Navigating the High Seas of Interoception: Trauma, Healing, and the Felt Sense

We've been diving deep into trauma research and PTSD among veterans in clinic conversations lately and with everything going on in the world these days, it's prompting us to keep digging in.  Here's a guest post from Clair Hamilton Araujo. Thanks for reading and sharing your thoughts!

HI all,

I’ve been getting ready to co-teach a meridian-inspired movement class this weekend with fellow MMI-inspired practitioner Josh Canter. As I am getting prepared, I find myself face-to-face with a core value I’ve long-held: the importance of connecting to the felt sense.  For so much of my life, movement and the felt sense within it has been a place of refuge, inquiry, creative expression, and healing.  I realize now that my belief in cultivating a deep relationship with internal experience is what has led me to where I am now in my approach to bodywork and acupuncture.  

And yet, it seems like the way we are living these days makes an embodied experience hard to maintain.

I like to think of reconnecting to our felt sense as a re-wilding of the body: shutting off and turning away from mechanized ways of knowing and interacting, and reconnecting with ourselves and each other more organically.  

Artwork from Carolyn R. Avalani's article The Sensitive Heart on www.elephantjournal.com
www.carolynriker.com

It’s uncertain, vulnerable even, but softer, and both refreshingly new and ancient to be in our bodies in this way. Trauma researcher and author Bessel Van der Kolk refers to this ability to follow the felt sense as interoception and he identifies it as a catalyst for our own transformation.  In his book The Body Keeps the Score, he writes:

“Agency starts with what scientists call interoception, our awareness of our subtle sensory, body-based feelings: the greater that awareness, the greater our potential to control our lives. Knowing what we feel is the first step to knowing why we feel that way. If we are aware of the constant changes in our inner and outer environment, we can mobilize to manage them.”  

Sounds a lot smoother than it actually is in practice! 

(For more of Van der Kolk’s work on trauma and resilience, check out this Brainpickings.org post or this On Being episode)

Traumatic Experience & Interoception

Some people have a more innately easeful relationship with their sensory, body-based feelings—it comes easily to them, they’ve cultivated it over time.  But many of us are acculturated out of our bodies and away from our felt sense.  In particular, if we’ve been through a traumatic experience or if we are holding past traumas in a certain area of the body, the process of interoception can become deregulated. 

Unresolved traumas can perpetuate confusing states of flight, fright, or freeze and inhibit us from discerning the difference between safety and risk.  The nervous system of someone with unresolved trauma can misinterpret calm as threat, peace as neglect, or a bid for connection as danger (or vice-versa).  The internal state of relaxed alertness that supports learning, social bonding, and enthusiasm can instead signal internal alarm.  In this confusion, the conditions for rest, relaxation, and safe relationships—all of which are necessary for healing and change—seem out of reach.

So, this unique tool of interoception that we could use as a map to navigate the oceans of sensation between inside and outside and to guide ourselves out of trauma, instead leaves the most victimized among us lost at sea.  The chronic stress that accompanies an inability to trust one’s one sensations intensifies the situation.  

There are so many instances in which traumas are happening at alarming rates and it simply shouldn’t be this way.  Unfortunately, experiencing trauma is not a rare occurrence in human experience and developing post-traumatic stress disorder, or PTSD, can happen to anyone. It is not a sign of weakness.  (Click here for a definition of PTSD.)  

(The next section relates to veterans’ traumas in combat.  You can avoid reading if this content is disruptive to your healing journey.)

Trauma Among Veterans

As I’ve been thinking about the importance of the felt sense and it’s restorative potential in healing traumas, I consider some of my traumatic brain injury (TBI) patients who’ve experienced incredible relief from bodywork, specifically cranial work.  Traumatic brain injury and PTSD are both common among returning veterans and each condition compounds the other.  Figures vary, but we know that the US has nearly 2.7 million veterans from the Middle East wars and upwards of 40% with PTSD and some percentage of those with TBI too.  Multiple resources indicate that these numbers are vastly under-reported. 

And then, the experience of war itself is traumatic.  

I recently came across a National Geographic article called The Invisible War on the Brain.  The article discusses a specific form of complex brain trauma in war veterans involving neurological and psychological effects due to blast forces from explosives.  

Neuroscience researchers debate the exact mechanism by which blast forces cause neurotrauma.  But so far, we know that the blasts cause injury through a combination of increased cranial pressure, brain motion inside the skull, extremely loud sounds, and flashes of light.  

Computerized images illustrate the breakdown of neural connections in the brain of a civilian victim of severe traumatic brain injury (right), compared with a healthy brain (left)

The constellation of symptoms that can result include chronic persistent “headache, seizures, motor disorders, sleep disorders, dizziness, visual disturbances, ringing in the ears, mood changes, and cognitive, memory, and speech difficulties” and can predispose people to psychological disorders.  Although these are all significant symptoms, for a long time, the condition went undiagnosed, unrecognized and untreated because, relative to more physical wounds of combat, blast force trauma survivors might have fewer outward signs of injury.

If you have a chance to read the article, you may find in it many things—among them heart-break, frustration, agony.  It’s maddening to read how long top officials and researchers rejected the idea that exposure to blasts could cause injury and hard to hear that incidents are under-reported.  It’s tragic to consider the human cost of war and the psychic suffering from this kind of experience.

For me, the story highlights our culture’s systemic blindness to the intangible: if it can’t be quantified, measured or commodified, dominant structures deny it exists.  

These injuries also serves as a talisman for all of us, a reminder, that our both individually and collectively, our unseen traumas are often the most gripping precisely because they escape appropriate awareness and attention.

How can these types of injuries begin to be healed from this place?  How can our cultural biases prevent us from treating the most severe forms of emotional suffering as real parts of dis-ease?

How can we respond instead? 

The Recovery of the Felt Sense

Can our own connection with the felt sense restore our connection to one another and transform our culture’s lack of caring for each other? 

I return to a quote from Tom Myers’ that Michael shared with me a while ago (it’s so good to circle back).  Myers was writing an introductory portion of a book on fascial research and in it he recommits to the importance of the felt sense. He says:

“Fully into my seventh decade, I remain convinced that the recovery of the body—the body as a felt, lived experience, not the body as a commodity—is our most pressing opportunity from a political, environmental, and social perspective.”

If the dominant structures in our society (medicine, science, government, narratives etc.) have failed to see the strain and stress in our patients, my sense is that reconnecting to our felt sense will.  Whether through bodywork, acupuncture, artistic expression, movement, relationship, or other routes, restoring the importance of the felt sense has the possibility to weave together the holes in our social and personal fabric.  

Of course, I am predisposed towards cranialsacral therapy in many contexts, as I have had the chance to see TBI, PTSD and post-concussion syndromes improve drastically with this work.  In fact, research has shown that cranial sacral therapy can assist in the reduction of symptoms, improve intracranial pressure, and enhance recovery in these cases.  Gentle forms of bodywork such as cranial work are also known to help survivors of complex trauma to reintegrate difficult emotional and interpersonal experiences. But I think the key is in re-weaving our connection to the felt sense as not only a therapy we offer others, but as a way of knowing and a way of being. Van der Kolk’s message:

“The body keeps the score: If the memory of trauma is encoded in the viscera, in heartbreaking and gut-wrenching emotions, in autoimmune disorders and skeletal/muscular problems, and if mind/brain/visceral communication is the royal road to emotion regulation, this demands a radical shift in our therapeutic assumptions.

Re-Weaving Community

I’m inspired and humbled by groups that have been doing this work in the most tender places in our community.  The Portland Veterans Acupuncture Project has been offering free acupuncture services to veterans and their families for the past 10 years.  With a background in medical research at the VA the Project’s originators saw firsthand the effect of acupuncture for veterans.  In true felt-sense form, they saw that anything affecting a veteran eventually affected the whole family, and they opened their clinic doors wider for all veterans and their companions.

Would you be interested in setting up a similar regular community clinic with a focus on offering bodywork? Currently Moving Mountain Institute is exploring ways to get involved in a project like this. If you are interested or have ideas or comments about this, please get in touch with us.

We love and invite your collaboration.

For those of you who have been curious, don’t forget we have a Cranialsacral I workshop running this weekend (Friday – Sunday) and we have a few spots left. 

with heart,
clair