Traumas

Acon.: „In drei Tagen sterbe ich!“

„Homöopathisches Beruhigungsmittel!“ Sagt seine Todesstunde voraus! Nach starkem Wind, Schreck, Schock oder Angst. Hochakute Situationen. Heftig und schmerzhaft.

Plötzliches hohes Fieber, starker Kopfschmerz, Schreck und Schocksituationen mit Unruhe. Typische Situation: Menschen, die z. B. nach einem Autounfall im Schockzustand unruhig umherlaufen. Kind verletzt? Mama braucht zunächst Acon., damit sie die Ruhe bewart und dem Kind gut beistehen kann!

Anaphylaktischer Schock: Apis C 200, bei Blaufärbung Lach. C 200

[Ed Schmookler, Ph.D.]

Healing the vital force damaged by trauma is a critical challenge in homeopathy. Most of our clients have experienced some trauma, many of them severely, some of them catastrophically.

With homeopathy we can play a key role in the healing of trauma, because we can stimulate healing of the vital force, which receives much of the impact of trauma.

Psychotherapists can help clients face the emotions that surface when long buried trauma emerges and can help the person forge a new life. But homeopaths can bring relief to a vital force

misshapen by trauma. Trauma can bruise, oppress, beat, puncture, fragment, shatter, and even destroy the vital energy that shapes our lives.

Homeopathy is an especially good modality of healing the kind of damage that trauma causes. Trauma freezes people in time. Years after a trauma is over, people are still living it:

the Vietnam vet still looks for cover when a helicopter flies overhead, the rape survivor still fears the shadows in the alleyway, the incest victim still fears intimacy, and the man beaten in

infancy still wishes to die. Trauma locks people into the past. Homeopathy unlocks frozen functioning:

Sulphur releases rage pent up in depression,

Sepia moves a woman out of post-partum immobility;

Nat-m. moves old salted away grief into tears again. Successful homeopathic treatment allows immobilized life to flow again.

3 Levels of trauma:

Trauma can impact different levels of the organism, and it is helpful to be clear at what level one is working when working with survivors of trauma.

The three levels of trauma are:

Basic Trauma,

Interpersonal Trauma,

Developmental Trauma. We shall examine each in turn.

1. Level - Basic Trauma

This level is common to all trauma, from car accidents to ritual abuse. No matter what the trauma, all trauma shares some features in common. This has been a surprise to me. I worked for many years with Vietnam vets.

Many of them shared features in common:

a broiling, brooding rage,

a sense of injustice, shock,

an inability to move out of the past,

mistrust,

difficulty maintaining relationships.

My surprise came when a man who had an auto accident, a woman robbed at gunpoint, and a man raped as a child all looked like Vietnam vets!

Their suffering was similar and so was their way of being in the world.

Examples: accidents of all kinds (car, sports, industrial) and natural disasters (earthquakes, floods, hurricanes, fires).

The Features of Basic Trauma

The primary feature of all trauma is overwhelmed. Trauma by its very nature presents the organism with more than it is accustomed to handle. By definition, trauma takes us beyond our ordinary capacity for coping.

I am accustomed to going down an elevator at normal speeds. I may be a bit pushed to be crowded in with far too many people; I would be very stressed to be stuck in an elevator all day caught between floors in the dark.

But I am entirely unprepared for it to descend suddenly four stories without brakes. That would be traumatic. But in going beyond what we are used to coping with, trauma does not catch our system entirely by surprise,

for we have survival mechanisms built in to deal with overwhelming experience.

The two major responses that arise in response to sudden and extreme danger are hyper-reactivity and shutdown.

Hyper-reactive response: the primary defense/attack mode of fight or flight. People become hypervigilant, startle easily, and are ready to run or attack at the slightest stimuli. They also have repeated flashbacks and nightmares relating to the trauma.

Picture of Hyper-reactivity

You come out to the waiting room to meet your client, and he looks up in surprise. He looks you intently in the eye, and pulls his hand away quickly when you shake his hand. "I'm not myself,"

he says, when you settle down in the office. "I'm jumpy, and I can't sleep. Ever since the accident, my mind isn't working right. I keep going over and over what happened. I can't seem to

make it stop. And then," he says, starting to get agitated, "every time I go out, I react in ways I shouldn't. I don't understand what's happening with me. Sometimes, I think I'm going crazy.

When people are walking on the sidewalk towards me, I feel like they are coming right at me. I get mad. I get mad real easily these days. The other day, at a fast food place, I almost got in a

fight with this kid that bumped into me. People just piss me off. I didn't use to be this way."

Shut-down

The other pole in traumatic response is shutdown. When an organism becomes overwhelmed, it has built-in responses to protect it from too much reaction. Physiological shutdown is shock.

The periphery closes so that the vital functions within the core of the organism can be preserved. Shock has a quality that is unmistakable once you become familiar with it. It is a combination

of frozenness, pallor, and brittleness. This can be lodged in the system and emerge many years after the trauma, when the trauma is accessed. Psychological shutdown in trauma is emotional

numbing and avoidance of stimuli that remind people of the trauma. People become detached, unemotional, and unable to have normal feelings. They avoid situations, such as public places or

open spaces or closed in spaces or crowed places which remind them of where they were hurt; or they may avoid people who remind them of people who hurt them. The deepest level of

shutdown is depression, which often accompanies Post Traumatic Stress Disorder.

Picture of Shutdown

She sits on the chair facing you. She looks stunned. You ask her questions, and there is a short pause before she answers. She sometimes draws a blank. Her face looks blank, staring straight

ahead. She slumps back in her chair. "What are you feeling these days?" you ask. "I don't know. Not much." She sits and waits. You ask for more. "I stay home and watch TV a lot.

I just sit in the house. I don't really want to do anything. My boyfriend comes over, but it isn't the same anymore. I really don't care if he comes over or not. It bothers me that I feel that way.

I know I should feel different. Ever since I got hit by the car, I don't really have interests in anything." Long silence. Her eyes look sunken in.

Most trauma survivors have both the activation and the shutdown going on simultaneously: they are driving full speed ahead with the brakes on. One reason that trauma has such devastating effects on the economy of the

organism is that it is a real burn-out. Hyper-reactivity combined with shutdown can overload and consequently exhaust the nervous system, the immune system, and the neuro-endrocrinological system.

People with disorders of these systems often have trauma in their background. Trauma thus becomes fertile ground for homeopathic treatment.

Here are examples of some rubrics one might use in such cases.

Fear, happen, that something terrible will

Sensitive, (oversensitive)

Disturbed, nightmare by

Irritability

Shock, injury from

Sleepless, frightened easily

Examples of remedies one might consider would be:

Acon: perhaps our best first aid in trauma, along with Arnica. For the shock stage of trauma. Shock becomes embedded in the energy structure and does not necessarily pass after trauma is over.

It can remain in the system for decades, emerging only as the trauma is uncovered again. Aconite can be used many, many years after traumas of all kinds to help remove shock from the system.

The best picture of Aconite is to my mind in Gibson's Studies of Homeopathic Remedies, where he describes the nature of the poisoning by this plant. It is a state of freezing anoxia.

The feeling state associated with Aconite is, "It happened too suddenly for me to accommodate, so I'm stopping and going inside to preserve myself."

Arn.: primary remedy for treating physical injuries, including physical abuse. Again, even years after the trauma, Arnica can be successfully used to bring about healing of trauma. A key aspect of

this remedy is that the person does not wish to be approached for fear of being hurt again. Its feeling state is "I need to stay still and go inside to heal. Don't come near or draw me out."

2. Level - Interpersonal Trauma

A car accident, an industrial accident, an earthquake, or a fire can leave people suffering from PTSD. But when the injury is at the hands of another person, when it comes from intentional violation, new features enter in.

Even though all trauma has impact on a person's relationships, interpersonal violence is more devastating. People lose their trust and their sense of personal power more deeply. Thus, what

you are treating is different and in a sense deeper than when treating Basic Trauma alone.

Examples of Interpersonal Trauma are war, rape, and armed robbery. Murder is another example which can impact others related to the victim. Another kind of Interpersonal Trauma is

loss of a loved one, especially sudden loss.

 The Features of Interpersonal Trauma

The two kinds of Interpersonal we encounter most frequently are interpersonal violence and loss.

Interpersonal Violence

When one person commits violence upon another, all of the responses of Basic Trauma are activated - hyper-reactivity and shutdown. But in addition to this, deeper levels of the self are violated, and different responses occur.

This occurs at two levels: one is in the relationship to others, and the other in relationship to oneself.

When people have been violated they not only fear and avoid the perpetrator; they also tend to generalize and mistrust all other people as well. Basic Trauma breaks the bubble of invulnerability people carry around themselves. We generally go around assuming ourselves safe, even though we may know that things can happen to us. When we are traumatized this illusion of safety is

broken. Energetically, the aura around a person which serves as a cushion against intrusive stimulation collapses, and the person feels exposed to danger. But, in addition, when people have

been violated by others, the native trust that people feel toward others is fractured, and they live in mistrust. They also often feel abandoned. This is universally true in abused children, but it

often happens with adults who were raped or who were harmed by war. Where was the protection? Why did this happen to me?

Interpersonal violence also disrupts the sense of self. Through violation, people experience helplessness and powerlessness. The usual impact of Interpersonal Trauma is a lowering of self-confidence and self-value. People feel

bad about themselves. Very often this is experienced as shame. Being beaten or raped by another is a deeply shaming experience. In addition, people feel immense rage at being violated. The sense of self is marred and the relationship to others disturbed.

Because trust, empowerment, and value have been so violated in Interpersonal Trauma, it is important for us as practitioners to treat such clients in a way that builds trust and supports empowerment. Even when the treatment is

not psychotherapy, the relationship is essential in the healing process.

Trust is supported by empathy, authenticity, and mirroring. Letting your clients know that you understand something of how they feel, being yourself, and telling them what you understand about how they experience their lives will help them feel "met" by you. Being open and being yourself will help people feel safe. Expressing doubt about their experience, minimizing its impact, or being cold or arrogant will reduce trust. It may take a long time for

a trauma client to come to trust you.

You can help your clients feel empowered by including them in your understanding of the healing process and allowing them as much choice as makes sense. Make sure that informed consent is complete, let them know what can happen from the remedies, and let them make choices about when and how they are to be treated. For example, some clients who have been abused by oral sex may prefer to take the remedy themselves rather than have the remedy put under the tongue by the practitioner.

Picture of Interpersonal Violence

She sits, crying. "Ever since the rape, I'm not the same. I used to enjoy life. I'd go out and have a good time. I loved my boyfriend. I guess I still love him, but we're not getting along any more, at least not like we used to.

We fight, about nothing really. I just don't trust him. He wants to have sex all the time, and I don't like it as much as I used to. To tell you the truth, I'd just as soon he'd leave me alone. I tell him I don't want to, but then I feel

bad about myself. Sometimes I feel like I'm just no good. Then other times, I think it's him."

Prototypical Case Example

Here is a prototypical example of such a case, combining several actual cases. A woman comes in who was a victim of a robbery two years ago. Since that time, in addition to the standard symptoms of Basic Trauma, she has

also had a severe disturbance in her relationships. She has difficulty in trusting anyone. She feels she was "shafted" by her employer, whom she warned about the possible dangers of robbery. She is angry at the employer and

at its representative, the insurance company who is paying for her treatment. She also has trouble trusting her own judgment, since she feels she should have left her employment after they failed to heed her warning. She is depressed, her relationship with her partner has deteriorated, and she doesn't like herself much, because she is ashamed of her distrust and even dislike of other people that has come about since the robbery.

Rubrics one might use could include:

Suspicious, (mistrustful)

Confidence, want of self

Rage, (fury)

Aversion, (being approached/to all persons)

Forsaken, feeling

Ailments from mortification

Remedies that one might use might be:

Staph.: sexually abused daughter, he feels shame, and often he will project this shame into her: look what you made me do, you are so bad. In addition, sexual abuse, because it is so secret and because it arouses

feelings of pleasure at the same time as it violates, is deeply shaming. This shame does not go away.

Is one of our best shame remedies [ailments from (suppressed) mortification], and it is one of our best remedies for sequelae of sexual abuse. It is good for the suppressed rage that arises in abuse. A child often cannot

afford to express the rage she or he feels against the perpetrator; it would make the situation even more dangerous. Staphysagria can bring rage back to the forefront and return shame to its rightful owner, the perpetrator.

Staph is also, incidentally, almost a specific for trauma involving cuts. Its feeling state is, "There is something rotten in me; I dare not fight back."

Ign.: prominent remedy for sudden loss or the loss of relationships that don't go too deep. It is also good for people who get stuck in a "black hole," one of the common subjective phenomena that accompanies trauma.

In trauma, including sudden loss, feelings often get stuck, unable to release.

Ign. can sometimes be of use here. Nux-v. + Ign. have strychnine as one of its constituents, both have the spastic working-against-itself quality. So it has somatizing and tensing shared by Nux-v and Rhus-t. I think Ign.

primarily tensing against the expression of grief and rage. A client obsessing about a boyfriend, calling him and going to his house at all hours and raging at him, collapsing in constant grief, unable to move on, came out of it

after a dose of Ign. The feeling state of Ign. is, "I am tightly immersed in grief."

3. Three - Developmental Trauma

When Interpersonal Trauma (or severe Basic Trauma) impacts early during childhood, then it has the deepest impact of all. It is while the tree is still growing, that the limbs can become most

easily deformed. People with Developmental Trauma suffer from more than PTSD; their personality structures have become altered - it is more than a condition, it becomes part of the being.

As one of my clients put it, "Recovery from incest is like trying to remove egg from the batter after the cake is baked." Thus, the tasks of healing are more complex than with Basic Trauma or Interpersonal adult trauma.

You must help the person heal from Basic Trauma, Interpersonal Trauma, and the impact on the whole personality structure.

Most Developmental Trauma come in the form of abuse. The different kinds of abuse are physical, sexual, emotional, spiritual, and ritual.

As we go through the layers, from Basic, to Interpersonal, to Developmental, we are, generally speaking, moving from acute to chronic. People usually recover faster and more easily from an earthquake than from a rape and

from an adult experience of rape than from childhood sexual abuse. Therefore, the choice of remedies will sometimes reflect the depth of the trauma.

Generally, in treating Basic Trauma we will be thinking of acute remedies; in treating Interpersonal Trauma, we'll be using remedies that work at an intermediate depth; and in treating Developmental Trauma, we will work

with remedies that reach much deeper into the organism, even down to the miasmatic level.

Developmental Trauma shares all the features of Basic and Interpersonal Trauma, but it has the added dimension of impact on personality and character structure.

When we treat Developmental Trauma, our work tends to be more complex, deeper, and slower than when working with purely Basic Trauma or adult Interpersonal Trauma.

Most trauma cases I see are Developmental Trauma cases. Even in situations where there has been an accident or a rape or war experience, very often there is also a background of childhood trauma. This results in a more prolonged recovery. If you are treating someone for a recent trauma and recovery is slower than seems reasonable, it may be that there is additional trauma in the background, which can sometimes be discovered through

inquiry.

Kinds of Abuse

Knowing about the different kinds of abuse you might encounter may help you avoid going into shock and getting vicarious PTSD, when you hear peoples' stories.

Physical abuse

Many, many children are hit. There is controversy about whether this is at all necessary. Alice Miller, in For Your Own Good, describes the consequences of what she calls "poisonous pedagogy" of the past few centuries, in which parents have justified serious aggression against their children by claiming it is in the child's best interests. Most of the physical abuse I have seen as a clinician, however, comes in the form of severe beatings, usually unpredictable. It is therefore usually not a form of discipline. The movie A Boy's Story, depicts physical abuse and its frightening and degrading impact. Physical abuse frightens people and damages their self-esteem.

Picture of Physical Abuse

"It would happen when he'd been drinking. When he was sober, my father was actually easy to get along with. I loved him. But then at night, I'd listen for the door, and when it would slam,

I'd know he was drunk. My whole body would freeze, and I'd sit in my room and wait. Sometimes I'd hear him and my mom yelling. Then after awhile I'd hear them fighting. One time he pushed

her down the stairs. I felt so terrible. I hated him. But I also feel so ashamed that I didn't do anything about it." "Could you have done something?" "I don't know. I was seven." Long pause.

"Other times, he'd come into my room, with that terrible look in his eyes. It was like he didn't even see me. He'd pull me off my bed and start whaling on me. One time, he threw me across the

room into a wall. I hate him. Maybe it's because of him that I can't get too close to anybody."

Emotional abuse

Sometimes this is more painful than physical abuse, because its impact is closer to the core. (see Vithoulkas) Parents who belittle, threaten, harass, criticize, intimidate, and rage at their children

can leave deep, traumatic scars that seriously warp their development.

I think that most people have some degree of emotional abuse in growing up. The manifestations probably cover most remedies, depending upon severity and kind of abuse. I think it would be

too hard to do a group anamnesis, because the kinds of abuse and responses vary too much. An excellent book on the subject, also by Alice Miller, is Drama of the Gifted Child, which most

people seem to be able to identify with.

Sexual abuse

Whether by a stranger or by a family member, sexual abuse seems generally more devastating in its impact than physical abuse. While physical abuse will usually leave its victim with a deep

sense of shame, because they have usually been told that the beatings are their own fault, sexual abuse leaves a deeper level of shame. It is almost always a secret, with severe threats for telling. Therefore, remembering

is often difficult and telling is frightening. When clients tell you about their abuse history, support for their truth is important in order not to retraumatize them.

Picture of sexual abuse

"I can't stand how I feel these days. When the memories first came, I felt so relieved. All the sadness I had always felt just suddenly was explained and now I don't feel that vague horrible depression anymore. But I can't stand

being touched right now, even by my husband. He doesn't understand, and I can't get him to understand. I feel so horrible. The other day, my girlfriend and I were talking. The same thing happened to her when she was a

little girl. She says all men are like our fathers. I don't like to think that way, but sometimes I think it's true. When my father used to do those things to me, I hated him. But I also loved him. It was confusing.

I wanted him to love me. But not that way. He made me feel real bad about myself. Sometimes my husband does too. Especially when he gets mad at me when I don't want to have sex. Sometimes I wish I was dead."

Ritual abuse

As difficult as it is to accept, there are organized groups of people, pederasts and sadists, who prey upon small children and others. Many people from all over the world are survivors of abuse by Satanic cults.

Some of them have been born into transgenerational families who have practiced ritualized, sexual sadism. These clients all share similar stories of ritual murder and worse. The abuse is usually prolonged and repetitive

and has understandably catastrophic impact on development. Similar, less horrific abuse appears in other cult and religious settings.

It usually involves the deepest level of attempted destruction, the spiritual level, and aims to destroy or otherwise impact the soul. In this kind of unimaginably severe trauma, deep and even miraculous healing is possible.

I have too little experience treating ritual abuse homeopathically. I work a great deal as a therapist in this domain, but it does not lend itself well to combining with homeopathy, because the transference is so deeply complex

and difficult in these cases, that taking on another role is too demanding and seems generally inappropriate. In addition, people who have been ritually

abused have usually been drugged by their perpetrators, which generates an additional, complex factor that requires special handling. If you find yourself treating a client with ritual abuse,

I strongly suggest getting consultation from a psychotherapist experienced in treating such trauma, so that you understand more about what you are dealing with.

Prototypical Case Example

Here is an example of a typical case of Developmental Trauma, drawn from numerous cases. A woman comes in with a history of depression, disturbed relationships, and chronic low

self-esteem. As her history unfolds, you discover that she grew up in a family with an alcoholic mother and an abusive father. The mother was emotionally absent. The father was severely narcissistic, and he took advantage

of the daughter's vulnerability to develop and perpetuate an incestuous relationship. She had forgotten about the incest until recently, when the memories began to emerge. Since then, her life has fallen apart. She has

difficulty sleeping, her relationship with her partner and friends have disintegrated, and she has difficulty on her job. She has always been a "caretaker," first of her younger siblings, then later of her friends and her

alcoholic partner. She has little sense of her own worth, she never did. She has a history of sexual promiscuity # with sexual aversion. She feels suicidal a lot and has always felt that way. She feels a great deal of despair and anguish underneath. She feels no one has ever been there for her, and in fact, no one has. She has little sense of any possible positive future for herself.

Examples of rubrics one might use could include:

Confidence, want of self

Despair

Fear, approaching him, of others

Fear, hurt, of being

Fear, injured, of being

Fear, misfortune, of

Fear, people, of

Sadness, (despondency, dejection, depression)

Ailments, from anger, vexation

Ailments, from anxiety

Delusions, injury, is about to receive

Worry

Weeping, mortification, after

Remedies one might consider:

Aur-met.: One of the fundamental loves, which is the love of living, of self protection is perverted and he longs to die..." (Kent) One of the most profound depression remedies. When trauma has hit hard and long, people

often simply do not want to go on. Trauma crushes the will to live, and one of the few remaining powers people have is to leave. In addition, trauma, because it feels like it contaminates one's very inside, makes people feel

that they and their lives are worthless. It is then time to leave. Suicidal despair. "I am crushed and life is too painful to endure."

Syph.: Abusive families, when there is violence +/o. alcohol is the most destructive and desperate miasm. Syphilinum is the pure homeopathic for this family miasm. See the movie, Once Were Warriors to observe and

feel this miasm at its horrific work. Sankaran describes the miasm as so unable to cope with the situation that it is desperately driven either to kill or to die.

After years of psychotherapy and homeopathic treatment, one client no longer needed therapy after Syph. CM. The inner desperation that came from a childhood of abandonment and physical abuse was healed by this remedy.

The feeling state of Syphilinum is, " There is black rage; this must be over and done!"

Conclusion

Many of the cases a homeopath sees have trauma as part of the picture. Awareness of trauma and its impact may help you to understand the case and select the right remedy. As usual,

careful selection of a remedy that covers the whole case will be the key to your success. With cases with significant trauma, it is helpful to have your client see a psychotherapist adjunctively

to help manage the overwhelming feelings that can emerge in the healing process. For dosing, it is best to start low and to go slow.

Author's Introductory Note: This manual was originally written for people working in the field with women survivors of rape in Bosnia, but it can be used more broadly as a guide for helping anyone of either gender who has survived any kind of trauma. Since it is written from afar and based on experiences similar to but not the same as the ones you are dealing with, please use what is useful or helpful and ignore what is irrelevant or wrong for

your circumstances, trusting more in your judgment and intuition than in anything contained herein. Also, please be aware that some of the suggestions and conversations suggested here may not fit the cultural context you

will be working in. It is best to ask local people about what can be discussed in private or in public with any group you are dealing with. For example, some people in the former Yugoslavia may be unwilling to discuss rape

with anyone. It may be necessary to talk "around" such subjects rather than directly. Some groups may not be willing to discuss feelings at all. When in doubt, follow rather than lead.

When people have experienced things they cannot stand, ordinary people can often give them what they need to help them begin to heal. This section gives general guidelines for working with people who have been

catastrophically violated.

What they are suffering

The people you will be working with have experienced events that have permanently changed their lives. But they can heal. People who have been raped, who have seen their loved ones killed -- their lives will never be the

same again. Yet no matter how great the horror people have experienced, they may recover emotional functioning, so that they are not feeling pain, terror, shame, fear, or horror all the time. Rape and murder may have

robbed them of a sense of integrity and wholeness, but in time and with your help, they may be able to resume life with their sense of self restored.

People who have experienced rape or torture or who have witnessed murders of loved ones usually suffer from Post Traumatic Stress Disorder, a psychological disorder that occurs when people have experienced

life-threatening, shocking events. It has symptoms that are often the same for different people, regardless of the specific events they suffered.

With Post Traumatic Stress Disorder (PTSD), many normal processes are more intense, while many are deadened. People whose normal lives have been drastically changed by the sudden intrusion of horrifying and

destructive events are experiencing more than they can integrate, and their sense of security and safety is shattered. In PTSD, some of people's responses are greatly heightened. The blow of a severe event has told them

that the world is not the safe place they imagined. So they become ready for danger at all times: they have hyper-vigilance -- greater readiness to flee or fight. They live in emergency mode, and they have learned not to trust.

At the same time as having heightened responses, they also shut down a great deal, so that many of their normal responses to life and to other people are not accessible to them. As a result, these are some of the symptoms you might see:

Intense emotion and reactivity. People exposed to traumatic events feel intense pain, terror, shame, horror, grief, rage, and shock. They are activated and alert most of the time, ready to react. People may be jumpy, looking constantly for danger, and easily startled. They may have difficulty sleeping or even relaxing.

Numbness. When hell suddenly breaks into a life, people become overwhelmed. They may experience shock and protect themselves through denial, disbelief, and dissociation (spacing out or splitting away from the terrible events as if they didn't happen to them). They feel numb, feel cut off from other people and from their own feelings, and as if they are no longer really alive.

Flashbacks. People who have had terrible things happen to them will often re-experience the events over and over again, against their will. They will experience their minds invaded by thoughts of the events and will feel

tortured by them.

Nightmares. Like flashbacks, but these occur in sleep. As a result some people can be afraid to go to sleep and may develop sleep deprivation.

Triggering. Often people will respond to events that remind them of the trauma with all the feelings that belonged to the trauma itself. Combat soldiers, for example, will respond to loud noises as if it meant incoming mortar; rape victims may respond to the smell of a man as if he were her rapist.

What they need

Most of all people need to feel relatively safe. Anyone who has been extremely hurt by other people, especially when they have been systematically tortured has learned not to trust anyone. This is how they survived. They will

not trust you at first, not for a long time, maybe never. Moreover, in areas of the world in which brutality, horror, and extreme danger have become commonplace, talking about safety can seem absurd or even offensive.

But you still can help people to feel relatively safer. All of us know how to do that with people; we just need to be reminded how: we may begin simply by performing simple acts of kindness, by letting people alone when

they want to be let alone, by treating other people as if you cared about them. Most important for survivors of extreme abuse is that they need to know these things:

They need to know that you will respect their boundaries. Trauma, almost by definition, breaches people's normal boundaries. It is as if life drives a bulldozer over people's normal sense of protection, sense of safety, and

sense of self. So people need to know that their wishes matter, that you will not force them to respond in anyway other than what they choose, and that you will not invade them.

They need to know they can leave if they want to. People who have experienced prison and torture must know that they are not trapped, that they can get out if they want.

They will not be touched if they do not want to be. People who have learned to associate touch with violation often cannot bear to be touched, even in kindness. Especially when the violation was sexual, they may not be able

to tolerate intimacy, even when you mean well.

They need to feel accepted and not judged. When people have been violated, they experience a lot of feelings about themselves they cannot stand. They judge themselves very harshly and can often not even stand the fact

that they are alive. They need those around to accept and affirm them as having value and not as having been "spoiled" or "ruined" by what they have been through, even if that is how they themselves feel.

People usually need to talk and be listened to. When people hurt, especially when they hurt more than you can stand to hear, or think about, or feel, it is hard just to listen to people. But it the most important thing you can do.

People need to be believed. Trauma is, by definition, something outside of ordinary experience. We should not let our beliefs about what can and can't be true get in the way of believing the stories of survivors. Life can bring events into the lives of others that we can hardly stand to imagine. We could try to protect ourselves by denial and disbelief. But it is best to try to stay open, so that survivors of horrific trauma are not further injured by our disbelief.

Often people need to have their feelings paid attention to. When people hurt in ways they cannot stand, they freeze up their feelings. They just try to survive. That is nature's way of helping them to get through what they have

to endure. But afterward they need to get their feelings back, so that they can function again, and so that they don't have to go through their lives closed down inside. If they are still numb, you should not push them. Nature knows when it is time to feel again.

Sometimes people need to be left alone. We should never force help on people who have already been forced to do things by other people. We should help people only when they want help. Sometimes people are unready to face what has happened to them, or to experience their own feelings, or to talk about what has happened. It is always important to respect people's healing process. Each person needs to heal in her own way in her own time. Some need to feel, some need to remain numb. The best approach, when you are uncertain about what a person wants is to ask. It is always good to ask people's permission to talk about what happened, to talk about their feelings, or to help them in any way. It is almost always damaging to people to insist that you know what they need better than they do.

What you can do to help: Your Characteristics

Your presence is the most important gift you can give. Many people think that to help severely emotionally wounded people they should have highly specialized medical training, or they should know the right things to say in order to make them feel better. That is not true. What is most important to badly hurt people is that they know that you are there and that you care. It is often remarkably simple what people need. They need you to be able to be present, focusing your attention on them; and they need you to be open, listening to them with your heart and your feelings, feeling with them.

Detachment. In addition to your compassion, survivors of trauma also need your neutrality. Many of the events that you hear about may elicit very strong feelings in you -- feelings that are very appropriate. You may feel

angry, sad, grieving, frightened, horrified, shocked, and deeply disturbed. Sometimes it is helpful to share a little of these feelings, so that people you are working with realize that they are with a human being, and so that you

can remind them that it is appropriate to feel. But for the most part, the goal of individual work is to help people find their own feelings again, and for that they often need your calm, grounded presence rather than a lot of your emotional reactions. They have already had their space violated by others, now they need their own space to work in, and you can provide that best by making sure that it is their feelings, not yours, that occupy most of the time

and space in the room.

What you can do to help: Procedures and Processes

Begin simply. Introduce yourself, tell the person you are working with (we shall call her the survivor from now on, because she has survived some terrible events) that you are there to help and to listen. Do not begin with discussion of the traumatic events unless they initiate that themselves. Begin by helping the survivor to become comfortable, asking her how she is doing in the present, whether she would like your help, how she would like to

you to help, whether she wants to talk to you, what she would like to talk about now. . The goal in the beginning is to meet and set up an agreement and a space in which hard work can later occur; it is not necessarily a time to begin that hard work, unless this is the only meeting you will have, or unless you will have very few meetings.

Let the survivor lead. Perhaps the simplest and best rule in healing is to trust the other person's process. Nature heals, not you, and the person will bring things up in their own way and own time, as they are ready. It is therefore often best simply to sit in comfortable silence, once initial greetings have taken place and you have let the other person know that they can talk about whatever they want, and wait for them to decide what they want to talk about.

Ask questions. Even though it is good to wait, you need not be passive. Once the other person has begun to talk about events it is good to engage with them, to let them know you are interested and also to help guide the process. What questions to ask is a matter of judgment and experience. Basically, it is good to trust your own intuition, instinct, and interest to provide the questions, but below are some further guidelines suggesting how to direct the process.

Always work with permission. Never force or pressure a survivor to remember or to feel. Always ask if they would like to discuss something before leading further.

As long as the survivor is not overwhelmed and is willing, create space for her to move into discussing more emotionally difficult material. One goal is to help the survivor to integrate what has happened to her. You are following nature. If the person is already having flashbacks and nightmares, part of her mind wants to bring the experience into consciousness and master it, making sense of it, integrating it into her life, so she can go on. Therefore you will want to help her do that. Here is an example of how one may work with a survivor by asking questions that permit movement into discussing more emotionally intense material.

Therapist: What would you like to talk about today?

Survivor: I've been having some disturbing thoughts lately.

T: Disturbing thoughts?

S: Yes.

T: Would you like to talk about those thoughts?

S: I guess so. It's just that the feelings are so disturbing, that I'm not sure that I want to go into it.

T: I understand that. The feelings are so strong that it is hard to be willing to talk about these things.

S: Yes. But I guess I need to talk about it. It won't just go away. Right?

T: If you want to talk about it, I'm interested in hearing. You should talk about it only if you are ready.

Let people tell their story. Generally, people who are healing from horror need to tell their story. They don't need you to push them, but they need to know that you are there who cares and want to know and are willing to listen. Generally, you can convey this through quiet openness and some encouragement to go into the story.

Survivor: I am haunted by nightmares of what happened to me.

Therapist: Do you want to tell me about the nightmares?

S: In each dream, I am alone in my house, and I hear noises outside. I feel absolute terror, just waiting for them to come in. They come in and I scream. Sometimes I wake myself up then.

T: It sounds like a lot of terror. Do these dreams remind you of what happened?

S: Yes.

T: Do you want to talk about it?

S: (Long pause.) I can't believe what happened. These people were my neighbors. My children went to school with their children....How can people....They were drunk. They made so much noise. I thought the door would reak....There were three of them. I didn't know what to do. I wanted to run out of the house, but -- I don't know what was wrong with me. I just froze. One of them said bad things to me. I knew what was going to happen. Their eyes. They looked like dogs, when they attack. I couldn't breathe.

Allow the experience and expression of feeling. In general, within the guidelines above it is helpful for people to experience and express the feelings they have about what they have endured.

The feelings that may emerge are fear, terror, shock, horror, anger, rage, grief, sadness, disgust, and shame. Each of these feelings is a legitimate and understandable response to the experiences survivors have had. Being able to re-experience and express these feelings in the context of a trusting relationship with you can help them to overcome the mistrust, isolation, and damaged relationships that experiencing rape and torture, and witnessing murder inevitably bring.

Many times you may find yourself very uncomfortable with the intensity of feelings that a survivor has. You may wish to make the person wrong for having those feelings by denying the reality of their experience or by telling them they should not feel as they do. Or you may want to try to make them feel better, to spare both them and yourself the rawness of their feelings. It is almost always wrong to tell someone they should not feel as they do. It is often not helpful to try to make someone feel better before fully registering, accepting, and mirroring the feeling as it is. It is generally best just to accept the feelings as they emerge, realizing that is probably the best you can do for their healing.

Some specific techniques are helpful in working with feelings:

Ask the survivor what she feels. Sometimes hearing the story is enough. Other times, it is helpful to elicit the feeling. For example,

Survivor: Every day they came in and did the same thing. (Speaks in monotone, without apparent feeling.)

Therapist: What are you feeling?

S: I feel terrible about myself now. I don't see any point in living.

Tt: Why? Why is it that you don't see any point in living?

S: I'm ruined. They spoiled me. I can never be the same again.

T: You feel ruined. [Notice that the therapist is not agreeing with the client's self-assessment, but is re-framing (changing the meaning) of the client's statement by pointing out that it is a feeling, not necessarily a reality.]

S: Yes. I feel dirty.

T: What they did to you made you feel terrible about yourself.

S: (Starts to cry.) I feel so ashamed. (Cries freely.)

T: When people have been violated as you have, it makes them feel a lot of shame. [This tells the client that it is natural to feel as she does, and it is not her fault that she feels this way.]

Reflect what you hear and see. Telling the survivor how she comes across to you can sometimes help her focus on how she feels. Example,

Survivor: I've been thinking about going back to my village.

Therapist: I notice you look a little frightened.

S: I am. I don't know if there is any chance I ever can go back. What is to keep the same thing from happening again. If I couldn't trust my neighbors before, how can I now?

Do not push for catharsis. People in shock do not always benefit from strong expression of emotion. Shock is a state in which functions get frozen and knotted. Sometimes, a spontaneous expression of feeling helps to thaw the freeze. Other times it is better to let the system unfreeze gradually and gently, letting the "knots" in the nervous system unwind slowly. While cathartic experience can help, repeated experiences of powerful emotion, especially when pushed by someone else, can sometimes be retraumatizing and reinforce the traumatic state.

Focusing on body sensations helps the nervous system to unwind from trauma. In trauma, people get stuck in the past. They need to move carefully out of being stuck. You can assist this by helping people follow their own inner sensations.

Survivor: I don't think I can stand how I feel.

Therapist: What are you feeling?

S: I don't know. I just know I can't stand it.

T: What do you notice going on in your body?

S: I don't notice anything.

T: Nothing.

S: I feel like I'm not even in my body.

T: Yes. Where are you?

S: Up there (points to ceiling). (Survivor is indicating she is dissociated.)

T: Good. What do you notice about your body from up there? (Begins to reintroduce the body back into consciousness.)

S: It's tense.

T: Where do you notice the tension?

S: In the shoulders. And the chest.

T: OK, good. (Saying "good" or "fine" lets the client know implicitly that she is on the right track, no matter what she reports; that she only needs to say what is there, and that whatever is there is fine.) So you're tense in the shoulders and chest. Anywhere else?

S: Yes, my stomach is tight.

T: Good. So let's see what happens if you pay attention to your shoulders and chest and arms being tight. Just notice that for awhile.

S: (Long silence. This kind of work is a very slow process. Don't worry if it takes a long time for anything to seem as if it is happening.) (Takes a deep breath) My stomach is starting to loosen a little bit. (Survivor is starting to unwind a little. This is good; in this kind of work, we don't need drama to be effective.)

If the person seems overwhelmed, lead away from emotionally painful material. It is important to monitor the survivor, to make sure that the feelings and experiences that are arising are not overwhelming to the survivor in the present. "Overwhelming" is not the same as intense. Overwhelming means that the person simply cannot take in the experience now. Signs that the person is feeling overwhelmed are the following:

The person experiences herself leaving her body. This is a symptom of dissociation and a sign that the person's nervous system cannot deal with the overload of sensation.

The person loses the ability to communicate. Sometimes people will become quiet when absorbed in the memory of an experience. That is often a sign of healing. Other times, however, they may find themselves unable to talk, speaking very haltingly, etc. This may be a sign that the person is feeling overwhelmed. If you are unsure about whether the client is handling the silence productively or is feeling overwhelmed, ask her what is happening.

The survivor seems "spacey," that is, the eyes become glazed, they seem "not there," or somehow seem to be far away. This is another sign of dissociation.

The person experiences perceptual distortions. Her body might feel like cotton, her visual field may narrow severely, she may feel cold and numb or unable to move parts of her body, or she may feel cut off from her surroundings.

If these signs and symptoms are present, or if you have other reasons to believe that the survivor is feeling more sensation and feeling than she can handle (not more than you can handle, more than she can handle), then lead the discussion back into the present. Here are examples of leading back to the present. Notice how in this example, body sensation is used to "ground" the person, that is bring her back into present time and in this place, away from the past trauma.

Survivor: Then this man came and got....I'm feeling strange now. I don't think I can go on with this.

Therapist: You're feeling strange. [Focusing on present feeling is sometimes a beginning point of getting someone back to the present, without being too abrupt.]

S: Yes. My head feels kind of funny

T: Pay attention to that now. Notice the sensations in your head. [ Focusing on present bodily sensations is the best way of bringing someone into present reality and away from overwhelm. It brings her "back into her body."]

S: I feel kind of dizzy.

T: What else do you notice going on in your body? [Moving away from the overwhelm in the head, moving to lower parts of the body can be "grounding," that is helping the person "root" in present time with both feet on the ground.]

S: I feel kind of sick to my stomach.

T: Pay attention to that feeling. Notice the sensations. [Here you are showing the person she does not have to be afraid of sensations that may have seemed overwhelming a few minutes ago.]

S: I feel nauseous.

T: Stay with that for awhile and see what happens.

S: My jaw feels tight.

T: What happens if you stay with that sensation?

S: I feel a softening happening in my arms.

T: Go with that: stay with that sensation for awhile. (Survivor is encouraged to experience the "letting go" into healing. Softening, melting, lightening sensations can be signs that the survivor is letting go and experiencing relief and healing.)

Enhancing the feeling of safety is another way to reduce overwhelm and allow integration of difficult material. If the person remains persistently overwhelmed but still wishes to go through her story, there is a way to help people to integrate difficult material more easily and safely. In the first part of the technique, the therapist asks the survivor to imagine in her mind a safe place. It can be a real or imaginary scene. It can be a place in nature or indoors. In war zones, nature may not be appropriate to imagine as a safe place, due to the high density of landminds and other dangers. Sometimes people who have suffered severe trauma will say they cannot think of anyplace safe. Then it is best to ask them to think of the safest place they can. Then the therapist asks the survivor to imagine being in the safe place, perhaps with someone whom they trust with them there too. After the person imagines herself there and is feeling somewhat secure, the therapist asks the survivor to leave the safe place and go back to the traumatic incident in her imagination. She is to remain with the traumatic memory, describing it to the therapist until she feels overwhelmed by feeling; at that point, she is to return to the safe place and discuss the incident with the trusted friend in the safe place.

By alternating back and forth between the safe place and the trauma, people can more easily integrate the memories of trauma and also the powerful feelings the trauma has generated. Here is an example of the use of this "safe place" technique.

Therapist: Would you like to try something that might make this process easier?

Survivor: What is it?

T: It involves imagining a safe place.

S: All right.

T: We will be going back and forth between a safe place and the camp where all the terrible things happened to you. Are you willing to do that?

S: All right.

T: I would like you to close your eyes and imagine a safe place. It might be a real place or an imaginary place. It could be in a house you know, or it could be in the mountains or in a field or wherever you feel safest.

Would you do that now?

S: (After a minute of trying, cries.) There isn't any place safe any more.

T: I understand that. Could you imagine the safest place that you can think of.

S: All right. I am in my aunt's house. In her front room. I always felt safe there.

T: Is your aunt there?

S: Yes. I always trusted her. She was very nice to me. My mother used to leave me there on weekends, when she went to the city.

T: Good. So now I would like you to go to the safe place for awhile and spend a little time there.

S: (Is silent for a minute or two.)

T: How are you doing?

S: Fine.

T: Good. Now I am going to ask you in a minute to leave the safe place and go to the camp. When you do that, I'll ask you to tell me what you are experiencing. And then as soon as you feel overwhelmed, like the feelings are too much, or that you start feeling like you are leaving your body or loosing touch with yourself, I will ask you to run back to the safe place. OK?

S: Yes.

T: All right. I want you to leave your aunt's house now and go to the camp. ....What do you see there?

S: I see my room.

T: What is it like? What do you notice?

S: It seems all grey to me. I see my clothes hanging on the door. And I notice the door knob.... I am starting to feel frozen in my body. ... I ...I... (Stops talking.)

T: I'd like you to run back to the safe place now. Will you do that please?

S: (Pauses, then breathes deeply.) I am with my aunt now.

T: Tell your aunt what you just experienced.

S: (Silent for half a minute, then begins to cry.) I am telling her about what the men did to me... (Sometimes it is easier for the survivor to "tell" someone in her mind than someone outside herself.)

Help people recognize and develop their resources. In the midst of trauma, it is sometimes hard to remember that people's lives are about more than their trauma and that their spirit is often greater than what has befallen them. In even the worst of circumstances, there are opportunities to grow beyond the obstacles that beset people. It is helpful to survivors to have their resources recognized. Some resources are inner ones.

Survivor: I spent time with a friend this morning. She was grieving over the loss of her baby.

Therapist: What did you do with her?

S: I just spent time with her and I held her while she cried.

T: It amazes me that after all you've been through you can still be there for someone else.

Or:

Survivor: I am feeling a lot of despair today. I just don't know how I can go on with my life.

Therapist: Yes, I can understand your despair. You've lost so much, and life looks like it is not presenting any hopeful possibilities for the future. How is it that you have been able to go on this far?

How have you been able to do it?

S: I don't know how I've done it. I guess I was always that way. I always went on no matter what. My mother was like that too. She grew up in a family where a lot of her brothers and sisters died. Somehow, she had

the strength to keep going.

T: It seems that maybe you have a lot of that kind of strength too.

S: Yes. But I'm not sure it is going to be enough to deal with all this.

T: Right. This seems too much to deal with sometimes isn't it?

S: It feels that way.....I don't know. I hope I'll have the strength. My children need me.

Sometimes the resources to be recognized and developed are external ones. Trauma disrupts life, and re-building life usually requires support. Help the survivor recognize and develop support of all kinds in her life:

friendship, medical help, housing, whatever is needed.

Avoid pushing for recovery too soon. In most cultures, there is a conventional tendency to respond to other people's traumas and sometimes one's own by saying clichÈs like, "You just have to keep on going," "That was in the past, there's no sense in dwelling on it," "I just try not to think about it, you should too," etc. But trauma freezes people into the past, and it robs them of a sense of future. Such clichÈs, though useful for some, are often hurtful for those who are not yet ready or able to move on. It is important to remain patient with the healing process, reassuring people that healing takes time. And healing from trauma usually takes more time than anyone likes.

Take care of yourself. Last but definitely not least, make sure you have support and that you do not overextend yourself. Secondary PTSD is a real phenomenon. You can be traumatized by exposure to other people's traumatic stories, energy, and emotions. Don't let your life be overwhelmed by others' traumas, and be sure to get plenty of support and help for the feelings that come up for you in working with other peoples' traumas. If you have had traumas in your own life that you are not finished dealing with -- and most of us do -- then you can expect that the memories and issues and feelings associated with them will be retriggered by working with other peoples' traumas. Get help sooner rather than later in dealing with whatever comes up for you. It can be a great opportunity and lead to greater health and healing for you as well as the people you are helping!

Summary

Survivors need a chance to express themselves and work with their experience in the context of a relationship they can come to trust. This will help them to restore their trust in others and in themselves and also to begin coming to terms with their experience.

In this process, it is helpful to give them lots of room to talk or not to talk, to remember or not to remember, to feel or not to feel, to express or not to express.

It helps to let the survivor lead the way, to ask questions, to reflect feelings, to mirror what you see and hear.

In general, it is helpful to encourage expression of their experience, feeling, and sensation, as long as they are not overwhelmed in doing so. It is best for them to absorb their experience a bit at a time rather than all at once.

It also helps to get people to understand that how they feel is normal and a result of what have happened to them. It helps to give them confidence that they can live with their feelings and experiences and patiently deal

with the intensity of feelings they have to absorb.

Most important, it helps for you just to be present, without judgment, trusting in their healing process and your own instinct and intuition.

When people are wounded in war, they heal. The same can be true of emotional wounds. With our help and with time, people may heal from the worst of experiences.

Final Word

Your feedback will help this page grow. Please let me know what works for you and what doesn't. If you have questions, please feel free to ask, and I'll do what I can to answer. If you wish consultation on any of your work with trauma, please ask me, and I'll try to help. E-mail me at the addess above.

To read a book I have written about recovery from the trauma of the attacks on the World Trade Center and Pentagon and about the sources of global trauma, go to Recovery 9-1-1.

THE TREATMENT OF TRAUMA

[Ed Schmookler, Ph.D.]

Healing the vital force damaged by trauma is a critical challenge most homeopaths face. Most of our clients have experienced some trauma, many of them severely, some of them catastrophically. As homeopaths we can play

a key role in the healing of trauma, because we can stimulate healing of the vital force, which receives much of the impact of trauma. Psychotherapists can help clients face the emotions that surface when long buried trauma emerges and can help the person forge a new life. But homeopaths can bring relief to a vital force misshapen by trauma. Trauma can bruise, oppress, beat, puncture, fragment, shatter, and even destroy the vital energy that

shapes our lives.

Homeopathy is an especially good modality of healing the kind of damage that trauma causes. Trauma freezes people in time. Years after a trauma is over, people are still living it: the Vietnam vet still looks for cover when

a helicopter flies overhead, the rape survivor still fears the shadows in the alleyway, the incest victim still fears intimacy, and the man beaten in infancy still wishes to die.

Trauma locks people into the past. Homeopathy unlocks frozen functioning: Sulphur releases rage pent up in depression, Sepia moves a woman out of post-partum immobility, Nat-m. moves old salted away grief into tears

again. Successful homeopathic treatment allows immobilized life to flow again.

The disturbing terrain of trauma

Treating trauma requires the best that is in us. Traumatized people can be the most rewarding people to treat, because the possibilities for recovery can be miraculous, but treating them may require us to face parts of life

and of ourselves that most of us would rather avoid.

Treating trauma is an intense confrontation with life and with oneself. Many of us prefer to surround ourselves with comfortable pictures of reality in which we can live our lives without excessive disturbance. Listening to

the traumatic life stories of others can severely disrupt these pictures.

Even if we have grown up with trauma, hearing about the violation and violence inflicted on our clients can be a violation in itself of how we would prefer to experience our world. Our first obstacle in dealing with the reality

of our clients' experience can therefore be our own denial.

About 25 years ago, a woman came into my office and announced that her father had been having intercourse with her, and that, as a result of his remorse and fear of discovery, he had committed suicide. I told her that I thought

she believed what she was saying, implying, of course, that I did not. She had the wisdom not to return. This was denial in its most blatant form: I had no conscious context in which to believe what she told me. At that time,

almost no one talked about incest or other forms of abuse.

Since then, thanks to the women's movement and the recovery movement, the truth about life in many homes has emerged. Even now, people refuse to believe in the reality of more horrific forms of abuse such as ritual abuse, because the horror is too great for most people to tolerate.

Our first major challenge in treating trauma is to remain open and be willing to hear people's stories, even when they violate what we like to hear. Even if we cannot believe what we hear, it is important to keep our doubt to ourselves and to consult with others outside the treatment session. Once we let the truth of others' experience in, we are confronted by another major challenge: the intense states and emotions of trauma.

If we as homeopaths are to treat effectively, we must understand the basic state our clients are in, and this may require a willingness to experience within ourselves the experience of our clients.

Rajan Sankaran: "Each remedy has a peculiar state of mind which is characteristic to it. Each remedy produces a state”.

Each patient has a state of mind. If you compare symptoms, you will be lost in the jungle. If you understand the state, you will find that there is only one remedy which produces the state. Aphorism 211 says, 'The state of disposition being characteristic, which can least of all remain hidden from the accurately observing physician.' You have to look, you have to see, you have to understand and you have to feel the state. You have to experience

the experience of the patient. This is the art of case taking."

It is not enough to list symptoms mechanically; we must understand from within where our clients are stuck, and with trauma this can be especially challenging, because the states are so intense.

The world of trauma is a strange and tortured landscape. It is made up of volcanoes of rage, sagging mountains of sadness and despair, frozen seas of horror, streams of fear running throughout, pits of depression, black holes

of frozen terror, blasted fields of shock and devastation, and oceans of grief. This is where our clients are stuck and what we can release them from with our remedies.

But to choose the right remedy may require us to be willing to feel, at least briefly, these deep and intense feelings. Trauma is perhaps as universal as the miasms and as devastating in its impact. Homeopathy is a great tool in returning to people what trauma has taken away. To connect with our clients and to find the right remedy, we need to do our best in being open, vulnerable and authentic.

The rewards can be not only healing for our clients but for ourselves as well.

Three levels of trauma

Trauma can impact different levels of the organism, and it is helpful to be clear at what level one is working when working with survivors of trauma. The three levels of trauma are: Basic Trauma, Interpersonal Trauma, and Developmental Trauma. We shall examine each in turn.

1. level = basic trauma

This level is common to all trauma, from car accidents to ritual abuse. No matter what the trauma, all trauma shares some features in common. This has been a surprise to me. I worked for many years with Vietnam vets.

Many of them shared features in common: a broiling, brooding rage, a sense of injustice, shock, an inability to move out of the past, mistrust, and difficulty maintaining relationships.

My surprise came when a man who had an auto accident, a woman robbed at gunpoint, and a man raped as a child all looked like Vietnam vets! Their suffering was similar and so was their way of being in the world.

Purely Basic Traumata are accidents of all kinds (car, sports, industrial) and natural disasters (earthquakes, floods, hurricanes, fires).

The primary feature of all trauma is overwhelm. Trauma by its very nature presents the organism with more than it is accustomed to handle. By definition, trauma takes us beyond our ordinary capacity for coping.

I am accustomed to going down an elevator at normal speeds. I may be a bit pushed to be crowded in with far too many people; I would be very stressed to be stuck in an elevator all day caught between floors in the dark.

But I am entirely unprepared for it to descend suddenly four stories without brakes. That would be traumatic. But in going beyond what we are used to coping with, trauma does not catch our system entirely by surprise,

for we have survival mechanisms built in to deal with overwhelming experience.

The two major responses that arise in response to sudden and extreme danger are hyper-reactivity and shutdown.

1. The hyper-reactive response is the primary defense/attack mode of fight or flight. People become hypervigilant, startle easily, and are ready to run or attack at the slightest stimuli/repeated flashbacks and nightmares relating to the trauma.

Picture of hyper-reactivity

You come out to the waiting room to meet your client, and he looks up in surprise. He looks you intently in the eye, and pulls his hand away quickly when you shake his hand.

"I'm not myself," he says, when you settle down in the office. "I'm jumpy, and I can't sleep. Ever since the accident, my mind isn't working right. I keep going over and over what happened. I can't seem to make it stop.

And then," he says, starting to get agitated, "every time I go out, I react in ways I shouldn't. I don't understand what's happening with me. Sometimes, I think I'm going crazy. When people are walking on the sidewalk towards me,

I feel like they are coming right at me. I get mad. I get mad real easily these days. The other day, at a fast food place, I almost got in a fight with this kid that bumped into me. People just piss me off. I didn't use to be this way."

2. The shutdown response: When an organism becomes overwhelmed, it has built-in responses to protect it from too much reaction. Physiological shutdown is shock. The periphery closes so that the vital functions

within the core of the organism can be preserved. Shock has a quality that is unmistakable once you become familiar with it. It is a combination of frozenness, pallor, and brittleness. This can be lodged in the system and

emerge many years after the trauma, when the trauma is accessed.

Psychological shutdown in trauma is emotional numbing and avoidance of stimuli that remind people of the trauma. People become detached, unemotional, and unable to have normal feelings. They avoid situations, such as

public places or open spaces or closed in spaces or crowed places which remind them of where they were hurt; or they may avoid people who remind them of people who hurt them.

The deepest level of shutdown is depression, which often accompanies Post Traumatic Stress Disorder.

Picture of shutdown

She sits on the chair facing you. She looks stunned. You ask her questions, and there is a short pause before she answers. She sometimes draws a blank. Her face looks blank, staring straight ahead. She slumps back in her chair.

"What are you feeling these days?" you ask.

"I don't know. Not much." She sits and waits.

You ask for more.

"I stay home and watch TV a lot. I just sit in the house. I don't really want to do anything. My boyfriend comes over, but it isn't the same anymore. I really don't care if he comes over or not. It bothers me that I feel that way.

I know I should feel different. Ever since I got hit by the car, I don't really have interests in anything." Long silence. Her eyes look sunken in.

Most trauma survivors have both the activation and the shutdown going on simultaneously: they are driving full speed ahead with the brakes on. One reason that trauma has such devastating effects on the economy of the

organism is that it is a real burnout.

Hyper-reactivity combined with shutdown can overload and consequently exhaust the nervous system, the immune system, and the neuro-endrocrinological system .

People with disorders of these systems often have trauma in their background. Trauma thus becomes fertile ground for homeopathic treatment.

Here is a prototypical example of Basic Trauma, which combines a number of different stories of actual clients.

A man working on the job falls from a considerable height. He loses consciousness in the fall and has injuries to his back. Since that time, in addition to pain in his back, he has flashbacks of the accident, he feels severely withdrawn, he cannot go back to work, because he feels panicky at the thought, he feels irritable, he is jumpy and hypervigilant, and he has nightmares several times per week.

Even though it is eight months after the accident, and his physical injuries have stabilized, he feels he is not himself. When asked to visualize the accident, he gets disoriented, dizzy, and frightened and does not want to go

on with the visualization.

He uses drugs occasionally to numb out and "feel better." Here are examples of some rubrics one might use in such cases.

- Fear that something terrible will happen;

- Sensitivity (oversensitivity);

- Feeling disturbed;

- Nightmares;

- Irritability;

- Shock;

- Sleeplessness, and/or

- Easily frightened.

Remedies one might consider would be:

Acon.: perhaps our best first aid in trauma, along with Arnica. For the shock stage of trauma. Shock becomes embedded in the energy structure and does not necessarily pass after trauma is over. It can remain in the system

for decades, emerging only as the trauma is uncovered again.

Aconite can be used many, many years after traumas of all kinds to help remove shock from the system. The best picture of Aconite is to my mind in Gibson's Studies of Homeopathic Remedies, where he describes the

nature of the poisoning by this plant. It is a state of freezing anoxia.

The feeling state associated with Aconite is, "It happened too suddenly for me to accommodate, so I'm stopping and going inside to preserve myself."

Arn.: Primary remedy for treating physical injuries, including physical abuse. Again, even years after the trauma, Arnica can be successfully used to bring about healing of trauma. A key aspect of this remedy is that the

person does not wish to be approached for fear of being hurt again.

Its feeling state is "I need to stay still and go inside to heal. Don't come near or draw me out."

2. level - interpersonal trauma

A car accident, an industrial accident, an earthquake, or a fire can leave people suffering from PTSD. But when the injury is at the hands of another person, when it comes from intentional violation, new features enter in.

Even though all trauma has impact on a person's relationships, interpersonal violence is more devastating.

People lose their trust and their sense of personal power more deeply. Thus, what you are treating is different and in a sense deeper than when treating Basic Trauma alone.

Interpersonal Trauma: war, rape, and armed robbery. Murder is another example which can impact others related to the victim. (sudden) loss of a loved one.

Features of interpersonal trauma

The two kinds of Interpersonal we encounter most frequently are interpersonal violence and loss. Interpersonal Violence When one person commits violence upon another, all of the responses of Basic Trauma are

activated - hyper-reactivity and shutdown.

But in addition to this, deeper levels of the self are violated, and different responses occur. This occurs at two levels: one is in the relationship to others, and the other in relationship to oneself. When people have been

violated they not only fear and avoid the perpetrator; they also tend to generalize and mistrust all other people as well.

Basic Trauma breaks the bubble of invulnerability people carry around themselves. We generally go around assuming ourselves safe, even though we may know that things can happen to us. When we are traumatized this

illusion of safety is broken.

Energetically, the aura around a person which serves as a cushion against intrusive stimulation collapses, and the person feels exposed to danger. But, in addition, when people have been violated by others, the native trust

that people feel toward others is fractured, and they live in mistrust. They also often feel abandoned.

This is universally true in abused children, but it often happens with adults who were raped or who were harmed by war. Where was the protection? Why did this happen to me?

Interpersonal violence also disrupts the sense of self. Through violation, people experience helplessness and powerlessness. The usual impact of Interpersonal Trauma is a lowering of self-confidence and self-value. People

feel bad about themselves. Very often this is experienced as shame.

Being beaten or raped by another is a deeply shaming experience.

In addition, people feel immense rage at being violated. The sense of self is marred and the relationship to others disturbed. Because trust, empowerment, and value have been so violated in Interpersonal Trauma, it is important

for us as practitioners to treat such clients in a way that builds trust and supports empowerment.

Even when the treatment is not psychotherapy, the relationship is essential in the healing process. Trust is supported by empathy, authenticity, and mirroring.

Letting your clients know that you understand something of how they feel, being yourself, and telling them what you understand about how they experience their lives will help them feel "met" by you. Being open and being yourself will help people feel safe.

Expressing doubt about their experience, minimizing its impact, or being cold or arrogant will reduce trust. It may take a long time for a trauma client to come to trust you.

You can help your clients feel empowered by including them in your understanding of the healing process and allowing them as much choice as makes sense. Make sure that informed consent is complete, let them know what

can happen from the remedies, and let them make choices about when and how they are to be treated.

For example, some clients who have been abused by oral sex may prefer to take the remedy themselves rather than have the remedy put under the tongue by the practitioner.

Picture of interpersonal violence

She sits, crying. "Ever since the rape, I'm not the same. I used to enjoy life. I'd go out and have a good time. I loved my boyfriend. I guess I still love him, but we're not getting along any more, at least not like we used to.

We fight, about nothing really. I just don't trust him. He wants to have sex all the time, and I don't like it as much as I used to. To tell you the truth, I'd just as soon he'd leave me alone. I tell him I don't want to, but then I feel

bad about myself. Sometimes I feel like I'm just no good. Then other times, I think it's him."

Prototypical case example

A woman comes in who was a victim of a robbery two years ago. Since that time, in addition to the standard symptoms of Basic Trauma, she has also had a severe disturbance in her relationships.

She has difficulty in trusting anyone. She feels she was "shafted" by her employer, whom she warned about the possible dangers of robbery. She is angry at the employer and at its representative, the insurance company

who is paying for her treatment. She also has trouble trusting her own judgment, since she feels she should have left her employment after they failed to heed her warning.

She is depressed, her relationship with her partner has deteriorated, and she doesn't like herself much, because she is ashamed of her distrust and even dislike of other people that has come about since the robbery.

Rubrics one might use could include:

- Suspicious (mistrustful);

- Lack of confidence;

- Rage (fury);

- Aversion (to being approached);

- Aversion (to all persons);

- Feeling forsaken;

- Ailments (illnesses) as a result of mortification.

Possible remedies:

Staph.: When a man sexually abuses his daughter, he feels shame, and often he will project this shame into her: look what you made me do, you are so bad.

In addition, sexual abuse, because it is so secret and because it arouses feelings of pleasure at the same time as it violates, is deeply shaming. This shame does not go away.

Staph. one of our best shame remedies (ailments from mortification; suppressed mortification), and it is one of our best remedies for sequelae of sexual abuse. It is good for the suppressed rage that arises in abuse.

A child often cannot afford to express the rage she or he feels against the perpetrator; it would make the situation even more dangerous. Staph. can bring rage back to the forefront and return shame to its rightful owner, the perpetrator. Staph. is also, incidentally, almost a specific for trauma involving cuts.

Its feeling state is, "There is something rotten in me; I dare not fight back."

Ign.: for sudden loss or the loss of relationships that don't go too deep. It is also good for people who get stuck in a "black hole," one of the common subjective phenomena that accompanies trauma.

In trauma, including sudden loss, feelings often get stuck, unable to release. Ignatia can sometimes be of use here. Like Nux-vomica, Ignatia has strychnine as one of its constituents, and so like Nux-v it has the spastic working-against-itself quality. So it has somatizing and tensing shared by Nux-v and Rhus-tox.

I think Ignatia is primarily tensing against the expression of grief and rage. A client obsessing about a boyfriend, calling him and going to his house at all hours and raging at him, collapsing in constant grief, unable to move on, came out of it after a dose of Ignatia.

The feeling state of Ignatia is, "I am tightly immersed in grief."

3. level - developmental trauma

When Interpersonal Trauma (or severe Basic Trauma) impacts early during childhood, then it has the deepest impact of all. It is while the tree is still growing, that the limbs can become most easily deformed.

People with Developmental Trauma suffer from more than PTSD; their personality structures have become altered - it is more than a condition, it becomes part of the being.

As one of my clients put it, "Recovery from incest is like trying to remove egg from the batter after the cake is baked." Thus, the tasks of healing are more complex than with Basic Trauma or Interpersonal adult trauma.

You must help the person heal from Basic Trauma, Interpersonal Trauma, and the impact on the whole personality structure.

Most Developmental Trauma comes in the form of abuse.

The different kinds of abuse are physical, sexual, emotional, spiritual, and ritual. We'll talk on a different day about the different features of each kind of abuse and what remedies can be helpful. As we go through the layers, from Basic, to Interpersonal, to Developmental, we are, generally speaking, moving from acute to chronic.

People usually recover faster and more easily from an earthquake than from a rape and from an adult experience of rape than from childhood sexual abuse. Therefore, the choice of remedies will sometimes reflect the depth of the trauma.

Treatment of Basic Trauma: think of acute remedies;

Treatment of Interpersonal Trauma: use remedies that work at an intermediate depth;

Treatment of Developmental Trauma: work with remedies that reach much deeper into the organism, even down to the miasmatic level.

Developmental Trauma shares all the features of Basic and Interpersonal Trauma, but it has the added dimension of impact on personality and character structure. When we treat Developmental Trauma, our work tends to be

more complex, deeper, and slower than when working with purely Basic Trauma or adult Interpersonal Trauma. Most trauma cases I see are Developmental Trauma cases.

Even in situations where there has been an accident or a rape or war experience, very often there is also a background of childhood trauma.

This results in a more prolonged recovery. If you are treating someone for a recent trauma and recovery is slower than seems reasonable, it may be that there is additional trauma in the background, which can sometimes be discovered through inquiry.

Kinds of abuse

Knowing about the different kinds of abuse you might encounter may help you avoid going into shock and getting vicarious PTSD, when you hear peoples' stories.

Physical abuse

Many, many children are hit. There is controversy about whether this is at all necessary. Alice Miller, in For Your Own Good, describes the consequences of what she calls "poisonous pedagogy" of the past few centuries, in

which parents have justified serious aggression against their children by claiming it is in the child's best interests.

Most of the physical abuse I have seen as a clinician, however, comes in the form of severe beatings, usually unpredictable. It is therefore usually not a form of discipline.

The movie A Boy's Story, depicts physical abuse and its frightening and degrading impact. Physical abuse frightens people and damages their self-esteem.

Picture of physical abuse

"It would happen when he'd been drinking. When he was sober, my father was actually easy to get along with. I loved him. But then at night, I'd listen for the door, and when it would slam, I'd know he was drunk. My whole body would freeze, and I'd sit in my room and wait. Sometimes I'd hear him and my mom yelling. Then after awhile I'd hear them fighting. One time he pushed her down the stairs. I felt so terrible. I hated him. But I also feel so

ashamed that I didn't do anything about it."

"Could you have done something?"

"I don't know. I was seven." Long pause. "Other times, he'd come into my room, with that terrible look in his eyes. It was like he didn't even see me. He'd pull me off my bed and start whaling on me. One time, he threw me

across the room into a wall. I hate him. Maybe it's because of him that I can't get too close to anybody."

Emotional abuse

Sometimes this is more painful than physical abuse, because its impact is closer to the core.

Parents who belittle, threaten, harass, criticize, intimidate, and rage at their children can leave deep, traumatic scars that seriously warp their development.

I think that most people have some degree of emotional abuse in growing up. The manifestations probably cover most remedies, depending upon severity and kind of abuse. I think it would be too hard to do a group anamnesis, because the kinds of abuse and responses vary too much.

An excellent book on the subject, also by Alice Miller, is Drama of the Gifted Child, which most people seem to be able to identify with.

Sexual abuse

Whether by a stranger or by a family member, sexual abuse seems generally more devastating in its impact than physical abuse.

While physical abuse will usually leave its victim with a deep sense of shame, because they have usually been told that the beatings are their own fault, sexual abuse leaves a deeper level of shame. It is almost always a secret,

with severe threats for telling.

Therefore, remembering is often difficult and telling is frightening.

When clients tell you about their abuse history, support for their truth is important in order not to retraumatize them.

Picture of sexual abuse

"I can't stand how I feel these days. When the memories first came, I felt so relieved. All the sadness I had always felt just suddenly was explained and now I don't feel that vague horrible depression anymore. But I can't stand

being touched right now, even by my husband. He doesn't understand, and I can't get him to understand. I feel so horrible. The other day, my girlfriend and I were talking. The same thing happened to her when she was a little

girl. She says all men are like our fathers. I don't like to think that way, but sometimes I think it's true. When my father used to do those things to me, I hated him. But I also loved him. It was confusing. I wanted him to love me. But not that way. He made me feel real bad about myself. Sometimes my husband does too. Especially when he gets mad at me when I don't want to have sex. Sometimes I wish I was dead."

Ritual abuse

As difficult as it is to accept, there are organized groups of people, pederasts and sadists, who prey upon small children and others.

Many people from all over the world are survivors of abuse by Satanic cults.

Some of them have been born into transgenerational families who have practiced ritualized, sexual sadism. These clients all share similar stories of ritual murder and worse. The abuse is usually prolonged and repetitive and

has understandably catastrophic impact on development.

Similar, less horrific abuse appears in other cult and religious settings. It usually involves the deepest level of attempted destruction, the spiritual level, and aims to destroy or otherwise impact the soul.

Even in this kind of unimaginably severe trauma, deep and even miraculous healing is possible.

I have too little experience treating ritual abuse homeopathically. I work a great deal as a therapist in this domain, but it does not lend itself well to combining with homeopathy, because the transference is so deeply complex

and difficult in these cases, that taking on another role is too demanding and seems generally inappropriate.

In addition, people who have been ritually abused have usually been drugged by their perpetrators, which generates an additional, complex factor that requires special handling.

If you find yourself treating a client with ritual abuse, I strongly suggest getting consultation from a psychotherapist experienced in treating such trauma, so that you understand more about what you are dealing with.

Prototypical case example

Here is an example of a typical case of Developmental Trauma, drawn from numerous cases. A woman comes in with a history of depression, disturbed relationships, and chronic low self-esteem.

As her history unfolds, you discover that she grew up in a family with an alcoholic mother and an abusive father. The mother was emotionally absent. The father was severely narcissistic, and he took advantage of the

daughter's vulnerability to develop and perpetuate an incestuous relationship.

She had forgotten about the incest until recently, when the memories began to emerge. Since then, her life has fallen apart. She has difficulty sleeping, her relationship with her partner and friends has disintegrated, and she has difficulty on her job.

She has always been a "caretaker," first of her younger siblings, then later of her friends and her alcoholic partner. She has little sense of her own worth, indeed she never did.

She has a history of sexual promiscuity alternating with sexual aversion. She feels suicidal a lot and has always felt that way. She feels a great deal of despair and anguish underneath. She feels no one has ever been there for her, and in fact, no one has. She has little sense of any possible positive future for herself.

Rubrics one might use could include:

- Lack of confidence;

- Despair;

- Fear (of others);

- Fear (of being hurt);

- Fear (of being injured)

- Fear (of misfortune);

- Sadness (despondency, dejection, depression);

- Ailments (from anger);

- Vexation;

- Ailments (from anxiety);

- Delusions;

- Worry, and/ or

- Weeping.

Remedies to consider:

Aur-met.: One of the fundamental loves, which is the love of living, of self protection is perverted and he longs to die…" (Kent) One of the most profound depression remedies.

When trauma has hit hard and hit long, people often simply do not want to go on.

Trauma crushes the will to live, and one of the few remaining powers people have is to leave. In addition, trauma, because it feels like it contaminates one's very inside, makes people feel that they and their lives are worthless.

It is then time to leave.

Suicidal despair is well met by the homeopathic remedy Aurum.

Its feeling state is "I am crushed and life is too painful to endure."

Syph.: I think the miasm driving abusive families, when there is violence and/or alcohol is the most destructive and desperate miasm, the Syphilitic.

Syphilinum is the pure nosode for this family miasm.

See the movie, “Once Were Warriors” to observe and feel this miasm at its horrific work. Sankaran describes the miasm as so unable to cope with the situation that it is desperately driven either to kill or to die.

After years of psychotherapy and homeopathic treatment, one client no longer needed therapy after Syph CM.

The inner desperation that came from a childhood of abandonment and physical abuse was healed by this remedy.

The feeling state of Syphilinum is, " There is black rage; this must be over and done!"

conclusion

Many of the cases a homeopath sees have trauma as part of the picture. Awareness of trauma and its impact may help you to understand the case and select the right remedy.

As usual, careful selection of a remedy that covers the whole case will be the key to your success. With cases with significant trauma, it is helpful to have your client see a psychotherapist adjunctively to help manage the overwhelming feelings that can emerge in the healing process.

For dosing, it is best to start low and to go slow. If you would like to read about the homeopathic treatment of trauma in greater depth, go to:

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