Waking the Tiger, A Brief Review, by Bob Evans, PhD
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Dr. Sarno has often spoken about initial consultations with patients. He'll ask them how their childhood was and often people will answer that it was 'fine' or 'uneventful'. Some people unfortunately have had major Traumas in their lives be it through 'shock' (for example a car accident) and/or developmental (for example childhood abuse and/or neglect) traumatic experiences. However, all humans experience some forms of trauma in their lives. We can call the first, more severe form, "Trauma" (with a 'Big' 'T') and the later as "trauma" with a small 't'. Either way, a single event or a series of events or a way of life which involves stress and tension and/or trauma often leads to some form of TMS later on in life if the individual does not learn the skills to combat and expel the negative 'stuck' energy that accumulates and becomes 'activated' in the body.
I am currently completing my second year of the 3 year Somatic Experiencing Training Program developed by Peter Levine. I am finding it extremely conducive to my work with patients with TMS. Many people 'adapt' to stressful, tension filled and/or traumatic events and/or environments by psychologically 'disconnecting' from their bodies (usually without being aware of this 'disconnect'). It is important to understand that the nervous system disconnects in order to protect the individual from what would other wise be a terribly uncomfortable if not intolerable experience. In Dr. Sarno's nomenclature we would say that the Unconscious 'represses' uncomfortable or painful emotions in order to do the same thing. Dr. Sarno and Dr. Levine are talking about two levels of the same dynamic. Dr. Sarno tends to approach it mostly from the level of 'repressed' emotion while Dr. Levine approaches it predominately from the level of sensation and 'trapped energy' in the Autonomic Nervous System. I tend to see TMS as trapped energy that can manifest in any of the general ways of experiencing which we refer to as 'S.I.B.A.M.' This refers to our experience of 'Sensation', Imagery', Behavior', Affect' (emotions) and/or 'Meaning' (intellctual insight and thought). Thus we can manifest TMS as pain, negative images and dreams, acting out and counterproductive behaviors, painful emotions and/or obsessive thought, just to name a few. I further tend to view a symptom as emanating from the 'Wisdom' of the Nervous System or Unconscious or 'Soul' as a way of communicating to the individual that it is 'safe' to begin the journey 'HOME' to rid oneself of past trauma still housed in the body, and learn to feel safe in one's body which is a birthright! I believe this is why so many people who previously had TMS symptoms have a sense of gratitude and view the past symptoms as a gift.
How does the 'energy' become trapped? Dr. Levine observed animals in the wild and noted that if an animal in the wild is attacked and survives, it is able to 'shake' off the 'trauma'. 'Wild' animals have not evolved a modern brain that can (and often does) 'override' the instinctual response to rid the body of trauma. He talks about how thwarted 'fight' or 'flight' responses in humans cause the energy to become trapped in the body thus leading to symptoms. If, for example, a child, is yelled at by a parent, the child may be too little to 'fight back' even if the impulse is there. The child may also not 'flee' for fear of getting caught. So the 'energy' from the 'fight' and/or 'flight' response must be thwarted in order to protect the individual from possible retaliation if the child were to hit back or run. Our Autonomic Nervous Systems know instinctively (unconsciously) to 'thwart' the energy from those fight or flight impulses in order to protect us from an even harsher possible reaction in retaliation. However, there is a price to pay, which may be symptoms derived from the damage caused by the trapped energy.
We are all human beings. However we are all animals as well. As Peter Levine discusses, we have evolved from the 'Primitive' (Reptilian) brain (Autonomic Nervous System responsible for pure instinctual responses such as 'fight' 'flight' and 'freeze)', to the modern brain which, among many wonderful attributs, has the ability to project into the past and/or the future. One problem arises when our modern brain is ruminating about a past event or worried about a future potential event. The body, unaware that this event that the mind is worried about is not actually happening in the present moment, reacts as if it is because the body does not know about or experience the concept of time. Our bodies are always in the present moment even when our minds are not. Therefore, we can actually be in a very safe, comfortable environment while, for example, worrying about something that MIGHT (and might not) arise in the future. Our bodies, rather than being relaxed, will be full of tension, ready to deal with the 'event' it thinks is happening now or about to happen. If we experienced trauma in the past, the Nervous System may still be 'stuck' in 'readiness mode' even though there is nothing present to be ready for. SE (Somatic Experiencing) along with many new treatment modalities does initially focus on mindfulness to help teach the person to be more present in his/her body in the here and now. Peter Levine calls it the 'Felt Sense' and utilizes certain exercises to accomplish this. I spend a certain amount of time, depending on the individual patient, teaching several mindfulness practices and encourage my patients to practice on their own. The more 'mindful' we are in the present moment, the more we are able to sever the old negative (and often painful) conditioned resposes to certain situations and events. However, Dr. Levine then discusses various techniques to help rid the body of the stuck negative energy present due to past traumas that were not resolved. We need to first learn to establish a certain level of comfort in the body in the present moment. Following this we can then utilize different techniques to help rid the body of the stuck negative energy by 'titrating' it away in tolerable 'doses'.
People with TMS may find 'Waking the Tiger' helpful especially if you know or think you may have experienced certain types of trauma. I recommend this book to many of my patients along with Dr. Sarno's three latest books.
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