A TraumaPractik© Discussion.
TraumaPractik© is both a technique as well as a philosophy.
We at TraumaPractik©have long been aware of the work of both Carl Pribram and David Bohm (vide above). When Bohm spoke of the various problems associated with the “fragmentary” way in which we go about looking at the world, this certainly “rang a bell” concerning our work. We are always mindful of reducing our focus onto one or two variables because, in doing so, we have found the results to be less than satisfactory. This is not to say that we don’t examine variables one at a time – we do, but this is always against the backdrop of there being more. What follows is a broad examination about our practice, but in passing, it must be mentioned that we will incorporate any other modality that may be appropriate – from psychosomatics to anatomy, from osteopathic techniques and philosophy44 to naturopathy. In short whatever works. Having said this, as any professional in the field of “trauma” will tell you, finding out what works is anything but easy. Our practice of ±30 years and we continuously draw on what we have learnt and even then there are daily surprises. Bohm’s explicate order is always interfacing with the implicate order. What this means that although the mechanism (the holographic nature and Fourier transform) whereby an individual uptakes and reveals their experience is universal (implicate), each individual’s history is personal and particular (explicate). All their losses, gains, loves, hates, hurts and health, in short, everything; once this is focussed on we are able to begin to address their issues and their pain.As a technique (or rather a body of techniques), this can be found at “www.anatomyoftrauma.com”. It is our firm belief that in “trauma”, the way to unravel this must have its ætiology with the “physical”. I say this because the body is a living index (so to speak) and working with “what is” provides us with access to “what has happened”. This also allows for a better platform as to “what is to be done”.
As a philosophy, this is based in a very particular definition of “trauma” and if one were to peruse the various definitions of trauma, e.g.
- “An injury physical or mental.”45
- “A wound or injury, especially produced by external force, e.g. surgical operation, impact, blunt instrument.46
- “A physical or emotional wound or injury.”47
It is clear that the words “trauma” and “injury” are considered almost as synonyms and are used interchangeably. At TraumaPractik© this is considered confusing at best, and, misleading at worst. Both “trauma” and “injury” occupy discrete domains.
Injury is to the body as trauma is to the psyche.
The reason for this distinction is not simply semantics. In our work we generally begin with a detailed analysis of the body (gait, anatomy, physical history, etc.). We do this in order to establish a base line as well as to determine whether the person is suffering from an injury or a trauma. This is important because in any situation it is clear that the interrelationship between “injury” and “trauma” is not a simple mechanistic one. In fact sometimes this is almost counter-intuitive. It is possible (and this happens all the time) that a person has sustained severe injuries without sustaining much by way of trauma. The reverse is also true—a person can sustain deep and abiding trauma without any apparent injury whatsoever. There really is no clear and definitive “marker” that allows us to make a decision as to where “injury” and “trauma” overlap. We know these are interrelated but the “how” would be in many domains – from the psychic to the psychological to the neurobiological to the physical. Suffice to say that given this, the distinction between “injury” and “trauma” is even more important. This leads us to the following…
Every sentient being has sustained both ”injury” and ”trauma”. Some come through the various experiences relatively unscathed whist others suffer deeply. In our work of some ±30 years we have come to certain conclusions based on said work:
- Injuries have to be dealt with in the physical plane.48 Be it a broken leg, a torn tendon or a simple sprain, these have to be dealt with. In the case of the obvious e.g., a broken leg, treatment is generally clear. What happens in the case of injuries sustained that have consequences that may not be so clear? Let us look back at the broken leg scenario. What if the injury had ramifications (e.g. a changed gait, an incorporated lesion, unattended myofacial changes, disturbance of the relative anatomical chain, etc.) that only appear much later? In some cases decades later? Much of our practice is devoted to the understanding of what has come to be. Hence the importance of that initial determination. Figuring out the physical is fundamental.49
- Trauma has to be dealt with in the “psychic” plane. What holds true for the “physical” holds true for the “psychic”. For a person to come to terms with trauma, there has to be an understanding that whatever has happened must be dealt with at a similar level. Having said this, one of the most important tenets to be understood is in that order for trauma to be overcome; a history must be developed with said trauma. By this, what is meant is that as long as the factors that invoke the trauma (e.g. a smell, a sound, etc.) continue to exist, and then to all intents and purposes, that trauma (no matter how old) continues to dominate the present and is as real and prevalent as when it had happened. When a person begins to talk about what has happened dispassionately (e.g. I remember when Mom died), then, and only then, is this settled.
- Trauma is not always obvious. Whoever works in the field of trauma quickly come to realise this truism. In our work, it has often happened that what has begun as what appears to be a commonplace injury has reared up as a very deep trauma. Again we go back to the statement that the interrelationship between “trauma” and “injury” is not a simple mechanistic one.
- Injuries, like trauma, are not necessarily restricted to any single layer. Both “injury” and “trauma” are experiential. Experience in whatever forms it takes is complex. Many a person that has come to our clinic has come to terms with an injury/trauma only to discover something even deeper. Generally our experience has been that the physical and/or emotional aspects may change but in the absence of that sense of health/calmness/wellbeing/stillness, these are unresolved. It is only a matter of time that something else will surface.
- In the absence of “new” experience replacing the “old”, people will revert back to what they know. This truism comes on the back of hard-learnt experience. People, who have experienced something deep and chronic, have had to reinvent themselves in a peculiar way. For example, chronic pain sufferers manifest a distinct kind of duality – the person with the pain and the person without. If there is a way to get better it involves dissolution of this duality (a really scary scenario considering that they have developed this in order just to be functional). Now if the person does “reintegrate”, it is vitally important that they are taught a new method, be it stretching, meditation, exercise etc. For if this is not done, the person will revert to what they know. Getting out of a situation is not the same as staying out of it.
So to re-iterate, at TraumaPractik© there is a clear and distinct difference between “trauma” and “injury”. Because of this our starting point is always the physical, however, one must always be aware that it is “only” a starting point but where it lands will be the prerogative of the patient/client.
This brings us to some other understandings that we have acquired on the way:
- As we have seen from Pribram’s and Bohm’s work, the brain functions in a holographic way. Given this we must also understand that the constituents of the physical body are continuously giving feedback to the brain, which it in turn interprets. In the case of injury that becomes trauma, we have postulated a “trauma wave©”. This “trauma wave©” is the force that is engendered trough the tissues of the body which overwhelm the mechanisms that are in place. For example, the Encyclopædia Britannica defines cerebrospinal fluid (CSF) as a “clear liquid that fills and surrounds the brain and the spinal cord and provides a mechanical barrier against shock…When an individual suffers a head injury, the fluid acts as a cushion, dulling the force by distributing its impact”.50 Within certain conscribes this is patently true, however, water-like fluid (CSF) is also an excellent conductor of force. Think again of the pebble-in-the-pond analogy. Even a small force ripples outwards, but what happens in the case of a violent shearing force especially when it is unexpected?51 52 Well the results are not very encouraging. When the trauma wave© rips through the various tissues, the protection afforded by the CSF, for example, can be completely overwhelmed. So too the tissues of the brain itself, as well as the tissues of the body.
- The trauma wave© of course has any number of powerful effects. It carries within it violent and disturbing information. The brain literally becomes bombarded and all the time it is manifesting these holograms of pain and suffering through the Fourier transform. It is here that trauma becomes entrained. Imagine this for a moment: A person sitting at a stop street in the motor vehicle is suddenly rear-ended. Now the force does not have to be that great – we have seen dire consequences from motor vehicle accidents at less than 5 m.p.h. (8 k.p.h.). What is important here is the unexpectedness (as mentioned before) and the amplitude of the force going through the tissues. The tissues, having suffered the trauma wave©, will continually inform the brain. As soon as focus is brought to bear on the multitude of holograms this has produced, the explicate is now filled with pain and the psyche suffers as well. Further the problem is compounded because a lot of destructive and potentially painful information has also been stored in the implicate only to be enfolded back as pain and trauma at any given time. In Post Traumatic Stress Disorder (PTSD) situations, there are many triggers (smell, taste, situational, etc.) that bring what initially was implicate, crashing into the explicate.
- Tissues of all sorts are the conveyers and storers of information. Let us go back to the CSF for example. The CSF is continually being manufactured in the ventricles of the brain and “is replaced every six to eight hours.”53 There is a continuous formation and absorption process.54 This means that the information stored within the liquid is also being continuously circulated. And yes, we do mean “information stored”. 55 56 In trauma, this circulation of information and what the brain does with it, gives us another tool in the TraumaPractik© toolbox.
To conclude this chapter, the separation of “injury” and “trauma” provides us with a better “operational process”. It is very rare for our work to begin without the physical. This is the domain of the “obvious” in so far as we know what to look for. There is never an assumption that an injury is simply that – an injury. There is always mindfulness that even what appears to be uncomplicated may be exactly the opposite. The human is capable of the most amazing scenarios – be they physical or emotional and in our practice we never cease to be amazed. We do realise that the work of Pribram et al may be difficult for a new student – be they a student of massage therapy to physiotherapy to osteopathy to medicine to psychology to any other discipline. Be this as it may, our experience has shown that in order to understand trauma and perhaps how to treat it must perforce have an understanding that what we are dealing with is not simply a mechanistic robot-like function of a bunch of tissue or emotions that simply “got mixed up”. Force disturbs and creates interference patterns that are the hallmark of the hologram. Be it in the body or the psyche, pain is an interpretation of the brain. When the psyche is “disabled” however, we then have trauma. Just by way of conclusion, what if there was no “real force”? By “real force” we mean there was no apparent injury or accident with which the trauma was mobilised. An example is some of the survivors of the showa or soldiers returning home. No, there may not have been that kind of force but one must bear in mind that the conditions for the trauma wave© is rooted in the brain’s ability to interpret. The perception of severity is condition enough. Were you to live in circumstances that might result in pain, injury or even death on a daily basis, this is more than enough to result in trauma.