We know plenty of strategies for engaging our trauma patients. But do we know what to avoid?
How to help patients heal is not always clear. And trauma patients, given all their diverse history and symptoms, can be some of the most challenging.
So it almost goes without saying that, when working with clients who have experienced trauma, there are extra precautions practitioners need to consider.
Let’s take eye contact for instance.
While many of us would say eye contact is essential, Stephen Porges, PhD has written about the importance of averting eye gaze when working with trauma patients.
Direct eye contact can be interpreted as threatening and may trigger a negative reaction from someone who has experienced trauma.
In his book, The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation, Stephen describes what happens to the social engagement system of trauma survivors.
Trauma can turn off the social engagement system. Attempts to engage a person with trauma history, rather that eliciting spontaneous social behavior, may trigger defensive and aggressive behaviors.
From a clinical perspective, traumatized individuals often present features of gaze aversion and flat facial affect. If we were to monitor the physiological state of those individuals, we would observe an ANS (Autonomic Nervous System) that is poised to fight or flee (i.e., high heart rate and low vagal regulation of the heart). The traumatic experience functionally retunes neuroreception to conservatively detect risk when there is no risk.
Most therapeutic strategies attempt to engage with direct face-to-face eye contact. Working with traumatized individuals creates a great challenge to therapists, since the normal social engagement behaviors of the therapist may trigger fear and reactive defensive strategies.
But this precaution leads to a new problem.
If we avoid eye contact, how else can we engage with a client?
Dr. Porges offers a solution that involves an entirely different sense all together. This is a strategy you might not have considered.
Music therapy provides a special portal to reengage the social engagement system that does not require an initial face-to-face interaction. Music can be used to stimulate the social engagement system without requiring face-to-face reciprocity. Since melodic music contains acoustic properties similar to vocal prosody, music may be used to recruit the social engagement system by challenging and modulating the neural regulation of the middle ear muscles.
If the social engagement system is effectively recruited, positive facial expressions will emerge, eye gaze will spontaneously be directed at the therapist, and the traumatized individuals will shift to a more calm and positive physiological state.
Through the use of music therapy, it’s possible to stimulate a patient’s social engagement system without triggering defensive behaviors.
So, to get to the eyes, you could go through the ears.
Intrigued? I was.
To find out more, you might want to check out Stephen’s book, The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation.
Stephen Porges is the creator of polyvagal theory, Distinguished University Scientist at the Kinsey Institute at Indiana University Bloomington, and Research Professor in the Department of Psychiatry at the University of North Carolina at Chapel Hill.
We’ve talked with Stephen before about how the polyvagal system can help us understand reactions following trauma. His research is often illuminating.
He’s also a profoundly wise person, and I’m always glad to share his thoughts with you.
What are some techniques you’ve used with trauma survivors to avoid triggering a fear response? Please share your thoughts in the comments section below.
Thanks for this. Maybe I could pay more attention to whether music I listen to triggers fear or wish to engage.
What to do with the eyes?
I have found therapy dogs, songbirds and even a fish tank to be helpful places for both patient and
Therapist to rest their eyes while attuning.
This brings some of what Nature provides, into the therapy session.
Yes! Parallel experience instead of mirroring, and parallel physical positioning instead of oppositional also helps
initial interactions and building trust.
Yoga has helped me to find comfort in a peaceful sanctuary where noises are tuned down or at least lowered tempo creating a protective feeling of being safe in the room. I usually close my eyes during the movements so I won’t be so self conscious. But my teacher would on the contrary encourage to do it differently: stay present in the moment and look around you.
Thank you for this post it helped. I am recovering from trauma and eye contact does affect me, strange thing is eye contact was very important to me but at times now find it intrusive. What I found is I was full of so many emotions and fears that as much as you want recovery you don’t always want someone to see your fears as this further makes a person feel vulnerable.
At times I am using special brain wave music in order to calm the atmosphere, but I have had Clients be annoyed by the music or simply declined music all togther.
As a music therapist I am very pleased to read about music therapy on this page – thank you very much and keep up the good work. Reading some of the comments I want to clarify, that the reccommendation is not to generally use music with trauma patients, but it is for the use of music therapy (which requires a music therapist). That then can be quite helpful for some trauma patients, definetively not for all of them.
Yes! I am a board-certified music as well, and I completely agree with Johanna. I highly caution against the application of music therapy with trauma clients without the presence of a board-certified music therapist whom is trained and knowledgeable on the type of, method of, instrumentation of, and potential responses to the music interventions used with trauma clients.
Just as a psychologist would not be able to prescribe medications to a client for anxiety without a psychiatrist or medical doctor involved, so to is it risky business to carte blanche recommend therapists using music therapy in sessions without a certified music therapist present.
I have read though many posts here and think passing on a newly released website may be useful and informative to many.
This is the first compilation of links to original research works that study the effects of hand drumming/percussion and significant improvements to our emotional and physiological states. Over 30 works are presented and grouped by population studied ( addictions, PTSD, child/adolescent, workplace wellness etc), and effects on brain structure and immune system, these studies strongly supporting the comment in the article above ” So, to get to the eyes, you could go through the ears.”
There are two pages on how this all is connected to mindfulness as well… I hope this is useful in your learning about creative modalities of therapy.
I am trained in Health Rhythms, an evidence based group wellness experience that combines hand drumming with non verbal expressions of feelings and emotions. A group of vets with PTSD tried this and came away engaged and smiling. Music, does reach someone deeply and the sensory and group engagement provides a social connection and a very mindful experience… probably allowing the feeling of safety to emerge… I distinctly saw more eye contact after drumming than when we started.
Thanks for this great article! I enjoy reading your work! Very helpful.
Oh this is lovely. I work a lot with giving certain clients space form my gaze. They are so deeply responsive to that level of attunement. I speak softly about what Im doing… “So Im just averting my gaze here… I want to give you space… Im still right with you… (and then I wait and feel how they are) …. because we don’t want to frighten anyone here…. and so i’m looking round the room…. and every now and again…. I will take a peek… just so I can see how you are doing….
Its always such sweet, deep work. I leave space between my little chatters obviously… and i’m feeling in my body how they are and what is happening in the field. It is profoundly appreciated.
I know I have felt almost bullied by a therapist who would not avert her gaze for me.
Dear Catherine
I am a trauma survivor and can say that you are absolutely right in your very wise and perceptive approach. We retain so much fear and hyper vigilance, we don’t understand the very strong emotions that keep coming out of nowhere, and that frightens us even more. It’s fear of fear. We have layers of fear and each one needs to be so gently eased away. I’m so happy for your clients.
Good info. Thanks.
Thanks. Useful information.
I use drumming effectively to activate the social engagement of my clients who are withindrawn. This is especially effective with trauma recovery patients. Starting with a simple heart beat rhythm I will eventually mix rhythms and actually communicate with them in complementary beats. Not only does this engage the social emotional system it lowers heart rate and releases muscle tension. In addition the client experiences empowerment in overcoming the fear and awkwardness of attempting a new unfamiliar activity. Drumming together is fun and the original form of distant communication in African cultures, the motherland of all peoples!!
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Chanting about God to wonderful music we all participate in , when I was in ashram , helped to clear my mind of trauma and I feel I need more of it.
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Very helpful, thank you. It became clear for me the defence used by the person traumatised
I ll try to use much more music from now on.
this is a second thought to my last comment. If both client and ally can together attune, and can consciously KNOW when something is shifting, or being triggered…. then we can also change the relationship TO fear. In itself, it is a phsyiological response meant to help us figure out what to do next. It is not wrong or bad, in itself. When we learn how to know what it is, give it attention, be with it in a safe place and with a safe person, then we shift the whole thing — the fear, and our body and our relationships. SO, with the right setting, we don’t need to AVOID fear, or even avoid triggers… we just have to learn to be with them and share them differently.
thanks to all who have written and shared. I think almost any specific tactic can work well,, or be a trigger, for individuals. Eye contact is only one way to build connection, which is the bottom line in any therapuetic alliance. So, in trying anything new, the first guideline might always be assessing and working with an individual’s ability to know what is going on with them… do they KNOW, can they tell, HOW do they know, if something is shifting and it’s ok, or if something is being triggered. If these skills can be taught and learned, with both client and ally both paying attention, connecting on that level, then trust can be brought in and it is more and more ok to try new things…. more like curiosity and discovery then, instead of an experiment or an imposition.
I was with you right up to the point you had the awful image of the person with a triangle bell. That instrument is the worst imaginable choice. I think your marketing person needs to change the picture or a harp.
I find that most patients in phase 1 trauma are sometimes unable to endure music as it in itself is very triggering. In fact some patients stop listening to music altogether as it is too painful. I would err on the side of caution before recommending this approach.
Indeed, Sarah, listening to music can be overwhelming in case of trauma. It all depends on the person of the client and on the situation, ànd the phase of the therapy. But therefore in music therapy playing music is often a better way of working: client and therapist play together, create on the spot a musical space, a musical connection between both: depending of the needs of the client every parameter can be modulated on the spot (intuitively): melody can be more or less emotional, beat can be put on the foreground or background, etc: in this way the client can build the distance and the connection he needs to feel safe. Like Porges says, while playing music the eye contact is not needed to create a bond, nor to know how the client is feeling; the nonverbal connection through music is even more intense and can nevertheless be felt safe. At least if the therapist follows the need of the client (like always essential in therapy). And therefore the therapist has to be a certified music therapist who masters the medium!
Brainspotting is an effective treatment modality that uses eye position to help clients reprocess trauma without the need for eye contact. If helpful for the client, a therapist who does Brainspotting can also use biolateral music to enhance the processing. Brainspotting is based on the attunement of the therapist to the client which calms the amygdala; this then allows reprocessing to happen at the client’s pace.
Very interesting
Often, I cannot TAKE vocals/sophisticated melody, music within the confines of a song. My Father was a gifted songwriter, guitarist and I was traumatized as a child and still as an adult. He passed away a week or so ago and I am Again, traumatized. Usually I cannot intake anything but silence for a while after incidences…….then, I go, as now, to sound stuff. Like Tibetan Bells. Windchimes, windstorms, snowstorms. Nothing with any construct. It disturbs my grieving/trauma healing process.
My ex and son are also gifted guitarists, musicians……and I, previous to marriage, was a professional ballerina.
I too have found the vast majority of people find music with meaning far too triggering. Thank you for sharing your experience.
As a massage therapist specializing in working with people who struggle with anxiety, depression, chronic pain, and trauma, I play music during my bodywork sessions. I would really like to have some specific suggestions from Stephen Porges of music that is likely to be helpful for a traumatized person’s NS. I have heard him mention folk music with female vocals in other interviews, but that is a wide genera! Specific songs or artists would be so helpful. Lately, I have been using classical Latin guitar music of Johannes Linstead, each piece carefully selected.
Always do ask the client. Music that is always right for everyone doesn’t exist. Everyone has his own associations, and own triggers to the music you offer. Therefore I ask the patient to tell his own preferences of music and bring his own music. I let him/her choose the length of the listening, the dynamics (loud, soft). I give him a sign he can use to stop (for example: a touch of the cymbal). Also when you are not a music therapist, you can use real sounds, that by the client are associated with positive connotations (peace, safety, connection): a chime, the sound of the sea (ocean drum), rain (rain stick),…
Thank you Ruth, I’m sold … So very helpful as always …Im ready to buy the book 😉
I love reading these comments. At our Rape Crisis Agency, we have incorporated yoga, photography, and equine group work with great success. All involving talking and doing–hmmm…. I am a certified equine specialist and EMDR trained. Part of my practice is work with individuals and groups in an equine- assisted environment (including Equine-Assisted EMDR). Clients who chose to work within the equine environment experience a real-time, nonjudgmental, and non-critical relationship with a half-ton animal whose nature is to react to changes in his environment with fight or flight. Sessions are carefully guided and monitored with a team approach and the therapist and equine specialist are de-centered. The beginning focus is on psycho-education about horse behavior and mindfulness strategies help build therapeutic trust. Clients who cannot engage often come to horse work and a natural progression occurs. It often begins with establishing eye contact with the horse and experiencing real-time practice with recognizing and tolerating affect. It is a powerful experience to realize you can choose to welcome a large animal to walk up, and then have that horse gently place his nose on your chest and breath slowly, while monitoring your own physiological response and rise in affect. It is, like all complex trauma work, a process that takes time and building relationship but often many of the individuals I work with find it easier to enter trusting relationship with the help and presence of the horse. While not for everyone, we have had phenomenal success with clients for whom other approaches seemed to not be working. And as mentioned above this is a specific field of study– Equine therapies can be trauma inducing for individuals if not provided by certified/trauma trained therapists, certified/trained equine specialists, and well-trained horses who are specifically chosen for this work.
The work of Stephen Porges is central to David Bercelis development and explanation of Tension and Trauma Release Exercises. You have had David on your Trauma series before. As a certified TRE provider I have found folks with PTSD respond well as they are developing a relationship with there body’s responses. In the beginning the practitoner assists in creating a sage space..ie co regulation…over time as the client gets more comfortable they allow their body to physically release the ovwr hyped protective body responses. As they learn to self regulate…they often become more comfortable with emotional releases as well. …..There is no need for eye contact..when they are learning the exercises. They offer eye vontact when they feel ready.
Thanks gor this great info exchange
Yes I agree that music is very powerful and “preferences” are very personal.
I have met many adolescents who report using music to help them self regulate -but they choose their own music.
I have also been very privileged to listen to a qualified music therapist give a presentation and demonstration of how she used her skills in a neonatal intensive care unit. She played on her guitar in a way that matched the baby’s breathing- which had a very calming effect on not only the baby but also the mother who had been struggling with her anxiety and was having trouble tuning in with her baby. I have also heard of other music therapists working with adolescents where she helped them express their feelings with the use of drums -where they “made the music”
I know I choose music for myself according to what I need.
I remember listening to some Tibetan healing music on a long car drive when I was grieving. The music was very simple and was created using only one instrument and I found it very soothing and was aware that a full orchestra -no matter how beautiful would have been too stimulating.
And I often recommend walking in nature as very therapeutic. I haven’t done it much lately with clients because I also need to be able to guarantee privacy.
When working with adolescents and pre-teens I’ve assumed that they are not going to tolerate just face to face talking- at least initially.
I love using art therapy when clients are open to it and find words inadequate..
I look forward to finding out more about how Stephen Porges uses music.
Thanks everyone -I too enjoyed reading everyone’s comments.
It’s great that you identified how much works for you personally! I just wanted to point out that just as music therapy is specifically provided by a credentialed, art therapy is facilitated by art therapists who get their masters is art therapy and LPC. I’d love to hear how you incorporate art during your sessions!
Thanks, Ruth, and all, for investing your energy in sharing your valuable ideas. I enjoy reading all of them.
I am an experienced therapist working mostly with patients who experienced emotional/physical abuse early in life and who are now diagnosed with chronic pain. I am sure that some forms of music will at some points in therapy help some patients. There is no kind of music that will always help all patients. On the other hand, I have found that introducing Diaphragmatic Breathing, simple forms of Yoga and Meditation has help almost all of my patients. I plan to try some forms of meditation music, Native American wooden flute music and Breathe with my patients at the beginning of a session and see how that goes.
From a survivor of preverbal childhood trauma. My mom had dead strait – on glaring eyes. It took me years to not trigger from eye contact. “Wild Eyes”. You’ll know if and when you see em.
Thank you the article and for all the interesting, helpful comments.
Another medium I have found very helpful with highly traumatized clients is art therapy. A current client finds it very difficult to stay connected, and tends to dissociate. Knowing she enjoys doing artwork, I suggested that she bring in a pad and oil pastels. She actually allows me to sit next to her while she is creating and expressing what she is feeling through art. And, added bonus: Drawing horizontal lines is bilateral stimulation. Surely but slowly, we are making progress.
Something I learned from Bandler and Grinder, is the fine art of pacing, i.e. copying people’s expressions and movements, but only sprinkled into dance or conversation, for example…because copying verbatim can trigger hyper-vigilant or guarded individuals, even MORE.
I very much appreciate this forum where we can all keep learning about the most current research along with anecdotal info for our work! A simple option (one of many strategies) I offer for trauma survivors’ sense of safety is provision of some large soft cotton woven blankets on the arm of my upholstered chairs & a pile of teddy bears and other non-threatening cuddlies. Clients who are re-experiencing the fears of their victimization can often feel protected when they are wrapped up and/or snuggling with something that they know is safe. I also use a lot of guided imagery and hypnotherapy about safe places and distancing from the parts of the trauma material that are too disturbing or just not useful.
By the way, in North Carolina the term “music therapy” is well-defended by certified music therapists and their national and state organizations as the exclusive territory of board certified music therapists. While I don’t believe it has any legislated teeth yet, one should expect a critical phone call for any public use of that term. The rest of us can say that we use music as part of our psychotherapy, or just do it and not call it anything. In their defense, these folks are working miracles on a regular basis with specific carefully researched protocols for clients with a wide variety of difficult-to-treat clinical issues.
Very nicely said. I agree. I believe the world would be a different place if we all still cuddled with stuffed animals. All of us. And not just in therapy. I believe it’s a way of self-soothing that we can learn from watching 4 year olds. The Little Child within us can still relate viscerally. It’s our intellects that get in the way.
And we do need to be careful of using trademarked occupational titles. I’m sure it would be the same with the phrase art therapy.
As an art/expressive therapist, my guiding philosophy is that everything works for someone, nothing works for everyone, and nothing works forever. Having some theoretical basis for suggesting what you and a client do is important, but most important is to assess each individual’s response to media, environment, and more.
Very well put
I am a woman in my late 40s, diag: CPTSD, various sources/events. I have had very little therapy at all thus far and it was barely effective [mostly good to get me to look more closely and identify my own triggers and be able to ask what of my issues are PTSD and which may be medical]. I could not imagine music on at any level while trying to sort thru complex traumatic memory. I would spend half my energy trying to block it out, and yes : low music is defintely a trigger for many of us! I would also squirm w eye contact and very much prefer to be drawing while speaking. using my hands on some task as I speak. It gives me more control and a focus as opposed to spending time/energy trying to not aim my stress at the person trying to speak to me. Staring directly at a therapist just leads to me automatically assessing their sincerity and getting lost in their details and if there are clocks/watches etc that are looming then forget it. I have a perhaps naive question: WHY don’t more therapist+client sessions take place outside??? Looking out a window at sky helps me a lot but being outside in ANY weather would open floodgates and work out better for me and I think many others. Is this a bad idea? Why? Just walk across a park or field or ANYwhere that is even a bit natural. is it time constraints? I think it would instill confidence in both directions.
I wish architects would design rooms with skylights, or just a simple garden “bay” window. I understand the need for privacy, but I also understand the need NOT to feel trapped in a room.
I also value talking while sketching, scribbling or playing with building blocks. Anything, but direct, “normal” eye contact. “Normal” eye contact is just too hard for the traumatic topic.
I’ve enjoyed reading this string. Very enlightening.
Yes! Or I let the client play with a little, soft ball (a tennisball or a joggling ball!) going back and forth between the hands, while we talk. By doing that, I notice that the client can stay more in het here and now, he has something to do. It gives him a feeling of control of the situation (something like a cigaret in the hand of a smoker). And it helps him to process unconsciously by activating both sides of the brain: it is a kind of EMDR, but much softer (and more controlled).
EF,
I absolutely, totally agree with you! It would be a HUGE help to me if therapy sessions could take place outside! I’m of an entire different degree of focus and relaxation when I’m outdoors, vs being trapped indoors. And I’m not claustrophobic…it is the shift in atmosphere which makes an amazing difference. To take the point further…say, walking together, or sitting on a bench together with a therapist is a perfectly natural way to converse without constant direct eye contact.
Thank you for sharing…I’m so glad I’m not the only one of this mind!
I have selectively done walk and talk sessions with some clients and have used music, art, movement, somatic experiencing as fits each particular person. What works for one person does not suit everyone.mwith eye contact I have taught those with insecure attachment histories to gently and slowly connect by letting me in through their eyes, ears or touch at their own pace. Truly connecting often leads to needed emotional expression such as crying or trembling which often leads to relief of PTSD symptoms.mwe must care enough to be attuned, flexible and creative in co-creating felt safety with those who have good reason to fear trusting untrustworthy others (including well intentioned health service providers who are not tuning in sufficiently). This is one f the better discussions I have come across. Thanks to all who have contributed.
EF, this is a wonderful post. I so agree with you. I suffered from Complex PTS too. Music distracted me like crazy. In fact, I could not do anything but the music if I liked it….and if did not, I wanted it shut off, which was often the case. I used to like to draw as well…doodle or copy things. It was soothing to me and I could listen intently with eyes averted. Like you said TRUST is a huge part of doing therapy and *Staring directly at a therapist just leads to me automatically assessing their sincerity*.
Hypnotherapy is scary concerning the trust issue, but helped me go below pockets of amnesia. Somatic Experiencing took me from dissociating states into rocking between inside and outside…and then to feeling more trusting. Recommend that you talk with a Homeopath if you experience panic attacks or flashbacks. My homeopath stopped these cold…after I somatically felt my *story*.
I’ve engaged the client’s other senses by asking them to hold a small container with strawberries in it and smell the aroma of the fruit, squeeze a small stress ball and describe how it feels, etc. This is helpful when the client is already triggered and beginning to escalate as well.
I listen to music through headphones partially because I just like music, partially because it blocks out some external noises, and partially because playing music through speakers seems to be a trauma trigger. It puts me into a state where my body is reacting as if the people in the neighboring apartments are going to hurt me for being too loud. And it only happens when I’m alone I’m fine with music even very loud club music in other situations.
Music can be a way to have a safe “relationship” with another. I’m a fan of this technique.
And yet, to acknowledge some of the other comments, music – like anything else – is a potential trauma trigger for some. For me personally, music that’s barely audible is a trigger, related to past abuse. Turn it up, and I can enjoy it. Many things that are innocuous to most people, are going to be triggers for others. It all depends on the details of someone’s trauma and what associations have been created in the brain. For example, pine needles and cozy pajamas were triggers for me. I think it’s most important for practitioners to just be aware of this and looking out for it – you can’t presume to know what a given trauma survivor’s triggers are.
What Porges gets at, is that certain triggers are related directly to our physiology – which tends to be on high alert for threat after trauma. So things like eye contact and focusing on the breath are very often trauma triggers.
I am grateful for the time each of have spent to share your thoughts so that others of us might heal.
I have very much enjoyed Ruth’s emails on various topics. Building on the adage: “if the shoe fits, wear it.” It seems like I am finding shoes that fit, slowly.
Thanks again.
Kelly McLaughlin Starr
I had an experience lately of going into a difficult situation fully regulated and coherent. The music was so loud, in that the people did not know how to regulate their new audio system, that I could feel my body going into contraction. The area of my brain stem was tightening and creating a severe headache. 2 hours after the event was over, someone very dear to me said something to me where I “felt” bullied, and I blew up. I raged with a loud voice at the person. I was in total hypervigilence fight mode. My reaction did not match the situation and I felt shame and regret and a lost at how to repair the situation. As I traced my body sensations over that day, I realized that my system was in full activation but being controlled before I blew and when I was in the presence of the loud music. I had enough resilience that day to not be reactive until the resilience ran out and I was exhausted and my nervous system was on overload. This experience of course was not in the presence of soft music, however it was a great lesson on how sensitive my system is to sound.
I personally do not want music during my sessions, for I would feel that I am just in the outside world where music, television and social media replace connection and listening and communication. It would be helpful however to use soft music in the waiting room instead of those white noise contraptions that activate my nervous system before going into my sessions.
Soft and inviting eye contact and a soft voice tone help me to feel accepted, safe and coherent. However, when I experience the “warden” therapist with their brittle stiff judgmental body language, bring their agenda to be thrust upon me, and who begin creating their own story about my experiences instead of remaining neutral and seeing my experiences as “what is happening in the moment”, eye contact is extremely activating in their presence. Those with a soft and welcoming connection with the eyes allow an opening in the session for trust to be present and for true healing to occur.
So with my own clients, I see each one as an individual with needs unique to them, and I allow my “Beingness” to be neutral and meet them where they are. If music is found to be helpful, then we can negotiate that together. My intention is to show up without an agenda and create a field of safety for what needs to unfold to unfold. I am grateful for my own healing journey with Traumatic Brain Injury and PTSD that has been my greatest teacher in being fully present for someone else on their journey.
As a therapist, I am quite directive in my work, and sometimes it takes me a bit to allow the person before me to unfold his/her story without my notions of “theory and treatment” getting into high gear. Thank you for reminding me.
I, too, am sensitive to sound and I have had many experiences with intrusive noises in many forms, e.g. traffic, “on hold” on the phone, and other areas where music might be intended as a soothing environment. If it is too stimulating in any form (not necessarily just loud), it wears on me and I can feel my physiology responding. I am trained enough to utilize self-soothing techniques, but the energy required takes its toll. I am interested in this subject because I treat and write about debilitating tinnitus and hyperacusis which many people are experiencing in this noisy society as well as with veterans returning from war zones. Most of these clients/patients reject any form of sound because in hyperacusis clients especially, sound HURTS. But treatment requires a gradual inclusion of sound and I feel this area of treatment could utiliza the work centered around polyvagal theory because debilitating tinnitus and hyperacusis is definitely a form of trauma.
Fascinating. I’m so enjoying everyone sharing their stories. I’m liistening.
Yes music works!!! I chanted God’s name ,in an ashram, for 12 years and know first hand how healing it is.
I’m wondering if there are some types of music that are better for this work than others? I would dearly love to get rid of our white noise makers in the office…If we could replace them with a music system that is useful in treating trauma, how wonderful would that be?
music is a profound way to slip through the cracks in recovery. it can be triggering and it can also be deeply resonating. Sometimes the music is the remedy for the poison in which it was originally used, like for instance if someone was abused with music in the background. Ii use music in all the ways with survivors. and in all modalities–orchestral, hip hop, rock, pop, world-whatever… i always look for good and articulate lyrics when there are those, in whatever language my clients are. i work with the MaleSurvivor weekends of recovery. music is absolutely essential to the process and the mood, and to attainment to the non verbal non linear place inside
I have a highly sensitive nervous system and am very sensitive to sounds. I think the term “music” is too broad a term to use as much as we do. I think a large part of what works for different individuals is dependent on the frequency/frequencies involved. Different frequencies resonate in different cellular ways. You don’t have to listen to one note to hear the frequency that helps you, like the many selections on YouTube. There are songs being written with different frequencies entwined to serve different purposes. Here is one composer.
Music can be overstimulating and a trigger in itself.
Just want to say I appreciate both of your comments, as a health professional whose suffered catastrophic trauma recently and is waking up to deeper layers of childhood trauma. It is complex and even with myself and my own care I cannot know what will help or hurt my wiring in every instance and I have suffered being an experiment of practitioners along the way. For those looking for related content, specifically about granular, possible approaches in being with the traumatized brain, Michele Rosenthal’s work has been helpful to me.
Hi Nik, have you looked into Diane Poole-Hellers work on trauma/somatic experiencing/attachment in therapy? She offers possibilities to work on their own attachment history to therapists. I will certainly look into Michele Rosenthal´s work, thank you and warm greetings, A
Instead of looking at each other – looking in one direction, literally, while taking a walk or sitting on a bench, and, metaphorically, using psychoeducational elements and engaging the person´s “inner healer” to tend to the traumatized parts alongside with the therapist, stirring away from fusion with the traumatized parts before they take over. That would be my intuition. My sense is that the therapist needs to stay part of the equation – as a significant other potentially providing opportunities for corrective experiencing and connecting in a safe way – in my imagination, “resorting” music might also be perceived/interpreted by the patient as being “abandoned” by the therapist into having to regulate on their own, which, in the case of complex trauma, might have been the problem with their caretakers in the first place. Co-regulation in a reparenting sense might be what is needed, hight attunement – but, of course, that might seem like too big a prerequisite, given that many of us therapists -or at least I and a couple I know – have an own history of insecure (or even trauma-inducing) attachment we never had the chance to work through entirely … my take, of course. All best, A
Andrea, thanks for this share. I too have wished my sessions were walking sessions, knowing that my brain was quite literally having to access both sides…right left, right,left. Staying put (seated and looking down, sort-of keep you down while movement is uplifting.
Yes. Even therapy can become narrow-minded if we don´t watch close. All best, Elena! A
Having complex trauma since before birth and having grown up with music, I want to remind people that it is much more complicated than it may appear at first glance.