what is most important to you.  Aim for about 4-5 people, things, concepts, values that are most significant.  Reflect on what they mean for you.  For example, if one of your values is “happiness,” consider what your ideal picture of happiness would look like.

Quadrant 2 (bottom left – moving away, inner experience)

What thoughts, feelings, urges, or other internal experiences get in the way of living into those values?  What limits me from being able to have what is important to me?

Reflect on the internal experience that gets in the way of the full expression of those values.  Perhaps your lack of confidence prevents you from being able to date and pursue marriage, which is valuable to you.  Maybe you feel bouts of intense sadness and grief over the loss of a loved one, which is preventing you from living out your goal to achieve at work or pursue friendships.

Quadrant 3 (top left – moving away, outer experience)

When I have the thoughts and feelings in quadrant 2, what do I do?  How do I respond in observable behaviors?

Now it’s time to see how these thoughts and feelings influence your behaviors and how you respond.  These may include attempts at coping with the troubling internal experience, for better or for worse.  What you’re looking for here is anything that moves you away from what is important to you.  For example, you may find yourself overeating every time you feel lonely.  Or you drink more when you’re dealing with a storm of insecure thoughts. Perhaps you withdraw and isolate from others when you’re feeling lonely or rejected.

Quadrant 4 (top right – moving toward, outer experience)

What can I do to move me toward what is important to me?

The ultimate goal of this guide map is to help you brainstorm and define ways to increase movement toward the things that are important to you.  By reflecting on the first three quadrants, you may be able to clarify for yourself what behaviors support your values and goals.  You might identify initiating a date with your spouse as an action that moves you toward intimacy in your marriage.  Or you might include exercise or getting more sleep if one of your values involves health and fitness.

Feedback Loops

Often where we get stuck is in the interplay between quadrants two and three.  Look at the behaviors you listed in quadrant 3.  When you engage in those behaviors, how do they impact your thoughts, feelings, urges, and inner experience?  Typically, they either reinforce the internal experience that’s already happening, or they create another inner dynamic that moves you away from what you value.

When we have an inner experience that is challenging, distressing, or painful, we respond to that experience with behaviors that reinforce it and send us back into the pain.  No wonder we find ourselves stuck in those loops!  But there’s good news: once you’re aware that this feedback loop is happening, you can change the way you interact with it, often by using the behaviors involved in quadrant 4.

Compassion

One strength of the ACT matrix approach is looking at these behaviors with a nonjudgmental lens.  When you see where they fit on this road map, you can identify how they function. All behaviors have a function and work to serve that function, even if they seem confusing or counterintuitive.  Another way to explain this is that everything you do works for you in some way – otherwise, you wouldn’t be doing it.  What you need to ask yourself is what function that behavior is serving in your life.

For example, if you find yourself endlessly scrolling through social media, perhaps that behavior is serving a numbing function.  Maybe it is a way to feel connected when you’re isolated from loved ones.  Or perhaps it’s a springboard for creative ideas.  Each of these potential functions (and sometimes a combination of several) drives and motivates this behavior. 

Seek to offer kindness to yourself and explore where you are on the continuum without judgment, exploring where you might want to go and what steps you can take to get there.

Agency

Some versions of this matrix include a circle at the center that overlaps all quadrants.  This circle represents you as the observer, becoming aware of the system of thoughts, emotions, and behaviors that influence you.  Awareness of the system can lead you to reflect on what’s in charge of the systems in place: for example, who is in charge of choosing what’s important to you (quadrant 1)?  Who is having these thoughts and emotional responses (quadrant 2)? Who is acting on these behaviors in response to the thoughts and feelings (quadrant 3)? The answer to all these questions is you.

This demonstrates how much agency you have over these areas of your life, empowering you to change.  If you are the one in charge, then you are the one capable of creating change in your life.  You can become aware of the feedback loops in your life and explore alternative options.  You can learn new skills to move you toward what is important to you.  Even small changes like intentional mindful breathing can shift your experience between your inner and outer world, demonstrating the control you have over your moment-by-moment experience.

Spend a day observing your movement on this ACT matrix: how your thoughts and actions influence how connected you are to your inner or outer experience, or how much you are moving toward what feels important or moving away from it. Become more conscious of the behaviors that move you toward what matters to you and to reduce the intensity of the feedback loops you experience.

If you find yourself noticing these patterns but still feeling stuck or unable to change, that’s where a good therapist can help you work through those stuck points. 

Additional ACT Matrix Resources

• Kevin Polk, one of the creators of the ACT Matrix, has trainings to understand this concept further through his ACT Matrix Academy.

• Mark Webster, another contributor to the matrix, has a three-part YouTube series demonstrating how it works.

• Jacob Martinez, an ACT matrix trainer, has resources at his ACT Naturally website.

EMDR’s Resourcing Tool: A Support in Challenging Situations

All of us have difficult conversations or tough people that we need to face at some time in our lives.  It could be a confrontative conversation with a boss, a tense conversation with a spouse or family member, or walking into a stressful or anxiety-inducing situation.  For an addict in recovery, you might notice triggers that propel you into a desire to act out in your addiction.  For those with trauma, re-engaging with a person, place, or circumstance that is associated with your trauma may lead to fear and anxiety as it brings the memory flooding back.

How can you walk into these challenging moments with a greater sense of confidence and courage?

EMDR, or eye movement desensitization and reprocessing, is a commonly used treatment for PTSD and complex trauma.  Part of the process of EMDR involves bringing awareness to past traumatic memories, which can feel scary or uncomfortable.  Because of this, before the processing of memories begins, you’ll be prompted to create what are called resources.

These resources associated with EMDR are not only effective for preparing you to face uncomfortable, scary, or painful memories.  They can also help you prepare for everyday moments of distress in the present and future.

What are resources?

Resources are places, people, feeling states, animals, objects, etc. that you hold in your imagination to create an internal emotional shift.  For example, a commonly used resource is peaceful place visualization, in which you imagine a place that feels calm and peaceful for you.  Other resources can include supportive figures in your life, such as a nurturing caregiver.  You may also find resources in character qualities or traits you display or have observed in others.  By connecting to these resources in an imaginal capacity, you can connect to the emotional and physical experience of them. 

In EMDR, we couple the imaginal connection to these resources with bilateral stimulation (BLS).  These could be the back-and-forth eye movements associated with EMDR but could also involve tapping alternate sides of the body.  In her book Tapping In, Laurel Parnell teaches strategies to “tap in” these resources using BLS, and much of the resourcing work in this article comes from her work.

Resources are important in EMDR because they can increase your confidence when facing memories, as you know you have your resources as support available to you internally.  In everyday life, resources can help you transition out of a traumatic memory or painful situation.  They can be accessed in your imagination in the present when you notice yourself beginning to spiral into negative self-talk, distressing emotions, or self-destructive behaviors.  They can prepare you for future situations in which difficult emotions or experiences might arise.

How to Find Your Resources

Now that you have an idea of what resources are and when you might need to use them, let’s explore using your imagination to create some of the resources. 

Peaceful, Calm Place

Bring to mind a place that feels peaceful or calm to you.  It can be real or imaginary – a beach, a river, a forest, a room in a secluded cabin – whatever works for you.  Notice what you see, hear, smell, taste, and feel in that place.  Connect to any emotions that arise or sensations you feel in this imagined place.  You’re trying here to connect to the emotional experience: the right-brain, felt sense of the place.  What’s most important isn’t getting the imagery perfect but connecting to the emotional experience of peace or calm that the place evokes.

If you notice your mind going toward the negative and/or your emotions head in that direction, remember that this is your personalized place.  You can control the weather, who is there, whatever you need.  Alter your imagined place until it truly feels peaceful to you.  If that is too challenging based on triggering factors related to that place, consider switching to a different place.

It might be helpful to journal through this or other resources to further solidify the connection to this visualization.  You can read through this journal later to re-connect to the sensations.

Supportive Figures

These three types of supportive figures (nurturing, protective, and wise) are based on Dr. Laurel Parnell’s resourcing work in her attachment-focused EMDR approach.

Nurturing figure

Imagine a person, animal, or symbol that carries a nurturing quality.  It can be fictional or real.  You don’t have to imagine that figure nurturing you: instead, be able to observe a nurturing quality to it.  Pay attention to the sensory experience of observing that nurturing and notice how it feels in your body and the positive emotions it stirs up for you.

Protective figure

Like the nurturing figure, imagine a real or imaginary person, animal, or symbol that carries a protective quality.  You can pull ideas from movies or books.  Remember, you don’t have to imagine that figure protecting you, but instead be able to observe a protective quality in it.  Pay attention to the sensory experience of observing or receiving that protection and notice how it feels in your body and what positive emotions come up for you.

Wise figure

Finally, the wise figure is the last imaginal, supportive figure.  Here, imagine a person, animal, or symbol that you consider to be wise.  Pull the image to mind with as much detail as you can.  When you have a sense of that wise figure, observe the emotions and sensations associated with receiving or observing wisdom.

Supportive figures as a team

Once you’ve identified one or several figures in these categories, you can imagine them together with you as a team.  As you become aware of the presence of each figure, observe how to feels to have all of them on your team, backing you up. 

Character qualities

When you consider the challenge of accessing memories and/or facing difficult moments in the present or future, what resources or qualities might you need to be able to face them?  For example, if you’re considering facing a feared situation, perhaps you’d need courage.  If you’re trying to remain sober, you may need willingness and resolve.  If you are having a challenging conversation with your boss, you might need steadfastness and confidence.

Whatever the character qualities you identify, look back through your life and identify times when you have expressed or embodied that characteristic.  If you can’t think of a time when you’ve displayed that characteristic, consider someone you know or a scene you’ve observed (real or fictional) when you’ve seen that character quality on display.  As you bring attention to that image or scene, observe how you feel and what sensations come up for you, again with a focus on the positive.

Now, imagine yourself in the situation you’re fearing, carrying that character quality with you.  How would you feel?  What would change in your body language?  How might it affect what you say or do?

Container

You may find that when distressing feelings, imagery, or sensations come up, they tend to overwhelm and take over.  This can be true when processing memories, but it can also be true when thinking about entering into feared situations.

In this visualization, imagine a container of some sort, like a steamer trunk, plastic organization box, a chest with a lock, a drawer, etc.  Bring awareness to the physical characteristics of the container by identifying sensory imagery that goes along with it.  You’ll be using your imagination to place negative internal experiences into this box, so feel free to add a lock, chains, or other items that help to make the container feel like it can securely remain closed.

Then, when you’re experiencing negative emotions, fears, memories, or sensations, imagine yourself placing that material into the container to be addressed later.

How to Tap In Your Resources

With any of the above resources, simply visualizing them can bring a sense of greater peace, support, or strength.  To ramp up the power of that experience, however, you can take advantage of the brain’s natural system of strengthening through adding bilateral stimulation in the form of taps.

When you have the picture, emotion, and sensation of the positive resource in your mind’s eye, slowly alternate tapping each knee or the outside of your thigh 6-8 times slowly.  Notice if the feelings evoked by the resource increase in their positive charge.  If so, take a pause, and then do another set of 6-8 taps.  Continue this rhythm until the feeling gets as strong as it can.

You can also try tapping using the “butterfly hug”, in which you cross your arms over your chest and alternate tapping each shoulder slowly for 6-8 taps.  For a demonstration of what this looks like, watch this video.

For more support on this practice of tapping in resources, look into the book mentioned above, Tapping In by Laurel Parnell.  In this book, she gives more detailed instructions and more ideas for resources you could tap into for these difficult moments.

How to Use In-the-Moment Mindfulness to Cope with Distressing Situations

Imagine you’re called into your boss’s office for a meeting about your performance at work.  How are you feeling before that meeting takes place?  What about while you’re in the office sitting across from him or her? 

How about when your spouse says those fateful words to you: “we need to talk.”  What’s going through your mind?  Do you feel dread in the pit of your stomach?  Resentment bubbling up internally about whatever they’re about to say?

Or maybe you’ve had to sit down with your child’s teacher to discuss their misbehavior at school.  Do you immediately jump to anger and defend your child?  Are you feeling shame about yourself as a parent?

We all have moments when we are caught off guard by relational tension, trauma triggers, marital strife, or unpredictable circumstances.  These events can stir up strong emotions that interfere with your ability to remain present and connected to yourself and the people around you.

You might get caught up in a shame spiral, lost in a cloud of your own insecurity and negative, self-critical thoughts.  Anxiety may take over and leave you feeling wired and on edge, interfering with your ability to hear what the other person is saying.  You can feel rage or anger toward the person with whom you’re engaging, leading to impulsive outbursts that you later regret.   

How can you cope with these intense emotional responses without letting them overwhelm you and derail the interaction?

Mindfulness

Mindfulness can be a helpful tool as you seek to soothe your anxiety, calm your fears, or reduce the intensity of your anger.  A simple definition of mindfulness is observing your current experience of emotions, thoughts, behaviors, and circumstances without judgment.

The “without judgment” quality is important, as judgments we make about our circumstances are often what intensify our negative emotional response.  To judge something is to see it as either good or bad.  For example, you might feel intense shame after a teacher talks with you about your child’s behavior because you feel like a bad parent.  Or you may be fuming at your boss because you think he or she is treating you unfairly in comparison with others in the company. 

Grounding strategies are a crucial part of mindfulness, as they create an access point to move you into more present awareness.  A grounding strategy uses physical sensations and sensory information to connect yourself to the present moment.  It involves tuning in to what is happening in the present as opposed to what has happened in the past or what you worry will happen in the future.

Ideally, daily mindfulness practice can set you up for success in these more distressing moments.  Practicing regular breathing strategies and sensory awareness allows for this response to come up more organically in your daily life.  But what happens when you’re in the middle of a conversation, work meeting, or parent-teacher conference when the distress hits?  What do you do when you don’t have time to take five or ten minutes away to do a more involved mindfulness exercise?

In-the-Moment Mindfulness and Grounding

These distressing situations provide an opportunity to adapt bigger-picture mindfulness skills you use elsewhere to keep you calm and engaged in the middle of challenging circumstances.  Using dual attention to focus on both what’s happening in front of you and your internal experience can be a game-changer in reducing your level of distress and emotional outbursts in stressful situations.

Use radical acceptance to limit judgment.

As mentioned earlier, the judgments and comparisons we make about our circumstances are typically what most contribute to our negative reactions.  Often, those judgments occur when we are powerless to change a situation.  The concept of radical acceptance teaches us to accept what we cannot change in the present moment, knowing that we can survive it.  Statements like “I can get through this” or “I’m strong enough to handle this” remind us that our current situation is temporary and make it easier not to judge based on the moment. 

Notice the points of contact between your body and the surfaces around you.

Using this technique to connect with your sense of touch can help ground you in the present. If you’re sitting in a chair, notice your back against the seat and your feet upon the ground.  If you’re standing, feel the ground under your feet.  Observe the feel of your clothing as it rests on your body. 

Tune in and slow your breathing.

Typically when distress, anxiety, or anger hits, your breathing will speed up and get shallow.  Notice your breath and whether you can feel your chest rising and falling (a typical signal of shallow breathing).  Intentionally slow down your breath and focus on breathing into your lower abdomen.  Counting your breaths can be helpful here, as it can give your mind a point of focus.  You could also use a breath ratio like four-square breathing (breathe in for 4 counts, hold for 4 counts, breathe out for 4 counts, and hold for 4 counts) or a 4-2-6 breath ratio (breathe in for 4 counts, hold for 2 counts, breathe out for 6 counts), if you are able to focus on counting while staying engaged.

Briefly scan through your body.

Another way to connect to yourself in the present is to complete a quick body scan.  Beginning at your feet, move awareness up through your body and note any areas of tension or stress.  When you feel tension, take a focused breath as if you are breathing into that area of tension and notice how it may relax in response.

Observe one item in the room.

Engaging your visual senses can help to ground you as well.  Look at an item in front of you: a stapler on a desk, the vase in your living room, a poster on the wall.  Notice as many details about that object as you can.  Observe its shape and texture.  Identify all the colors you see on it.  Estimate how big that item is.

Repeat a supportive word or phrase to yourself.

Words have power, and when you can remind yourself of supportive, encouraging words in crisis, it can defuse the tension you feel.  Use a short phrase like “I’m going to be okay” or “I can handle whatever happens.”  If you tend to feel shame or insecurity, use affirming statements like, “I can make mistakes and still be a good person.”  If you’re trying to contain out-of-control emotional reactions, remind yourself, “I can have strong feelings and still cope with this situation.”  Sometimes even a short word or phrase that cues you to breathe and calm down can help: words like “relax,” “breathe,” “peace,” or “calm.”

Pray.

When you feel powerless over your emotions or the circumstance you’re facing, offer up prayer to God, who is in control.  Pray for the outcome of the situation or ask God to help you stay present even though it might be challenging to do so.  At times, you can match a short phrase of prayer to your breath, such as “Come, Lord Jesus” or “Holy Spirit, come.”

Hold or touch an item and notice how it feels.

Similar to noticing the points of contact between your body and the surfaces it is touching, actively holding an object can help ground you using your sense of touch.  Bring a small object with you into a conversation you expect to be distressing and hold it in your pocket.  You can touch the arm of the chair you’re sitting in or the table in front of you and notice how it feels.  You can even hold your hands together or gently run your fingernails over the inside of your palms or fingers to observe the sensation.

Relax your facial muscles.

When we are in a stressful situation or are observing someone else’s distress or anger, we tend to mimic what we see in other’s facial expressions.  This can cause us to feel the same emotion that other person is feeling.  Instead, intentionally seek to relax the muscles of your face to take on a more neutral expression. Your emotions will likely follow suit.

Putting Kindness into Practice When Recovering from Trauma

If you’ve experienced a traumatic event, whether a “Big T” trauma (like a natural disaster) or a “small t” trauma (like prolonged bullying in a toxic workplace), you’ve probably felt some negative aftereffects.  In some cases, you might have had heightened anxiety for a few weeks, but it resolved when the disaster passed.  But for others, it’s possible to find yourself dealing with reminders or fear for months or years afterward.

In the case of childhood trauma, past abuse, or sexual assault, these effects may be more hidden. You could notice strange or unusual behavior and not even link it to those past experiences, because you believe you’ve gotten over them or moved past them.  Typically reminders of these events exist deep under the surface and stir up emotions or physical responses that seem to have no cause. 

For many partners recovering from betrayal trauma, you’re still living in the reality of the trauma.  Your spouse may be in recovery, but that process takes time, so it can feel as though the trauma isn’t over.  It’s like you’re living in the house being affected by the natural disaster: sometimes it seems like everything is okay, and then another wave of pain washes over you as you find out about a slip or relapse.  This “present trauma” effect can happen also for those who are in toxic or harmful situations without an easy way out.

How Trauma Affects Your Emotions and Self-Talk

One of the hallmarks of trauma is a tendency to minimize or question the impact of that trauma on yourself.  Many survivors of trauma have thought, “My experience wasn’t so bad.  Not as bad as so-and-so had it.”  More than that, depression can be an aftereffect of trauma, fueled by negative, self-defeating self-talk.  You might feel doubt about the trauma itself and your own role and responsibility within it, which affects your sense of self-worth.

This unique combination of minimizing your own experience, thinking negatively about yourself, and doubting your own perspective can lead to destructive self-criticism and self-hatred that derail your path to recovery from trauma.

Symptoms of Trauma and Post-Traumatic Stress

In your story of trauma, you may be dealing with some or several of the symptoms of post-traumatic stress disorder (PTSD).  These symptoms are worsened when you’re still experiencing the trauma, as with betrayal trauma discussed above.  Those symptoms include:

• Intrusive memories of the traumatic event

• Flashbacks (re-experiencing the memory of the trauma as if you were still there)

• Nightmares

• Avoidance of people, places, and things that remind you of the trauma

• Insomnia/difficulty falling asleep

• Exaggerated startle response (jumping at things more easily, being on edge)

• Hypervigilance (being extra aware of your surroundings and anticipating danger)

• Irritability

• Depression

• Anxiety

• Memory lapses related to the traumatic event

• Chronic negative beliefs about yourself, others, or the world

• Lack of interest in things you used to enjoy

• Distorted self-blame or blame of others about the event

• Intense emotional surges (fear, horror, guilt, anger, shame)

• Feeling isolated or withdrawn from others

• Inability to experience positive emotions

• Self-destructive behaviors

• Lack of ability to focus or concentrate

Why Kindness is Important in Trauma Recovery

If you relate to any of the symptoms listed above in relation to your trauma, my guess is that you also have expressed unkindness toward yourself.  Some of the symptoms directly create that self-hatred: having a negative view of yourself, feelings of self-blame, and shame associated with the events.  Other symptoms can be frustrating and lead to self-criticism, like insomnia, irritability, flashbacks, and nightmares.

For some, the person you were before the trauma happened and the person you are now feel drastically different from one another, and you long to go back to where you were before.  Or, if the trauma occurred when you were young, you long to be “normal” and not have such intense, symptomatic response to triggers of the trauma.

I cannot overemphasize the power and necessity of good psychotherapy if you are dealing with PTSD.  At the same time, learning to approach yourself with kindness while you are healing from trauma is essential. Healing from trauma takes time, and it can be a tiring process. You need an extra dose of kindness to move forward through it.

How to Practice Kindness

Call it what it is.

Stop minimizing your experience and let yourself name it what it is: trauma.  Naming the experience as trauma can give you more of a sense of understanding and peace, as you know that there is an explanation for your symptoms, as well as proven treatments to help you process and learn to cope.

Research the impact of “small t” traumas and acknowledge that they can have just as significant of an effect as a major, “big T” trauma. In fact, sometimes the chronic nature of “small t” traumas can make them harder to move past, as they create ingrained patterns of thought and behavior that need more work to change.

Offer yourself grace and understanding for your symptoms.

Rather than becoming annoyed with yourself for experiencing the very real symptoms of trauma, learn about what they are and acknowledge that is what is happening when you feel them.  Then, when you have symptoms, you’ll know why they’re happening, which can offer a sense of relief. 

When you know your emotional response is tied to trauma, it can also give you more clarity on how to best care for yourself within it. Putting your emotions in the correct context helps you not to feel crazy and reminds you to rely on coping strategies specific to trauma.

Affirm your resilience in surviving the trauma.

Recognize that you made it through whatever traumatic event occurred to you, and (in most cases) it is over now.  If it isn’t fully over, as in the case of betrayal trauma, recognize what you’ve made it through so far and the strength it’s taken to get there. 

Honor what you did to survive, even if it wasn’t the healthiest choice.  Some of your responses to trauma may feel crazy or irrational, but often they are motivated by a legitimate desire for safety or security, particularly after experiencing such an unsettling event.  Consider the root of some of these responses and offer understanding to yourself of why you responded in this way.

Give yourself what you need.

If you’re managing the aftereffects of childhood trauma, ask yourself what you needed then.  Was it someone to listen to you?  A safe place to go when you felt afraid?  A sense of comfort? If you’re still coping with the trauma, ask yourself what you need now.  Healthy distraction? Connection with your recovery community? Rest and nutrition?

Then do it: give yourself the space for extra comfort or care as a result of the reminder of the trauma.  Connect with loved ones or give yourself space and alone time, whichever feels more authentic to your needs.  Practice grounding through deep, mindful breathing or connecting with your five senses.  Practice sensory self-soothing behaviors like taking a bath, putting on warm and cozy clothes, smelling a scented candle or essential oils, or eating a comforting meal.

Use kind words to talk to yourself.

Rather than self-defeating or destructive thoughts you might be used to, consider positive coping thoughts you might use to support you.  Put today’s experience in the context of the bigger picture: you’re working your way through trauma, and it isn’t over yet.

Our words have power. Choose words that remind you of resilience and empowerment rather than hopelessness and helplessness within your response to trauma. Remember your unique character qualities that are supporting you through this crisis.

Practice kindness toward others.

Sometimes the most helpful way for us to move through our own traumatic experiences is to find mutual support through places like support groups, advocacy organizations, or volunteering opportunities.  Find a way that you can love and support others who are going through something similar to you.  If the trauma still feels too fresh, it may be helpful to find a place where you can volunteer or help others that has nothing to do with your area of trauma.  Offering help to others can promote a sense of gratitude and love that brings you out of the all-consuming nature of your trauma experience.

How to Cope With a Trauma Response: Part 2

In Part 1, we discussed how trauma responses are intense physical and emotional sensations that seem to come out of nowhere, but are often related to a trigger of a past traumatic experience.  They can be confusing and bewildering, causing a fight-flight-freeze response to arise.  They toss you out of your window of tolerance and lead you to feel uncertain about how to respond.

The first and most important step covered was how to respond to the initial impact of the trauma response.  Calming your body’s reaction to the trauma needs to happen before you can engage in critical thinking about what led to the response and how to address it more adequately in the future.  Detailed in more depth in Part 1, these calming techniques included:

• Breathing and grounding strategies to calm the nervous system

• Coping thoughts to remind yourself of distance from the traumatic experience

• Distraction techniques to focus your mind elsewhere until the intensity of the emotional response recedes

Now, we’ll get into more depth on how to approach your trauma response with curiosity instead of criticism and learn more about yourself and your needs through this exploration.

Identify the traumatic event that triggered your response.

In some cases, it is easy to connect a past traumatic event with a current trigger.  An experience in combat, a spouse’s betrayal, or physical abuse from a caregiver are all examples of experiences that may resurface in a flashback.

With other experiences, it’s more challenging to identify the trigger or what might be intensifying the experience.  As an EMDR practitioner, I often prompt my clients to connect the dots by identifying the emotion they’re feeling, where it is located in their body, and any thoughts associated with that feeling.  Then, I ask them to let their mind go back to other experiences in their life where they’ve had a similar response.

Sometimes, what comes out of that exercise may feel unrelated to the trigger, but let your mind make those connections and be curious about what it finds.  The purpose of this exercise is to validate your experience and help you understand that you’re not crazy: this is a trauma response.  If you notice this experience brings up even more emotional intensity, mitigate it with some of the self-soothing, coping thoughts, or breathing practices discussed earlier.

Ask yourself what you needed then.

Once you recognize the event that triggered the negative reaction, you can then reflect on what needs might have gone unmet or what threats were occurring that left you feeling unsafe.  For example, in an abuse situation, the need may have been for protection or escape.  In a major car accident, safety and help may have been the primary needs.  For a betrayed partner, empathy and connection may be needs they’ve experienced when dealing with addiction.

It may take some digging to get at the core needs you feel here.  Often, they aren’t right at the surface.  It may help to take a look at your reaction to the trauma: if your immediate response to a harsh word or anger from your spouse is to run and hide, this might indicate the escape you needed from an abusive family member.  Once you’re aware of these needs, then you can more easily bring them into the present moment. 

Seek healthy ways to get your needs met.

In some situations, you can easily get your needs met.  For example, if your traumatic experience relates to living with an abuser in the past or a combat experience that occurred several years ago, you can remind yourself that you are no longer in that situation, it is over, and you are safe in this moment now.  This can help increase a sense of safety.  Grounding strategies work well at supporting this need, to bring you into awareness of the present moment and connect you to that sense of present-moment safety.

In other situations, there might be a few more steps you need to take to receive support for your needs.  Perhaps you’re still living in the place of trauma, as when your spouse is a recovering addict and you can’t lean on them for support or trust.  You may have had a traumatic experience at work, but you aren’t able to quit or leave your job, and so you feel anxiety or stress each time you walk through the door into your office.

When you can’t immediately talk yourself down from a lack of safety, consider opportunities to meet your needs in healthy ways.  For the betrayed partner, seek out a therapy or support group or helpful, understanding friends with whom you can talk to receive empathy.  Practice self-validation of your experience and acknowledge to yourself that it makes sense why you would feel unsafe.  Set boundaries in your workplace or in your relationships to meet needs for protection and security.

Consider trauma-based therapy with a trained counselor.

The strategies listed above and in the previous post can help in some situations, but if you notice your trauma triggers aren’t going away, it may be time to consider more formal therapy to address some of the trauma.  EMDR is a method of psychotherapy that directly addresses and reprocesses traumatic events so that they don’t continue to hang around in your mind and plague you with intense triggers and flashbacks.  Good trauma counseling can help you create deeper change to see lasting resolution from the traumatic memories.

How to Cope With a Trauma Response: Part 1

Your day is progressing just like any other.  Waking up, getting the kids ready for school, going to work, preparing dinner…when all of a sudden, out of nowhere, you’re hit with a flashback of the event.  You feel a pit in your stomach, sweat breaks out on your forehead, and you feel your heart rate spike.  You’re having trouble breathing, and you feel the urge to escape. 

If you have post-traumatic stress disorder (PTSD) or symptoms related to PTSD, you probably know this experience well.  Memories of the trauma or triggers that remind you of the event can send you into a tailspin: you’re fine one moment, then in a panic or shut down the next.  For partners who have experienced betrayal trauma, this response arises with triggers related to their addicted spouse’s behaviors.

The experience of a trauma response can be scary, as it often comes on suddenly and feels impossible to stop.  It can be exhausting to go through one of these experiences as your body goes into overdrive, trying to protect you from a threat that (often) isn’t there.  To cope with your response, you might shut down into a depression, lash out in anger or irritation at the people around you, collapse into grief and sadness, or turn inward with shame.

How do I know I’m having a trauma response vs. pure anxiety or panic?

There are several common symptoms of post-traumatic stress disorder that may come up when trauma resurfaces:

• Flashbacks to traumatic events (re-experiencing the memory as if it were happening now)

• Mood swings and emotional volatility

• Exaggerated startle response

• Avoiding certain triggers or activities that you used to find enjoyable

• Low self-esteem

• Isolation and withdrawal from others

Trauma shares symptoms with anxiety and/or panic attacks.  Anxiety often includes worries that are more future-oriented than trauma.  While it is true that some anxiety centers around worry about events from the past, trauma responses are different in that they can be traced back to a specific memory of a traumatic event.

Panic attacks can also arise as a result of trauma, with symptoms such as racing heart rate, sweating, feeling faint, nausea, and worry that you’ll die (often related to the heart rate symptoms).  If you experience these symptoms, be sure to meet with your doctor to rule out any underlying medical causes.  However, if there is no obvious medical cause, see if you can connect your reaction to a specific reminder of trauma (as in a trauma response), or notice if the panic arises seemingly out of nowhere (as in panic disorder).

How to Manage Trauma Responses

There are two stages to handling trauma responses.  First, you need strategies to bring yourself back into your window of tolerance by calming the physical and emotional reactions you’re having.  Once you’ve been able to calm and self-soothe, the next step involves exploring the cause of the traumatic response and some options for processing and addressing that trauma.  Today, in Part 1, we’ll talk about the first step: reducing the intensity of your initial response. 

Reduce the physical and emotional overwhelm caused by the initial hit of trauma.

You can’t think straight when you’re in the middle of a trauma response, as your body and mind take you out of your prefrontal cortex (the part of your brain involved with decision-making, impulse control, and executive thinking) and move you into your limbic system (the emotional center; the fight-flight-freeze response).

In order to bring your thinking brain back online, it is necessary to calm down your nervous system enough to communicate to yourself that you don’t need to run from a threat, as the adrenaline response is prompting you to do.  Deep breathing, guided meditations, progressive muscle relaxation, grounding exercises, and other ways of calming down the nervous system are useful during these moments.

Use coping thoughts to calm your emotions.

Often, the traumatic event happened in the past and is not currently occurring, as in an experience of a car accident or a past experience of sexual assault.  In these cases, you can use words to remind yourself of your current distance from that painful experience.  They can help you ease the initial intensity of the trauma response.  These might include phrases like:

• I’m safe now, in this moment.

• I’m no longer in that situation.

• I can get through this.

• This too will pass.

• That was a painful experience, and I am not living it now.

But what if the trauma is ongoing?  When you are in a relationship with a sex or love addict who has betrayed you and are working the process of recovery, the traumatic experience may feel more present and real due to broken trust.  In those cases, it may be more helpful to use self-encouraging statements to affirm the strengths you have that are carrying you through.  These might include words like:

• I’ve been through painful moments before, and I’ve survived.

• I’m strong enough to handle this.

• I can’t control other people’s actions, but I can control my decisions and how I respond.

• I can handle this one day at a time.

• This is hard now, but in the long-term, I’m going to be okay.

Use a distraction technique.

If meditations and coping thoughts aren’t cutting it, use a distraction technique.  These are not meant to create unhealthy dissociation from your feelings or events, but instead are meant to help calm the intensity of your experience so that you aren’t as overwhelmed by it and can approach it with more curiosity.  It helps to think of this distraction as temporary, meant to bring your level of intense emotion down so that you can make sense of your reaction and respond differently. 

Using strategies popularized by dialectical-behavioral therapy (DBT) can help create this distraction.  Find an enjoyable activity that you can engage in for a period of time that takes your mind off the trigger.  Engage in a self-soothing behavior that helps you connect to your five senses.  Use the acronym ACCEPTS to help you connect with ways you can distract yourself from the distress. 

In Part 2, we’ll delve into how to explore and process the trauma response, creating tools to help you navigate its impact differently in the future.

Taking Courage Through the Storms of Life: A Reflection on the TED Connects Talk by Elizabeth Gilbert

If you’re reading this article in real-time, we’re all learning how to manage emotions through a major, unprecedented, global crisis in COVID-19.  We’re all being affected in some way, even though those specific patterns look different from person to person. 

Yet many of us will, at some point in our lives, walk through our own personal crises or traumas.  The loss of a job.  The betrayal of a spouse or partner.  The death of a loved one.  

Elizabeth Gilbert, author and creative thinker, recently was featured on an episode of TED Connects processing responses to the COVID-19 crisis.  In her talk, she shares reflections on emotional impact of this crisis and ways to shift thinking and behavior in order to offer more compassion and grace for ourselves.  While the principles in this video fit the crisis we’re facing collectively right now, they also shed have universal principles for personal crises you may face.

Here are a few of the key takeaways I gathered from listening to this talk.

Anxiety

Gilbert encourages us to give ourselves mercy and compassion for any emotions we experience through this crisis.  When we realize that our experience is normal and that everyone is going through or would go through some version of this same response, it helps take some of the pressure off to have it all together.  When you’re in a personal crisis, finding a grief or support group or talking with someone who’s been through this crisis before can be a great help, as it hits home that you aren’t alone and others understand what you’re going through.

Recognizing your resilience is another component she shares that will help you have confidence to make it through your crisis.  Reflect on past experiences that have been challenging or painful. Remind yourself of how you made it through and what allowed you to do so.  Review this list when you find yourself struggling to maintain compassion or courage despite the crisis.

Practicing presence and gratitude are also important.  Instead of numbing out or trying to escape, pay attention to the emotions you’re experiencing in the present, even if they’re uncomfortable.  Notice the things that you have in your life that you are grateful for. Make lists and speak these words of appreciation out loud.

She also highlights the myth of control: anxiety comes out of believing that we’re in control of our lives, when in reality we have little to no control over our circumstances.  We are only in control of our own actions, beliefs, thoughts, and choices.  When you surrender control, you’re allowing yourself to be released from the burden of anxiety and the myth that you can be in control of your circumstance.

“Surrender means letting go of something you never even had.”

— Elizabeth Gilbert

Loneliness

Living through a crisis can be an inherently isolating experience, and you likely have to cope with loneliness in a new way.  Notice your tendencies toward escaping or avoiding and how the crisis may have removed some of those coping mechanisms.  Recognize the ways your behaviors function as a way for you to withdraw from painful emotions.  Consider exploring negative emotions that arise, journaling through them, asking yourself what you fear and what you run from. 

Use this crisis as a way to get to know your mind and practice shifting your thinking.  You might notice more self-doubt, criticism, judgment, or fear.  Take inventory of your self-defeating thoughts so you can recognize them when they arise and begin to fact-check them with reality.  Just like focusing more on gratitude, this mindset shift requires intentional action.  You can literally change structures in your brain as you begin to make these shifts.

“The hardest person in the entire world to be with is yourself.”

— Elizabeth Gilbert

Productivity and Creating

While discussing creativity during a crisis, Gilbert references the fact that she prefers following “curiosity” rather than purpose and passion.  What might change in your life if you focused more on following your curiosity? Rather than focusing on what you “should” be doing, consider what you’re curious about and move toward that. 

Recognize that anxiety and fear stifle your ability to be productive or creative as well.  The content you consume impacts your mind and your capacity to focus.  Instead of trying to shame or beat yourself up into being more productive, release those “shoulds” and give yourself more freedom.

She also suggests reframing the crisis as a retreat, or a stimulus for learning.  She suggests doing what you used to do as a child, returning to play, as a way of coping with the difficult emotions that arise and awakening greater creativity within yourself.

A Note on Spirituality

Much of what Elizabeth shares in this TED talk is interwoven with her spiritual understanding.  While I disagree with the foundations of her spirituality, I think she offers concepts that can be adapted to a Christian worldview and can lead you to take a more grace-filled approach toward yourself in a season of crisis.  If you also share Christian beliefs, I encourage you to consider how some of the following ideas may help you.

Write a letter to yourself from God.

Near the end of the video, Elizabeth shares a practice that she engages in daily where she writes a letter to herself from “love.”  As I listened to her read her example letter aloud, I realized that the words “love” was saying to her were strikingly similar to how God speaks and comforts His people – phrases such as, “I’m with you.”  “I’ve got this.”  “You are my beloved.”  The connection between these words of love and God comes through the understanding that God is love (1 John 4:16) and that His perfect love drives out fear (1 John 4:18).

How might you write a letter to yourself from the point of view of God, who loves you unconditionally (Romans 8:35-39) and has promised to be with you forever (Matthew 28:20)? What would God say to you in your current circumstance, in your pain, in your struggle?  If you struggle to hear God’s voice as a voice of love, start out by reading 1 Corinthians 13:4-8 and replace the word “love” with “God.”  If God is all of the things listed in that passage, how might he speak to you? 

Surrender control through prayer.

As mentioned earlier, releasing anxiety involves recognizing that you never had control in the first place.  We are not in control, but God is (Colossians 1:16-17).  When you recognize your powerlessness over your circumstance, you can use prayer as a way to remind yourself of this fact.  Refocusing on prayer helps us to come back to God and surrender to Him what we cannot control. 

I reference the Serenity prayer often because I think its simple structure provides a framework for releasing control and seeking wisdom.  It goes like this: God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.

Listen to the Holy Spirit.

In the talk, Elizabeth shares a story about a woman who became dangerously lost on a hike.   She offered up a prayer of surrender when she realized she was in trouble and felt led by her intuition to act in a way that would preserve her safety.  This reminded me of the importance of asking for wisdom and guidance from God (James 1:5) and being open to the Holy Spirit’s direction and leading (John 16).  Of course, it is important to compare where we feel led by the Spirit to Scriptural truth to determine its validity, but it was a helpful reminder to listen to where God is leading rather than trying to figure it all out on our own.

Understanding the Window of Tolerance and How Trauma Throws You Off Balance

Have you ever felt out of control of your emotions?  Overtaken by anger or rage?  Swarmed by anxious thoughts and worries? Confused by the intensity of your emotional reactions?

What about feeling shut down emotionally? No matter how hard you try, you can’t seem to feel anything.  You’re disconnected from relationships and others, and you coast through your day feeling numb.

Chances are, if you’ve had this happen to you, you’ve been outside of your window of tolerance. 

What is the window of tolerance?

Coined by Dr. Dan Siegel, the term “window of tolerance” describes the space where your level of arousal (how alert you are) matches up with what is required for you to do.  This window is the space where you can approach day-to-day life most effectively, handling emotions without losing control and making clear-headed decisions with rational thought.

Imagine an average day where you aren’t troubled by too much stress, but you’re still alert and able to focus on your tasks.  Typically, this would place you right in the center of your window of tolerance: you’re not facing anything beyond what you can handle.  You can experience emotions without being overtaken by them and feel safe in general.

Let’s say a minor stressor comes up: you get a phone call from your boss that requires you to do additional work, or an email comes in from your child’s teacher about misbehavior in their class.  That stressor will increase your level of arousal, maybe even to put you at the edge of your window of tolerance, but if you’re still within that window you can handle the stress without getting too out of sorts.

Our brains are designed to handle the ups and downs of emotions and experience by remaining within this window of tolerance.  We may have unconscious coping mechanisms in place that help us handle that stress, or the passage of time brings us back to the center of that window.

The National Institute for the Clinical Application of Behavioral Medicine (NICABM) has provided this infographic to help you visualize the window of tolerance.

What happens when I go outside the window?

When a circumstance, stressor, or trigger is enough to throw you outside the window of tolerance, you enter into survival mode.  Outside the window of tolerance, the prefrontal cortex of your brain (involved in impulse control, decision-making, and regulating emotions) shuts down.

If your level of arousal is too high and jumps above the window of tolerance, you’re experiencing hyperarousal.  Usually this is the initial response when a stressor throws you off balance.  Hyperarousal comes from your fight-or-flight adrenaline response, which can show up with increased heart rate, racing thoughts, digestive issues, or hypervigilance in your surroundings.  You might feel an intense wave of anxiety, panic, or anger.  Your emotions can be overwhelming and out of control.

If your level of arousal is too low and dips below the window of tolerance, this is hypoarousal.  This comes from a freeze and shut-down response, often as a reaction to the adrenaline rush of hyperarousal.  Hypoarousal can look a lot like depression.  You might notice lack of motivation, exhaustion, and feeling numb and disconnected from emotions.

How Trauma Affects the Window of Tolerance

If you’ve experienced trauma, whether big T (like a natural disaster or prolonged abuse) or little t (like gaslighting or emotional manipulation that adds up over time), you know that reminders of those experiences can bring you back to how it felt then.  These triggers happen out of nowhere.  A sound, smell, or location can send you into a negative spiral.  Often, these triggers go unnoticed and you’re left feeling anxious, depressed, or some combination of the two without really knowing why.  Other times, these are obvious reminders that trigger flashbacks or physical reactions in your body.

If you have experienced trauma, your window of tolerance shrinks.  The traumatic experience has likely taught you that the world is unsafe and unpredictable.  Triggers related to the trauma also increase emotional response, skyrocketing you out of your window of tolerance before you’re even aware of what’s happening.

Because the window of tolerance is smaller, you’re likely to fluctuate more often through hyperarousal and hypoarousal.  Something as simple as that call from your boss or email from your child’s teacher could send you into an anxious spiral. 

In some cases, when you’ve been outside of your window of tolerance for a long period of time, clinical levels of anxiety or depression can develop. Survivors of trauma may learn to adapt to fluctuations between hyperarousal or hypoarousal by moving toward unhealthy behaviors, such as addictions, to manage their discomfort.

How can I stay in my window of tolerance?

There are healthy alternatives to addictions or other destructive ways of coping that can help you to return to your window of tolerance.

• Breath work and grounding. Bring yourself into the present moment by taking a few deep breaths.  Use a breathing technique like four-square breathing or the 5-4-3-2-1 grounding exercise to help you remember that you’re in the present.

• Check your thoughts. Talk to yourself about what’s going on in the present.  Question whether the feelings of panic or lack of safety are based in factual reality, or if they’re an echo of the past trauma.  Affirm yourself for changes you’ve made and work you’ve done or are doing to heal from the trauma.

• Self-care. When you notice your emotions getting out of control, think of that as a red flag indicating your need for self-care.  This can include things like going for a walk, taking a hot shower, giving yourself a few minutes to breathe, or calling a friend.  Look for self-soothing actions that help you not to be overcome by the emotion and ground you in the present

• Connection with loved ones.  Feeling supported and cared for by your loved ones can serve as an important part of self-care when you’re reeling from a trauma-related trigger.  Connect with your loved ones via phone call, text, or in-person meeting to remind you of their present role in your life. 

Expanding Your Window of Tolerance

The solutions above can be great in an emergency when you find that you’re already outside of the window of tolerance.  But if you’ve experienced trauma and are coping with a smaller window of tolerance, these will only provide a temporary fix.  Luckily, it is possible to grow that window of tolerance with focused work.

• Therapy. Creating space to process and deal with the impact of trauma on your everyday life with a professional counselor or psychologist can help create a buffer for your emotional reactions.  Your relationship and connection with your therapist is the most valuable part of any therapy relationship, moreso than what technique that therapist uses.  Find someone with whom you feel comfortable and safe and who can help you stay within the window of tolerance in your sessions, as healing can’t occur when you’re outside of that window.

• EMDR. As an EMDR-trained clinician, I have seen EMDR change the game with clients who have survived trauma.  EMDR (eye movement desensitization and reprocessing) helps process and reorganize the traumatic memories in your brain such that they aren’t creating such strong emotional reactions.  This technique replaces the negative narratives and emotions from those memories with a more grounded and centered perspective coupled with positive, affirming words.

• Regular meditation practice.  While the short version of meditation and breathing mentioned above can help in a pinch, regular meditation practice can do wonders for extending the window of tolerance.  Doing regular breath work over time can create a habit that develops into a reflex to react to stress with conscious breathing.

Releasing Your Body from Trauma's Grip: A Review of The Body Keeps the Score by Bessel van der Kolk

If you’ve experienced a traumatic event, you know the symptoms that follow.  It could be physical or emotional pain directly related to the trauma, but also symptoms in response to reminders of the event once you’re physically healed.  You might be dealing with panic or out-of-control flashbacks that pull you into re-experiencing the trauma.  You may have trouble putting words to what happened to you, with gaps in your memory or difficulty placing a beginning, middle, and end to your experience. 

Bessel van der Kolk, in his book The Body Keeps the Score, describes the experience of holding trauma in our bodies both through changes to the structures of our brain and effects of trauma on daily living for those who have experienced traumatic events. 

In his 40+ years of clinical experience as a psychiatrist, van der Kolk has done extensive research on the effects of trauma on brains and bodies of children and adults.  His focus on neuroscience and attachment form the basis of his points in his book.  

How This Book is Organized

How Trauma Affects the Brain and Body

Van der Kolk begins the book giving background information about trauma and how it impacts both the structures of the brain and interpersonal relationships.  He discusses how trauma activates your fight-or-flight response in the amygdala, or emotional center of your brain.  This affects not only how you remember and tell the story (typically more images than biographical details), and it also changes how that information is stored in your brain.

He normalizes traumatized individuals’ difficulty improving, not because they don’t want to, but because of the impact of the symptoms and the weight of self-blame they carry in response.  This can cause physical symptoms and reactions in the body that echo long after the traumatic event has ended.  It can affect their lives as they lose their ability to focus or concentrate, they dissociate or disconnect emotionally, and they have difficulty feeling safe with other people.

“When the subject of blame arises, the central issue that needs to be addressed is usually self-blame – accepting that the trauma was not their fault, that it was not caused by some defect in themselves, and that no one could ever have deserved what happened to them.”

— Bessel van der Kolk

The Impact of Trauma in Childhood

Next he moves on to discuss the impact of childhood trauma and insecure attachment on adults.  He highlights insights from research with children and teens to highlight the detrimental effects of trauma and how it can be reversed.

One insight he shares is that how we cope with trauma as children usually translates into how we cope as adults.  We learn to survive amidst chaos using certain strategies, some of which can include addiction, destructive relationships, or other unhealthy patterns.  Recognizing where these patterns originated can release some of the self-blame you carry. 

“Many traumatized children and adults simply cannot describe what they are feeling because they cannot identify what their physical sensations mean…trauma victims cannot recover until they become familiar with and befriend the sensations in their bodies.”

— Bessel van der Kolk

How to Treat Trauma

Luckily, trauma is not a death sentence, because our brains are designed with healing mechanisms in place.  During this section, van der Kolk highlights several different methods of psychotherapy that can help heal the effects of trauma, such as EMDR (eye movement desensitization and reprocessing), yoga, internal family systems therapy, writing, theater, psychomotor therapy, group therapy, and others. 

He speaks about using an approach to trauma treatment that focuses both on top-down interventions (strengthening the control center of the brain with activities such as mindfulness and yoga) and bottom-up interventions (regulating the emotional brain through breathing, touch, and movement).  He emphasizes that revisiting the trauma is an essential part of this process, but it needs to be done when you are feeling safe and grounded in the present moment.  Ultimately, he believes (and I agree) that experiential knowledge is much more powerful than intellectual knowledge, and therapy should incorporate these aspects.

“More than anything else, being able to feel safe with other people defines mental health; safe connections are fundamental to meaningful and satisfying lives.”

— Bessel van der Kolk

How to Use This Book

If you are someone who has experienced trauma or helps others who have been traumatized, The Body Keeps the Score will be a helpful resource to put words and explanations to what you feel and experience.  You might discover a completely new perspective on your story of trauma as a result.

Begin with the first section of the book if you are curious to understand how trauma affects the brain.  His anecdotes about individuals who have experienced trauma coupled with images of brain scans illustrate the connection between trauma and the brain.  My guess is that you’ll find your story to be more common than you realized.

In particular, I think the first section of the book is helpful for women who have experienced sexual assault or other violent crimes.  He speaks at length about the freeze response of the brain that shuts down and inhibits the victim’s ability to fight back against their attacker.  This survival response often becomes a source of self-blame after the traumatic event.  Knowing it is a natural biological reality to shut down can lift some of that blame.

If you’re interested in the concept of attachment and how trauma during childhood can affect development, read the middle section of the book, where van der Kolk shares research insights into the impact of attachment on children.  He speaks about the impact of a caregiver’s ability to emotionally attune to their children and respond to their needs so that children can learn to self-regulate.  Children who don’t receive that attunement can grow up to be anxious (feeling too much) or avoidant (not feeling at all).

If you want to learn more about a particular type of therapy to treat your trauma, jump ahead to Section Five of the book, where van der Kolk outlines the different methods of therapy that have been helpful in his experience of treating trauma.  As an EMDR practitioner, I enjoyed how he described the way a typical EMDR session works, as that can give you an idea of what to expect.

Overall, I think the combination of personal anecdotes, research, and hope this book offers make it an invaluable resource for therapists who work with traumatized clients, but also for those who are seeking to heal from their personal stories of trauma.