"Trauma and Memory: Brain and Body in a Search for the Living Past..." Peter A. Levine, PhD

Key takeaways for non-therapists

“Addiction always co-occurs with other issues. If you can understand and help someone through addiction, you can help anyone,” my future graduate school advisor said, “that’s why you want to pursue this specialization.”

Driving away from Marquette University after a meeting with the program director and my future advisor, Dr. Todd Campbell, what he said rang true. I applied to the Clinical Mental Health Counseling Addiction and Co-occurring Disorders track of the graduate program.

The other selling point of that program was the immediate immersion in the business of substance abuse treatment. At that time, the counseling program ran a clinic that provided free services to people in Milwaukee, mostly homeless or court-ordered treatment. It was run by the PhD students, and therapy was provided by second-year master’s students. The first-year master’s students conducted observations the first semester and intake assessments the second. This was a dive-in headfirst program, and I am thankful I had that experience.

Something one learns early in an experience like this is that the people seeking treatment, or even those mandated to treatment, have complex histories that are not just about drug abuse. Each of their stories was different, but a common theme was the presence of extensive trauma. Often that trauma started very early in their lives. I remember thinking that if I had their lives, I would probably turn to drugs too.

Ironically, our education did not provide much knowledge or training about trauma, so I sought out a mentor who could help me. Dr. Kathy Coffey-Guenther not only pointed me in the right direction to learn more about working with people who experienced trauma, but she showed me how to integrate themes of faith when working with clients who identify as nonreligious. She also connected me with my internship at The Healing Center, where I learned even more. With her guidance, I learned about the intricate complexities of trauma, substance abuse, and mental illness; I have not stopped learning. Without addressing the trauma and helping a person through that, the addiction serves the purpose to cover up what trauma destroyed. You can’t take that away without replacing it or healing it.

While pursuing self-education, I discovered the work of Peter Levine, Bessel van der Kolk, and Judith Herman, among many others. All three do tremendous research work to help therapists understand the effects of trauma. Their work helped me become more proficient in helping people overcome and move through it. Like understanding the body’s role in trauma and how developmental and complex trauma are more insidious than PTSD and more challenging to treat. A lot of therapists misdiagnose trauma as borderline personality disorder, ADHD, or bipolar disorder and then wonder why a client does not make progress. Hopefully, that is not happening as much as it did when I was working. While working with clients for over seven years, I helped many who had worked with other therapists and gotten nowhere. I credit their healing to the techniques associated with understanding the body’s role in trauma and God’s grace.

Peter Levine developed a mode of therapy called Somatic Experiencing (SE). I went through the beginner course, so I could learn to use the techniques with clients, and it was remarkably effective. Be aware that SE gets into new-age spirituality, and the training talks about many leftist ideas, neither of which I agree with. Set that stuff aside, though, and pay attention to the concepts. (A good book written much earlier is called Waking the Tiger, and you can watch a video about it here.)

The important concepts revolve around how trauma is stored in the body beyond our conscious awareness and are a powerful way to understand how to help people move beyond trauma. In working with my stepson and other young kids in a counseling setting, I saw how this understanding helps them move past trauma without needing to talk about or “process” trauma. It works on adults, but the kids were the best to watch.

In this book, Trauma & Memory, Levine explains how memory works, including the multiple layers of memory. The book is accessible to the layperson and definitely helpful for therapists. It would likely inspire therapists to learn the basics of SE to use with clients.

To summarize Levine’s main points, memory operates with multiple layers. There is the explicit level, which is conscious memory that includes declarative memory and episodic memory. Declarative memory is what I am using here to share what I learned from this book. It deals with facts. Episodic memory is connected to emotions a bit more and includes feelings and sensations. Like the memory of a first kiss or the first time you caught a fish. These memories can be verbalized and shared but bring up emotions during recall.

The other layers of memories are implicit and not conscious. This includes the emotional memories, which are a deeper layer than episodic memory, and then the procedural memory, or the things you do on autopilot. These implicit memories cannot be called up at will like the explicit memories, but they are central to the trauma response. The procedural memory includes learned motor actions, emergency responses, and the approach-avoidance response. These implicit mechanisms are associated with trauma, and they are what get stuck and create adverse reactions to trauma. These are the mechanisms that activate your fight, flight, or freeze response, and they have the very important role of keeping a person safe from danger. It happens outside of conscious awareness, which means you can’t talk your way through it or out of it.

Without delving too deeply into the science because Dr. Levine explains it so much better, here are some key takeaways that non-therapists can benefit from:

• Trauma is a full-body experience, whether you are aware of that or not. The body holds onto those implicit memories as a means of protecting you and furthering survival.

• The various types of memory help us understand why talk therapy does not work for trauma recovery.

• Drugs won’t work either for the same reason. They may offer a temporary band-aid that can help you do the work of recovery, but the drugs will not heal trauma.

• Just talking and reliving the trauma over and over won’t work and may make things worse. There is research suggesting that cognitive behavioral therapy and prolonged exposure therapy work, but read the work of David J. Morris (The Evil Hours: A Biography of PTSD) to hear what that experience is really like.

• Levine, Van der Kolk, and even Dr. Robert Scaer all suggest that trauma memories are stored in the body, and until those are resolved, one cannot move beyond them.

• To heal trauma, one needs to tap into the body’s memories and allow the body to resolve the trauma.

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You may be asking yourself what’s the point of knowing. I would say that everyone, at some point in their life, has either experienced trauma or knows someone who has. In my humble opinion, the greatest epidemic we face as a society is the exorbitant damage caused by unresolved trauma that shows up in behavioral problems, emotional problems, relationship problems, child abuse, neglect, engaging in high-risk behavior, substance abuse, violence…the list goes on. In every story I can think of where someone hurt someone else, the perpetrator had some evidence of past trauma left unresolved that serves as an “excuse” for what they did. What villain, real or fictional, does not have a traumatic past that “explains” their descent into villainy? How might society change if we made a concerted effort to help people heal from early trauma?

The point is healing trauma should be a public health priority.

Sometimes trauma occurs outside of our conscious awareness. Dr. Levine demonstrates with compelling evidence how complications at birth or surgeries during infancy put children in a continual state of fight or flight. The young ones with diagnoses of ADHD by age five may be hyperactive because their body has stored trauma that needs resolving. In Trauma & Memory, Levine gives an example of using SE techniques on a four-month-old boy who experienced a traumatic birth. The cord wrapped around his neck, and he could not get out of the womb until doctors finally performed a C-section on his mother. His body remembered that trauma, and his behavior showed it. We tend to think babies do not remember this trauma, but their bodies do.

God made us beautifully and wonderfully. He made our bodies so intricate and complex that our cells can heal. Therefore, it is not outside the realm of Christian therapy to consider that the body God created was also created to protect us from harm. It also means that figuring out how to help the body heal from trauma is an important part of healing. As a practicing therapist, I combined concepts from SE with Christian principles and saw people heal in ways they had not before.

Every recovery journey is as unique as the individual going through it. My caution to people seeking professional help is to trust your instincts. If a suggested therapy is not working within a few sessions, find someone else. Therapists are not the authority figures and experts society deems them to be. Keep in mind that even a C student can become licensed. Furthermore, do not discount the importance of the body’s response to trauma because just as it responds to trauma to protect you, it needs to be at the forefront of healing.

I hope to write more about the things I continue to learn. Just because I share this information does not make me an expert or authority on it either. The purpose here is to share information and inspire more questions.

God is the ultimate healer, and all we can do is keep learning, keep trying, and keep praying.