Elizabeth Stanley: Trauma-Sensitive Mindfulness

Tami Simon: Welcome to Insights at the Edge, produced by Sounds True. My name’s Tami Simon, I’m the founder of Sounds True. I’d love to take a moment to introduce you to the new Sounds True Foundation. The Sounds True Foundation is dedicated to creating a wiser and kinder world by making transformational education widely available. We want everyone to have access to transformational tools such as mindfulness, emotional awareness, and self-compassion, regardless of financial, social, or physical challenges. The Sounds True Foundation is a nonprofit dedicated to providing these transformational tools to communities in need, including at-risk youth, prisoners, veterans, and those in developing countries. If you’d like to learn more or feel inspired to become a supporter, please visit soundstruefoundation.org.

You’re listening to Insights at the Edge. Today, my guest is Elizabeth Stanley. Liz Stanley is a Georgetown University professor and the creator of Mindfulness-based Mind Fitness Training®, referred to as MMFT® for short. MMFT is taught to thousands in civilian and military high-stress environments to help people in those environments be better resilient high-stress situations. Liz is a longstanding mindfulness practitioner and a certified practitioner of Somatic Experiencing, a body-based trauma therapy. With Sounds True, Liz Stanley has created a new eight-week online course bringing MMFT to the online world, trauma-sensitive mindfulness training. Throughout this online course, Liz Stanley guides people through the neurobiology of stress, trauma, and resilience, and she gives us interactive tools and daily practices so that we can recover, heal, and increase our ability to thrive in stressful times.

Originally, I thought that MMFT was designed for people who had high-stress jobs— people who were first responders, people working as firefighters, as EMTs, as police professionals, serving in the military. Listening to Liz and feeling the amount of stress so many of us are under during this time, it’s clear MMFT is for all of us. Here, you can listen to Liz Stanley describe how our mindfulness training must be trauma sensitive and trauma informed. Here’s my conversation with Liz Stanley:

Liz, I wanted to start with our listeners getting a more thorough introduction to you. I know that you were born into a military family. What I’d love to know more of is how your upbringing and early life and then service in the military led you to want to design a mindfulness program for active military members.

 

Elizabeth Stanley: So Tami, I come, as you said, from a very long warrior tradition. I’m the ninth generation in my family to serve, and I’m the first generation who didn’t serve during some form of combat. As a result, my mind and body were wired at this unconscious level from the prior unresolved chronic stress and trauma of my parents and their parents and their parents. It had a real effect early on in my life. I experienced a lot of childhood adversity, a lot of chronic stress and trauma in childhood that had detrimental effects on my wiring, and that also led to these very unconscious perceptual patterns that drew trauma to me. It became a vicious cycle, and by the time I served in the military myself, I was overseas, served several very stressful military deployments. While I was in Bosnia, I had a near-death experience. I stopped breathing completely.

By the time I got to graduate school, my system was done. I had been socialized, as many warriors are, many people in high-stress professions are, to suck it up and drive on. To push it under, to suppress it, to compartmentalize and to power through, to keep going. And we can do that. Our minds and bodies can do that for a fair amount of time, but at some point, the cost of that comes due. My body really bore the burden of that denial and suppression, and it came out sideways in physical health problems, in PTSD and depression, and eventually, even in losing my eyesight for a period of time, which was like my cosmic frying pan upside the head. It made me realize I needed to learn a new way of being. I had to learn to do this differently.

In my own healing journey, I began to see how much the different tools that I was learning to heal my own mind and body could be so helpful for other people who are working in high-stress environments, to really improve their performance during stress and to help their minds and bodies recover, because our society has this very imbalanced understanding of performance. We focus so much on the performing and not on the recovery, and it leads to these imbalances that show up over time, and we don’t always connect the dots of how those pieces fit together. So I wanted to share that, and there’s nothing that I teach that I didn’t learn first in my own mind and body, and then from observing it in so many other minds and bodies that I’ve worked with.

 

TS: Now, Liz, in addition to creating the MMFT, Mindfulness-based Mind Training Fitness program that Sounds True has now partnered with you to bring online for people, in addition to creating that training program, you’ve written a book called Widen the Window, and here at the beginning of our conversation, I’d love for you to explain to our listeners this concept of widening the window.

 

ES: Yes. So, our window is our window of tolerance to stress arousal. When we’re inside our window, we can keep all of our decision making, attention, other executive functions online, fully online. When we’re inside our window, it’s much easier for us to function effectively during stress, recover from stress afterwards, and keep all those deliberate decision-making skills online. This is the place where we can access choice, and it’s also the place where we can connect with other people socially, give and receive social support during stress. So everybody has a window. Our window is wired throughout our life. It starts being wired before we’re even born while we’re still in the womb. Then in the book, I lay out the different pathways by which we can narrow our window.

People with wider windows are much more tolerant of uncertainty and ambiguity. They’re much more flexible when life throws a curve ball, when things don’t go the way we’ve planned and the way we want them to. They’re much more comfortable with difficult people and challenging situations, and they can keep their social skills online during stress. They can handle conflict effectively and not act out.

The reason why I talk about it as a window, and there are other people who talk about it as a window too, is because it is something that we can narrow or widen as a result of our repeated experiences. We can widen our window through repeated choices that help our neurobiology to recover so that we have more capacity during stress. Resilience is not something we have or we don’t, it’s something we can train in our minds and bodies.

 

TS: Now, how do I know at any given moment, Liz, if I’m within this window of effectively acting in a situation? I mean, I think other people probably could tell you pretty well whether I’m in or out, but how do I know internally whether I’m inside or outside my window of effective integrated action?

 

ES: That’s a great question, Tami. When we’re inside our window, we are able to consciously up- and downregulate our stress arousal or our emotions to be able to keep ourselves at a moderate arousal level that lets us keep our attention focused. It lets us think creatively, problem solve, ask and receive information from other people, be aware of what’s going on and make—access choice. Feel like we have some agency in the situation. When we’ve moved outside of our window, we’re much more likely to have our stress and our emotions driving our behavior, driving our decisions. That’s when we’re much more likely to be impulsive or reactive or act out. That’s when we’re much more likely to do some of that overriding of what’s going on in our minds and bodies, like I did for decades.

That’s also where we’re much more likely to have our survival brain, the part of our brain that is assessing threats, to have that part of our brain code us as powerless, or helpless. We can end up in a response that is either apathetic or feeling overwhelmed or feeling paralyzed and unable to act. That’s a response on the freeze spectrum.

 

TS: Is it fair to say that with the design of MMFT, what you’re trying to do is help people who are in high-stress situations, whether it’s out in military combat or someone who’s a firefighter or a police professional, or working as a first responder in some fashion in the healthcare field, anybody in that situation, you want them to have as wide a window as possible in their profession. I’d be curious to know what that means specifically for these professionals operating in high-stress environments, what that looks like in those high-stress environments.

 

ES: I’d like—before I answer that piece, Tami, I want to pick up on something you slightly earlier in your comment there. You’re right, the goal is to have the widest window possible, because trauma occurs whenever our survival brain perceives us to be helpless, powerless, or lacking control. Knowing that, the best way to ensure that trauma doesn’t happen is when we can access agency, and we can access agency when we’re inside our window. The wider our window, the more likely we can access agency. The narrower window, the more likely it is we’ll experience traumatic stress, and then all of the downstream effects that come from not recovering from trauma and having challenges with healing. The less agency we perceive we have, the more traumatic it’s likely to be. That’s the principle on which I built MMFT.

So someone who is working in a high-stress profession like first responders, or right now, during the coronavirus pandemic, all of the essential healthcare workers who are coping with really challenging situations that might make them more likely to fall into this position of feeling powerless or helpless. If someone has this very wide window, they’re going to be able to keep their decision making online, they’re going to be able to evaluate which things are under their control versus aren’t, and make peace with the things that aren’t. They’re going to be able to focus their attention and not get lost in distractions. They’re going to be able to actively call on what is important that they know in their memory versus not—having problems with short-term memory. And they’re not going to let anxiety or impatience or other challenging emotions start to filter their decision-making.

Finally, someone who is inside their window is going to be much less likely to rely on the coping habits that actually add to our stress load. In the book and in MMFT, I talk about these as stress reactions cycle habits. These are things that feel good in the short-term, they soothe us immediately, but they’re actually not helping us get true recovery. Things like relying on too much caffeine, or nicotine, or alcohol, or adrenaline-seeking behaviors, infidelity—there’s a whole range of different habits that we use to feel better in the short-term, but that are actually making stress worse over the long-term. When someone is very stressed in a high-stress environment, they’re more likely, as their window narrows, to rely on those habits, and set the stage for stress and trauma down the road.

 

TS: Liz, at the beginning of the MMFT training program and in your book, Widen the Window, you teach a lot about neuroscience and the model of how our mind-body system works as a way to frame everything that you teach. I think it would be helpful here at the beginning, first of all, to know why, why you emphasize that so much, and then secondly, share with our listeners the basic model. You mentioned a little bit that we have this survival brain and you’re trying to help us find the place of agency, but you describe all this and you teach all this from a framework of neuroscience. I think that’d be very helpful for our listeners to get the basics.

 

ES: Yes, absolutely. When I was first trying to widen my own window, to recover from PTSD and depression and all of my respiratory problems and regain my eyesight, as I was having these experiences, I was wondering, why are these things happening to me and why do I respond in particular ways? I wanted to understand that. As I learned about the way that our minds and bodies are wired, my thinking brain, the parts of my brain that make conscious decisions, my thinking brain found it incredibly helpful to understand why my mind and body were acting the way they were, why I had the symptoms of dysregulation I did, why I responded in certain ways in situations in my past. It was so liberating for me to understand that this was neuro-biological wiring that had not been under my control when it first was wired.

That helped me take it much less personally. It helped me loosen the cycles of shame and self-judgment that I had been caught in. It also floored me, the more I learned about how much these things had been conditioned in early childhood and how much that set me on this lifelong trajectory, that played out because I wasn’t aware of it.

I want readers of the book and participants who take the course to have this same understanding, so that if they are coping with symptoms of dysregulation, they’re not going to beat themselves up during the recovery process. We get so attached to our stories and narratives about why things are the way they are. We often criticize ourselves for lack of willpower or lack of self-discipline, and we expect that we can somehow just will ourselves to be better.

But one of the important pieces of the model that I’ll talk about in a second is survival—the recovery process, the healing process, these are not up to our thinking brain, and willpower is a thinking brain function. The recovery functions and the healing functions all belong to and are controlled by the survival brain. So when we try to will ourselves to have a stronger willpower, stronger self-discipline, and then those strategies don’t work, we somehow think that’s a problem with us. It isn’t. That’s because recovery and healing are survival brain jobs.

I want everyone to understand that when we’re experiencing stress arousal or trauma or negative emotions or irrational impulses or urges to do violent things or harm ourselves, those are just past neuro-biological conditioning playing out. It’s not saying anything about who we are, and when we can understand that, it opens up these choice points where we can interrupt that conditioning and we can choose something else, we can decondition it and rewire and condition something better. For me, at least, the best path to making better choices is self-understanding, and I want people to have that self-understanding.

That was a long answer, but let me explain now more about the model. In the book and in MMFT, I talk about us having a thinking brain and a survival brain. I want to be clear, these are brain regions that have overlapping circuitry, but the reason I divide them out in this way is it helps to understand which functions are under our conscious control, which functions are not under our conscious control.

The thinking brain—and if anyone has read Daniel Kahneman’s book, Thinking, Fast and Slow, he uses this dual pathway model. I just use thinking brain and survival brain. The thinking fast part, this unconscious, very rapid automatic process belongs to our survival brain. These are the evolutionarily older parts of our brain, and the survival brain is what controls all of our threat appraisal process. It’s happening all the time, unconsciously, automatically. If our survival brain perceives any current situation outside of us, inside of us, if it perceives that as threatening or challenging, it’s going to turn stress arousal on. If it perceives us to be safe, it’s going to turn stress arousal off and turn recovery functions on. That’s really important for MMFT. Being able to help direct our attention so that our survival brain perceives that we’re safe and stable, and then it turns on recovery functions. That’s an important part of healing and widening our window.

So survival brain controls, survival functions, this threat appraisal process, it has an implicit memory system, which is the collection—all the prior moments of threat appraisal it’s ever done, and it controls recovery. Those are all survival brain functions. Survival brain’s not verbal. We can’t hear it. We can only see its effects in our body through physical sensations, through emotions. Those are its cues to us.

Thinking brain is the evolutionarily newest part of the brain. This is what Kahneman calls the “thinking slow process,” that very deliberate, it’s conscious, cognitive—our conscious, cognitive response to our experience. So this is thinking, paying attention, remembering things, planning, task de-confliction, willpower, and explicit memory. Things that we intentionally call up and think about.

Thinking brain functions get degraded when we experience prolonged stress. They also get degraded when we experience very high stress levels, like trauma. That’s one of the reasons why, when we’ve experienced trauma, we may not have a good memory of it, consciously. It might be inconsistent or fragmented. Our survival brain is remembering a whole lot, because the more stress we experience, the more the survival brain learns while the thinking brain may be offline. For many people who work in high-stress situations, their thinking brain functions are often very degraded. Even two weeks of getting six hours of night of sleep is enough to begin to really degrade your thinking brain functions. It isn’t like you have to be in combat. Everybody can experience degradation there. But as I said before, our thinking brain doesn’t control recovery, even though many of us want it to, and that’s why we sometimes are trying to get better or trying to recover and it’s not really working. We have to work with the survival brain.

Another thing that’s really important in MMFT is understanding the autonomic nervous system. This is the system that controls stress arousal and recovery, and it’s linked from the survival brain down into all the organs. It controls breathing and heart rate and digestion or elimination, reproductive functions—all of our visceral organs. When we become dysregulated from too much stress or too much trauma without recovery, because all these systems are linked, we can begin to see symptoms of dysregulation, all of these different systems. So part of the recovery process is also helping the nervous system to begin to recover. We use certain exercises in MMFT to direct the attention in particular ways to help that happen.

I’ll say one last thing here, which is that the underlying principle behind any of this, wherever our attention is in any moment, consciously or unconsciously, it is affecting what our survival brain is perceiving in terms of that threat appraisal, and if what we’re paying attention to consciously or unconsciously is something that our survival brain is finding threatening or challenging, it’s going to have all these ripple effects of turning stress on. So one of the really important ways to get a wider window is to become aware of where our attention is in any moment, and if it’s attending to something that’s making stress worse, learning how to disengage our attention and redirect our attention to something else that helps the survival brain perceive safety and stability so that it can turn stress off. That’s the core thing that’s so important in understanding all this neurobiology.

 

TS: Well, there’s a lot in what you’re describing here, Liz, and I found one of the ways of referencing the survival brain and the thinking brain that was helpful to me, and I’d love for you to explain it a bit more, is that the survival brain is a type of bottom-up processing, and the thinking brain is a top-down processing. That might give our listeners some intuitive feel to how these different functions work—at least it did for me. Can you share a little bit about this notion of bottom-up and top-down?

 

ES: Thank you very much for calling that into the conversation, Tami. Top-down processing is these conscious cognitive responses to our experience. Thinking—and also, part of it being top-down is using our willpower to control or regulate our emotions or our stress or our cravings. That’s what willpower is all about. That’s a top-down function. It’s using our most of all parts of the brain to help control these different pieces.

The survival brain is bottom-up in that all of its communication with us comes through our body. It comes through our physical sensations, comes through our stress arousal, comes through our emotions. As a result, the survival brain is always interacting with and appraising our experience and then creating these physiological and emotional responses. It’s coming from underneath.

As we begin to bring awareness into our mind and body through an awareness practice, like the exercises we have in MMFT, that process of bringing awareness into the body has the potential for those of us who may have narrowed windows, it has the potential to have that bottom-up processing get pretty intense. My own first experience with mindfulness practices was that way. Many of the Marines and soldiers and first responders that I’ve trained, it’s that way— even my Georgetown students, it’s that way. One of the important things to do with that bottom-up processing has helped to pace it so we don’t end up flooding ourselves, because it’s not under our thinking brain’s control.

 

TS: Now, you have these other two phrases which were really useful to me, which is when we’re outside of our window, it could be a survival brain hijacking, or a thinking brain override that are happening. I thought it’d be useful to explain both of those ideas. And I have a third question here for you, Liz, I know you can stay with me. What’s it like when we’re not being hijacked by our survival brain, we’re not being overridden by our thinking brain, but these two are in some beautiful collaboration? You say, that’s what like—oh, they’re collaborating. I want to understand more about the collaboration.

 

ES: Yes. OK. When we are outside our window, when we’ve exceeded our stress capacity threshold, our thinking brain functions are going to be degraded. That’s when we have trouble paying attention and our mind wanders more. We might have short-term memory problems. We’re also more likely to cope and function using what I call thinking brain override, which is that powering-through pattern. Suppressing the body’s physical pain, suppressing the body’s emotions, our physical sensations, and not really paying attention to our body’s needs and our bodies’ and minds’ limits. Many people in our culture live in thinking brain override. In fact, there is a fair amount of romanticization of it. The idea of grit is very much a thinking-brain override way of being, and it can work for a fair amount of time. In my case, it worked for three decades until the costs started coming due.

But eventually, the costs do come due because when we are in thinking-brain override, we have so shoved under emotions, stress, arousal, trauma, physical pain, that it begins to just continue to build. And the more we do that, the more the survival brain feels like its message isn’t getting through to us, and so the bigger the symptoms it creates to try and get our attention. I really was exhibit A of thinking brain override.

The other option is survival brain hijacking. That’s when our physical pain or our intense emotions or our stress arousal begin to drive our decision making, they drive our behavior. We act out, we get very impulsive and reactive. We have no impulse control. Not to be very political, but there is a lot of survival brain hijacking in the White House right now, for example. That is a way of being. It’s outside of a window, and it’s letting the stress and emotion drive behavior. When someone is in survival brain hijacking, they might have waves of anxious thoughts, or they might wake up in the middle of the night ruminating, constantly thinking about something.

These two patterns often go together. Someone might function well during the day at work by using thinking brain override, like they’re just shoving it under and getting the job done, and then at night, they’re acting out, having violent outbursts with their family, or they’re lying awake in bed with anxious, anxious, racing mind. They’re doing thinking brain override during the day and survival brain hijacking at night, but they’re just two sides of that outside the window coin.

So these are all examples of outside the window, what’s it like when the thinking brain and survival brain aren’t at odds like that? What’s it like when they were working together in an allied way? Well, when they’re working together in an allied way, we have much more capacity to take in information from the environment around us, see it clearly. We take in information from inside of us—our physical sensations, our emotions, our thought patterns, our impulses, and before we act on those things, we take that in as inputs along with the external pieces that are inputs, and all of it can be used together as information to make the best decision.

This is often a hard concept for my students to get, because they’re so used to, at a very subtle level, not giving into—as I put it—giving into their anxiety or giving into their impatience, when sometimes that anxious, that wave that anxiety or that wave of impatience is really important information we need to be taking note of in our decisions.

Being able to use all of those inputs, we’re going to get the best decision, the one that’s most authentic for our current situation, the one that’s most appropriate for our current situation, if we’re using all of that. So we’re taking the information from the survival brain, we’re not necessarily acting it out, but we are using it to make a good decision. Then, if we’re at a very high arousal level, we’re also using these two parts of the brain together in concert to bring us back to a moderate arousal level, because that’s the place of optimal performance.

 

TS: As you’re talking, I’m reflecting on situations where I really had to take some time in order to digest and come into some harmony in a stressful situation between my thinking mind and bottom-up emotional reactivity that was coming up. So I’m curious, it seems like sometimes we need to really know how to spend time with ourselves, to digest these different inputs in order for any kind of harmony and collaboration to come into being. It can take a while, some personal work.

 

ES: It definitely can take a while. Actually, the first step is just being able to learn all of the different tells of what is anxiety in the mind and body, so that when it’s happening, we know, “Oh, I’m anxious. Now, what’s that about?” Then we can use that information to figure out, “Why am I anxious? What piece am I not paying attention to here that is clearly got my survival brain upset? I need to figure out what that piece of information is and then I can make a choice.”

But because so many people in our culture live going 90 miles an hour, constantly in motion, constantly doing and moving, and they’re constantly flipping between thinking brain override, just powering through, and then having these waves of big emotions and waves of stress that’s out of the window, they’re never learning to do those pieces. In MMFT, one of the core skills is learning how to, if it’s a very high amount of arousal, to regulate it down so that we’re back in our window so that we can take advantage of the information inherent in those cues.

 

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TS: As you know, I’ve experimented with a lot of different approaches to spiritual growth, but one approach I somehow found a way to successfully avoid was anything that had to do with extreme cold emersion. That is until I met Wim Hof, also known as the Iceman, someone I’ve interviewed on Insights at the Edge and learned how controlled, no-shock cold showers are part of a practice that can help us release stress, support immune response, and deepen our awareness of the spiritual dimension of our being. Wim Hof is a bold revolutionary who believes that cold is an intelligent and righteous force. You can learn more about Wim Hof and his method at findyourcold.com.

 

TS: Now, one of the other principles that you bring forward at the very beginning of Widen the Window is this notion that stress and trauma exists on a continuum. I don’t think that—that was not obvious to me before I heard you say it, then when I heard it from you, I was like, “Well, that makes a lot of sense.” I’m curious, when does stress turn into trauma? What’s that line that gets crossed?

 

ES: Thank you for that question, Tami. It’s a great one. One of the reasons why we don’t think of stress and trauma as a continuum is because the people who research and treat stress and trauma are totally different communities and they’re talking past each other. We don’t tend to think of them as being the same animal, but they are. They are a continuum. So in MMFT and in the book, I talk about the stress equation, which is, we have a stressor, the thing that our survival brain perceives as threatening or challenging. We have a stressor, we have that perception of threat. And when those two things are happening, we will have stress arousal. It’s like a neurobiological done deal they’re going to happen together.

If the survival brain is perceiving the stressor to be uncontrollable, unpredictable, novel, or physically threatening to our survival or our self-identity, it’s going to make more stress. Those are characteristics of stressors that make stress greater. And if the survival brain, while all that’s going on, also perceives us to be helpless, powerless, and lacking control, that’s the line that tips us from stress into the realm of traumatic stress.

The way trauma is often discussed in our culture is that it’s inherent in the event. Trauma is a rape, or trauma is combat, or trauma is a natural disaster, but it isn’t. Trauma is an internal mind/body response, and we’re each going to have different responses. If we perceive an event as really threatening and we perceive ourselves as powerless, we’re going to be traumatized in that event. If we perceive event is really challenging, but we still feel empowered in agency, we’re not going to be traumatized in that event.

So where we fall on this continuum from stress and trauma, during any particular threatening or challenging situation, is determined by how our own survival brain is perceiving that threat, how it’s doing it in that moment. And the width of our window will have a big effect on that. If our window is narrow, we’re much more likely to perceive that stressor in a way that we feel powerless and we end up in trauma. If our window is wider, even if we turn out a lot of stress, we’re not going to feel quite so powerless, we’re not going to be traumatized.

In the book, I use the example of 13 people on an infantry squad going through an ambush. Many people would think of an ambush as traumatic, but not all 13 of those people are necessarily going to experience trauma, because there’s 13 different minds and bodies that are meeting that ambush with 13 different windows of different widths, and then there’s going to be 13 different responses. Some might be mild stress, some might be very traumatized. It has to do with the mind and body we bring to the event.

 

TS: How do you increase people’s sense of agency, sense of choice when they’re under intense stress?

 

ES: Well, one of the reasons I like to use the stress equation as a framing device for this idea is that, often when we have turned stress on, our thinking brains devalue or dismiss, “Oh, I shouldn’t be stressed right now, or this really isn’t that challenging a thing. This isn’t combat, why am I having a problem?” Or “So-and-so doesn’t have a problem with this.” Our thinking brains get all these judgments about the fact that we’re stressed right now, and that actually makes it worse. The whole reason I use the equation is to highlight how much we’re turning on stress has to do with what our survival brain is perceiving. Initially, the most power over the long-term, the most influence on the stress equation of the long-term is changing how we perceive a stressor, but in the short-term, the way we get there is that when stress has already been turned on, if we work with it effectively and we can recover from it so that we’re not staying in an aroused state, that teaches our survival brain that we can go through stress and not have it be a big deal.

That process changes our survival brain’s implicit memory, so that the next time we encounter that situation, it’s not going to turn on quite as much stress. That’s how we begin to shift that perception. It all has to do with, once stress has arisen, choosing to work with it effectively. That’s what we teach in MMFT, how to do that moment by moment. When stress is there, we can’t control that the stress is there, but we can always choose what we do with it.

 

TS: Now, you’ve a couple times mentioned recovery, the importance of recovery. So recovery from some type of super stressful event, and you’ve said that it’s our survival brain that is really what’s important when it comes to recovery. Help me understand that, and how am I going to recover? I’m thinking of certain ordinary stressors that I find—the going to the dentist or something like that, that I notice I go to this place of feeling kind of traumatized by it, even though other people might not. I’m thinking, “Well, what am I going to do? How am I going to use my survival brain in these situations to come back strong?”

 

ES: Two things we can do in that situation, Tami. As you’re going into—let’s say you’re going to the dentist, you’re not there yet, but you arrive and you sit down in the chair and you’re starting to feel yourself getting stressed. You might be noticing some butterflies in your stomach, maybe your breathing got shallow, maybe your hands got clammy. You can, in that moment of recognizing, “OK, my survival brain has perceived this to be threatening, it’s turned stress on.” You have a choice in that moment, having seen the stress is here, you can redirect your attention to something that the survival brain is not going to find threatening. In MMFT, one of the real target objects of attention for survival brain to perceive safety is the contact between our body and whatever’s around us.

So if you’re sitting there in the dentist chair, you have the whole backside of your body there in that chair as you’re lying back. You, instead of paying attention to those sensations of stress, or instead of having your mind wonder, “How long am I going to be here and what are we going to do today,” just redirect your attention to that weightedness of the chair. As simple and bizarre as that sounds, that is enough of unintentional cue to help the survival brain remember you are stable and safe, and the arousal begins to shift.

Now, I had a gum graft surgery—I talk about it late in the book—where I was doing fine, I was with that contact point the back of the chair as the periodontist is cutting my mouth open. It’s totally fine there, and then there was this moment when my thinking brain had the image of, “Oh my gosh, he has just sliced open half of my cheek and he’s peeling it back to put some tissue in there.”

That image of it, in my mind, having that image turned my survival brain just to freak out. I had such high arousal levels, like I was losing my attentional focus like that, you know when you’re about to pass out, it gets very dark, and I got very woozy, and the dentist realized it, and he shoved gauze in my mouth and he stepped away for a moment, and I was able to go back to my contact points. And in that moment, I did some recovery.

So as I went to my contact points, after that very high arousal level, what started happening that showed me my system was recovering, was that I exhibited signs of the parasympathetic nervous system coming online. I yawned, I got really hot. I had some little tears on the sides of my eyes, little tears over here. I started feeling some rushes of tingles down my arm. Then I had a wave of chills, and then everything was fine, and I was back fully in my body and the stress was gone.

So there’s kind of recovery at a macro level, but the kind of recovery I’m talking about and that we teach in MMFT, is how to direct our attention in ways to help the body recover at this very biological way. I hope that made sense.

 

TS: It did, and this teaching on contact points and giving our weight into the contact points, that seems like it’s something people can really get a sense of. I want to make sure that people get that as a practical takeaway. I mean if you’re walking, it could be the contact point of your feet on the ground, or as you said, the back of a chair. So what do I do once I’m paying attention? I know I need to find a place of safety, I’m paying attention to the contact point. Do I just give my weight in and breathe?

 

ES: The best thing to do is to direct the attention to all the sensations at that point. There might be dampness, there might be sweatiness, there might be heat or coolness, there might be pressure, hardness, softness, sometimes itchiness. And we’re not thinking about the contact. We’re actually noticing these kind of physical qualities of contact, and keep redirecting the attention there. If the mind wanders off, it might get bored. Sometimes it does, it wanders, it’s OK. Just keep redirecting it to the contact.

When we’re sitting, we have our butt and the backs of our legs with the chair. We have the feet with the floor, have our hands touching the lap. And for some people, when they first try this, they might not be able to notice sensations of contact. So for them, the first couple of times, it can help to really push your feet in the floor or sit bare feet, so that there’s sort of more tactile sensation there. Or you can rub your hands up and down your legs, feeling that contact of the fabric against the palms of your hands as you rub them.

One of my favorite places to do contact points is sitting outside, or standing outside against a tree, feeling the trunk of the tree against the back of your body. Nature is very regulated, and so when we’re in physical contact with nature, it actually can help support that recovery as well. It’s really important when we’re using the contact points exercise, to sit with our back against a solid wall. We don’t want to sit in an open space with our back in an open space or sit again, facing with the back to the door, back to the window, because then the survival brain is always wondering, what’s going on back there? You want it to kind of be really focused on the contact, and a solid wall helps it get safe.

 

TS: Now, Liz, I know that you’re trained as a somatic experiencing practitioner, which is a body-based approach developed by Peter Levine for healing trauma. Part of what really interested me in MMFT is this trauma-sensitive approach to mindfulness training. I’d love to know more about how you present mindfulness training differently because of your training as a somatic experiencing practitioner, and also because of your own trauma and discoveries.

 

ES: When I was first learning mindfulness meditation, the first practice I learned was awareness breathing. In fact, that’s often the practice that most mindfulness teachers start with. The reason they do is they think breathing is this relatively neutral stimuli. Well, that isn’t the case for those of us who are sitting on large stress loads from lots of prior chronic stress without recovery or prior traumatic experience without recovery. In fact, if anyone has experienced a history of trauma or asthma or a near-death experience or a near drowning, any trauma experience, they go into a freeze response, and when the nervous system is in freeze, we have oxygen conservation and breath constriction. For those of us with those experiences, if you bring your attention fully to breathing, you have the potential to have the survival brain tap in to a prior unresolved traumatic memory capsule related to breath, because in any memory capsule, there is a breathing component to it because we were always breathing during those events.

In my initial practice, that’s what was happening with me. Sometimes—my mind would be racing, but sometimes I would be practicing and I would flip into this massive panic. I’d get really anxious. I would feel like I couldn’t breathe, that I was gasping for air. And it makes sense. I had completely stopped breathing in Bosnia, I had a near death experience that had killed my breathing for a chunk of time, so I was tapping into those memory capsules, but I didn’t know that. Then afterwards, so the next several days, I would be just horribly traumatized again. I would be catatonic. I couldn’t get out of bed. I’d be claustrophobic. I would have nightmares. I would have nausea. I couldn’t eat. I didn’t understand how these pieces fit together, and I assumed I just must be doing this wrong, and I try again. I would just sort of grit my teeth and do it. Of course, any time I was gritting my teeth and doing it, I was just reinforcing my thinking brain override again. I wasn’t actually helping. I was making it worse. I was really retraumatizing my survival brain.

I didn’t begin to understand that this was what was going on until the first pilot study that we did in 2008 with a group of Marines that were preparing to deploy to Iraq. There were 40 men in this group, and it quickly became clear that they were all having very similar experiences. In fact, 6 out of 10 of them, 60 percent of them were coping with major symptoms of dysregulation, either from prior combat deployments, or—this was a reservist unit, so some of them worked in SWAT teams, there were firefighters, there were EMTs. Even those who hadn’t been to combat, they had these stressful civilian day jobs, and they were sitting on a lot of unresolved stress and trauma.

When I started seeing their reactions, I began to realize, “Oh, this wasn’t just me. This is something that happens.” When we’re dysregulated, the process of interoceptive functioning is what allows us to pay attention to sensations in our body and regulate them. It allows us to pay attention to emotional states and regulate them. But for people with narrowed windows, that interoceptive functioning gets compromised. It’s especially compromised for those of us who come from histories of a lot of childhood stress and childhood trauma, but for anyone, even in adulthood, if they are currently suffering from depression or anxiety disorders or PTSD or addictions, they have compromised interoceptive functioning.

When these people—and I was one of these people too—when those of us who have these narrowed windows sit down and practice mindfulness, it has this potential to tap into some of these unresolved memory capsules, and then flood the survival brain and make our symptoms worse. So once I understood all that, and I was in the middle of going through my somatic experience in clinical training at the time I was working with that first group of Marines, so I started connecting these dots. I realized we need to really go gradually and we really need to sequence which target objects of attention we’re paying attention to so that our survival brain can slowly, gradually build up this capacity to tolerate awareness in the body in a way that’s safe without flooding and retraumatizing.

That’s why we start with contact points. It is the first exercise in the sequence, because the stimuli, the awareness of sensations of contact is so grounding and stabilizing for the survival brain. I don’t teach awareness of breathing until the fifth week. There’s a whole lot of other stuff that happens first to help the survival brain know what to do, and help the person know what to do in case that flooding happens. Because if we can redirect our attention somewhere else, it’s fine, but if we don’t know that, we can inadvertently be making it worse.

 

TS: So by changing the sequence of how you introduce various exercises and by starting with contact points, then when you introduce awareness of breathing later on in the MMFT training, what does someone do who has trauma capsules? You introduce awareness of breathing, and they have the same experience that you described six out of ten of these Marines went through in the research study, what do they do then? It’s only week five.

 

ES: By then, they’ve already learned the core exercise for recovery, which is called ground and release. They already know how to do ground and release. If they’re paying attention to breathing and they notice themselves getting activated, they notice their heart rate is increasing or their breath is getting shallow, or they’re getting a pit in their stomach, or they’re having an image of something from the past, they know at that moment to disengage from awareness of breathing and they switch over to using the ground and release exercise, and they discharge all of that stress activation that’s come up. In the process of doing that, they are starting to heal that memory capsule, because what the survival brain implicit memory learns in that process is, “Oh, I can experience this unresolved thing and it’s not going to take over. I have agency here.” This is how we learn agency, how we train our survival brain to gain agency in these very micro ways, that then have kind of global effects in our lives.

So no one learns awareness of breathing until they know how to work with what potentially might happen, and that’s why we wait until the fifth week. There’s a lot more movement exercises in MMFT compared to many other mindfulness programs. The exercises are much shorter in length, partly because we have to build up tolerance for awareness of what’s going on in our system. And many of the exercises can be integrated into daily life because people who work in high-stress environments are really, really busy, and it’s great to be able to integrate the exercises into what they’re doing during the day, so that they’re more effective with what they’re doing and they’re getting practice in at the same time.

 

TS: Now, I realize you designed MMFT for people who work in high-stress occupations, as we’ve described—starting with the military where you began, and then expanding to all these other professions of first responders. But I think a lot of people would say, we’re all in a high-stress situation today. All of us. I don’t know anyone who’s not. I wonder if you think, “Oh my, MMFT actually became universally applicable.”

 

ES: [Laughs] I absolutely think MMFT became universally applicable. I actually think it was universally applicable before that point, because we all have minds and bodies that are moving through challenges all the time, and we are all wired as social animals, and so we’re always picking up the stress and dysregulation of people around us. And if we don’t know how to work with that, we have the potential to constantly—even for those of us that are most regulated, we could potentially be making ourselves more stressed. We are living in an environment right now with COVID, with all of the protests, with racism and social injustice, with this challenging electoral season, with all of the physical challenges from global warming, there’s just so many things going on. Homeschooling, working from home, difficulties with boundaries between work and your home space. It is challenging, and this is applicable to all of us right now.

I think it’s also incumbent on all of us right now to do what we can to keep our own windows wide, because our individual window contributes to the collective window, and the collective window today is very narrow and we want to help it get widened, because the challenges facing us need creative problem solving. They need clear thinking and wise choices, and that’s only going to happen if we can approach it with wide windows.

 

TS: It’s interesting. I realize the window is a metaphor, and sometimes, when—narrow, windows wide windows, it’s almost like it’s a static idea, but it’s not. It’s incredibly dynamic. At any given moment, our window could be much bigger or much smaller. It’s not like, “Oh, that’s a wide-window person or a narrow window.” It seems like that could be too pigeonholing.

 

ES: Rigid. Yes, you’re absolutely right. It could be pigeonholing, and I don’t want to do that, because small shifts that we make in the course of a day can have tremendous effects on our window for the rest of that day. So yes, understanding that and knowing some of the things we can do. And they don’t have to be big things. It doesn’t have to be like we have to spend a year—just little things can make a tremendous difference and have these big resonating and rippling effects on the people around us, on the world around us.

 

TS: Now, there’s one more topic that I want to take the lid off of, which is you mentioned in the very beginning of our conversation that you came from nine generations of a family that served in the military, a warrior lineage. And in that, that there was quite a lot of intergenerational trauma passed down. Now, you also write in your book, Widening the Window, about trauma extinction, and I was like, “Really? Really, is there such a thing? Can we actually resolve— extinction, extinguish the trauma in our lives and that we’ve inherited? Is that possible?”

 

ES: Well, trauma extinction is the term that is used by the neuroscientists who write in this literature. I’m using their word. It wasn’t my word initially. One of the reasons why trauma extinction is hard is that the pathways in the brain, when we have been traumatized, that are going from the survival brain up to the thinking brain kind of overpower the thinking brain pathways back down. So that’s what they talk about.

I don’t know if we can fully extinguish it. We are the accumulation of all of our repeated experiences. We can decondition it to the point that the default programming that got wired through trauma is no longer driving our behavior and our choices and our perception. We have a lot more flexibility and choice to sometimes use those responses, but not have to default into those responses.

In terms of intergenerational trauma, there’ve been so many studies in the last 20 years that have started looking at the neurobiological mechanisms by which trauma is passed intergenerationally. It’s really hard to disentangle in humans because our process of wiring our brains and our nervous system—the nervous system continues wiring until our late teens, at least the part of the nervous system that controls recovery. That part doesn’t exist when we’re first born, and it wires only after birth up till when we’re 18. The thinking brain functions, they continue wiring all the way into our early thirties. So as a result, the experiences that we have in our early social environment, especially repeated experiences, have a big effect on how we wire, whether we wire on all of the social engagement capacities and recovery function capacities, and all the thinking brain capacities.

If our parents experienced chronic stress and trauma or loss, and they didn’t fully recover from it, their windows get narrowed, that affects the way that they care for us early on, and that affects our wiring. That’s one way that the process transmits. Another way that the process transmits is through stress and emotion contagion. There’ve been several studies that have looked at how parents who are stressed, they then check—and with stress hormones active, they check the stress hormone levels in their children, and they’re matched, even though it’s the parents’ stressor, something that kid has no contact with, but it’s passing through.

Then one of the really biggest ways that intergenerational trauma shows up is in epigenetics. Epigenetics is the science of how repeated experience affects our gene expression. And epigenetic changes, which is turning a gene expression on or off, those epigenetic changes can convey through multiple generations. Most of the studies that have shown this most clearly have been with rodents. They have shorter lifespans, they don’t have all of this complicating long wiring process like we humans, so they can really just look at the epigenetic piece. And they have a mouse or a rat, and they expose them to really stressful situation, that mouse or rat is experiencing repeated stress, and then they see epigenetic changes in their metabolism or in the way that they perceive safety. They stop perceiving safety, they stop moving to safety, or changes in their immune function. Then they have babies, and they have babies, and they have babies. Four generations away, even though the other mice throughout these other generations had none of the same stressors, they have that same epigenetic change turned on.

For humans, one of the biggest detrimental epigenetic changes comes from chronic stress. It turns on chronic inflammation in our body, and that is linked underneath of whole bunch of physical and mental health issues. So when people say, “Well, these genes run in my family,” it’s often that there is an epigenetic change that has run through multiple generations. We can heal that and turn that off. There were epigenetic changes turned on in me as a result of my parents and their parents, and I have been able to reverse some of those things through repeated experiences in this lifetime. Is that trauma extinction? I don’t know.

 

TS: Now, Liz, it was about a year ago, I think, that you and I started talking on the phone about Sounds True bringing the MMFT program online, and having it widely available as an eight-week training program. Everything in me lit up for a couple reasons. One, that the program would be a trauma-sensitive, trauma-informed mindfulness training. Intuitively, I knew that was so important. Then secondly, it was so important, I think, to both of us, that we make the program as widely available as possible and remove barriers to access for active military, and veterans, and people in the police force, and firefighters, and emergency responders of all kinds—and through the Sounds True Foundation, that kind of access is available.

I want to say to people who are listening, you can go to soundstruefoundation.org, and there’s a contact page. And if you’re in touch with an organization that supports those people who are working for our collective good, and you would like access to the MMFT online training, to please write to us. But here at the end of our conversation, what I wanted to hear from you, Liz, is your greatest hope for this online training that you’ve invested so much of your life into creating and designing so intentionally.

 

ES: Tami, I was so happy when we started our conversations, and it has been such a pleasure and honor to work with the Sounds True team, and I’m so excited about the version of the program that we’ve created for online users. The way that it is in sort of small digestible pieces that somebody can work into their life. At the time we started this, we were not all working in this virtual world where everybody is doing things remotely. But now, especially, when we are in this time of really remote engagement, it’s like the perfect time for people to be using this. My biggest intention and hope—my biggest hope, I guess, is that, as many people as possible who want to be feeling more empowered during the uncertainty and stress of what is going on in our world today, that they take advantage of this and that they learn new ways of being in the world that have these potential ripple effects to others.

I love the fact that resilience is a gift we don’t just give ourselves, it’s a gift we give to the world around us. There are so many people who are at wit’s end right now, and I want them to have this gift, and to be able to share this gift with the people in their lives, through the changes that they make in their own minds and bodies. So my hope is that this is really—that people take us up on it. I am so glad that we have this capacity to share it freely with people who are working in stressful situations—teachers, medical people, police, firefighters, veterans, people who are helping to keep our society, serving our society, I’d like us to be able to give back to them.

 

TS: Hear, hear. The MMFT online training is now available at SoundsTrue.com, you can check that out, as well as Liz Stanley’s book, Widen the Window: Training your Brain and Body to Thrive During Stress and Recover from Trauma. Liz, great talking to you, and thank you so much for everything that you’ve poured into the creation of MMFT. It’s an honor to partner with you to bring it online. Thank you.

 

ES: Tami, it’s been an honor to partner with you too, and thank you for this great conversation today. I’ve really enjoyed it.

 

TS: Thank you for listening to Insights at the Edge. You can read a full transcript of today’s interview at SoundsTrue.com/podcast. If you’re interested, hit the subscribe button in your podcast app, and also if you feel inspired, head to iTunes and leave Insights at the Edge a review. I love getting your feedback, being in connection with you, and learning how we can continue to evolve and improve our program. Working together, I believe we can create a kinder and wiser world. SoundsTrue.com: waking up the world.