How to Heal Trauma and Build Resilience: An East Meets West Approach
As a result of working in the Newtown, CT community after the Sandy Hook shooting and in working with 9/11 survivors, first responders and family members, Trauma Therapist Bonnie C. Rumilly, LCSW has spent years supporting trauma victims in their healing.
With 19 years teaching yoga and meditation, a background in social work and writing, Jackie Jackson has taught the Eight Limbs of Yoga for stress reduction and lifestyle management to hundreds of students.
Coming together, our purpose is to delve into the best practices of a trauma therapist and explore where Western healing modalities meet the Eastern complementary practice of yoga therapeutics.
Jackson: What have you found to be the number one determining resilience factor with your clients in your trauma work?
Rumilly: “Some people have the ability to build strength and grow through challenges. When people are in a vulnerable place, resilience can be cultivated and growth can occur. For example, in losing a loved one.
People evolve over time and are able to integrate a new normal with learned coping skills and new sources of strength. This is what we refer to as post-traumatic growth. Resiliency is a mix of nature versus nurture. Each individual is unique and complex. Every situation is different. Some people find strength and purpose in starting agencies or companies and helping others. Some people have the ability to hone in on advocacy work to fight for others. Some find a way to channel, to focus their pain and energy to help others.”
Jackson: We’ve heard of protective factors which are things like personal temperament, social orientation, personal ability, faith, etc., that all seem to predict a person’s ability to move on and heal. Please break it down for us. What’s the best way for people to make themselves more resilient?
Rumilly: “Yes, to the best of their ability, finding social connectedness like support groups and peer support. It is extremely beneficial to be with those who share similar feelings and experiences. Many find so much healing in this way and they learn they are not alone.
Jackson: Yes, according to the American Psychological Association (APA) the primary factor in resilience is social support. Caring, supportive and compassionate relationships offer love, a sense of trust, encouragement and reassurance.
Rumilly: Develop a new hobby or long forgotten passion. It could be knitting, fishing or an old childhood pastime. Learn to use it as a coping skill. The more coping skills and self-care strategies at one’s disposal, the more present they become. Allow yourself to feel your feelings. This is mindfulness, which is the practice of being in the present moment, in the here and now. When people have anxiety and/or trauma, they tend to live in thinking about the difficulties from the past and worrying about the future. Mindfulness can help people learn to be present and in the current moment with their feelings and emotions. People can learn to accept the feelings and move through them, in turn growing from them.
Jackson: Similarly, yoga practice is about being present to whatever arises in the form of thought, sensation or emotions without judgement as a means of learning more about ourselves. Research shows that a regular yoga practice: decreases stress, improves flexibility, strengthens our joints, improves memory, improves sleep, reduces depression, improves digestion, helps us focus, increases serotonin and much more. Its historical roots also have a strong connection to spirituality, a key component of building resilience.
Jackson: Is the term Post Traumatic Growth, the shift in perspective from negative to positive, the same as the goal of CBT (Cognitive Behavioral Therapy)?
Rumilly: “CBT is a very specific tool for addressing symptoms.” [According to Psychology Today online, CBT is a form of psychotherapy that treats problems and boosts happiness by modifying dysfunctional emotions, behaviors and thoughts.] I use CBT to teach people self-regulation techniques and help them change unhelpful or negative thought patterns.
For example, I’ve had clients who have had success with CBT for OCD [Obsessive Compulsive Disorder which features a pattern of unreasonable thoughts and fears (obsessions) that leads to repetitive behaviors (compulsions), according to the Mayo Clinic.]
It works by calling attention to specific thoughts in order to gain awareness and change the negative/detrimental thought pattern. People on a path of negative thinking can use CBT as a tool. One example is closing their eyes and visualizing themselves at a fork in the road with a stop sign at the end. They can focus on the stop sign, see it and choose their direction to break the negative thought. This works with people when their thoughts are looping.”
“Whereas post- traumatic growth answers a question. How did a person move forward and grow as a result of what happened to them? An individual may turn to clinical advocacy. For example, if someone loses a child to SIDS (Sudden Infant Death Syndrome), they may find empowerment and healing in helping others prevent such a loss. There is a reprioritization of what’s important. What is the spark that happens? Often this shift in priorities becomes a catalyst for change as people do what they feel is important, like using their experiences to help others.
For example, take a client who had multiple miscarriages. They are left with no physical evidence to show for their losses but are carrying the burden every day. EMDR is useful when a person finds they are having traumatic symptoms and also carrying a negative belief about themselves as a result of the trauma, like self-blame. A person may think they caused the trauma to happen to them or they failed in some way. EMDR is useful for letting go of that belief once the memories are reprocessed.
Jackson: Why do you use EMDR (Eye Movement Desensitization and Reprocessing) above all other techniques in your practice and how does it work?
Rumilly: “In my work, I mostly use EMDR, created by American psychologist and educator, Francine Shapiro. It is effective for processing traumatic events and other disturbing life experiences.
It’s important to note that not everyone who lives through trauma will have Post-Traumatic Stress Syndrome (PTSD). A person could have post traumatic stress without meeting the criteria of an official diagnosis of the disorder. Trauma is different to each person and there is not an equation for how it is classified or treated. I use a multi-pronged approach and a combination of treatments to support clients.
In order to be diagnosed with PTSD they must meet the DSM-5 criteria.” [The Diagnostic and Statistical Manual of Mental Disorders from the American Psychiatric Association classifies PTSD as follows: The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence. The traumatic event is persistently re-experienced in the following way(s): unwanted upsetting memories, nightmares, flashbacks, emotional distress after exposure to traumatic reminders, physical reactivity after exposure to traumatic reminders.
Avoidance of trauma-related stimuli after the trauma, in the following way(s): trauma-related thoughts or feelings and trauma-related external reminders. Negative thoughts or feelings that began or worsened after the trauma, in the following way(s): inability to recall key features of the trauma, overly negative thoughts and assumptions about oneself or the world, exaggerated blame of self or others for causing the trauma, negative affect, decreased interest in activities, feeling isolated and or difficulty experiencing positive affect.]
Jackson: Can you give an example of how individuals could use the multi-prong approach?
Rumilly: A client could use EMDR with their therapist and then employ other coping skills and therapeutic techniques such as CBT in order to manage symptoms and heal. The person may use CBT when they are at home or work to manage intrusive thoughts, like imagining the stop sign technique and changing their negative thought or going into a mental calm place, which is taught in early stages of EMDR therapy.
EMDR is not just for extreme trauma situations. It can help with self-esteem and negative feelings about self which interfere with personal growth. It alleviates symptoms which makes it useful and such a successful and useful therapy modality.
First, I gather a client’s history and learn their history to see what the impactful traumatic memories are. If someone is experiencing nightmares, they are common symptoms of PTSD. EMDR will help people process the traumatic memories in order to get to a place where nightmares subside and they are able to attain successful sleep again.
EMDR uses bilateral stimulation to activate both sides of the brain allowing the brain to process the memory until it can be stored properly in the brain. New neural pathways are formed in the process of EMDR. As the memories are processed symptoms subside. It helps the brain to heal itself, which is the brain’s natural inclination.
Jackson: Based on Bonnie’s success with the EMDR method and my own research, I chose a practitioner and met her carrying with me a mental list of about seven or so traumatic experiences I felt I needed to release. Over the course of four sessions, each time my response to EMDR was interesting.
Each traumatic memory I explored somehow jumped across the years to one from my childhood. In my mind, it was like following the neural pathways and seeing them connect with each other. Each window had a different picture of my life and it went so fast that I couldn’t focus clearly on a single one. It was more like a moving target.
After those sessions, it was like those memories were put to rest or “properly stored,” as is the goal of the therapy. In those moments, looking back I realized I had done the best I could in some tough situations and I didn’t have to blame myself.
As a yoga therapeutics teacher, I found it interesting to try the EMDR-specific, Butterfly Hug Technique which reminded me of Garuda Mudra. In both practices, hands cross over the chest. In Butterfly hands with fingers tapping under the collar bones side to side while focusing on the breath, as a bilateral stimulation technique to self soothe. This is also a means to bring ourselves back into the body and the present moment.
Garuda Mudra is the same hand shape with the thumbs crossed and translates to “gesture of the eagle”. In yogic philosophy, its purpose is to bring air flow and balance to both sides of the body while increasing blood circulation. The hand shape in sanskrit is called mudra and means seal. It's as if the fingers were wires and holding the thumbs is closing a circuit so the energy can be strong and directed.
Using these techniques with intention proved to be beneficial in conjunction with a calming breath ratio of 3:5. That is, inhaling for the count of three and exhaling for five. With these techniques, I was able to self soothe in session. The focus on the exhale calmed the central nervous system, just as I teach in my yoga classes.
In the process, memories that had haunted me for years were put behind me. They became like a shadow and I wasn’t reliving them as I had been before. Each time I went, it helped me deal with my fears and anger. It gave me a greater sense of being in control. I don’t know how it really works to draw both eyes back and forth but somehow allowing my brain to process the trauma, made it far more workable. Those memories haven’t come up in the same way since.
There are other parallels in yogic techniques to what Rumilly teaches in her psychotherapy practice. The goal of CBT is not unlike Patajali’s Yoga Sutras, a collection of 196 sanskrit sutras or verses dated from 500 BC on the theory and practice of yoga. Verse 2.33 states, vitarka-bādhane prati-pakṣa-bhāvanam. When disturbed by negative thoughts, opposite (positive) ones should be thought of. The act of replacing negative thoughts is called pratipaksha bhavana in sanskrit. For example, when caught up in feeling fear, one can shift their focus on calm and safety or the expansive healing energy of love.
Like Rumilly’s mindfulness reference, there is a parallel breathing technique in yoga. Trauma sensitive breathing technique: Calming Breath. If inclined, try it out with a deep breath in. Then make the sound mmmm as you breathe out. The sound like that of a bee and hence it has been called “bee” breath or bhramari pranayama for a soothing effect on the brain which calms the mind. The humming sound is produced during a slow exhalation with the lips pressed gently together. The goal is try to find the level of pressure between them that creates the most vibration through your whole head from the sound.
Here is the technique: Make the sound as long as you can, and then breathe in again. Do this for around 8 breaths, paying attention to the vibration feeling in your head. A humming sound is particularly effective in stimulating the vagus nerve, the main branch of the parasympathetic nervous system, which helps an over-aroused nervous system to reset, allowing us to relax.
Similar to the “Safe Place” protocol used for self soothing during EMDR, which may be thought of as an emotional sanctuary where a person can internally go to recover stability when feeling stressed, is the concept of Dharana or concentration from the Yoga Sutras
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The latter involves teaching the mind to focus on one point or image. “Concentration is binding thought in one place,” says Patanjali. The goal is to still the mind — gently pushing away superfluous thoughts — by fixing your mind on some object such as a candle flame, a flower, a mantra [or a safe place]. One knows the mind is concentrating when there is no sense of time passing.
In sum is a quote from a master, “Yoga allows you to rediscover a sense of wholeness in your life, where you do not feel like you are constantly trying to fit broken pieces together.” ~ B.K.S. Iyengar.
Likewise, the whole of Patanjali’s Yoga Sutras give a framework for how to practice yoga and explain the outcomes of yoga. The core teachings dive deep into understanding our motivations and behaviour which offers insights into the psychological conditioning and transformation of human beings. The practice of yoga allows us to see our conditioned way of life and teaches us how to let go of those patterns. Then we can positively transform ourselves and, from that, others, too.
Patanjali focuses on an eight-limbed (Ashtanga) system of self-discovery. It is a system of yogic practices designed to bring liberation from the patterns of the mind, or in other words, bring awareness and transformation. The limbs are yama (self-restraints), niyama (observances), asana (posture), pranayama (cessation of inhalation and exhalation), pratyahara (sense withdrawal), dharana (one-pointedness of the mind), dhyana (meditation) and samadhi (dropping the sense of self, feeling of oneness).
One of the purposes of this article was to explore yoga philosophy and offer insights and solutions for trauma as studied in Western psychology. As earlier stated, every individual is unique and healing trauma is an experiential practice. The complementary practices of yoga techniques are meant to be combined in such a way as to enhance one’s work in healing trauma through therapy but are not a substitute for professional therapy.
In sum, yoga and mental health care professional practices can come together when appropriate to empower clients to manage their moods and find relief from stress. In a clinical setting, this may lead to trauma recovery. Together they offer an integrative, holistic approach to healing.
For more information on Bonnie C. Rumilly, LCSW, contact her practice at: A Greater Me, LLC 237 Danbury Road, Wilton, CT 06897. Email: bonnie.rumillylcsw@gmail.com or (203) 957-1810.
Jackie Jackson is a yoga therapist, IAYT, E-RYT-790, YACEP®, writer and author. For more info visit online at: https://www.jacquelinejackson.net/
References:
The Yoga Sutras of Patanjali
David Emerson, Trauma Sensitive Yoga.
Bessel van der Kolk, The Body Keeps the Score
David Treleaven, Trauma-Sensitive Mindfulness
American Psychological Association: https://www.apa.org/monitor/2016/11/growth-trauma
EMDR Research Foundation: https://emdrresearchfoundation.org/toolkit/butterfly-hug.pdf
Calm Place/Safe Place meditation link: https://www.goodtherapy.org/blog/using-emdr-to-find-your-safe-place-in-trauma-recovery-0815164
EMDR Light stream Technique video guidance: https://www.youtube.com/watch?v=NizVehwXD6I
EMDR Light stream Technique written guidance: https://www.hopeandhealingforlife.com/2011/08/reducing-anxiety-the-light-stream-technique/
