MINDFULNESS BASED PSYCHOTHERAPY

Trauma is an emotional response to events or circumstances that create more stress and/or pain than we are able to cope with. Consequently our survival systems are activated, which can leave our nervous systems overly sensitised and on alert for threat or danger within our environment. We can be traumatised by: one-off accidents and attacks; physical, psychological or sexual abuse; bereavement, abandonment, neglect and/or conflict; the lack of a relationally attuned parent as we were growing up.

Beyond having an awareness of our personal history, what might indicate we have been impacted by traumatic experience? There is an interesting article – Daniela F. Sieff (2017), Trauma Worlds and the Wisdom of Marion Woodman, Psychological Perspectives 60(2) pp.170-185 – which helpfully identifies three internal trauma worlds that can be created as a part of our survival response to traumatic experience. The nature of these worlds are:

• HYPERVIGILANCE, fear and/or anxiety: which can leave us with an over-stimulated nervous system and cause us to have difficulty trusting others and/or resting in a feeling of safety.

• DISCONNECTION and/or dissociation: making it difficult for us to know or be in touch with our emotional and/or somatic realities.

• SHAME: which can leave us with feelings of self-hatred, inadequacy, unworthiness and/or a belief that we are unlovable or, in some profound way, not enough.

If feelings of fear, disconnection or shame colour or dominate our experience, we may be living with the legacy of developmental, relational and/or incident-related trauma. We might also think of trauma worlds as territories within a wider internal landscape, which we move in and out of, and so do not inhabit at all times. We can feel resourced and well for varying amounts of time, but then become activated or 'triggered' (sometimes unknowingly or by the most subtle of cues, for example, the way another person looks at or speaks to us) and we find ourselves inhabiting one or more of our trauma-related territories.

It can be helpful to think of traumatic history creating internal territories because it serves to remind us we are more than just our symptoms and/or our reactivity. We do not have to be wholly identified with the impact and consequence of traumatic experience; herein lies the possibility of making a subtle but important shift away from completely identifying with our experience of self or ‘I’ ("I am unlovable" or our "I am anxious"), towards experiencing self as an ever-changing and fluid process. Making this shift strengthens our observing ego or witness-consciousness and supports our capacity to notice our trauma worlds beginning to spin, to be aware as we fall into the black hole of our shame, and to be mindful when we experience 'other' through the veil of our own fear.

How might therapy support our discovering more choice and freedom if/when we find ourselves dwelling in trauma-related territories? Let’s look at each territory in turn.

• HYPERVIGILANCE: Our experience of this territory might include anxiety or panic-attacks, restlessness, aggression, avoidance behaviours, addiction (often in an attempt to self-regulate), difficulty trusting others/partners including a fear of abandonment. A therapeutic approach might include: bringing awareness to our particular trauma-related patterns, understanding them and developing our capacity to notice when they are arising, whether in the form of emotions, thoughts, sensations or impulses; learning to calm an overactive nervous system through breath, relaxation and movement; building our internal and external resources (including somatic, emotional, relational, creative, spiritual), which can support us to find more internal ground and resilience.

• DISCONNECTION: When sufficiently resourced, and if our therapeutic relationship offers enough safety, we can begin to explore and connect with aspects of our mind-body experience that we have either become numb to or have banished into unconsciousness. An example might be early anger or grief in response to a history of misattuned parent/care-givers who offered fear/neglect in place of safety/nurture. By allowing and connecting to trauma-related feelings - in present-time and within a safe-making relationship - we can learn they do not have to overwhelm us. Connecting to our experience at a greater depth offers the possibility of processing and integrating what was once cut-off, which can in turn release us from fear and/or our need to avoid feelings/situations that might once have felt overwhelming.

• SHAME: The territory of shame is associated with intense feelings of being unlovable, undeserving, defective and/or not enough, which can also settle upon particular aspects of self such as appearance, weight or intelligence. We might defend against our sense of lack by, for example, turning towards perfectionism, having a tendency to blame or control others or by becoming defensive or rageful if/when we feel criticised. We can also become weighed down by feelings of shame, and withdraw into depression, despair and/or addiction. A powerful 'inner-critic' may reside within, who judges, berates and/or acts to undermine us within our intimate relationships, work and/or social life. We can be supported to challenge our inner-critic and develop greater shame-resilience by finding/forming a therapeutic relationship, where we experience the attuned presence of a therapist who reflects us back to ourselves without distortion. We can bring awareness to shaming messages internalised through our childhood and adult lives, and so begin a process of disentangling our truth from the distorted and distorting perceptions of others. Within a relational atmosphere of allowing, kindness and curiosity we can be supported to find a greater acceptance of self and a more authentic way of being as we dare, perhaps for the first time, to let that which shames us be seen and met within the holding field of an attuned and compassionate relationship.

By establishing resource and creating space around our reactivity, anxiety or fear, by coming to allow, know and see ourselves more clearly within an attuned relationship, and by relaxing our defences against feelings of anger, pain, shame and vulnerability we may come to find an easier way of being. Our trauma territories will remain a part of us, familiar places we will inevitably revisit, but in a way that enables us to take greater responsibility for ourselves within them, resting in a knowledge they were borne out of our instinct to survive.

While it is not unusual for people to enter into psychotherapy knowing they wish to understand their experience of, for example, anxiety or depression, it is less common for them to identify shame as something they wish to explore, even when their lives have been significantly and unhelpfully impacted by it. For me, this suggests something of the deep-rooted, underlying nature of shame, which can lie close to the heart of our relationship with self.

Shame has been variously described as, “an enemy of well-being” (DeYoung, 2015) and “the dark mirror within” (Gilbert, 2011), capable of reflecting back to ourselves feelings of anger, disgust, loathing or self-hatred. Common ‘hooks’ for shame-based feelings include: appearance, weight, intelligence; personal histories; our sense of purpose or perception of achievement; sexual and/or hunger drives; interpersonal needs; our internal emotional and cognitive worlds.

A person who is shame-prone may hold a perception of themselves as any of defective, inadequate, not enough, helpless or hopeless. Powerful core-beliefs may underlie such perceptions, including “I am unlovable”, “There is something wrong with me”, “I am bad”. It isn’t hard to imagine how such perceptions and beliefs cause suffering, create difficulties in relationships and/or undermine our capacity to realise our potential. Indicators of shame include low self-esteem, having a powerful inner-critic and a tendency to be anxious or insecure in relationships.

Early shaming environments may have lacked relational attunement, or been any of neglectful, abusive or abandoning. In such environments we may have developed strategies to defend ourselves against shame-based feelings, which otherwise would have been overwhelming to our early, developing selves. Strategies originally created to help us survive and defend against shame will potentially continue to play themselves out unhelpfully in our adult lives. Indicators that we are managing or defending against shame-based feelings include: a tendency to quickly anger if/when we feel criticised; a capacity to feel envious of, or easily threatened by others; a tendency to avoid, blame or withdraw from others; a capacity to be hubristic or grandiose. The presence of internal shame may also be indicated by addiction, perfectionism or a potential to dissociate as we manage the tension arising in the gap between our ‘real’ and ‘ideal’ selves.

We can see how tendencies, born out of an original need to protect the self, might no longer serve us in adult life and relationships. It has been said that one thing chronically shamed people have in common is a feeling of profound loneliness. Judith Jordan (1997) powerfully captures this painful truth when she writes, “…shame is most importantly a felt sense of unworthiness to be in connection, a deep sense of unlovability, with the ongoing awareness of how very much one wants to connect with others”

Shame-based wounds were originally established in relationship, and so it follows their healing can best be supported in relationship with another. Based upon my experience, and with reference to contemporary shame theory (Brown, 2007; Gilbert, 2011; DeYoung, 2015; Sieff 2015), there are a number of what might be called ‘antidotes to shame’, which can be found and/or co-created within a good therapeutic alliance, and have a potential to support a process of ‘de-shaming’. Antidotes include: the attuned presence of another, who can offer empathic listening, curiosity and compassion; making authentic connection with ourselves and with other, supported by our capacity for mindfulness, self-compassion and self-expression; critical awareness, which can support increased consciousness and the cultivation of shame-resilience.

By cultivating our capacity to be mindful and compassionate towards self, within an attuned, empathic and compassionate relationship, we are supported to come into a more authentic relationship with ourselves - including our feelings, needs, internal conflicts, vulnerabilities and inherent health - and with others - by connecting with and sharing our emotions, negotiating relational needs, and lowering our relational defences (De Young, 2015). A good psychotherapeutic relationship can provide the antithesis of a shaming relationship, where empathic curiosity offers a safety in which we may become more self-aware, open and less defended, where attunement supports us to connect with our relational needs, and where compassion and acceptance supports our discovery of a greater spaciousness and equanimity around all that shames us.
​
At the heart of Core Process Psychotherapy there lies an inherently healthy and de-shaming intention: to deepen into experience rather than seeking to change it. By holding this intention mindfully, and bringing an attitude of curiosity and openness to all that arises within ourselves and in relationship, we are already embarking upon a process of disentangling from shame-based beliefs, which might then allow us to come into a gentler and more spacious way of being.

REFERENCES – FURTHER READING
Brown B. (2007) I thought it was just me (but it isn't): Telling the truth about perfectionism, inadequacy, and power, Penguin Group: New York.
De Young, P. (2015) Understanding and treating chronic shame: A relational / neurobiological approach, Routledge: London.
Gilbert, (2011) The role of compassion focussed therapy, in Dearing, R. L. and Tangney, J.P. (Eds.) Shame in the therapy hour, American Psychological Association: Washington, DC.
Jordan (1997) Relational development: Therapeutic implications of empathy and shame, in Jordan, J. (Ed.) Women’s growth in diversity: More writings from the stone center, pp.138-161, Guilford Press: New York.
Sieff (2015) Understanding and healing emotional trauma, Routledge: London.