IN CHAPTER 2, we explored the concept that if our natural reactions to threats are not completed and released from the body, the accumulation of ongoing bracing and defensive reactions related to fight, flight, and freeze can generate continued pain, resulting in a pain trap.
This chapter will discuss how the shift occurs from normal, necessary pain to more chronic pain that persists after the initial cause of the pain has resolved. Self-regulation can fail for all of the “big three” trauma reactions—fight, flight, and freeze—through the mechanisms of:
• dissociation
• anxiety, fear, and panic
• helplessness and hopelessness
• anger, rage, and irritability
We will discuss each of these, and offer you a toolbox for working with them and breaking free of pain entrapment.
The first type of shift we’ll explore occurs through the defense of dissociation, which is connected to the freeze response. Dissociation is the most primitive element of our natural response to pain, as well as to threat and trauma. It’s a kind of automatic disconnection from the environment as a whole. It allows us to deal with overwhelming anxiety and fear by minimizing movement and the expenditure of energy as well as by numbing so that we do not feel pain.
If you’ve ever been in even a minor vehicular accident, you know firsthand how this works. You can be driving along in the flow of traffic, listening to music, registering the scenery flashing by, aware of your own thoughts, daydreams, and memories. In the next moment you can be plunged into the darkness of fear and uncertainty, as well as the disorienting aftereffects of a punishing impact with another vehicle. You may be able to check your body for obvious injury, get out of the car, check with the other driver, and retrieve and exchange information. You may possibly even be able to tell your story to a police officer or paramedic called to the scene (as Bill was able to do, even with a head trauma).
At some point in this process, however, you may notice that you do not actually feel your body, so, in fact, you cannot be a fully reliable witness of your own injuries. This numbing is due to the shock response and the protective activation of chemicals, such as endorphins, turned on by various centers of the brain. These chemicals are designed to minimize pain so that appropriate defensive action can take place. Dissociation is actually a vital survival skill. When dissociation becomes habitual, however, the dissociated person gets lost in this condition and cannot find the way back to a more connected state.
If you are significantly dissociated from your body, including its pain responses, the first step to coming out of shock (whether recent or longstanding) is to begin to sense when and how you’re dissociated, and then learn to gradually reconnect with your body. As you reconnect, you will discover and build various types of resources that will help you to resolve your body’s stress and pain responses. We call this self-regulation. The ability to achieve successful self-regulation of your body’s stress responses will lead to less reliance on dissociation, faster resolution of pain, and a greater sense of empowerment and strength.
There are many tools that can help you begin to decrease your dissociation, so that you can reconnect with and begin to explore your body experience (including your pain) in a safe, productive way. In this part of the chapter, we will introduce you to several necessary skills and tools, while also giving you opportunities to practice them.
One starting place is to find out what you experience in the dissociated state. Sometimes this can be the kind of classic dissociation, where you perceive that, “I’m outside my body; I’m looking down at the room; I see you; I see me.” If you are aware of detaching, it’s important to notice how you’re detaching, by expanding the experience of it. For example, if the detachment begins to feel like a floating sensation, an expansion of this experience might lead to the question: “Do I feel like I’m floating more to the right or more to the left, or in some other direction?” Then, can you describe what you see from that place?
Next, after expanding the experience from outside your body, try to describe what you are aware of in your body—even if this is very tenuous. Within a few moments, you may have the astonishing experience of coming back into your body and returning to yourself, with your anxiety and fear significantly reduced. The key is always to follow your felt sense, as best as you can, through the dissociation. This is something that has to be a slow, gentle, stepwise process so that you experience a “return home” to the knowledge that it’s OK to come back into your body.
As you read this, you might react to this suggestion with a comment like, “But I don’t feel anything. I’m just numb.” Whether you’re aware of it or not, there has to be a part of your body that feels less numb than any other part. In this situation, you can use a body scan,1 focusing methodically from the top of the head to the bottom of the feet to track your body experience more carefully. This way you will find differences, even if they are small or subtle ones.
To perform and experience a body scan, take a few minutes right now to focus on your body experience. Begin either at the top of your head or with the bottom of your feet. Gently “sense in” to the area you have chosen, becoming aware of various types of sensations. If you “don’t feel anything,” ask yourself what it’s like to feel nothing, and note your response.
Then move on to the next area that you sense. From the top of your head, you might move down into your face, jaw, and the sides of your head. If you started at the bottom of your feet, consider what it’s like to find and focus on the tops of your feet and on your lower legs. What sensations do you find here?
Continue to flow through various areas of your body somewhat systematically, finding a rhythm with how and where you move from place to place. When the experience feels complete, what feels different in your relationship with your body as compared with when you started this practice? (For more extensive information and practice about body scans, please refer the resource section).
If you are experienced in working with your body, you may wonder if the tools in this section are too basic for you. We ask that you experiment with them, even though you might think you know what will happen. Both of us regularly use these tools ourselves, and consistently make important discoveries that add to our body resources, sometimes in unexpected and creative ways.
A primary self-help skill that will support your reconnection to your body is to develop mindfulness in order to become a better observer of your body experience. One important way of engaging mindfulness is to develop awareness of a relatively neutral or comfortable place in your body that is reliable across time. In other words, whenever you become upset, over-activated, or disconnected, it’s very helpful to find the place in your body that brings you a consistent sense of connection and a relative sense of security and safety. Finding even a neutral somatic experience that evokes feelings of security, no matter what is going on inside you or around you, is often very effective.
The following exercise will encourage you to develop the resource of rest in your body by finding a place (or a series of places) that can serve as a refuge for you from pain and discomfort.
Starting at your head or feet (whichever you prefer), gradually journey to areas where you find some degree of “OK-ness” in your body—not necessarily positive sensations, but not painful ones either. Then, pay attention to the parts of your body that you cannot feel—those that are numb or blank. These may be areas from which you consistently disconnect, such as your feet and legs, hands and fingers, chest or pelvis. Notice whether they seem connected with past injury or areas of habitual stress.
Take a few moments to use your breath and sense your way into one of the numb or disconnected locations you have chosen. Breathing in, feel that part of your body; while breathing out, feel that part of your body again. After three to four breath cycles, ask yourself, “What am I sensing in that area now? Does this part of my body feel more connected? Less connected? Is my sense of it shifting in a positive direction?”
Come back to this exercise again either later on in the same day or another day. Has your sense of this part of your body changed? In what ways does it feel neutral? Does it offer more comfort over time? How does your connection with this place in your body change your pain?
Note your experience with this and the other exercises in your pain journal to maximize your results.
Another simple resource to help you shift out of dissociation is grounding through your feet and legs. This next exercise will help you learn to feel grounded as a way of staying centered in relation to pain.
Grounding is one of the foundational skills in learning to connect with your body. Grounding generally involves balancing the energy in your body by connecting with the gravitational forces that hold us securely on the earth. Grounding exercises, such as the one we’ve recorded on track 4, will help you link with physical and spiritual, mental and emotional energies, bringing them into alignment, and making it safe for you to inhabit your body.
In a way, grounding is similar to electrical grounding, which connects electrical circuits to the earth, allowing energy to move safely into the earth and preventing mechanical damage, fire, or other negative effects. Lightning rods, for example, are grounding devices that allow the electricity of lightning to pass safely from the air into the earth without damaging humans or property.
Grounding processes, like the one we are guiding you through in this exercise, allow you to connect fully with your body without stressing or overwhelming your energy circuits. They will also help you engage with your legs and feet so as to provide a solid foundation for exploring the rest of your body.
First, begin by gently shifting your weight from foot to foot. Perhaps imagine that they are like the suction cups on a frog’s foot connecting you firmly, but flexibly, to the ground.
Next, while breathing in, press gently, through one or both legs, into the floor. While breathing out, let go of the tension in your body. Experiment with how much tension you can release while still being able to hold yourself up in a stable way. Now try the reverse. Breathe in and feel the flow of breath coming into your body, then while breathing out, press gently into the floor through one or both legs.
How do the sensations of pressing down, alternating with letting go, help you feel more connected with your body? Experiment with decreasing or increasing the pressure through your feet and legs until you feel a positive sense of connection. How does grounding affect your sense of well-being?
Don’t forget to note your experience with this exercise in your pain journal.
Another resource to shift out of disconnection and dissociation is to keep a sustained focus on breathing. Rather than trying to control or change how you breathe, our goal is to teach you awareness of the actual experience of breathing. Often, just taking this simple step results in a shift of tension and pain. If nothing else, your awareness of breathing will usually result in a feeling of greater connectedness to yourself and to others.
Without consciously trying to change your breathing, simply follow the sense of your breath as it moves in and through your body, and again as your breath moves out, just like waves lapping on the beach flow in and out. What changes in your body during that one inhale/ exhale cycle? What changes in your pain?
If this is helpful, follow the pathway of a second breath as it moves through your body, as it comes in, and then as it goes out, again sensing it like the tides of the ocean that ebb and flow. What changes in your body this time? What further changes in your pain do you notice?
Feel free to come back to this exercise again and again.2 Use it whenever you are aware of anxiety, stress, or discomfort.
One important distinction we emphasize is that the focus of the breathing practice is not as much on inhaling, but on exhaling. In other words, it is essential to learn to allow a full exhalation rather than to focus on creating a full inhalation. The next exercise will help you practice extending your out-breath.
Tibetan and other spiritually guided chants have been used successfully for thousands of years to facilitate healing and open the doors of perception. We borrowed this exercise, with certain modifications, from these chants. The “voo” sound will open, expand, and vibrate the organs in the belly. This vibration, in turn, may stimulate the vagus nerve (the largest nerve in the body after the spinal cord) and will provide new signals that can help a shutdown or overstimulated nervous system to rebalance. This simple exercise can make a real difference in your relationship to pain, sometimes shifting your pain dramatically, and other times creating a more gradual shift.
Begin the exercise by finding a comfortable place to sit. Slowly inhale a full breath, then pause momentarily. On your out-breath, gently vibrate the sound “voo,” as though the sound were coming from your belly. Sustain this sound throughout the whole exhalation. Let the breath go all the way out, and then pause, waiting for the next breath to come in on its own. If you like, repeat this several times. Then feel your body, particularly your fingers, hands, and feet, as well as any other parts of your body that feel enlivened or reduced in pain.
You can do this exercise as many times a day as you want. We suggest doing it at least three times a day, especially when you begin to feel stress or when your pain starts to increase. You can also use this at the end of the day when you’re lying in bed and about to go to sleep—and then in the morning (along with a cat-like stretch) to greet the new day.
Record your experience with this exercise in your pain journal, noting how you feel after you use it in a variety of circumstances.
For some people, over-focusing on breathing can be a problem if they attempt to control their breathing. Controlled breathing is generally only helpful for a breath or two; for example, if you’re in a state of panic or intense anxiety and you want to calm yourself just for the moment, you might take a few deep, easy breaths—accenting the out-breath. Try this next exercise to help you find a different kind of spontaneous regulation of your breathing.
Place one hand on top of the other just above your belly button. While inhaling, press down gently with both hands, and then while exhaling, let all the muscles in your belly relax or loosen, including those in the hands.
You may want to experiment with reversing this breathing practice. To do this, keep one hand over the other on your diaphragm and press down gently while you exhale, letting all muscles relax when you breathe in. Continue for several breath cycles. What differences do you find in the results between the two approaches?
Some people also find it helpful to add grounding through the feet or legs to this practice. If you’d like to try this, press gently through your feet and legs at the same time you are pressing down gently with your hands on your diaphragm (either during the inhale or exhale, whichever you prefer). Notice how this feels.
What do you discover as you do this exercise? Within a few seconds, many people discover that those feelings of connection with their breathing and their bodies increase. As always, if the exercise does not feel helpful, please discontinue it for the time being.
Please note your experience with this exercise in your pain journal.
An important caveat is that, for some people, just focusing on their breathing can lead to more anxiety, especially if the breathing practice is unguided. If this occurs for you, circle breathing (see exercise, track 2) can be a better alternative. This is because the focus is more on the periphery of the body and not on the diaphragm, belly, or core. Remember, it is always a matter of what works best for you. It’s essential to feel full permission to experiment, and if a technique or practice isn’t working, let it go and move on. There are many other techniques that may be more appropriate, more timely, and more effective for you.
Another of the most common sets of reactions to trauma and pain consists of anxiety. Generalized anxiety is diagnosed when there is chronic, exaggerated worry and tension. And even though there’s seemingly nothing that provokes it (or alternatively, everything provokes it), there can be very clear symptoms.
One set of symptoms is related to the sympathetic branch of the central nervous system and includes restlessness, feeling keyed up, or on edge. Other symptoms include feeling easily fatigued, especially as the situation becomes more and more chronic. Also, there can be difficulty with concentration, disturbance of thoughts or awareness, or problems associated with blanking out mentally. General irritability, muscle tension, and sleep disturbance constitute yet another set of difficulties. The latter category can include difficulty falling asleep or staying asleep. Panic, in contrast, is usually associated with strong somatic sensations such as a racing, pounding heart, difficulty breathing, shortness of breath, or a queasy twisted gut.
What we can conclude from neurobiological research is that panic and fear are triggered by the amygdala, our “all-points bulletin” natural alarm center. Trauma disrupts our alarm system through the mechanism of memory. Past traumatic events are stored in procedural or implicit memory as though they were ongoing and still happening at the present time.3
The result is an alarm system that seems to be randomly firing, but is actually firing due to unconscious cues from the past. We end up with a perpetual warning that something is wrong, that we’re always in danger. So we can have nearly constant activation from fragmentary emotional memories that impair our thinking brains. That is why we can’t intervene very well when we are having an anxiety or panic response.
In addition, pain can intensify greatly when the nervous system, over-activated by fear, goes rogue. Nerves begin to send out false alarms due to the development of pain hypersensitivity. This hypersensitivity can cause even benign sensory experiences, such as the touch of cloth on skin, to be triggering and painful. When this happens, pain ceases to be adaptive and becomes an illness in and of itself, creating persistent, unceasing torment.
Some individuals with unresolved trauma seem to experience more of a terror or fear response first thing in the morning, while others report this surge in the evening. Although we don’t know exactly what causes this phenomenon, we suspect that it’s due to fluctuating cortisol levels. It’s been widely accepted that people suffering from chronic PTSD have low cortisol levels, due to its depletion over time from heightened amygdala response.4
A research study of individuals involved in self-harm cutting5 indicated that cortisol levels were very, very low on the first day, then increased gradually, until on the seventh day the subjects exhibited relatively high cortisol levels. At the high point of the cycle, participants tended to cut themselves. What seemed to help them was to ask that they not get out of bed immediately to avoid their anxiety, but begin to make small stretching movements instead.
When most people wake up in an anxious state, they tend either to stay in that state or they try to jump up and occupy themselves with something else. If you tend to wake up with high anxiety, try moving just a little bit. You might practice some of the breathing exercises that have already worked for you in this program. Then, slowly get out of bed and begin to mobilize more gradually by doing your regular morning activities at a relatively slow pace. Periodically, you may want to sit for a little while and evaluate how the anxiety feels and how you feel in general. This kind of self-paced approach seems to result in more stabilized cortisol levels and less fear.
Many people in pain are aware that as soon as their pain levels increase, they fall into states of anguish and anxiety. This reflects the intimate relationship that exists between pain and anxiety. In this program, we present a number of tools that work effectively with anxiety related to pain, and with pain related to anxiety. The key is to find what works best at a given time. Sometimes even an hour or perhaps a day later, the solution may change.
One effective strategy is to build “islands of safety.” When you find yourself in a raging sea of trauma, anxiety, fear, or pain, you may find a tiny island where you can settle, if only for a moment’s rest. One idea is to find the resting place in your body that you discovered in the first exercise in this chapter, Securing a Resting Place in Your Body. Repeat the exercise now and find a resting place or refuge from pain or discomfort. From there you can search for another tiny island. Then perhaps, you can create a bridge between these islands. As you continue along, you can begin to assemble a real landmass, a large solid island, which may have hills and an interior.
The key to working with these very difficult states of fear, of anguish, of helplessness, is to learn tools that can change your experience even a little bit. The nervous system really can’t change too much at once, particularly in chronic situations. But if you can achieve one small shift here, and then another there, eventually you discover that you’re on stable ground, and that the raging sea of pain and stress is going on around you, but you’re not in the middle of it anymore; you’re settled on the safety of an island instead.
Another idea is to find relief from anxiety through a simple three-step model. When you become aware of an increase in pain or anxiety, the first and most important step is to pause. Really get a sense of pausing and slowing everything down.
The next step is to take one breath with full awareness (see the Just One Breath exercise, track 5). Notice what happens in your body as you take only one full breath.
After that one breath—and you may want or need to take several more—you will then be in a position where you can make choices. You can choose to explore the possibility of islands of safety, of gentle stretching and movement, or use other tools based on breathing, mindfulness, or energy psychology, or any of the other techniques presented in this program. Just taking that one breath may set you in motion beyond fear, pain, and trauma.
Focus on resolving anxiety and fear states needs to take place throughout treatment of pain. We believe that all chronic pain conditions are also anxiety conditions—that is, pain is intimately related to the experience of dysregulated fear, when fear causes the body to constrict or brace against the pain. This causes the organism to experience more pain, which then triggers more fear and anxiety, and so forth.
One important way to work with fear is through mindful observation. When we are able to stand at a distance from fear, observe it, and take it apart as physical sensation along with its related thoughts and images, the fear often dissolves and transforms.
To get a sense of how this works, imagine that you are able to flee the source of your pain. If there’s an incident that started your pain, like an accident or injury, imagine that you can run away from that scene.
Joe, for example, imagined that he could sense the impact that caused the motorcycle accident that left him with chronic back pain before it actually happened. He envisioned revving up his engine and directing his bike safely in a different direction, then feeling the sense of successful escape in his body.
If there is a scene for you that is connected to the onset of your pain, imagine that you can use your legs to run away, or jump and roll out of harm’s way, or otherwise execute a planned escape. What do you feel in your body as you imagine this? How do you experience the flight response? What effect does this have on your memory of the incident? What effect does it have on your pain now? You might want to note your reactions to this mini-exercise in your pain journal.
Helplessness comes from being overwhelmed by anxiety and fear. If you’re not overwhelmed, you may be able to experience fear, or even terror, without a long-lasting effect, because you know somehow that you’re going to be able to move through it. But when people don’t have this experience of knowing that they will be able to move through anxiety, chaos, and fear, this can lead to sensations, feelings, and postures of helplessness and of hopelessness.
Much of the research on helplessness has been done by psychologist Dr. Marty Seligman, who developed the term “learned helplessness”6 to refer to a situation where we perceive that we have no choices, or no control, over the outcome of very difficult, in some cases, life-threatening circumstances. Robert Scaer has suggested in his book The Trauma Spectrum that helplessness and hopelessness may be related to an unresolved freeze response.7
We invite you to experience a series of tools to help you resolve helplessness and collapse. Take your time to explore these possibilities, working with one or more that seem to resonate for you. If none of them appeal to you, or if they feel overwhelming in any way, feel free to leave them for now and return at another time.
Helplessness and resignation are embodied as a collapsed posture—the shoulders slumped forward, the chest caved in, a folding around the area of the diaphragm (midriff). The posture is one of giving up. So in helping people begin to become aware of those postures, we often work with them in a standing position. When you’re standing up, your muscles have to deal with gravity, and can’t completely collapse. If they are sitting down, collapse can occur far more easily. Here’s an exercise you can use to find out how to explore the sensations and feelings of helplessness.
While standing up, notice the parts of your body that feel strong in some way. Maybe you notice strength in your ankles, legs, thighs, arms, elbows, or shoulders. Pay attention to sensations in those areas that are even a little bit different from helplessness and collapse. Spend a little time exploring the sense of strength throughout your body, mapping and affirming those areas of improvement using the language of sensation. In your pain journal, note your experience of discovering your strengths.
Another important step is to notice in daily life whenever you start to experience the feeling or sense of helplessness. This might be related to your pain or some other challenge. If possible, go to a mirror and notice your posture. See if you can recognize specific places where your posture seems or feels collapsed, and then continue by practicing a few simple movements to begin to shift it. Remember to record your experience with the posture of helplessness in your pain journal.
Another way of working with this type of collapse into helplessness can be accomplished by connecting with conflict-free experience8 in your body. This technique refers to finding areas where you don’t experience helplessness, pain, or self-blame reactions.
A simple way to find conflict-free experience is to ask yourself, “When, in the last day or so, have I felt least anxious or least in pain, and most like the self I hope to embody most of the time?” You may not be completely free of pain in this kind of moment, but there are always moments when you feel a little less pain, for example when you are laughing with a friend, taking a walk, or during other times of simple, pleasant engagement.
When you find that moment, see if you can represent that experience in your mind’s eye—as an image or a thought. Then shift back and forth between that image (or thought) and your body sensations. As you do this, notice how your body may be containing or holding the experience that is free of conflict, anxiety, pain, or helplessness. Then use your attention to go back and forth between your image or memory of the experience, and whatever sense of it you have in your body.
Repeat these steps two or three times, and then think of another time a week or two ago that was relatively conflict free. What do you notice? How can you describe the sensations in your body that result from this practice? Now think of another moment when you felt less pain and more freedom. Explore the felt sense of this moment. What happens to your pain as you practice? Note your experience with this tool in your pain journal.
Another strategy is to use various techniques to lower anxiety, panic, or helplessness before finding a conflict-free moment. One example of how to do this is to use a technique (derived from applied kinesiology) often used in the practice of Energy Psychology called the “over-energy correction” or Cook’s Hookup.9 From this point of view, panic, fear, and anxiety all involve a situation in which too much energy is trying to flow through your energy pathways or meridians. There’s a lack of containment and a lack of flow.
If you’ve never encountered this type of approach before, be forewarned that it can seem a little strange and unfamiliar. Yet many people have good results with it in terms of reducing anxiety or fear—so if you’re ready for an “out of your usual box” experience, give it a try.
To practice this technique, while sitting or lying down, cross your left ankle over your right if you are right-handed (reverse the directions if you’re left-handed). Then stretch your arms in front of you so that they’re parallel to the floor (if you are lying down, just reach toward the ceiling), with the backs of your two hands touching each other. Next, cross your right hand over your left and clasp your fingers together, fold your hands and arms, drawing your fingers down and back toward you, eventually pointing your fingers toward your face. Rest your hands and elbows on your chest. If you are at all uncomfortable in your wrists or your arms, modify this position by just crossing your arms over your chest with your right arm over your left (See more specifics including a diagram under “Energy Approaches,”, in the resources section).
Then place your tongue at the back of your upper front teeth, on the palate. Close your mouth and eyes, and just breathe for a few moments. Usually within the first ten seconds there begins to be a shift. Notice what happens for you, and continue for as long as your response is positive.
Many people report a deep settling into their bodies with a sense of calm. If this works for you, you can use this approach before you go to bed at night or if you wake up and are not able to return easily to sleep. You can also use it to manage many kinds of anxiety-fear responses including panic.
Note your experience with this exercise in your pain journal.
As with any technique, pay attention to your experience so that you can make nurturing choices in selecting those tools that have positive or neutral effects. As we have said before, this program includes many alternative possibilities so that you can find and choose the methods that are most effective for you.
Every day we have stresses that frustrate us and trigger anger. A driver pulls sharply in front of us without warning and we slam on the brakes, narrowly avoiding a collision, and the papers we had on the front seat are thrown all over the floor. Later in the day, a coworker repeats a mistake for the fifth time in a row, even after promising to resolve the issue. That evening, we learn that our spouse or partner has forgotten, once again, to complete a promised financial transaction, missing a deadline and incurring late fees.
Whether we want to or not, we have predictable reactions to these kinds of situations: elevated heartbeat, flushing, or the feeling that an internal volcano is about to erupt.
Anger is a normal reaction and can stimulate us to take action in adverse situations. It is related to the third of the “big three” reactions to pain and threat—the unreleased fight response. Like flight and freeze, fight reactions are important survival options when we are threatened with danger. When the fight mode is turned on through our body’s alarm system, powerful chemicals are released to give us more energy to persist in the face of obstacles, to ward off attacks, and even to counterattack.
Feeling anger can serve an enlivening function, empowering us to stay strong instead of collapsing into helplessness. It’s also a normal reaction when we lose basic trust in other people, because this is yet another type of threat to our sense of safety and security. Like the other survival responses, however, problems occur when the fight response is continually activated in the present moment due to reminders of past threats. When the energy of the fight response is not completed or released in appropriate action or discharge, it can create intense muscle tension, inflammation, and other systemic reactions that contribute significantly to pain. When feelings of anger or rage go unmanaged, they can trigger fierce reactions that are out of proportion to current realities, creating fear at the power of our angry reactions, whether provoked or not.
The problem here is not anger. The problem is that we often don’t know how to cope with, or express, feelings of anger in a fruitful way. We are also confused by other companion feelings such as resentment, hurt, frustration, disappointment, jealousy, and shame. Anger is simply a natural instinctive response to obstacles in our path and to many different circumstances where we feel powerless or victimized.
However, the habitual ways we express angry feelings and the energy of the fight response may be counterproductive. If we are unable to express our anger effectively, our automatic “short fuse” reactions may trigger us to react with full activation as if our circumstances were actually life threatening, causing problems in our work and family relationships. Continually angry individuals may actually provoke others to react aggressively and with hostility toward them, because of the inflexible ways they attempt to control their environments. This can set up a self-fulfilling prophecy associated with trauma-related beliefs like “I can’t trust anyone,” or “After all I’ve been through, I deserve to be treated better than this,” or “Why didn’t so-and-so prepare me for what could happen?”
Any effective treatment of pain should include awareness that fight responses are always present, as are freeze and flight reactions, whether or not they are being expressed. And as with any persistent discomfort, pain itself can activate arousal of the fight response since we can become angry at the events that created the pain to begin with, angry that our pain is unmanageable, angry that no one can protect us from the suffering that pain provokes. Additionally, if we have been significantly threatened or abused at a young age, we may not have learned flexible, effective ways to respond to conflict.
As emphasized in chapter 1, all pain conditions have sensate, emotional, and cognitive components. Discussion of anger, and the fight response, gives us the ideal opportunity to examine the wedding between emotion and sensation. Similar interfaces exist between fear reactions and the flight response, and between helplessness and collapse related to the freeze response.
We have said that the pain trap is created by the vicious cycle of bracing against the threat of danger, possible injury, or further pain; which leads, in turn, to constriction and more pain and fear, and so on. We can also become trapped by anger responses that become too compulsive, rigid, easily triggered, or explosive.
The primary intervention to prevent imprisonment in any of these traps is through the use of body awareness to process the emotional component of a threat response just as it is in the body. If we experience anger in its purest form in any given moment, free from mental analysis and judgment, we can begin to “dismantle” our habitual responses and enter into new, and energizing, somatic experience. In other words, when we access our feelings through carefully paced body awareness, rather than through rapid cathartic emotional release, we are able to create the lasting change in emotional patterns that we desire.
There are numerous tools that can help you effectively regulate your anger and fight responses. Try one or more of the following options and, as always, enter into an attitude of curious exploration so that you can move on if you aren’t satisfied with the results.
Learning how we deal with and resolve prolonged states of anger and rage has enormous impact on our abilities to transition to a pain-free life. Since these emotions trigger terror of our own aggression, we often turn these feelings in on ourselves because we are too afraid of expressing—or even feeling—them. The exercises that follow will teach you how to track, contain, and safely express these powerful emotions and their related sensations.
Tracking Bodily Sensations. The first step in shifting destructive emotional patterns is to track the bodily sensations that underlie the anger. Take a moment to think of a situation that frequently triggers anger, irritability, or frustration for you. Notice what happens in your body. You may become distracted by negative thoughts related to the anger response, but don’t be distracted by their content or your analysis. Instead return to and stay with the sensations in your body.
At first this may be confusing or distressing because it’s so different from your usual focus. However, as you hold these sensations in your awareness, without trying to change anything, feeling them just as they are, eventually your body experience will seem more spacious and settled. This is because as the underlying sensations of anger become uncoupled or separated from the emotion and then unhooked from related thoughts or beliefs, and even from images or memory, the felt sense becomes more fluid, moving toward subtler, freer “contours” of feeling.
What happens right now as you stay with the sensations of your anger? Note your experience in your pain journal. What part of your body wants to express anger when you think of the anger trigger you selected a moment ago? What part seems afraid of the anger and wants to hold it back? Remember, the feeling of anger evolves from the fight response of wanting to strike out and attack. This holding back accumulates in our bodies as muscle tension and pain, and prevents the expression of healthy aggression.
Containing Powerful Feelings. To befriend your anger, you will also need to learn how to contain, or hold within you, powerful feelings. When we give into our usual ways of dealing with anger (which is either to stuff or suppress it or mindlessly express it), we are often trying to release the tension and feel relief from the powerful emotional charge. However, this may make no lasting change in our capacity to tap into the positive, life-affirming energy of anger.
To feel what healthy aggression is like, take a really crisp apple and take a big bite out of it. Now chew it with great vigor. Then take another big bite, enjoying the crunch and the power of your teeth biting down and destroying the apple by pulverizing it. Finally, take in the juicy nourishment of the fruit. This is what pure healthy aggression feels like.
Examine Your Reactions in the Past. Think of a time in the past when you actually expressed your full anger at another person. Maybe you shook your fist, raised your voice, exploded into swear words, shoved him or her, or pointed your finger.
What was the effect of your behavior on the other person and on yourself? Notice as you explore the answer to this question whether you become more connected with anger or less connected.
What did you learn? What do you think might happen the next time you encounter a similar situation?
To continue your study of the fight response, it can be useful to feel the animal roots of this powerful response to threat.
Imagine that you are your favorite wild animal—strong, powerful, and quick—whatever appeals to you at the moment you are reading this. Feel the sense of your strength and power in your animal body. What sensations do you notice? Now stand up and begin to walk around the room. Let your eyes narrow so that you can get a sense of deliberate movement as you, more and more, “step into” the body of this animal. How do you experience your strength, power, and forcefulness?
Now imagine that another animal is approaching. You know, instinctively, that this animal is also strong and powerful; it is a force to reckon with, just as you are. You also sense that this animal wants to attack you. What do you begin to feel in your body? If you sense that you are going to collapse or shrink back, remember that this is your territory and that you have a right to defend it. What are the sensations that signal your determination to protect what is yours? Pay particular attention to sensations of determination and strength in your head, neck, shoulders, face, and jaw. What movements and tensions do you feel? What emotions are you aware of? Feel the strength in your shoulders, arms, legs, and feet.
Finally, prepare to take action toward the animal that is trying to invade your space and usurp what is yours. Notice what happens as you prepare to fight back and to protect your vital interests. Follow those sensations and movements, staying grounded in your body’s felt sense of your own animal power and strength. Feel how your shoulders, arms, and neck tense as you prepare to strike out. Does the energy related to fight begin to shift? If so, how? Continue to stay with these sensations until you sense completion. What does completion feel like? What happens to your pain?
The following exercise can help you process anger about an event in the past as well as work with current anger reactions.
First, constrict your hand into a fist and clench it tight. This act can represent being locked up in anger. You might even want to name the resentments, irritations, and anger that you’re aware of, and sense your fist clenching tighter and tighter to hold onto the anger.
Now gradually open your hand and extend your fingers so that they’re mostly straight but also form a bit of a cup. Where did the anger go? The lesson is that if you can learn to let go of anger in your body, it will tend to dissolve, or even “disappear,” because its energy is transformed in the letting go.
Now make your hand into a fist again, and again gradually allow it to open. What sensations are you aware of as your hand continues to open? Name all the ones you are experiencing. What do you notice as you practice using the language of sensation to describe your experience?
Often when we surrender to the urge to get angry, we simply let off steam like a pressure cooker. This does not allow us, however, to find ways of turning down the heat so that we can regulate the underlying buildup of anger (or steam). This next exercise teaches you how to feel the underlying sensations.
Start with a feeling of anger toward someone in your life. Feel and name the sensations as you track each one from its starting point to a sense of completion, change, or stuckness. Resist the temptation to detour by getting into your thought process.
If you feel stuck, just track your breathing as you focus on the anger. Feel the rhythm of the rise and release of your chest, the wave of energy and where and how it moves through your upper body. Stay with the sense of movement, the feel of muscles expanding and then letting go.
As you sense your somatic experience beginning to shift, return your attention to the anger you began to explore. What is different now? If you envision the next time you’re likely to experience the same kind of irritability, frustration, or anger, can you imagine shifting your attention to your sensations and breathing whenever you feel blocked or stuck, and then returning and expressing your anger with words meant to connect rather than to distance?
Jot down your experiences in your pain journal, then return to this exercise at a later time when you are feeling triggered by anger. What happens over time as you practice this approach?
The next chapter will help you continue on the journey from uncontrollable or unmanageable emotional or physical pain, which can result from insufficient self-regulation, back to the place of stable functioning. As in the current chapter, you will encounter additional practice exercises to help you develop specific skills in self-regulation that lead to further wholeness, balance, and stability. Our message will continue to show you how your unresolved stress reactions to threat and trauma can serve as the pathway to transforming your pain condition through the use of simple tools we present.