Tian Dayton

Emotional sobriety is a term first introduced by Bill W. who felt that, though the AA movement had made enormous strides in helping people to become physically sober, many “oldsters” were still finding it difficult to live in what he referred to as “emotional maturity and balance”. They had “put down the booze” for example, but they were still driven by a somewhat wobbly emotional world. Though they had laid down their primary substances, they were at risk for turning to other forms of self medication like food, sex, spending or compulsive activity. Without addressing the emotional lack of sobriety that led them to use in the first place, balance and maturity still eluded them.

Emotional sobriety is about finding and maintaining our emotional equilibrium, our feeling rheostat, the one that helps us to adjust the intensity of our emotional responses to life. Emotional sobriety is tied up in our ability to self regulate; to bring ourselves into balance when we fall out of it.

Where Do We Process Emotion?

Emotions are processed by something called the limbic system also referred to as our “emotional brain”. Our limbic system, which is where we experience and process emotion, actually sends more inputs to the thinking part of our brain, i.e. the cortex, than the opposite; (Damassio) meaning that our feelings have the potential to overwhelm our ability to think if they are more intense than we can tolerate or regulate.

What does the Limbic System have to do With Emotional Sobriety?

Emotions are a mind/body experience. When we have good emotional sobriety it means we’re not only thinking in balance but we are experiencing our emotions, which are coursing through our bodies in the form of mood shaping chemicals like adrenaline (stressing and exiting), serotonin (soothing and regulating) and dopamine (elevating and calming), within a manageable range. The limbic system governs our mood, appetite, motivation, libido and sleep cycles.

When we have problems in our deep limbic system they can manifest as moodiness, irritability, increased negative thinking and perceptions of events, depression, anxiety, decreased motivation, floods of unmanageable emotions, appetite and sleep problems, decreased or increased sexual responsiveness or social isolation.

But anyone who has lived with the ups and downs of addiction or abuse can become emotionally deregulated. For all concerned, emotional sobriety becomes sorely challenged. Addiction either to a substance or a behavior may indicate a loss of ability to “self regulate” an attempt to use substances or behaviors to bring quiet to a turbulent inner world.

How Does Our Limbic System Get Out of Balance?

When I see clients shoot from O to 10 in a split second, or veer quickly towards extreme modes of thinking, feeling or behavior, I look for some form of trauma. That “black and white” way of being, that makes us think, feel and act in absolutes, may be a trauma related pattern. Fight, flight, freeze is our natural response to physical and yes, emotional danger. From the bodies perspective they are same. Whether we are staring into the eyes of a saber toothed tiger or an irate or drunk parent, our bodies become flooded with stress chemicals like adrenaline that enable us to flee for safety or stand and fight. When we can do neither, as is so often the case as children in abusive homes, we freeze. We become overwhelmed with extreme fear and anxiety until we can’t stand it any longer, then our emotional circuit breakers flip and we “turn off”. We go numb.

When this happens repeatedly, it can undermine our ability to “self regulate” or to bring ourselves into emotional balance. We tend toward emotional extremes going from 0-10 and 10-0 with no speed bumps in between. We have trouble staying within the 4,5 & 6 range. Living in the middle provokes anxiety, we don’t know what to do with it. It makes us feel worried, triggers our hyper vigilance, we wait for the other shoe to drop so we can shoot back to what we know, numbness, helplessness or rage. We lose track of what normal is. Addicts may well be using substances and compulsive behaviors to bring calm to a limbic world that is out of whack.

How Do We Develop an Ability to “Self Regulate” that Leads to Emotional Sobriety?

We learn how to “live and be” in relationships from those who surround us when we’re growing up. Just as addition, subtraction and multiplication form the basis for higher math skills, emotional closeness, distance and interaction form a relationship template from which we develop higher relationship skills.
We learn the skills of self regulation primarily from our parents and caretakers. As children, if we get frightened or hurt, for example, we look to our mothers, fathers and close people to sooth us, to help us to feel better, to bring us back into balance. When we get out of balance, they woo us back into a state of equilibrium. They hold us emotionally till we restore our own sense of calm. Gradually we absorb the ability to do that for ourselves.

How Do We Lose an Ability to Self Regulate?

Growing up with abuse, neglect addiction or trauma can deregulate the limbic system. It’s a double whammy. Not only is a child being hurt; but the person s/he would normally go to for comfort may be the one who is causing them pain and anxiety. This pattern can wreak havoc with their ability to learn good skills of self regulation.

This also can set up for addiction later in life. When we aren’t able to bring ourselves back into balance when we’re upset, we may reach outside of ourselves for something that will bring quiet to our inner storm. Drugs, alcohol, sex, food or spending become used for self-medication; for self regulation.

Following is a list of characteristics that adults, who have grown up with trauma in the form of abuse, neglect or addiction, may exhibit.

Deregulation in the Limbic System

* Depression with Feelings of Despair
* Hypervigilance/Anxiety
* Hyperreactivity/Easily Triggered
* Emotional Constriction
* Learned Helplessness
* High-Risk Behaviors
* Somatic Disturbances
* Desire to Self-Medicate

Relationship Issues

* Loss of Trust and Faith
* Loss of Ability to Take in Caring and Support from Others
* Cycles of Reenactment
* Distorted Reasoning
* Survival Guilt
* Traumatic Bonding
* Development of Rigid Psychological Defenses

How Can We Achieve Balance?

In order to achieve sustainable emotional sobriety we need to process those unresolved emotions that churn around inside of us or deaden our ability to live in the present by bringing them into consciousness and translating them into words so that we can understand them as we feel them. As we do this we reframe the past through the more mature and aware eyes of today. We create new more mature and balanced meaning.

And because the body process emotions, here are some tips to create body balance. These are nature’s mood stabilizers; they act in the same way that anti depressants act; they help us manage our moods.

* Exercise to stay in shape and to get that daily dose of serotonin, nature’s natural antidepressant. Serotonin keeps our moods balanced and up beat. It calms anxiety and improves our sleep.
* Eat nutritious foods and avoid caffeine, and an excess of white sugar and flour.
* Maintain a network of supportive relationships. Sharing emotions releases serotonin. Touching releases oxytocin, that bonding chemical that mediates emotional closeness. It paradoxically helps us to feel close and connected AND to set boundaries.
* Hot baths or showers give us a shot of prolactin (and serotonin) which is associated with that serene state that nursing mothers enjoy.
* Twelve Step meetings and group or one to one therapy release serotonin as we share our feelings. This brings us into balance through the phenomenon of limbic resonance, one mammals ability to balance another (think of petting a dog or cat and bringing heart balance).

Serotonin management amounts to paying attention to all of those little things that make us feel good and systematically building them into our daily routines. Walking to work, exercising with a friend, taking time to relax and just be, breathing…all allow us to calm down the natural way. We know intuitively that certain activities open that secret door into our sense of well being. Even thinking positive thoughts throughout the day releases serotonin into our bodies, creates heart rhythm coherence and elevates our immune functioning; we can sense it. When we intentionally make these sorts of activities and intentions part of our daily lives, we’re managing our moods the natural way and taking care of our mental (and physical) health. So that instead of engaging in synthetic mood managers that may be unhealthy or self destructive, we can depend on those that are sustainable and natural to stay in balance and to achieve and maintain emotional sobriety.

All of this is from Emotional Sobriety: From Relationship Trauma to Resilience and Balance

Attaining Emotional Sobriety (click here for 3 min video)
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Characteristics

Deregulation in the Limbic System

Our emotions are processed by something called the limbic system also referred to as our “emotional brain”. Emotional trauma can de-regulate the limbic system causing us to go from 0-10 without being able to regulate our intense emotional responses. When we have problems in our deep limbic system they can manifest as moodiness, irritability, increased negative thinking and perceptions of events, depression, anxiety, decreased motivation, floods of unmanageable emotions, appetite and sleep problems, decreased or increased sexual responsiveness or social isolation.

Addiction can be seen as a problem with self regulation; a lack of ability to regulate powerful emotions, use of substances and behaviors.

Depression with Feelings of Despair
The limbic system regulates mood. When we are deregulated in our emotional system, we may have trouble regulating feelings such as anger, sadness, and fear, all of which may contribute to depression. Elevated levels of cortisol, associated with the fight or flight response, are also found in high amounts in people who report feeling depressed.

Hypervigilance/Anxiety
When we’re hypervigilant, we tend to scan our environment, people’s faces and moods and relationships for signs of potential danger or repeated relationship insults and ruptures (van der Kolk 2004) to protect ourselves against perceived danger.

Hyperreactivity/Easily Triggered
Living with relationship trauma can over-sensitize us to stress. The limbic system gets set on high alert, it is cocked and ready to go. Consequently we may over-respond to stress or blow out of proportion conflicts that could be managed calmly. Stimuli reminiscent of relationship trauma, such as feeling helpless or humiliated, can trigger intense reactions.

Emotional Constriction
Emotional numbing is a natural response to trauma and can last anywhere from a few hours to many years. Emotional constriction refers to a restricted range of feelings or a lack of expression of authentic emotion. The kinds of sharing that are part of therapy and 12-step programs slowly and over time counter this numbing and constriction as we learn to safely feel and share our strong feelings in the presence of others.

Learned Helplessness
When we feel we can do nothing to affect or change the situation we’re in, we may develop learned helplessness, that is, we may give up. We may lose some of our ability to take actions to affect, change, or move a situation forward (van der Kolk 2004). The program slogans “Take the next right action” and “a day at a time” help the person who feels immobilized to break their frozen position and move forward.

High-Risk Behaviors
Whether to jump-start a numbed-out inner world, act out intense emotional and psychological pain or mood alter– high-risk behaviors may be self medicating by stimulating a predictable rush of adrenaline. Adrenaline can be as addictive to the brain as heroin.

Somatic Disturbances
Because the body processes and holds emotion, we may experience our unconscious emotions as somatic disturbances. Some examples of emotional pain affecting the body are back pain, chronic headaches, muscle tightness or stiffness, stomach problems, heart problems, or heart pounding, sweating, queasiness, shivering, and shaking (van der Kolk 2004).

Desire to Self-Medicate
The emotional, psychological, and physiological setup that accompanies relationship trauma can lead to self medication, in which we seek a chemical solution for human problems (van der Kolk 2004). Thus, the relationship between trauma and addiction takes hold. Emotional and psychological trauma leads to self-medication, and self-medication leads to continued and ever-complicated emotional and psychological problems.

Relationship Issues

Those who have experienced relationship trauma through addiction, may tend to re-create dysfunctional patterns of relating in the present, that mirror unresolved issues from the past, whether or not addiction is still present. This can occur through psychological dynamics such as projection (projecting our pain onto someone or a situation outside the self), transference (transferring old pain into new relationships), and reenactment patterns (re-creating dysfunctional patterns of relating over and over and over again).

Loss of Trust and Faith
When our personal world and the relationships within it become very unpredictable or unreliable, we may experience a loss of trust and faith in relationships and in life’s ability to repair and renew itself (van der Kolk 2004).

Loss of Ability to Take in Caring and Support from Others
The numbing response along with the emotional constriction that is part of the trauma response may lead to a loss of ability to take in caring and support from others (van der Kolk 2004). Additionally, as mistrust takes hold, our willingness to accept love and support may lessen.

Loss of Ability to Take in Caring and Support from Others
People who have felt traumatized may have a tendency to isolate and withdraw into themselves when they are feeling vulnerable. They have learned to take refuge in avoiding connection. Isolation is also a feature of depression. Unfortunately the more we isolate, the more out of practice we become at making connections with people, which can further isolate us. Twelve step programs, one to one and group therapy help to restore connection with others.

Cycles of Reenactment
The reenactment dynamic is one of the most common ways that trauma from one generation gets passed down through subsequent generations. We tend to re-create and repeat the relational patterns that are familiar, even if they do not work to get us what we really want.

Distorted Reasoning
We make sense of situations with the developmental equipment we have at any given age. When we’re young, we make childlike or immature meaning, which may be laced with magical thinking or interpretations that are based on the natural egocentricity of the child who feels that the world circulates around and because of them. We may live by this meaning well into adulthood.

“Stinkin thinkin” is also a sort of cocktail of denial and truth distortion that grows out of minimizing and hiding the pain and degradation of addiction.

Survival Guilt
The person who gets out of an unhealthy family system while others remain mired within it may experience what is referred to as “survivor’s guilt.” This person may become overly preoccupied with fixing their families, because the thought of being happy when their families remain locked in dysfunctional ways of living can be very painful to them.

Traumatic Bonding
Trauma impels people both to withdraw from close relationships and to seek them desperately. The profound disruption in basic trust, the common feelings of shame, guilt, and inferiority, and the need to avoid reminders of the trauma that might be found in social life, all foster withdrawal from close relationships. But the terror of the traumatic event intensifies the need for protective attachments. The traumatized person therefore frequently alternates between isolation and anxious clinging to others. (Herman 1997) Traumatic bonds have a tendency to repeat themselves; that is, we tend to repeat this type of bond in relationships throughout our lives, often without our awareness.

Development of Rigid Psychological Defenses
People who are consistently being wounded emotionally and are not able to address it openly and honestly may develop rigid psychological defenses to keep pain at bay. Dissociation, denial, splitting, repression, minimization, intellectualization, and projection are some examples of these defenses.

Learned Helplessness
When we feel we can do nothing to affect or change the situation we’re in, we may develop learned helplessness, that is, we may give up. We may lose some of our ability to take actions to affect, change, or move a situation forward (van der Kolk 2004). The program slogans “Take the next right action” and “a day at a time” help the person who feels immobilized to break their frozen position and move forward.

Emotional Constriction
Emotional numbing is a natural response to trauma and can last anywhere from a few hours to many years. Emotional constriction refers to a restricted range of feelings or a lack of expression of authentic emotion. The kinds of sharing that are part of therapy and 12-step programs slowly and over time counter this numbing and constriction as we learn to safely feel and share our strong feelings in the presence of others.

Somatic Disturbances
Because the body processes and holds emotion, we may experience our unconscious emotions as somatic disturbances. Some examples of emotional pain affecting the body are back pain, chronic headaches, muscle tightness or stiffness, stomach problems, heart problems, or heart pounding, sweating, queasiness, shivering, and shaking (van der Kolk 2004).

Loss of Trust and Faith
When our personal world and the relationships within it become very unpredictable or unreliable, we may experience a loss of trust and faith in relationships and in life’s ability to repair and renew itself (van der Kolk 2004). This is why the restoration of hope is so important in recovery (Yalom 1985[QY: Give year, and give complete information in Bibliography]). It is also why having a spiritual belief system can be so helpful in personal healing.

Hypervigilance/Anxiety
When we’re hypervigilant, we tend to scan our environment and relationships for signs of potential danger or repeated relationship insults and ruptures (van der Kolk 2004). We constantly try to read the faces of those around us so that we can protect ourselves against perceived danger. When we’re hypervigilant we’re constantly waiting for the other shoe to drop or walking on eggshells. Unfortunately, this may also create problems because we may perceive danger even where little exists or become overly reactive to perceived slights, making ourselves hard to be around or even driving a situation toward problems. If we go through the world looking for people to insult us, we can usually find them.

Hyperreactivity/Easily Triggered
Living with relationship trauma can oversensitize us to stress. Consequently we may overrespond to stress or blow out of proportion conflicts that could be managed calmly. Stimuli reminiscent of relationship trauma, such as feeling helpless or humiliated, can make them feel vulnerable, anxious and at risk all over again.

Traumatic Bonding
Traumatic bonds are unhealthy bonding styles that tend to become created in families where significant fear is present. Traumatic bonds have a tendency to repeat themselves; that is, we tend to repeat this type of bond in relationships throughout our lives, often without our awareness.

Trauma impels people both to withdraw from close relationships and to seek them desperately. The profound disruption in basic trust, the common feelings of shame, guilt, and inferiority, and the need to avoid reminders of the trauma that might be found in social life, all foster withdrawal from close relationships. But the terror of the traumatic event intensifies the need for protective attachments. The traumatized person therefore frequently alternates between isolation and anxious clinging to others. (Herman 1997)

Depression with Feelings of Despair
The limbic system regulates mood. When we are deregulated in our emotional system, we may have trouble regulating feelings such as anger, sadness, and fear, all of which may contribute to depression. Elevated levels of cortisol, associated with the fight or flight response, are also found in high amounts in people who report feeling depressed.

Brain imaging has demonstrated that trauma can affect the body and brain much more than had previously been understood. For example, in depression, which is a symptom of post-traumatic stress disorder, the amygdala, which is a center of negative emotions in the brain, runs unchecked–in other words, everything feels threatening. In addition, a center of memory, the hippocampus, may lose nerve-to-nerve links. Brain imaging research shows that both of these centers of the brain may even be altered in size and shape in victims of sexual abuse or in prisoners of war. Research in animals and in people shows that stress or trauma early in life can sensitize neurons and receptors throughout the central nervous system so that they perpetually overrespond to stress (van der Kolk 2004).

Distorted Reasoning
We make sense of situations with the developmental equipment we have at any given age. When we’re young, we make childlike meaning, which may be laced with magical thinking or interpretations that are based on the natural egocentricity of the child who feels that the world circulates around and because of them. This kind of reasoning can be immature and distorted. When our family unit is spinning out of control, we may tell ourselves whatever is necessary to allow ourselves to stay connected. We may tell ourselves that our drunk mother has the flu or that our sexually invasive father loves us best. We may deny the truth that is right in front of us in an attempt to make more palatable meaning out of confusing, frightening, or painful experiences that feel senseless. We may carry this distorted reasoning into adult relationships.

Loss of Ability to Take In Caring and Support from Others
The numbing response along with the emotional constriction that is part of the trauma response may lead to a loss of ability to take in caring and support from others (van der Kolk 2004). Additionally, as mistrust takes hold, our willingness to accept love and support may lessen. We’re perhaps afraid that if we let our guard down, if we let connection feel too good, we’ll only set ourselves up for more pain when the inevitable happens and we’re disappointed again and again. So we protect ourselves as best as we know how imagining that by avoiding meaningful connection we will also avoid hurt.

Part of recovery is being willing to take that leap of faith to let life and relationships feel good again. This, of course, means that we have to try to set up a recovery network of people who can be reliable enough so that recovery and relationships are reasonably safe. Twelve-step programs and therapy are a great place to start, because rather than depending on only a few people, we have a network of people.

Tendency to Isolate
People who have felt traumatized may have a tendency to isolate and withdraw into themselves when they are feeling vulnerable. They have learned to take refuge in avoiding connection. Isolation is also a feature of depression. Unfortunately the more we isolate, the more out of practice we become at making connections with people, which can further isolate us.

Cycles of Reenactment
The reenactment dynamic is one of the most common ways that trauma from one generation gets passed down through subsequent generations. We tend to re-create those circumstances in our lives that feel unresolved, perhaps in an attempt to see the self more clearly and master or resolve our pain, or perhaps because we are locked in circuits of brain/body patterning that are largely unconscious. We repeat and repeat the relational patterns that are familiar, even if they do not work to get us what we really want.

High-Risk Behaviors
The clients whom I see who are engaged in chronic high-risk behaviors (van der Kolk 2004) seem to be trying to do a couple of things. One, they seem to be trying to jump-start a numbed-out inner world, to feel something, anything. Or they appear to be acting out intense emotional and psychological pain. Another dynamic that appears to be operating is that they are trying to alter their mood–that the high-risk behavior serves to get them high by stimulating a rush of adrenaline. Adrenaline is highly addictive to the brain and may be a powerful mood enhancer. Speeding, sexual acting out, spending, fighting, drugging, or other behaviors done in a way that puts one at risk are some examples of high-risk behaviors.

Survival Guilt
The person who gets out of an unhealthy family system while others remain mired within it may experience what is referred to as “survivor’s guilt.” This term was originally used to describe the experience of soldiers who left mates on the battlefield. This person may become overly preoccupied with fixing their families, because the thought of being happy when their families remain locked in dysfunctional ways of living can be very painful to them.

Development of Rigid Psychological Defenses
People who are consistently being wounded emotionally and are not able to address it openly and honestly may develop rigid psychological defenses to manage their fear and pain. Dissociation, denial, splitting, repression, minimization, intellectualization, and projection are some examples of these defenses.

Relationship Issues
Those who have experienced relationship trauma, may tend to re-create dysfunctional patterns of relating in the present, that mirror unresolved issues from the past. This can occur through psychological dynamics such as projection (projecting our pain onto someone or a situation outside the self), transference (transferring old pain into new relationships), and reenactment patterns (re-creating dysfunctional patterns of relating over and over and over again).

Desire to Self-Medicate
The emotional, psychological, and physiological setup that accompanies relationship trauma can lead to self medication, in which we seek a chemical solution for human problems (van der Kolk 2004). Self-medicating can seem to be a solution in the immediate moment, as it really does make pain, anxiety, and physiological disturbances temporarily disappear, but in the long run, it creates many more problems than it solves. Thus, the relationship between trauma and addiction takes hold. Emotional and psychological trauma leads to self-medication, and self-medication leads to continued and ever-complicated emotional and psychological problems.

Our new design for living works best when it is body, mind, and soul. Our bodies, as well as our thoughts, behaviors and emotions need hope and healing. In fact, neuroscience tells us that that the body is, in fact, where we experience and process our emotions. For this and other obvious reasons of health and overall well being, getting our bodies back on our side so that they can be a friend rather than a foe, is an important part of recovery. Depression and anxiety can become overwhelming as medications are removed and we look for new ways to feel better and manage moods that are natural rather than synthetic. We know that regular exercise is an important part of our physical fitness, but research reveals that it can contribute to our emotional and psychological fitness as well.

In a Duke University study, published in the American Medical Association’s Archives of Internal Medicine, October 25, 1999, exercise was found to be almost as effective as medication in reducing symptoms of depression. 156 patients diagnosed with major depressive disorder were divided into three groups in order to study the impact that exercise might have on depression:

Group 1    Did exercise only with no medication
Group 2    Used medication only with no exercise
Group 3    Used a combination of medication and exercise.

Much to the surprise of the researchers, all three groups, after 16 weeks, showed similar and significant improvements in their depression.

Here are the statistical findings of the study:

• 65.5% of the group who used medication alone, were no longer depressed after 16 weeks.
• 60.4% of the group who did exercise alone, were no longer depressed after 16 weeks.
• 68.8% of the group who did both exercise and medication were no longer depressed after 16 weeks.

The researchers did note that patients who took the antidepressants (in this case Zoloft) saw their symptoms relieved sooner, but by 16 weeks the group differences had virtually disappeared. Medication can be a life saver for some in recovery and no one wants to suggest otherwise, but adding exercise to a regime that includes medication or incorporating it into a recovery program as part of overall mood management offers more choices to the recovery menu. “One of the conclusions we can draw from this,” according to psychologist and study leader Dr. James Blumenthal, “Is that exercise may be just as effective as medication and may be a better alternative for certain patients. “ While we don’t know why exercise confers such a benefit, this study shows that exercise should be considered as a credible form of treatment for these patients. Almost one-third of depressed patients in general do not respond to medications, and for others, the medications can cause unwanted side effects. Exercise should be considered a viable option.”

Depression also has a social side and people who are depressed, socially anxious, or emotionally traumatized may tend to isolate.  Part of recovery, is to learn to make new connections and practice new relationship behaviors as we do in twelve step rooms.  Dr. Blumenthal reflected that the structured and supportive atmosphere of the exercise program could have contributed to improving the symptoms of the exercise group.

Blumenthal feels that exercise may be beneficial because patients are actually taking a proactive role in their own physical and psychological health. “…Taking a pill is… passive,” says Blumenthal.  He went on to say,  “Patients who exercised may have felt a greater sense of mastery over their condition and gained a greater sense of accomplishment. They may have felt more self-confident and had better self-esteem because they were able to do it themselves, and they may have attributed their improvement to their ability to exercise. These findings could change the way some depressed patients are treated, especially those who are not interested in taking antidepressants.  Although these medications have been proven to be effective,  many people want to avoid the side effects or are looking for a more ‘natural’ way of feeling better.”

Kristin Vickers-Douglas, a psychologist at Mayo Clinic, adds that exercise is “not a magic bullet, but increasing physical activity is a positive and active strategy to help manage depression and anxiety.”

What Exercise Does to the Body

When we exercise, our bodies release certain mood-enhancing endorphins. Endorphins trigger a positive feeling in the body, similar to that of morphine. These feelings of euphoria, sometimes associated with a “runner’s high,” may contribute to our good feelings about ourselves and our lives.

Endorphins also act as sedatives, actually diminishing our perception of pain. They are manufactured in our brain, spinal cord, and many other parts of our bodies. Not coincidently, the neuron receptors that endorphins bind to are the same ones that bind some pain medicines. However, unlike morphine, the activation of these receptors by the body’s own endorphins is less likely to lead to addiction, dependence or negative lifestyle patterns.

Exercise boosts the brain’s feel-good endorphins, releases muscle tension, improves sleep, and reduces levels of the stress hormone, cortisol. It also increases our body temperature, which may have a calming effect. All of these changes in our mind and body can improve such symptoms as sadness, anxiety, irritability, stress, fatigue, anger, self-doubt, helplessness and hopelessness that are associated with depression.

“Small bouts of exercise may be a great way to get started if it’s initially too hard to do more,” Dr. Vickers-Douglas says. Though the research suggests that it may take at least 30 minutes of exercise a day, three to five times a week to significantly improve depression symptoms, any amount of activity,  as little as 10 to 15 minutes at a time, can still improve mood in the short term.
Regular exercise has been proven to help us:

• Reduce stress
• Ward off anxiety and feelings of depression
• Boost self-esteem
• Improve sleep

Exercise also:

• Strengthens the heart.
• Lowers blood pressure.
• Improves muscle tone and strength.
• Strengthens and builds bones.
• Reduces body fat.
• Increases energy levels.
• Helps with over all fitness.

Research also shows that we’re more likely to maintain good exercise habits if we get exercise to fit into our lives, say by walking or biking to work, or walking, jogging or playing a sport with friends. Some forms of exercise that are user friendly are:

• Biking
• Dancing
• Gardening
• Housework
• Jogging at a moderate pace
• Low-impact aerobics
• Golf (walking the course)
• Playing tennis
• Swimming
• Walking
• Yard work
• Yoga

Don’t wait for will power to begin exercising, says Dr. Vickers-Douglas.  “Some people think they need to wait until they somehow generate enough willpower to exercise. But waiting for willpower or motivation to exercise is a passive approach, and when someone has depression and is unmotivated, waiting passively for change is unlikely to help at all. Focusing on a lack of motivation and willpower can make you feel like a failure. Instead, identify your strengths and skills and apply those to taking some first steps toward exercise.”

People who feel anxious feel a perceived lack of control over their lives. They feel, in other words, out of control. Both anxiety and depression can make us feel helpless, which can lead to more anxiety and depression. It’s a Catch 22. Exercise is proactive. Along with the obvious physiological benefits, it is helpful psychologically to feel that we can do something each day to help ourselves. Getting ourselves to a meeting, or out for a walk are both activities that require personal motivation.  These could be called “victorious circles”. Unlike the vicious circles that sink us further into disease where helplessness and hopelessness lead to more helplessness and hopelessness, combining exercise with recovery activities like regular meetings, becomes part of Good Orderly Direction and breeds more of the same. So bike, walk or jog to a meeting. Join a yoga class, a team sport or a hiking group. The personal and social benefits will enhance recovery and improve life.

It is no social secret that having wealth can provide one with status and power.  It also opens the door to acquiring education and polish.  If a wealthy person also develops and maintains healthy moral and personal values, he or she will generally have a strong enough inner world to sustain his/her core needs for belonging, self esteem, contribution and love. In this case, wealth can be a great blessing. But, when wealth subsumes the self and substitutes for what we need on a deep, human level; it can become a Faustian bargain.

Children of wealth often begin life with prescribed identities and a sense of social and financial superiority; they can be easy targets for jealousy and are often seen as a success by their peers simply for being born where they are born.  This can make it difficult for them to form a personal identity. The world that their family likely inhabits comes with an already established set of rules and expectations that the child of wealth is tacitly expected to buy into. Also, having too much of everything can undermine their personal dreams as well.  They may reason that they do not deserve more and have no right to extended personal success.  They may give up their dreams before they get a chance to even formulate them in their minds.  Who are they to want anything when they already have so much? On the other side, why should they go through the tedious and frustrating experience of being on the bottom when they’re already at the top?  But, it is often just this experience of mastering the many small challenges that are part of climbing the ladder of success that builds confidence and self esteem. However, while climbing that ladder, the child of wealth encounters the same fears of failure that any person trying to succeed does, though in their case, the stakes can feel much higher.  What if they try and fail?  What if their deep fear that they can’t create a success equal to what they have inherited is confirmed.  Then their guilt over being handed such a life and their shame at feeling they both don’t deserve it and couldn’t do it for themselves is justified?  What if the shadow of the family founder is just too long and they never find their way into their own patch of sunlight? They may reason that it’s better not to try and opt to become professional rich person, where their entry level is already assured.  Additionally, the kinds of professions valued by the family founder may be the last ones the child of wealth might want to undertake.  They may have already seen and felt the loneliness of being unimportant in the eyes of the founder who may value money above all else.  They don’t wish to repeat this pattern so professions that seem to perpetuate this pain can become repelling. Furthermore, they have probably already experienced the dark side of wealth, the pain behind the publicly professed pleasure; the empty stage set after the curtain facing the audience has been drawn.

The no talk rules around money can make wealthy people feel that they’re carrying secrets.  Needless to say, this is an elephant in the living room since everyone clearly sees their wealth and all of its accoutrements. This sense of hiding an important part of themselves may add to a client’s feelings of not belonging.  The family who has kept addiction or wealth a “secret” while fostering the feeling of living outside of the norms and ordinary rules of much of society may set the child of wealth up for the lifestyle of an addict which tends to be secretive, outside the norm and rule breaking.

Money as a Mood Manager

Money can be a very effective mood manager.  But when we use money to control our inner and outer experience we are setting ourselves and our children up to do the same; to look for quick fixes to shift moods or gain a sense of belonging and connection. Over time we become dependent on this behavior, this process of spending to regulate mood, fill an inner void and provide us with an identity. But, as with any substance or process addiction, we build up a tolerance. Our ability to hear the voice of our inner world and respond to it can decrease as money, spending and its trappings occupy an ever increasing part of our lives and psychology. The perfect looking life that money can create comes to feel like a necessity rather than a privilege. It becomes an identity, a way of being in the world; in short, it becomes who we are.

Our current economy reflects this mania for more. We lose track of what we really need to sustain a sane life and mortgage our financial security to attain immediate gratification. Clearly, this financial drunkenness leads to a hangover or  crash on all levels, emotional, psychological and financial.

The Family

When too much wealth flows through a family system, small daily pains and annoyances can be skillfully removed from day-to-day living.  Unfortunately, it is these small frustrations that often teach us to develop what psychologists call “frustration tolerance” which eventually translates into an ability to tolerate larger frustrations.  Little of worth can be accomplished in life without an ability to tolerate frustration whether in the work place or at home.  Developing a meaningful profession, tolerating the ups and downs that are a part of any intimate relationship, and having the stamina to take care of children all require an ability to tolerate frustration.

When an over abundance of wealth flows through the family system, family members don’t learn how to regulate the ever fluid substance of money so poor affect regulation may become a family problem. They don’t learn what normal is.  This lack of ability to regulate can generalize to all sorts of areas liquor, food, spending, sex… how much is too much?  And remember the shadow side.  Parents may act on their guilt about having money by depriving themselves and those around them as often as they indulge them.  Couple this with the true and real deprivation of attention and caring that a child of wealth may experience from parents who have hired people to put do the job parenting, while they themselves make cameo appearances. When this happens, the pain of the child is significant.  In this case the child is asked to tolerate too much frustration, too much unrequited yearning, too much loneliness for the attention of the parent he/she longs for.  This further blows his/her frustration tolerance circuits.  If the parents are providing things, in lieu of time, the child is learning one of the primary lessons of addiction: I can kill my pain, at least temporarily, with something outside myself – bring on the mood regulators.  The catch 22 is that while they may be experiencing significant inner pain, the outside world is telling them that they are lucky.   And so, the child is ever more deeply confused as to what he/she really needs and how to realistically set about getting it.  Add to this feelings of being undeserving and over-entitled and you have a potent cocktail for inner turmoil that can contribute to a desire to self medicate.

Relational Issues

This population is used to getting what they want when they want it whether it’s good food, services or things. Personal relationships are a different story, however, and the wealthy person can find himself confused with the dynamics of intimacy. Friends, spouses and children are not employees; they don’t collect a pay check and don’t like receiving a bulleted list of tasks and objectives. Though the person of wealth cannot fire blood relatives they may fire them emotionally if they become too demanding, preferring the types of relationships where they are more in control, less challenged and feel more “appreciated”. This can especially be true of the person who holds the purse strings; why should they endure the interpersonal demands and disappointments of real intimacy when the rest of the world writes them thank you notes, gives them awards and does what they’re told?

On the other hand, there is always what psychologist Carl Jung referred to as the “shadow” or the part of a person that is the submerged opposing aspect. The same person who feels overly entitled and important can have a shadow that feels small and insignificant.  They may feel guilty and out of balance and even yearn for someone to “put them in their place” so to speak.  The other end of being controlling is feeling out of control, and on the other end of feeling over entitled is feeling under entitled. In this scenario, the wealthy person may tolerate too much, their guilt allows other people to use them and take advantage of them.  They tend to have a hard time feeling entitled to personal boundaries. Their guilt and shame about having gotten too much, too easily, immobilizes.  Their issues around regulation keep them from knowing what “normal” is.  They dare not ask for more and they feel undeserving of more while simultaneously feeling entitled to the superior treatment they have always had.

In their growing years, some children of wealth have spent most of their time with employees – people who were paid to care for them, who had shifts and could be hired and fired.  This can make the most consistent relationships in a child’s life, ie the parents, somewhat distant and formal while they learn skills of intimacy from their primary caretakers, who may not be parents. Being “raised by the help” can open the door to anything from neglect, abuse, emotional alienation, wonderful bonds with down to earth people, having an unnatural edge over authority figures to being under the direct authority of and spending the bulk of their time with people who come and go. These are not the best ways to learn skills of intimacy.

Socially speaking, wealthy people may feel both superior and marginalized, or out of the main stream. This is often missed by others as the wealthy person seems so lucky or prominent but underneath may feel that they are different and that they don’t belong. This split between feeling like a highly valued member of society because of social status yet different from the general population, can be exacerbated if there is trouble at home. Feeling undervalued in the family system or by the family founder (read: wealth generator) can lead to a cognitive and emotional dissonance.  It can become a cumulative trauma which may lead the child of wealth to self medicate in order to obliterate the pain and confusion.

A Target for Jealousy and Transference

Another issue that the wealthy client may face is the clinician’s own counter transference issues when it comes to money.  Without a therapist understanding this, the client is at risk of being shamed, misunderstood or hurt by a clinician who is using pat answers and projecting their own unresolved money issues onto a vulnerable person in need of help.  This can be re traumatizing for a wealthy client.

The client who possesses wealth can be a target for transference and counter transference in other ways, too. In a group, for example, those who might be struggling financially may experience envy toward the wealthy group member. The envy might express itself in excluding the wealthy group member from cliques, criticism about things they do in group or put downs that are covering up jealousy. The therapist who has their own unresolved issues around wealth can act out their counter transference by colluding in this non preferential treatment unconsciously, putting the wealthy group member in a vulnerable spot. There may be a tendency on the part of others, whether fellow group members or therapists, to want to see wealthy people as unhappy, snobby, spoiled or superficial as a way of mollifying their own jealous feelings. Somehow it makes it easier to tolerate feelings of envy if we can see the person possessing wealth as in some way miserable or “paying a high price” for their privileged status. The idea that they have something we just don’t have, much as we may wish we had it, is easier to swallow if we devalue it in some way.

Recently, I’ve become aware of two cases of therapists acting out with their wealthy clients in hurtful ways. One is a therapist who called an old client who had previously spent six years in therapy with him and asked him to float him a loan or bail him out financially.  The other is a therapist who asked his client to put him up for membership in his client’s social club.

This is a population that needs and deserves the same sensitive treatment as any other group. They can feel marginalized and insecure.  They crave acceptance and love, not the kind of sympathy that may represent a counter phobic response of a biased or even envious therapist or group member, but genuine empathy and understanding.

Characteristics of Children of Wealth AND Addiction

Guilt and Shame vs Self Indulgence

The child of wealth may carry deep guilt and shame over their privileged status in life.  They have grown up feeling different from their less wealthy friends, called  “ rich-kid” names or expected to chip in extra when paying the food bill or the bar bill.  They have been seen as lucky and successful, connected to the kind of power and privilege that our society values as the ultimate prize and the most significant of all accomplishments.  These kinds of shallow values, seeing the acquisition of wealth as the end all and be all, can deeply confuse the child of wealth who may already be paying an internal price at feeling different from other kids.

With bewildering, conflicting feelings of superiority and inferiority and an identity that doesn’t feel like his own, the child of wealth may take refuge in a self indulgence that is designed to take away these inner conflicts, nagging fears about the future or feelings of alienation and insecurity.

When family addiction is also present, this child can experience mind and heart numbing swings between emotional deprivation and over indulgence.  Their “beautiful” world can feel like it is constantly mocking what is going on underneath.

Entitlement  vs Feeling Undeserving

Entitlement is one of the most commonly cited qualities of the child of wealth (though it can emerge with equal force at the opposite end of the social spectrum). Things have always magically appeared for the child of wealth with or without effort on his part.  His family money has generally provided him with layers of service that grease his path through the world and remove frustrating obstacles that others have had to learn to cope with and accept. This can become a habit and an expectation that gets layered onto many situations.

On the other hand he may reason, “I have so much I don’t deserve to want any more so I will foreclose on my own dreams.  I will play small so people won’t hate me; I’ll be self deprecating and hold my wants back so that no one can point a finger at me and call me over indulged.” The sad truth here is that the children of wealth don’t allow themselves to be as big as they naturally are.  They hold back and stay beneath the radar so that they won’t feel over exposed. They play small and withhold their own natural talents and desire for success. Sibling order may play a role here.  Perhaps the first follows the family founder and the second or third look for other roles.

When addiction is present feelings of not deserving and feeling objectified by both their family and their social world are driven even deeper underground.  The hole in the soul of the child who is isolated by both wealth and addiction grows ever deeper and wider.

Hi Profile vs Hi Isolation

Children of wealth, oftentimes, have access to a social status that carries a certain amount of high regard in worldly terms. Doors are open to them that might be closed to others. Positions on boards, memberships to clubs, and entrée into social situations is oftentimes a natural part of the life of wealthy people. This allows them an assumed level of social status.

Wealth also allows one to live in a sort of splendid isolation. Wealthy people can afford to live in exclusive worlds apart from everyday people. Deep feelings of disconnection from others, not feeling “normal” like other people, feeling marginalized from the rest of the world – all of these feelings can simmer beneath the surface for this population. Then, as they feel disconnected and lack the natural security gained from feeling “part of the gang”, they may erect defensive walls that further isolate them. This feeling of disconnection can be a traumatizing experience that is cumulative over time.

Addiction is traumatizing and trauma victims tend to feel different from others and often isolate themselves in their own private worlds of pain. The combination of the isolation that follows wealth and the isolation that accompanies trauma and addiction can be a double whammy for the child of wealth from an addicted family. This becomes a vicious circle in which the more isolated one becomes, the more difficulty there is in re-engaging, and the more difficult re-engaging is, the more isolated one becomes. This cycle can deepen pain which can lead to a desire to self medicate with drugs, alcohol, food, spending, sex and so on.

Low Self Esteem  vs.  Grandiosity

The child of wealth may feel that nothing they can accomplish will ever match the huge accomplishment of the family founder.  The founder all too often values making money above any other accomplishment, seeing money as strength, power and the ultimate success. Family founders tend to have their own identity, they “came from behind, they made it” while the child of wealth is always living up to an identity other than his own – a family identity or the identity of the dominant person.  This may, or may not, fit for him and his natural personality. In addition, the wealthy family may tend not to value professions that don’t lead to wealth or a high profile.   All of this can undermine the self esteem of the child of wealth.

Furthermore, people worship other people with money.  Money in our society buys anything – houses, cars, clothes, social status– spouses, friends. These are the people who tip big, pick up the check and donate to causes, schools and museums. The child of wealth and addiction may opt for the easy way of feeling good about himself, depending on what his wealth can buy rather than what he can accomplish on his own. He may become grandiose as a defense against darker emotions that threaten to protrude into his consciousness.

High Expectations vs. No Expectations

The child of wealth can be caught in a painful bind between feeling the pressure of succeeding in larger than life terms, trying to reach an ever heightening bar of success and having very little expected of him or her. This tends to be the child who has a summer program rather than a summer job, who has no practical needs that drive him to work. Getting a job and contributing to one’s life in needed and practical ways can be a real source of self esteem for any growing person. The fact is that the child of wealth does not have these needs, whatever he will earn as a young person will probably be less than he has easy access to through his parents. And, if addiction was present he has likely swung between emotional abuse and over indulgence. Children of wealth have often been a part of a family that has unusual focus and discipline. Fortunes aren’t made by magic and family founders are often among the most disciplined of society and scorn those who aren’t. They can also be ruthlessly competitive as illustrated by the well known problem Thomas Edison had losing in any game to his children, even when they were very young. This is not a normal sentiment for most fathers and can leave children confused about what is normal to expect of those close to them and of themselves.

If addiction is also present the child of wealth can experience much more emotional abuse than is easily seen. They can be psychologically battered by a parent who sees them as shiftless, lazy and undeserving and who feels a very real contempt toward them along with the abuse that follows in addictions wake. The addict may well be the spouse of the founder who is self medicating his or her own loneliness and disillusionment.  In this case, the child of wealth may lose access to two parents, one who is lost in alcohol and drugs and one who is lost in work.

Helplessness vs Perceived Powerfulness

The children of wealth have often had many situations in life handed to them. They have not had to “put up” with the initial stages of getting something started for themselves, getting a job or starting at the bottom. They have had housekeepers who wash their clothes and pick up their messes and gardeners to mow the lawn and other kinds of help that have removed them from many daily tasks that others have to cope with in order to take care of themselves. As a result, wealthy people may actually not know how to take the steps to organize their lives that others take for granted. Their social skills may not crossover to types of skills necessary for succeeding in business or even recovery. Their relationships with people may have been limited to socializing rather than networking, for example. They may also lack a certain aggression in career paths because they didn’t need to be aggressive, in fact the opposite, they were more likely to be cordial or to fend off those who were aggressing toward them. When they are faced with needing to “make friends” they feel compromised or unable to take the preliminary steps involved. Also, the learned helplessness that accompanies trauma, which is inevitably incumbent on addiction, can exacerbate the helplessness of the wealthy client and immobilize him.

At the same time, wealthy clients may feel they are entitled to special treatment, that they shouldn’t have to go to twelve step meetings like other people or get “down and dirty” in recovery. They are used to having other people do things for them and they may want or expect other people to get them well, too. They may want it to happen easily or quickly, to be provided with crib notes on recovery so to speak. This can frustrate clinicians who are aware that addiction and codependency are basically the same for everyone and it doesn’t get better by itself.

High Bottom vs No Bottom

Earning a living can provide boundaries that set off alarms that we respond to where necessary. But, for the person with wealth, that boundary is often removed. There is no bottom. The need to earn a paycheck may not exist and bills get paid whether the substance abuser is using or not.  Addicted parents can “buy out” of parenting by hiring others to do their job whether they are using or not. This can mean that even thought the wealthy person or parent can be extremely sick and addicted, outward appearances are more or less maintained. The wolf never gets to the door. The child in this circumstance suffers deeply. While to the outer world he may seem fortunate, the inner world of his family is falling apart and he is living a split identity.  In the absence of the kinds of constraints that would bring most families to their knees, this family lives with a wound that never heals, a constant low level of desperation. Smiling to the world in which they operate has the effect of making them feel that they are unseen and living a lie.

On the other hand, this is also the family who has access to the best resources money can buy and the wit and savvy to use them. Being able to reach out for help, gives this group an excellent chance at recovery. It does require, however, that the family, addict, enabler et al, come to the humble realization that they have fallen prey to an illness that is bigger than they are.  In short, that in spite of their wealth and status, they are really no better or different from anyone else.

For the purpose of the online CE Course, the article objectives are:

• To make therapists aware of their own counter transference issues as related to wealth.
• To outline the issues common among wealthy clients that may emerge during the course of treatment.
• To show how money can set the stage for addictions and how growing up with money can lead to other process addictions.

These days more then ever I seem to be seeing people who are carrying extra loads of anxiety, stress and anger. But according to research in these areas, human beings aren’t the only ones who experience stress. All vertebrates–fish, birds, and reptiles–respond to stressful situations by secreting the same hormones that we humans do, such as adrenaline and glucocorticoids, which instantaneously increase the animal’s heart rate and energy level. Our fear response, remember, is nature’s way of keeping us safe. We all have it encoded into our DNA, whether fish or fowl, human or animal. But fish and reptiles metabolism doesn’t get derailed and deregulated the way it does in people and other primates, like baboons for example. Baboons and people, it seems, are both intelligent enough to think our way into lots and lots of extra stress that luckier fish and reptiles seem to avoid. What’s the crucial difference here? Our ability (and a baboons ability) to THINK and our quality of SOCIAL CONNECTEDNESS, it’s that psycho-social thing.

Dr.Robert Sapolsky of Stanford University found that “Primates are super smart and organized just enough to devote their free time to being miserable to each other and stressing each other out. . . . For example, having your worst rival taking a nap one hundred yards away gets you agitated.” A professor of biological and neurological sciences, Sapolsky has spent more than three decades studying the physiological effects of stress on health. “If you’re a gazelle, you don’t have a very complex emotional life, despite being a social species,” he says. “But primates are just smart enough that they can think their bodies into working differently. It’s not until you get to primates that you get things that look like depression. . . . If you get chronically, psychosocially stressed, you’re going to compromise your health. So, essentially, we’ve evolved to be smart enough to make ourselves sick.”

How Social Rank and Connectedness Impact Stress

Sapolsky’s team has found that baboons, especially “type A” baboons, often have chronically elevated levels of stress hormones that impact their health negatively. “Their reproductive system doesn’t work as well, their wounds heal more slowly and they have elevated blood pressure. . . . So they’re not in great shape.” Interestingly, both low-ranking and type A baboons are among the most susceptible to stress. But here’s an interesting finding, relationships and social connections can actually counter this stress response. Baboons who need baboons, it turns out, are the luckiest baboons in the world, just like people who need people. Among baboons, social isolation may play an even more important role than social rank as far as stress goes.

“Up until fifteen years ago, the most striking thing we found,” says Sapolsky, “was that, if you’re a baboon, you don’t want to be low-ranking, because your health is going to be lousy. But what has become far clearer, and probably took a decade’s worth of data, is the recognition that protection from stress related disease is most powerfully grounded in social connectedness, and that’s far more important than rank.” That’s why when you’re feeling stressed out, calling a friend, gossiping with a co-worker or going out for a walk or lunch with someone can make you feel so much calmer.

How Human Beings Can Use Imagination to Reduce Stress

Human beings can even take stress reduction to another level, we can do something that animals aren’t equipped to even conceive of. We can think creatively. We can imagine ways of seeing a situation, for example, of reframing and understanding it that can turn what could be a stressor into something that we don’t worry about as much or that we can manage differently. “Letting go and letting God”, “turning it over”, “taking baby steps” and living “a day at a time” are all wonderful ways of reducing psychological and emotional stress and unnecessary worry, the kind that adds nothing to our lives and gets in the way of emotional sobriety. Human beings can, in short, conceive of and create change; we can use our minds to reframe, to see things in a better light. “We are capable of social supports that no other primate can even dream of,” says Sapolsky.

For example, I might say, “This job, where I’m a lowly mailroom clerk, really doesn’t matter. What really matters is that I’m the captain of my softball team or deacon of my church”–that sort of thing. It’s not just somebody sitting here, grooming you with their own hands [as in the primate world]. We can actually feel comfort from the discovery that somebody on the other side of the planet is going through the same experience we are and feel, I’m not alone. We can even take comfort reading about a fictional character, and there’s no primate out there that can feel better in life just by listening to Beethoven. So the range of supports that we’re capable of is extraordinary. We can use our creative imaginations to get all tied up in knots or to do just the opposite, to enjoy and relax into the life we’re living.

Twelve step programs are perhaps one of the most successful networks of social connectedness, isolation reduction and stress management in the world. So many of us who find the rooms come to a sense of deep gratitude for whatever brought us there; program also supplies Good Orderly Direction and gives meaning and purpose to our lives and relationships; if ever there were a network that aids in stress and anxiety reduction, this is it.

Why a Mind/Body Approach to Treating Trauma is Important

Psychodrama is a role playing method developed by J .L. Moreno in Vienna and the United States . Its mind/body focus makes it unusually successful in treating issues of trauma and grief and helping to strengthen autonomy, motivation and resilience.  It has therefore gained wide popularity in the addictions field. Additionally, psychodrama acts as a sort of intervention into both the self system and the internalized relational network of the individual being treated, helping clients to clarify both their intrapersonal and interpersonal issues.

Moreno felt that, “the body remembers what the mind forgets,”  understanding, far before his time, that there is such a thing as somatic memory and that the body, as well as the mind, needs to participate in therapy for full healing to occur. Talk alone, according to Besel van der Kolk, author of  Psychological Stress, is not enough to knit together the disparate fragments of memory and sensorial data that trauma leaves in its wake. We need a method that allows the body as well as the mind to come forward into the therapeutic milieu and tell the trauma story. Psychodrama uses role play to mimic the body’s and mind’s natural way of relating; we are not talking heads in our real life, rather our natural movements and interactions are what lead us to feel and then search for the words to describe what we’re experiencing. As clients participate in a psychodrama, the body begins to wake up from its emotional numbness and reveal the pain and confusion that it’s holding. For example, as a  protagonist in a role play participates in an interchange she finds frightening, her stomach might tighten up or become queasy, her throat may suddenly go dry as she struggles to speak or, as she begins to stand her own ground, her muscles might constrict or her legs begin to shake or shiver. All of this is the body/mind beginning to reveal the subtle nuances of the experience that it has been storing, perhaps for years; the body/mind showing us what relational dynamics she found frightening, frustrating, upsetting or enraging.

How Fear Shuts Down Memory

One of the challenges in treating trauma is that intense fear can shut the body and brain temporarily down. Later in life, when clients are asked to “describe” their traumatic experiences they may find themselves uncomfortably agitated or even shut down and blank.  They may be unable to draw their disparate fragments of memory and sense impressions together and present them to the therapist as a coherent whole. This can put them at risk for adopting another person’s version of the story as their own either in order to please someone, like a therapist, authority figure or even peer group or to feel less anxious and crazy themselves.

Here’s how this trauma reaction gets set up. People, when overwhelmed with fear, temporarily shut down more elevated or “human” ways of thinking and making sense of a situation and hunker down, just like any dog or reptile, until danger passes. Nature doesn’t want us to be thinking about running from a charging elephant (or car) but just running from it,  so she has evolved a system whereby our thinking mind can temporarily shut down while our feeling or limbic mind goes into high alert. We go into a state of hyperarousal when we’re frightened.  We experience increased blood flow to our muscles, our hearts quicken, we’re hyper alert and we spurt adrenaline; all this so that we can stand and fight or flee for safety. If we can do neither we freeze.  Eventually we return to “normal” but the body memory of the charging elephant can linger in our unconscious in an unprocessed state. Because our thinking was shut down, we may not know why we carry these fears as we never made sense of them to begin with.  We never integrated the experience into a coherent whole and placed it into context. We might dream about elephants, fear circus elephants or even not like circuses at all. Or we might be unduly fascinated by any of these things, the mind is tricky when it comes to handling and attempting to master leftover unprocessed, frightening traumatic imagery. But we won’t necessarily be able to talk about what actually happened because our memory is fuzzy and filled with unconscious fear and anxiety. That’s why traumatized people so often self medicate, in order to manage this disturbing and confusing state of hyperarousal when it gets triggered.

Traumatized people wait for the other shoe to drop; they live as if the stressor is still present long after it has been removed because their body/mind “remembers what their mind has forgotten”.  According to van der Kolk, in order to make traumatic memory conscious, so we can see and heal it, we need to bring the body back into a feeling state. We need a method that can allow that state of hyperarousal that results from trauma and gets retriggered over and over again causing us to over react to situations that are in some way reminiscent of earlier pain, to emerge and be managed and brought back into balance safely. In psychodrama clients learn how to manage their hyperarousal themselves by witnessing themselves in this state in a controlled and safe manner. Their feeling of safety allows them to begin to think about what they are feeling rather than just react or act our their painful emotions unconsciously.
As a role play is entered into, protagonists begin to remember how they felt or what they wanted to say or do that they could not say or do at the time of a trauma perhaps because they were too scared, too small or trapped by circumstances. They also begin to wake up the emotions or the unfulfilled actions (thwarted intentions) that they may have numbed out, medicated or shut down at the time(s) of the trauma or throughout subsequent years. As they do this, the thinking mind which was also shut down at the time of the trauma, witnesses and makes sense of the relationship and situational dynamics being role played.  The protagonists are increasingly able to understand how and why their own complexes and conflicts got set up to begin with. Light dawns. Pieces of the puzzle begin to fit together.

Healing in a Relational Context

Psychodrama is not only mind/body but also relational.  It allows the full relational context in which one has experienced disruption or pain to be part of the therapeutic milieu. Moreno understood that “by the group they were wounded and by the group they shall be healed.”  When we treat family trauma we’re treating emotional pain that was set up in a relational context. If there was an imbalance of power as is the case between parent and child that relational imbalance becomes evident in the psychodrama. Some of the reasons that children experience threatening family dynamics as traumatic is because they are small, vulnerable and dependent upon parents for survival. Had they been big enough to fight back, had some larger person defend them or been able to get out of the situation and take care of themselves they may have felt less at risk and, hence, less traumatized. Through psychodrama the protagonist revisits that early vulnerability and, through role play, “corrects” some of the imbalances that have become psychically glued into place and recreated in subsequent relationships. They can finally shout back and defend themselves, run for safety or simply stand their ground.

Triggered: Revisiting and Re-experiencing Early Pain

For better or worse we tend to carry our early relational templates with us throughout life and recreate them. The healthy aspects of those patterns are all to the good and help us to create healthy adult relationships, but the painful, unresolved aspects also tend to get recreated.  These painful fragments of memory and sensory details are associated with trauma and in some way banished from consciousness (numbed, shut down, split off). As a result we may tend to project, displace or transfer unconscious pain onto people, places and things surrounding us, seeing it as belonging to them and not us. To complicate matters even further, we may have made distorted meaning of them as a way of maintaining our emotional equilibrium in the face of scary relationship dynamics. (Dad’s not drunk just happy.  Mom’s not depressed and dissociated just creative.  My little sister’s overly sensitive.  I’m stronger, better). Sorting out these distortions can become a bit mind boggling in the therapeutic process.

But as afraid as the traumatized person is to re-experience the “forbidden” feelings that he shut down out of fear or even terror, he needs to re-experience those emotions and disparate fragments of sensorial memory in  order to knit together the bits and pieces of memory that became fragmented through the traumatic, splintering experience. When people have been traumatized they may become afraid of action; action becomes bound up with fear or a sense of danger. As adults, when they become triggered by some relational dynamic that is reminiscent of earlier trauma (e.g. when they feel humiliated, scared, vulnerable, dependent, belittled or abused) their whole body can once again become the body that they inhabited at the time of the trauma. In other words, they get triggered and shaky inside but all too often don’t know what’s going on with them. (van der Kolk)

Why Words are Not Enough

Psychodrama allows the client to re-inhabit her own body, to “live in her own skin” in a safe and clinical manner along with therapeutic witnesses and allies who can buffer, support and encourage. It allows the client to shift from being a in collapsed, animal brain state to a state in which she is remembering unfulfilled actions. If done carefully following the lead of the protagonist imposing no agendas, psychodrama can allow the protagonist and all involved to fumble their way through their own nonconcious memories in body as well as mind. It helps to re-occupy their own body in space and in relationship to others at the time that it may have shut down. Before they are asked to talk about what happened and describe things that they themselves hardly remember, they can allow their bodies to organically take the actions that they feel impelled to take and to let sound, gesture and word follow. They can feel what they need to feel, do what they need to do and say what they need to say.
When clients are asked to “describe their pain or trauma” simply through words they are faced with a real dilemma, “Should I admit to myself and the therapist that I barely understand the question let alone the answer?” or “Should I just piece something together and give it my best guess?” or worse, go along with the therapist’s best guess and adopt it as the truth of my own experience. Psychodrama allows the protagonist more latitude in connecting with their own truth as it emerges through the body as well as the mind.

“Fundamentally, words can’t integrate the disorganized sensations and action patterns that form the core imprint of the trauma….[because] the imprint of trauma doesn’t ‘sit’ in the verbal, understanding part of the brain, but in much deeper regions such as the amygdala, hippocampus, hypothalamus and the brain stem, which are only marginally affected by thinking and cognition.” (Ibid)  Because psychodrama incorporates the body into the healing process the body can, in a sense, feel first and words can then grow out of the feelings that have been woken up through role play.
One common misconception of psychodrama is that it is necessary to recreate the traumatic scene in order to access traumatic memory. This is not the case. It is only necessary that client revisits themselves, their own sense of vulnerability or helplessness or rage or whatever they are carrying from the time of trauma. Revisiting the scene can be re-traumatizing and is not necessary for healing. What does get revisited most often are relational dynamics that are part of a model scene, one that may not have taken place in reality, but is representative of underlying qualities and dynamics of a particular relationship or situation.
For further information on the “how to” of using psychodrama to treat issues of addiction, grief, trauma and childhood abuse see the two training tapes listed below that can be used in treatment centers, educational settings or homes to 1) learn about psychodrama and 2) illustrate the intergenerational dynamics of addiction and abuse.

JL Moreno, Psychodrama Volume One, 19___, Beacon House Publishing, Beacon, NY.

Solms, M., Turnbull, O. (2002). The Brain and the Inner World: An Introduction to the Neuroscience of Subjective Experience. New York

van der Kolk 2004) “The Limits of Talk: Bessel van der Kolk wants to transform the treatment of trauma by Mary Sykes Wylie Jan 30 2004, in The Psychotherapy Networker).