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In Consultation - Page 2

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Notice that as I guided Carol in forming an image, I didn’t use the word safe, as this might have triggered Carol’s mind to think of the opposite, putting her back in a position of fear and anxiety. I also didn’t suggest a specific image, but guided her to create her own. That way, she felt ownership of the image, and her sense of self-efficacy and empowerment was bolstered.

Arm movement, breath, and mudra. Because her breath was shallow and in her upper chest, I didn’t ask Carol to breathe deeply at this stage, since that might have been too difficult. Instead, I chose a breath practice to work with the short breaths she was already taking. I call this practice Stair Step, but it’s actually an ancient technique known in Sanskrit as Anuloma Krama. I demonstrated how to open her arms wide to the sides, raise them up over her head, and then interlace her fingers with her index fingers extended toward the ceiling. This hand position is a mudra.

Mudras engage many nerve endings that activate various regions of the brain. In addition, by asking her to raise her arms over her head, I helped her increase body sensation and body awareness, which is important because many trauma survivors feel unsafe in their bodies. They often say they feel as though they live from the neck up. At the end of the exercise, you’ll see how, through my cuing, I made use of her heightened body awareness to allow her to reoccupy her body safely without ever having to use the word safe.

As we began the practice, I invited Carol to close her eyes or, if that didn’t feel comfortable, to lower her gaze to the floor. I kept my eyes open, so I could see how she was breathing. As a clinician, you want to keep your eyes open while leading a practice, unless your client requests otherwise, so you can monitor the effect of the practice.

As she was lifting her arms, I instructed her to inhale little sips of breath through the nostrils, as though she were climbing a mountain with her breath. When she arrived at the top of the mountain, I cued her to pause and imagine the beautiful scene on the beach in Hawaii she’d chosen as her image—sky, waves, sand, everything. After just a heartbeat or two, I guided her to lower her arms to the side, knowing that from this final position, she’d let her breath out slowly on her own. “Beautiful,” I said.

Adding the mantra. We practiced the Stair Step exercise twice, and then I told Carol that we’d add the mantra so-hum, a soothing sound that I explained means “I am that” in Sanskrit. From my intake form, I already knew that Carol’s religious beliefs wouldn’t be in conflict with a simple, nondeity mantra in Sanskrit. Had this been otherwise, we might have used shalom, amen, or soob-hahn-all-ah to meet her religious beliefs as a Jew, a Christian, or a Muslim, respectively.

We practiced the Stair Step exercise three more times with the mantra. Using the sound helped her slow her breathing even more. Research has shown that mantras are effective because an extended exhalation stimulates the parasympathetic nervous system, relaxing the body. In addition, a soothing sound like so-hum or om deactivates the limbic brain, which is often hyperaroused in individuals with a history of trauma.

Body sensing. As we finished the practice, I invited Carol to sit with her eyes closed and observe the sensations in her arms, palms, and fingertips. “Sense deeply into your palms,” I said. “The mind is a time traveler, but the body is always present. Sensing that feeling in the palms is like having a window into the present moment.”

Notice that I didn’t ask her to feel the sensation in her body in a global way. A client with a history of trauma similar to Carol’s may carry a belief that it isn’t safe to live in her body, or that she’ll be overwhelmed with emotion if she lets herself feel her body. But when we’re specific in our cues to feel sensations in the palms or fingertips, for example—places where there are a lot of nerve endings—we give the client the gift of reoccupying the body in a manner that feels safe.

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