IN AN" Unsp oken Voice HOTV the Body Releases Trauma and Restores Goodness Peter A. Levine, PhD Foreword by Gabor Mate, MD 6 North Adantic Books Berkeley, California Further praise for In an Unspoken Voice "Peter Levine's first book, Waking the Tiger, changed the world of trauma treat- ment: somatic therapy, specifically Somatic Experiencing®, the name of the specific approach he developed, no longer alternative fringe practice, became a major player in the world of the mainstream psychotherapies. Like an anthro- pologist acquainting us with a different culture that he has made his own, Levine, in his new book, In an Unspoken Voice, systematically and engagingly initiates us into the ways of the body and the nervous system that animates it: how it works, what makes it tick, how to make friends with it, how to under- stand it, how to communicate with it and, last but not least, how to treat it and release it (and with it, us) from the hold of posttraumatic stress disorder (PTSD). No longer unspoken, all that is held in the body—in trauma and in health, in psychosomatic illness and in resilience—is described, articulated and made coherent. The result is a masterful, fluent book that seamlessly moves between evolution, science, Polyvagal theory, mind-body practice, impassioned defense of our animal natures, self-disclosure and specific step-by-step guide to treat- ing trauma and restoring resilience. It is erudite, it is impassioned, it is learned and it is accessible." —Diana Fosha, PhD, director of The AEDP Institute, co-editor of The Healing Power of Emotion: Affective Neuroscience, Development and Clinical Practice and author of The Transforming Power of Affect: A Model for Accelerated Change "To be traumatized is to be condemned to endless repetitions of unbearable experiences. In this beautifully written and engrossing book, Peter Levine explains how trauma affects our body and mind and demonstrates how to call upon the wisdom of our bodies to overcome and transform it. The accounts of his personal and therapeutic experiences, integrated with the essentials of the sciences of trauma and healing, are highly informative and inspiring. His distinctive voice should be widely heard by survivors, clinicians and scientists." —Onno van der Hart, PhD, Honorary Professor of the Psychopathology of Chronic Trauma, Utrecht University, Utrecht, The Netherlands, and co- author of The Haunted Self Structural Dissociation of the Personality "Like a wise old weaver Peter Levine painstakingly blends together strands of many dense colors into ever-fresh patterns emerging from his honed intelli- gence and fertile imagination. These strands comprise careful reflections on his own personal healing, his work with others, insights from studies with ani- mals, different views from indigenous peoples here and elsewhere, various sci- entists exploring the biologies of the body, spiritual practices in many traditions and whatever else passes in front of his sparkling eyes. His first (and now iconic) book, Waking the Tiger, is now part of the canon for the education of thera- pists. This major new book is a welcome landmark in his long history of cre- ating an intricate tapestry of Somatic theory and practice." —Don Hanlon Johnson, PhD, professor of Somatics at California Institute of Integral Studies, founder of the first accredited graduate studies program in the field and author of Bone, Breath, and Gesture: Practices of Embodiment and Everyday Hopes, Utopian Dreams: Reflections on American Ideals "For more than forty years, Peter Levine has gently, humorously, and with stunning simplicity, shown us how trauma responses are part of a brilliant psy- chological self-protection system; a protection system that we, professionals and laypeople alike, unwittingly block with our many 'normal' responses. If you want to grasp the essence of how and why the trauma response can help people heal, read this book. If you want to help a traumatized person lessen the impact of the trauma while it's happening, read this book. If you want to understand your own journey through stress and trauma, read this book. If you want some trail markers for a path from the daze of dissociation to the reemer- gence of deep vibrant aliveness and spiritual feeling, read this book." —Marianne Bentzen, international trainer in Neuroaffective Psychotherapy, Copenhagen, Denmark "Peter Levine conveys his profound scientific understanding of posttraumatic stress disorder (PTSD) so vividly that the reader can sense, feel and identify with the many traumatized children and adults he has worked with. Levine helps us to understand the complexity of PTSD seen from the outside as well as felt from the inside. He invites us into a spiritual dimension that draws equally on science and experience. Through his poetic style the reader is con- ducted from the built-in reactions of the nervous system to deep mental scars, and to how the skilled PTSD therapist can guide far-reaching healing processes. Levine's understanding is vast in its scope, from an evolutionary understand- ing of the source of trauma to a spiritual dimension of how we as human beings can be strengthened by healing from trauma." —Susan Hart, Danish psychologist, author of Brain, Attachment, Personality: An Introduction to Neuroaffective Development and The Impact of Attachment: Developmental Neuroaffective Psychology "This book stands as a worthy sequel to Levine's groundbreaking Waking the Tiger. He expands his concepts of the neurophysiology] basis for trauma with a thorough review of the science of trauma and his own creative theories, pro- viding rich insights for application to the business of healing. Valuable case studies illustrate the 'whys' of the behavior of the trauma victim, and useful tools help the therapist enlist the body in the process." —Robert Scaer, MD, author of The Trauma Spectrum and The Body Bears the Burden "Peter Levine's approach to understanding and healing trauma is innovative, vital and thoroughly creative. The map for therapy that he introduces is very helpful to any healer of trauma. Once again Levine reminds us that our evo- lutionary ancestors are not so removed from us. That we and the other ani- mals are all one family and that we should learn from them, as our survival and sanity depends on it. Levine's suggestion to change posttraumatic stress dis- order (PTSD) to posttraumatic stress injury (PTSI) is much more realistic as we are healing the hurt and not the disorder." —Mira Rothenberg, author of Children with Emerald Eyes and founder of Blueberry Treatment Centers Copyright © 2010 by Peter A. Levine. All rights reserved. No portion of this book, except for brief review, may be reproduced, stored in a retrieval system/or trans- mitted in any form or by any means—electronic, mechanical, photocopying, record- ing, or otherwise—without the written permission of the publisher. For information contact North Atlantic Books. Published by and North Atlantic Books ERGOS Institute Press P.O. Box 12327 P.O. Box 110 Berkeley, California 94712 Lyons, Colorado 80540 Cover and book design © Ayelet Maida, A/M Studios Cover art © fotosearch.com Author photograph © Gerry Greenberg Printed in the United States of America Figures 6.2a through 6.4d—From Healing Trauma: A Pioneering Program for Restor- ing the Wisdom of Your Body written by Peter Levine and published b/Sounds True. Used with permission from Sounds True, www.soundstrue.com. Diagrams A and B (color insert)—Netter illustrations from www.netterimages.com. © Elsevier Inc. All rights reserved. Used with permission. Creative design of all other figures: Justin Snavely In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness is spon- sored by the Society for the Study of Native Arts and Sciences, a nonprofit educa- tional corporation whose goals are to develop an educational and cross-cultural perspective linking various scientific, social, and artistic fields; to nurture a holistic view of arts, sciences, humanities, and healing; and to publish and distribute liter- ature on the relationship of mind, body, and nature. North Atlantic Boob' publications are available through most bookstores. For further information, visit our website at www.northatlanticbooks.com or call 800-733-3000. Library of Congress Cataloging-in-Publication Data Levine, Peter A In an unspoken voice : how the body releases trauma and restores goodness / Peter A Levine ; foreword by Gabor Mate, p. cm. Includes bibliographical references. Summary: "Based on findings from biology, neuroscience, and the emerging field of body-oriented psychotherapy, In an Unspoken Voice explains that trauma is not a disease or a disorder, but an injury caused by fright, helplessness, and loss and that this wound can be healed only if we attend to the wisdom of the living, knowing body"—Provided by publisher. ISBN 978-1-55643-943-8 1. Psychic trauma. 1. Title. RC552.T7L483 2010 616.85'21—dc22 2010023653 1 23456789 UNITED 15 14 13 12 11 10 In all things in nature there is something of the marvelous. —Aristotle (350 BC) Acknowledgments Everything responsible for our "human existence" is due to an anonymous multitude of others who lived before us, whose achievements have been bestowed upon us as gifts. —H. Hass (1981) F OR WHERE I STAND TODAY, I am indebted to the great scientific tra- dition and lineage of the ethologists, those scientists who study ani- mals in their natural environments, who have contributed greatly to my naturalistic vision of the human animal. A most personal thanks to Nobel Laureate Nikolaas Tinbergen, whose suggestions and kind words of support encouraged me to pursue this naturalistic worldview. Though I have never met them, except through their written gifts to history, I would like to honor Konrad Lorenz, Heinz von Hoist, Paul Leyhausen, Desmond Morris, Eric Salzen and Irenaus Eibl-Eibesfeldt. Other "vir- tual" teachers include Ernst Gellhorn, who informed my early neuro- physiological thinking, and Akhter Ahsen, who helped consolidate my vision of the "undifferentiated and welded unity of the body and mind." A giant, whose broad shoulders I stand on, is Wilhelm Reich, MD. His monumental contribution to the understanding of "life-energy" was taught to me by Philip Curcuruto, a man of few words and simple wis- dom. My deep appreciation and personal debt go to Richard Olney and Richard Price, who taught me what little I know about self-acceptance. Having known (and been inspired by) Dr. Ida Rolf has been a catalyst in forming my identity as a scientist-healer. To Dr. Virginia Johnson, I thank you for your critical understanding of altered states of con- sciousness. And to Ed Jackson, thanks for trusting my nascent body/mind practice in the 1960s and for referring Nancy, my first trauma client. vii viii IN AN UNSPOKEN VOICE I am grateful for the tremendous support and help from my friends. Over the years (beginning in 1978) I have had many stimulating dis- cussions with Stephen Porges, already a leading figure in the field of psychophysiology. Over the following decades, our paths have contin- ued to cross as we shared our parallel and interwoven developments and a special friendship. Thanks and admiration to Bessel van der Kolk for his voracious inquiring mind, his broad comprehensive vision of trauma, his professional life of research advancing the field of trauma to its modern status, and his courage to challenge existing structures. I fondly recollect our sharing Vermont summers on the banks of East Long Lake, swimming, laughing and talking trauma into the wee hours. In putting this book together I am indebted to the creative chal- lenge and tremendous editorial help from Laura Regalbuto, Maggie Kline and Phoebe Hoss; also thanks to Justin Snavely for his awesome technical help. And, once again, I appreciate the cooperative endeavor of a continuing partnership with North Atlantic Books; with Emily Boyd, project manager, and Paul McCurdy, the line editor. To my parents, Morris and Helen, I give thanks for the gift of life, the vehicle for the expression of my work, and for their unequivocal support from the "other side" of the physical plane. To Pouncer, the Dingo dog who had been my guide into the animal world as well a con- stant companion, I have fond body-memories of play and goodness. At the age of seventeen (arguably, over a hundred human years), he con- tinued to show me the vital joy of corporeal life. Finally, I stand in awe of the many "coincidences," "chance" meet- ings, synchronicities and fateful detours that have impelled and guided me on my life's journey. To have been blessed by a life of creative explo- ration and the privilege to contribute to the alleviation of suffering has been a precious gift, a pearl beyond price. Thanks for all my teachers, students, organizations and friends through- out the world who are carrying out the legacy of this work. PETER A. LEVINE Contents Foreword *i PART 1 — Roots: A Foundation to Dance On CHAPTER L The Power of an Unspoken Voice 3 CHAPTER 2 Touched by Discovery 19 CHAPTER 3 The Changing Face of Trauma 31 CHAPTER 4 Immobilized by Fear: Lessons Learned from Animals 39 CHAPTER 5 From Paralysis to Transformation: Basic Building Blocks 73 CHAPTER 6 A Map for Therapy 97 CHAPTER 7 Mapping the Body, Mending the Mind: SIB AM 133 PART n — The Body as Storyteller: Below Your Mind CHAPTER 8 In the Consulting Room: Case Examples 157 CHAPTER 9 Annotation of Peter's Accident 213 PART in — Instinct in the Age of Reason CHAPTER 10 We're Just a Bunch of Animals 22 J CHAPTER 11 Bottoms-Up: Three Brains, One Mind 249 PART IV —Body, Emotion and Spirituality: Restoring Goodness CHAPTER 12 The Embodied Self 271 CHAPTER 13 Emotion, the Body and Change 305 CHAPTER 14 Trauma and Spirituality 347 Epilogue 357 Notes 359 About the Author 370