Reclaiming Calm

Nightmares. Anxiety. Flashbacks. A traumatic event can trap you in a cycle of pain. Get your life back with these mind-body techniques.
By Kristin Bjornsen

Once a bright student in his Gaza City classroom, 16-year-old Ahmed (name changed to protect identity) could no longer concentrate. His school performance took a nosedive after he watched Israeli soldiers kill his best friend. Images from that day haunted him: his friend’s body in pieces, his face ghostly white, and blood everywhere. In the aftermath of the tragedy, Ahmed began seeking out Israeli tanks and throwing rocks at them, hoping they would fire back. “I wanted to die,” he said.

Concerned for Ahmed’s health, one of his teachers recently sent him to an alternative treatment center in the Palestinian territories. There he learned to use guided imagery—specifically, an exercise that would help him use his inner guide and his intuition to heal his pain. At first, his inner guide manifested as his grandfather, then later as the Koran. Finally it turned into his dead friend. “He told me to stop throwing rocks at the tanks,” Ahmed said. “He told me, ‘You won’t honor me by dying, but by living a long and productive life and then rejoining me at the end.’” With that, a deep serenity settled on Ahmed.

Ahmed’s experience typifies the success most post-traumatic stress disorder (PTSD) patients have with mind-body treatments, says James Gordon, MD. The founder and director of the nonprofit Center for Mind-Body Medicine (CMBM), in Washington, DC, Gordon has worked extensively with trauma victims, both in the United States—with returning soldiers and victims of 9/11 and Hurricane Katrina—and abroad, in places like Israel, Gaza, and wartime Kosovo.

Although wars and natural disasters represent two well-known and significant causes of PTSD, this anxiety disorder can result from any terrifying or life-threatening event, such as sexual assault, physical abuse, a serious car accident, or even the traumatic death of a loved one. In fact, 20 percent of people involved in auto accidents (the most common cause of PTSD) will show symptoms within a year of that experience.


Events like these can leave the brain in a state of hypervigilance, in which “it still thinks there’s an emergency,” says Gordon. It’s like your body’s alarm system gets stuck in the “on position.” The siren keeps sounding and your systems lock down. Four clusters of symptoms characterize PTSD and usually show up several weeks or more after the traumatic event occurred:

A state of continual arousal resulting in anxiety, fearfulness, insomnia, irritability, and inability to concentrate
Emotional numbness (a sense of isolation and the inability to express emotions)
A state of avoidance (the unwillingness to deal with situations reminiscent of the traumatic event)
Episodes of reliving the event, characterized by flashbacks, nightmares, or reoccurring memories

While nearly 20 percent of veterans from the Iraq and Afghanistan wars suffer from PTSD or major depression, about 8 percent of all Americans will also experience PTSD symptoms sometime during their lives. Conventional doctors often prescribe antidepressants and antianxiety drugs, but more and more people recognize that most of these aren’t very effective, according to Gordon. “Drugs may mask or reduce the symptoms for a while,” he says, “but their effect wears off.” Side effects include, ironically enough, an increased suicide risk, as well as weight gain, and liver and kidney damage.

Fortunately for these sufferers, a growing body of research shows that a host of holistic therapies can heal the condition far better than drugs.


Guided imagery
What you imagine can often become reality. Think of ants, for example, and your skin begins to itch. Picture biting into a lemon wedge, and you salivate. By guiding the imagination, according to this modality, the power of the mind over the body becomes a powerful tool for transformation.
What to expect: A therapist, audiotape, or even the patient herself gives the mind a series of verbal prompts, such as “You are walking on the beach” or “You’re lying in a grassy meadow.” Mentally conjuring these experiences stimulates the calming parasympathetic nervous system and relieves tension and anxiety.
How it helps: With PTSD, different parts of the brain don’t effectively communicate with each other. The prefrontal lobe (important for reasoning) and the areas involved with emotions, vision, and hearing stop “talking” to each other, while the autonomic “fight-or-flight” system commandeers control. This aborted connection, Gordon explains, seems to prevent the mind from processing the traumatic event and moving past it. This may be one reason PTSD sufferers often have trouble verbally expressing what happened to them.

Guided imagery engages all of the senses. By visualizing the beach, hearing the waves, smelling the saltwater, feeling the sun, and then putting the experience into words, the different parts of the brain communicate. “My hypothesis is that this reintegrates the parts of the brain that have split from each other,” Gordon says. This exercise also helps the patient create a “safe place” where she feels free from the immediate threat of trauma.

Meditation, autogenic training (repeating phrases like “My heart beat is calm and regular”; see “The Power to Heal” on page 53), art, dance, and music work in similar ways by involving multiple parts of the brain, not just the “rational thought” prefrontal lobe. People usually start seeing long-lasting results after just a few sessions.
More info: The Center for Mind-Body Medicine, cmbm.org


EMDR
Eye movement desensitization and reprocessing (EMDR) eases anxiety with rapid eye movements.
What to expect: During a session, you mentally or verbally recreate the sights, sounds, feelings, and thoughts associated with the trauma. As you do this, the therapist moves her finger back and forth in front of your eyes; keeping your head still, your eyes follow the movement of her finger.
How it helps: Researchers suggest this “back-and-forth” mimics the rapid eye movement (REM) we experience while dreaming. Dreaming, according to researchers, synchronizes both hemispheres of the brain so they can sift through the day’s events and “clear” them from the system. EMDR allows the hemispheres to sift through the trauma in the same way.

“By stimulating both sides of the brain, you can fully process the traumatic emotions and memories that have become trapped in the fight-or-flight part of the brain,” says Melanie Smithson, an EMDR practitioner who works at the Smithson Clinic in Greenwood Village, Colorado.

A separate part of the therapy involves holding “tappers” in each hand, which you alternately buzz, first the right one, then the left, and so forth. This back-and-forth engages both sides of the body and triggers different parts of the brain to work together. While holding the tappers, you identify your negative self-beliefs surrounding the event, such as I’m weak and vulnerable; I can’t take care of myself, and replace them with positive affirmations. In this way, you transform an emotionally charged, trapped memory into an objective and functional memory.

A 2007 study, published in The Journal of Clinical Psychiatry, found that EMDR treated PTSD sufferers far more effectively than the antidepressant fluoxetine. In fact, “many insurance companies now recognize EMDR as ‘the’ treatment for PTSD,” says Smithson.
More info: EMDR International Association, emdria.org; the Smithson Clinic, smithsonclinic.com


Tapping
Psychological trauma blocks the flow of our life’s energy and creates negative emotions, says Fred Gallo, PhD, developer of energy tapping and a clinical psychologist in Hermitage, Pennsylvania. By stimulating acupressure points, energy tapping and its cousins (including the emotional freedom technique and thought field therapy) restore the positive flow of energy.
What to expect: During a tapping session, you conjure up a particular aspect of the trauma you want to work through—the smell of smoke from a fire, perhaps—and using a scale of zero to 10, rate how much it bothers you. The energy psychologist then guides you to tap with your fingertips at various acupuncture points on your body for a few minutes. You then revisit that memory and rate how it makes you feel—maybe the anxiety you feel has decreased from a nine to a seven. You continue tapping until the memory no longer causes a reaction, registering as a zero on the scale. You then think of another aspect of the trauma and “tap” through it in the same way. So, basically, “you work through the pile until there are no more disturbing elements to the traumatic memory,” says Gallo, co-author of Energy Tapping (New Harbinger, 2008).
How it helps: Gallo explains that tapping heals PTSD on two levels: First, tapping on the acupuncture points removes the emotional blockages from the trauma and balances energy flow along the meridians. Secondly, tapping discharges the emotional “static energy” built up in the amygdala—the almond-shaped part of the brain that scouts for danger. During overwhelming trauma, the brain’s circuits can short-circuit, locking the energy in the amygdala, which then stays in an alarmed state. Tapping defuses that energy by “distracting the amygdala, which goes to investigate the tapping,” he says. “While it’s distracted, the traumatic emotion you’re monitoring can get processed and recorded as a completed memory.”
More info: Fred Gallo’s Energy Psychology, energypsych.com; the Emotional Freedom Technique, emofree.com or eftmastersworldwide.com


Biofeedback
This therapy puts you in touch with the physiological changes trauma produces—in heart rate, blood pressure, and skin temperature—and then gives you the skills to control these normally involuntary processes (for example, you can change your breathing patterns so the body gets more oxygen).
What to expect: Electrodes attached to your body measure everything from blood pressure and skin temperature to heart-wave patterns, perspiration levels, and CO2 levels in the breath. Monitors then display this information for you and the therapist to see.

Slowly, you get in touch with bits and pieces of the original trauma—either in your imagination or in real life—while paying attention to how and where it affects your body. Is your chest tightening? Your palms sweating? Your stomach clenching? During that time, the therapist gives you feedback on your body’s vital signs. The therapist then offers suggestions on how to breathe correctly and how to use positive thoughts to influence your heart rate and blood pressure.
How it helps: By monitoring heart-wave patterns, the biofeedback therapist can determine what state your nervous system is stuck in: fight-or-flight, “freeze” (e.g., deer in the headlights), or both fight-or-flight and “freeze,” which is like pressing the brake and the accelerator at the same time, says Bob Whitehouse, a psychologist in Denver. The therapist coaches you out of that state by helping you imagine taking an action in the traumatic situation (fighting off an attacker, for example). This helps discharge the energy stored in the nervous system.

Biofeedback helps PTSD sufferers discover that they can control and even change their heart rate and blood pressure through conscious breathing, and how their positive thoughts can alter their emotions and physiology. “You’re gently unwinding the stress system that’s stuck in a wound-up mode,” Whitehouse says. Usually, people see results after eight to 10 sessions or, with severe trauma, 20 sessions.
More info: Association for Applied Psychophysiology and Biofeedback, aapb.org


Acupuncture
This ancient Chinese modality removes illness-causing “blockages” along the meridians and restores the healthy flow of qi, or vital energy.
What to expect: An acupuncturist places very thin needles into specific points on the body that tap in to various meridians—the channels along which your qi flows.
Why it helps: By using points connected to the nervous system, acupuncture calms the brain and relaxes the sympathetic fight-or-flight system, explains Allison Kitchen, LAc, MAc, an acupuncturist at Nova Medical Group in Ashburn, Virginia. She picks points that are associated with your particular symptoms (like nightmares, headaches, or insomnia). She may also incorporate a protocol traditionally used for drug addiction using five points on the ear. “With addiction, the body has to let go of the memory of being addicted and realize it’s OK,” she says. “Likewise with PTSD, the body has to let go of the memory of being threatened and realize the emergency has ended.” By removing the trauma-induced blockages in qi, acupuncture restores healthy function to your nervous system and other organs and lets your body return to a tranquil, nonemergency state. Kitchen says most patients report having few or no symptoms after eight to 12 sessions.
More info: Acupuncturists Without Borders, which specializes in healing trauma, acuwithoutborders.org; National Acupuncture Detoxification Association, acudetox.com; Allison Kitchen, akitchen@novamedgroup.com

Kristin Bjorsen is a freelance writer living in Boulder, Colorado.


The Power to Heal
These three mind-body exercises—which you can do anywhere, anytime—calm the mind, alleviate PTSD symptoms (or any anxiety you may feel), and help you regain control of your life.
1. Soft-belly meditation: While sitting or lying down, breathe in through your nose and out your mouth. Allow your belly to be soft, letting it rise and fall gently. During the inhale, say the word soft to yourself, stretching it for the duration of the inhale. On the exhale, say, belly. Do this for seven minutes. You should see a drop in your blood pressure and heart rate.
2. Autogenic training: Lie comfortably, and do soft-belly breathing for a few minutes. Then slowly repeat the phrase “My arms are warm and heavy” six times. Now do the same with the following phrases: “My legs are warm and heavy”; “My heartbeat is calm and regular”; “My abdomen radiates warmth”; “My forehead is cool”; “My breathing is easy.” If you don’t have time to do all six phrases, do the first, second, and last one. This simple exercise will activate the calming, parasympathetic nervous system. Perform it in the morning and then during the day or at night if you’re feeling anxious or restless.
3. Energy tapping: If a stressful emotion or disturbing thought strikes, allow yourself to experience it fully. On a scale of 0 to 10, decide how bad it is. Then with a fingertip, tap on each of these points for a few seconds: the center of the forehead (the “third-eye” point), underneath the nose, the center of the chin, or the center of the sternum. Check in again on the problem. If it still registers on the scale, tap on the points that helped the most for several seconds. Repeat until the emotion or thought no longer registers and you feel calm and serene.



Internal Support
These herbs and supplements help relieve stress and anxiety, says Melinda Ring, MD, medical director of the Northwestern Center for Integrative Medicine. Since supplements may interact negatively with some medications, let your doc know before you start taking any.
5-HTP. This amino acid helps the brain produce the feel-good chemical serotonin. Take 50 to 150 mg daily.
Rhodiola. Support adrenal function with this herb. Take a standardized dose of 100 to 300 mg in the morning to feel its energizing effects.
Magnesium. Many women have an undiagnosed magnesium deficiency, which can contribute to anxiety. Get 400 to 500 mg a day.
L-theanine. Found in green tea, this amino acid reduces stress. Take 50 to 200 mg before bed.
Valerian. Used in Chinese medicine for insomnia, this herb promotes relaxation and curbs anxiety. Take 400 to 800 mg in divided doses throughout the day.