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by Ruth Buczynski, PhD
with Bessel Van der Kolk, MD, Joan Borysenko, PhD, Ron Siegel, PsyD and Rick Hanson, PhD

1. Moving from self-loathing to an improved self-image

Developmentally traumatized people often have a high degree of self-loathing. Dr. Ron Siegel discusses how to change that thinking to something more positive

"All of the folks that I’ve ever worked with, particularly who have suffered from complex trauma, have had many experiences in which the world was either profoundly disappointing or injurious to them and they wind up taking that in and assuming that there’s something terribly wrong with them.

If you’re growing up in a household and your parents are treating you as though you’re bad in some way, you have two options. One is to think, “Oh, my god – there’s something really wrong with my parents” – and that is terrifying because, as a child, we rely so utterly on our folks.

The other option is to think, “They must be right and there’s something terribly wrong with me.” That is almost always the conclusion people come to.

So how do we deal with that? It’s useful to differentiate between trying to develop self-compassion and trying to develop self-esteem.

Self-esteem, which is what we tend to think about most in our culture, involves telling ourselves that we are really okay competitively, in some sense. There’s the joke about Lake Wobegon where all the children are above average.

Self-esteem is always comparative in some way: “Okay, so I’m not so good in one regard, but I’m really good at basketball / I’m excellent at math…”

A very good approach is developing self-compassion – and Peter Levine alludes to this when he discusses the various ways in which one can hold the body when doing body work.

My friends, Chris Germer and Kristin Neff, who do a lot of teaching about selfcompassion, do this very simple technique of holding the hand over the heart and then doing some kind of loving-kindness practice.

In the Buddhist tradition, these are called metta practices, and they often involve repeating phrases silently to oneself. This is one: “May I be safe – May I be healthy – May I live with ease – May I be happy – May I be peaceful – May I be free from suffering.”

The particular content isn’t critical; what’s critical is generating this kind of loving-holding that the pediatrician and analyst D.W. Winnicott used to talk about, which is the way in which the therapist holds the patient emotionally, or a parent holds the child emotionally.

From this, we start to transform – in the self-compassion literature it’s called the “holy trinity of self-criticism, self-isolation and self-absorption.”

We’ve been telling ourselves bad things about ourselves – we’re totally focused on “me” because “I am so bad” and we’re isolated from other people because of this kind of focus.

The alternative is developing this kind of kindness or self-compassion, which means noticing our common humanity – that whatever we are involved in, this suffering is also the suffering of other human beings: “I am not really isolated by the fact that I’m in pain.”

Finally, mindfulness as opposed to self-absorption brings us to: “Let me simply see these phenomena arising as impersonal events rather than all about me.”

It is a whole package. But those kinds of approaches are a very nice antidote to the kind of posttraumatic self-torment and self-degradation that we see so often.”
(p. 28-29 in your transcript)

2. How to teach self-regulation to children on medication

Dr. Joan Borysenko tells a story to remind us how important it is not to assume that children on medication can't be helped with treatments.

"One of the things about medication is, from time to time, it can be good.

Maybe medication helps somebody focus so they can learn. But I am not talking here about the antipsychotic treatment for ADD. With a child who’s on any kind of medication, clearly the learning is impacted.

But I want to give you an anecdote here that first convinced me that, no matter how children are medicated, they can actually be reached.

This is not about a client of mine – I don’t work with children and I never have – I work with adults. However, this was a boy in fifth grade. He was a friend of one of my sons, and he came to live with us for a couple of months.

He was on several medications. Clearly this was a kid with terrible problems with attention and affect regulation and relationships. He was quite a handful.

He came home one day and he said – now this was when he was in fifth grade, “We had the most interesting health class. Somebody came and did a guided imagery with us.”

I was shocked and I said, “Really? You could focus on that? What was it like?”

He said, “I went to this place and it was so calm inside. I had this huge insight; I thought of my baby brother, who I loved so much, and it occurred to me that God is actually love.

I was thoroughly amazed that in a child who had as many problems as he did and was on as many medications as he was that he had such a glorious insight. It was a short guided meditation and he was able to do it.

Then he asked me, “You meditate – I know you meditate because you always tell us to be quiet and not to bother you when you do that. Can I come with you? Can I learn this?”

I thought – and I was a teacher of meditation at the time – “How can I possibly teach this child to meditate? How can he do this?”

And do you know? He actually took to it very, very well. Not in long periods, but for two to three minutes – he would do that and it would always bring him a sense of calm.

It’s so important, with either adults or children, that we don’t immediately say, “They can’t do this – somebody like that can’t concentrate. They’re on too many meds.”

We have to try and see – and there are many different techniques that we can use. For him, guided imagery – and it was a simple form – a counting meditation that I did with him, and it worked very, very well.

By the way, he also liked yoga; I used to run a yoga class in my home and the boys would always come and be part of it.

For any person who has trouble concentrating or who has a trauma and you don’t want them to go to deepened meditation, focusing on positions and breathing in yoga can be a tremendous help.

Once again, medication doesn’t block one’s entire ability to do that – one can really benefit." (p. 26-28 in your transcript)

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