It Takes a Community - Page 4

TRM draws from several sources, including Jane Ayres's Sensory Integration Theory (SIT), Eugene Gendlin's concept of the "felt sense," and Peter Levine's Somatic Experiencing model. Sensory integration is our unconscious ability to take in and organize the deluge of sensory experience to which we're continually exposed (taste, sight, hearing, touch, smell, movement, gravity, and position), without being overwhelmed and paralyzed. A traumatic experience can profoundly affect our ability to absorb, modulate, and use sensory information, resulting in overload, which prevents us from responding to the world in a coherent, purposeful way. Although SIT has been widely used by occupational therapists to treat children with autism spectrum disorders, it isn't commonly used in psychotherapy.

Gendlin's concept of the "felt sense" refers to a mode of engaged, accepting attention, a way of getting in touch with an inner-body sense or preverbal "knowing" of something important. By focusing on this sense, individuals can feel important physical and emotional shifts in how they experience their lives, leading to fresh insights, new attitudes, and a different "take." Because our ancestors lived as both hunters and prey, our nervous systems are highly attuned to danger. In essence, we're wired for survival-oriented vigilance—a tendency that traumatic events exacerbate.

Peter Levine's Somatic Experiencing is a body-awareness approach based on the idea that traumatic symptoms result when the survival responses of the autonomic nervous system (fight, flight, or freeze) are aroused during a trauma, but never fully discharged after the traumatic situation has ended. The model helps people become aware of, and gradually release, the traumatic energy "locked" in their bodies.

Our model trains people to attend to body sensations that are less distressing, neutral, or even positive, which allows us to work with traumatic activation in a gentle, graduated way. This process of shifting between organization and disorganization in the nervous system expands awareness, decreases anxiety and depression, and helps individuals achieve a degree of calm and inner stability.

A Public Health Focus

Our international work in impoverished areas that have suffered catastrophic trauma has shaped our shift from a clinical to a public health perspective. In these areas, there generally is a communal orientation, rather than an emphasis on the individual. People often reject clinical services because their culture doesn't focus on emotional expression or insight. They may even have negative perceptions about what it means to seek mental health treatment—an attitude that also characterizes many of our troops.

We consider the military to be its own kind of communal culture, which, like others we've encountered, distrusts outsiders and prefers being served by people like themselves. Those in the military don't want to feel like patients receiving standard clinical interventions. They're drawn to skills-based programs that teach them how to self-regulate and build strength, preferring to see themselves as simply learning techniques that enhance their own ability to rebalance and carry on their daily roles in the most "normal" way they can, without being marked as somehow different from others.

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