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Presence

Presence

Presence – Simply Being…and Being With – Heals Trauma

The Healing Moments in Trauma Treatment conference, at UCLA four weekends ago, began with a morning of mindfulness practice led by Jon Kabat-Zinn, developer of Mindfulness Based Stress Reduction, and Dan Siegel, author of The Mindful Brain and The Mindful Therapist, and Trudy Goodman, senior vipassana teacher at Insight L.A.

The intention to focus 800 clinicians on mindful presence, even as the news of the traumas of the earthquake, tsunami, and nuclear reactor meltdown in Japan was coming in on participants’ I-phones, steered the ethos of the entire three-day conference toward presence, awareness, and acceptance as the foundation for any effective recovery from trauma, acute or developmental.

Even as we learned about neurofeedback and neural de-consolidation – re-consolidation, the essential message was that presence – a mindful, compassionate, and active being with whatever needs attention and acceptance – was the first step in creating the psychobiological sense of safety that would allow the brain to re-process and re-wire experiences of traumatizing events.

It’s hard for us human beings to get through an entire day without being triggered, or an entire lifetime without being traumatized, at some point, by interactions with other people or stressful life events. I’ve written here often, and will continue to, of the importance of relationships – trust, love, connection, belonging – in healing from distress and trauma. This e-newsletter privileges the power of presence to also re-wire the brain and heal the heart/mind/soul.

Presence, we’re learning, is a refuge, then a resource, for safely engaging with experiences that can threaten to overwhelm or de-stabilize us, including entrenched troubling memories from the past. As we probe more deeply into how the brain accesses that state of embodied presence within, and as we learn why the wisdom of “what to do next” intuitively emerges from that being-ness, we are better able to meet any moment, or heal any past moment of trauma, wisely compassionately, transformatively.

May these reflections and exercises for cultivating a deeper, steadier sense of presence – simply being and being with and re-engaging with the world from there – be useful to you and yours.

REFLECTIONS ON PRESENCE:
SIMPLY BEING…AND BEING WITH…HEALS TRAUMA

Presence is simply being…and being with…. We experience presence as connection, an embodied resonance, an openness to engagement, an open flow of energy back and forth between our being-ness and the being-ness of an other, or the being-ness intrinsic in the moment.

Presence creates a neural receptivity which opens up the fields of awareness and acceptance to whatever is happening in the moment, and allows the wisdom of “what to do” to emerge in the next moment.

This neural receptivity can be cultivated because our brains can process experience from two distinct (though integrated) neural networks. According to the research of Norman Farb in Attending to the Present and Rick Hanson, author of Buddha’s Brain (see Resources for both) a medial (midline) network in the pre-frontal cortex of the brain allows focused processing, especially on future and past events, is evaluative, goal-directed and purposeful. The medial network is what helps us constellate the narrative of the personal self (thank goodness!) and allows us to attend to all the necessary tasks of verbalizing and “selfing.” Lateral networks, especially in the right pre-frontal cortex, allow processing that is more now-focused, more sensory-based than thought-based, more experiential than narrative, more panoramic and impersonal, less verbal, less judgmental. The lateral network is what brings us into a state of mindful presence. (Even deeper thank goodness!)

It’s the brain’s capacity to access the lateralized state of mindful presence, get the big picture, be comfortable with the unknown, the uncertain, and shift back and forth between lateral and medial processing, between presence and the drama of the story, that creates the healing moments in all trauma treatments, that creates the resilient dancing with all moments of life in general, with awareness, acceptance, and emergent wisdom.

In two articles published in the AEDP Transformance Journal (see Resources) one last September and one two weeks ago, Kai Macdonald suggests that a “hidden island of cortex” called the insula may be the switching station for shifting from a more exterior, [medial] goal-oriented, narrative oriented mode of processing to a more interior [lateral] “felt sense” of experience and self. The insula is the brain’s structure of interoception – the felt sense of the physical and emotional state of the body. And, as part of the medial network, a component of the re-representation of those states in conscious thoughts and words.

The insula is increasingly seen as the neural substrate for empathy and compassionate acceptance of the emotional states within ourselves and of others. Since the nuances of modern neuroscience compellingly inform us that emotions profoundly impact our decision making, Kai says, “the insula appears to be an important component in a dynamic coalition of brain regions that codes “how we feel in the present” and uses these valenced, often unconscious feeling states to guide action.”

We know from research by Sara Lazar and others that mindfulness practice activates and strengthens the insula and the related anterior cingulate, allowing us to move more easily from “story” to being in the present moment and from there to re-wire our story.

We come into presence first by coming into awareness of simply being in our body, here, now, even for a breath or two. Knowing where our feet are, knowing what tightness we are holding in our jaw or chest. (Lateral network sensory and present moment focus rather than medial network past-present, thought-story focus.) Awareness of the body requires activation of the insula; activation of the insula brings the felt sense of what’s happening in the body (somatic markers of feelings) to consciousness (essential to later emergent decision making).

Coming into presence in the body sometimes requires calming an agitated body or re-engaging a numbed-out body. The engagement of the “noticing and naming” of mindfulness keeps the conscious cortex engaged and helps regulate the body back into equilibrium. (See exercises below).

We then come into presence more deeply by intentionally focusing attention away from the story or whatever is troubling us in the moment and temporarily accessing a more spacious “open field” of awareness. Traditional mindfulness practices of focusing attention on the breath brings the mind to this more open field of awareness; we can let go of the story temporarily because we are tapping into the being-ness that underlies any moment of experience: we are alive, here, now, breathing in this moment, regardless of the drama/trauma we are also attending to. We drop into a spacious receptivity, more space than agenda, more being than doing. (Lateral network panoramic bird’s eye view rather than medial network of personal, tighter, self-referencing focus.)

Focusing awareness on simply being requires the activation of the anterior cingulate, the neural structure of focal attention that focuses our attention on anything. By activating the anterior cingulate, we are able to maintain a dual awareness – awareness of the object we are attending to – body sensations, feeling tone, memory of a particular event, a thought or belief system – and awareness of the mindful presence itself that is “holding” the particular object of attention. Successful trauma therapies such as the EMDR, Sensorimotor, and AEDP being taught at the Healing Moments in Trauma Treatment conference, entrain the client into the safety of presence by the therapist being with the clients in that spacious dual awareness. Client and therapist together are holding the awareness of the drama/trauma to be worked on in a mindful, empathic shared consciousness.

We then come into full presence by being with whatever our open field of attention has allowed to come to consciousness. Being with requires acceptance based on empathy and compassion for the human experience. (Seeing trauma as a normal response to abnormal circumstances, not as pathology or deficiency.) [Lateral network of experiential, less verbal activity, being with rather than talking about, rather than medial network of narrative and abstract verbal talking about.)

Presence is healing in and of itself. (See Stories to Learn From.) It is not exactly the same as empathy or intimacy, though certainly a pre-requisite for both. It is not exactly the same as mindfulness or equanimity, though certainly a pre-requisite for the awareness – consciously registering life in the moment – and acceptance – compassionately allowing-embracing life in the moment – of both.

Presence is a refuge of a steadied, embodied ease and inner peace. Over time, we notice our capacities for sustained presence allow us to be increasingly present with widening circles of life experience, even past experience. With more and more of humanity, glorious or torturous. We remain present in the face of the distinctly unpleasant, the truly worrisome, the downright disgusting, the previously unbearable. Simply being and being with can become our primary way of being, how we automatically meet the slings and arrows of every moment, even of someone else’s moments. Now our refuge of presence becomes the re-Source for the intuitive wisdom that knows “what to do next” to heal trauma, or any suffering, any confusion or distress.

Neuroscientists are just beginning to map how skillful and wise action emerges, often very quickly, seemingly out of the blue, from a steady, engaged presence as we re-engage with the surges and flows of our dynamic lives (or moments of past turbo-charged and troubling surges). As we interact with other living-breathing-acting-reacting human beings (or memories of same). As we re-engage with all beings, all processes, all forms, all of everything, actually.

I’m halfway through reading How We Decide by Jonah Lehrer, a brilliant yet accessible exploration of the emerging neuroscience of decision making, especially decision making that has to happen so quickly there’s no time to think. It’s increasingly evident to scientists, despite centuries of previous philosophies that assumed all decisions were made by the rational mind (or should be) and plagues of bodily impulses and “destructive” emotions were better set aside or “conquered”, that good decisions are really made by an uncanny millisecond-by-millisecond switching the networks and integrating the rational, the emotional, the visceral, the intuitive. (Sorry to not finish the book by the time of this posting! More in future e-newsletters.)

We do know, from 2,500 years of “presencing” in mindfulness practice, that our intuitive wise effort (letting go of the unwholesome and cultivated the wholesome) emerges spontaneously from the exquisite paying attention, the spacious receptivity, the ultimate awareness and acceptance of what is, that presence evokes. (Brilliant that the title of the conference was Healing Moments in Trauma Treatment rather than Healing Modalities….)

Presence harnesses the brain’s innate neuroplasticity, moment by moment. The safety and trust experienced through the lateral network of mindful presence allows a new relationship to the old story, a new emergent response to the old story. Presence creates a new neural platform for what trauma therapies call the “self-righting” innate to all human beings. The integration of lateral-medial networks in the therapist is what re-wires the same lateral-medial integration in the client. The client can now switch the story by switching the networks – and heal, change, and grow.

POETRY AND QUOTES TO INSPIRE

To be present is far from trivial. It may be the hardest work in the world. And forget about the “may be.” It is the hardest work in the world – at least to sustain presence. And the most important. When you do drop into presence…you know it instantly, feel at home instantly. And being home, you can let loose, let go, rest in your being, rest in awareness, in presence itself, in your own good company.
– Jon Kabat-Zinn

* * * * *

Presence is the bottom line. Presence can begin with interest, which can open up to fascination. Once you’re fascinated with the experience of the moment, you’re like this (gesture of fingers crossed, intimately touching) with life. It doesn’t get any better than that.
– Edward Lewis

* * * * *

The state of being is not only delightful and renewing, it has a very practical benefit as well. Deeper than conflicting thoughts, it is the source of wisdom. When we find ourselves confused or pulled apart by indecision, tapping into presence can align us with what will bring our life into harmony….A deeper wisdom is always available. It might be covered by a lot of static, but it’s there, and we hear it when we drop into being present, when we get past all the noise, relax our grip, and tune into the clarity that arises from the stillness within.
– James Baraz and Shoshana Alexander

* * * * *

Stop talking and thinking and there is nothing you’ll not be able to know.
– Third Zen Patriarch

* * * * *

Focus attention on the feeling inside you. 
Know that it is the pain-body. 
Accept that it is there. 
Don’t think about it – don’t let the feeling turn into thinking. 
Don’t judge or analyze. 
Don’t make an identity for yourself out of it. 
Stay present, and continue to be the observer of what is happening inside you. 
Become aware not only of the emotional pain but also of “the one who observes,” the silent watcher. 
This is the power of the Now, the power of your own conscious presence.
-Eckhart Tolle

* * * * *

If your everyday practice is to be open to all your emotions, to all the people you meet, to all the situations you encounter, without closing down, trusting that you can do that – then that will take you are far as you can go.  And then you’ll understand all the teachings that anyone has ever taught.
– Pema Chodron

* * * * *

Awaken to the mystery of being here
And enter the quiet immensity of your own presence….
Take time to celebrate the quiet miracles that seek no attention….
Experience each day as a sacred gift woven around the heart of wonder.
– John O’Donohue

* * * * *

This we have no is not imagination.
This is not grief or joy.
Not a judging state, or an elation, or a sadness.
Those come and go.
This is the presence that doesn’t.
– Rumi, trans. by Coleman Barks

* * * * *

True listening…is the arising of alert attention, a space of presence in which the words are being received. The words now become secondary. They may be meaningful or they may not make sense. Far more important than what you are listening to is the act of listening itself, the space of conscious presence that arises as you listen. That space is a unifying field of awareness in which you meet the other person without the separative barriers created by conceptual thinking. And now the other person is no longer “other.” In that space, you are joined together as one awareness, one consciousness.
– Eckhart Tolle

* * * * *

The most precious gift we can offer others is our presence.  When mindfulness embraces those we love, they will bloom like flowers.
– Thich Nhat Hanh

* * * * *

Enough. These few words are enough.
If not these words, this breath.
If not this breath, this sitting here.

This opening to the life
we have refused again and again
until now.

Until now.
– David Whyte

STORIES TO LEARN FROM

Presence of mind is deeply akin to the Buddhist practice of equanimity. The venerable Buddhist teacher Thich Nhat Hanh relates that many, many times, when Vietnamese refugees were escaping in boats across the open sea to Thailand, vulnerable to storms, food shortages and pirates, if even one person on the boat kept their cool, stayed in presence, it had a calming effect on everyone else in the boat. If no one embodied presence, the refugees fell into chaos and contention.

* * * * *

Presence opens us to a field of awareness and acceptance that leads to compassionate action. A story told by Frank Ostaseski, founder of the Zen Hospice Project:

A young man is in bed, receiving hospice care, dying of AIDS. One afternoon five family members and friends are gathered around the bed, chatting, joshing, distracting themselves and him from the imminent reality of his body weakening toward death. Another young man, the hospice volunteer, comes into the “up” energy of the room, says nothing, simply sits at the foot of the bed and holds the patient’s feet for about twenty minutes. Silence. Presence. Gentle touch. Compassion. The patient later told the director of the hospice facility that it was those moments of gentle touch and quiet presence that helped him release his fear of dying and trust the unknown of the inevitable.

* * * * *

I have told this story here before; please forgive. It stands as a signpost in my psyche for the healing power of presence.

After my 80-year old father had a slight stroke, he was released from the hospital to a skilled nursing facility. His second day there the staff called me at 5:30am; my father was standing on the second floor balcony threatening to jump into the parking lot below; would I please come get him and take him home?

As I drove to the facility, I realized how unnerved and discombobulated I felt. What would I do now? I managed to get my father into my car and then, as I was walking around to the driver’s side, I just lost it. I sat down on the curb at the edge of the parking lot and just sobbed and sobbed.

The discharge nurse saw me through the window; she came out and sat down on the curb next to me. She simply put one hand on my back, held my other hand, and quietly sat with me. No words, just comforting presence. After about 30 minutes, I could feel myself re-group and feel able to cope. I took my father home. He actually recovered from his stroke well and lived another richly full nine months before he died peacefully at home.

EXERCISES TO PRACTICE

We can easily recognize an embodied, reassuring presence radiating from master practitioners like Pema Chodron or Thich Nhat Hanh or Jon Kabat-Zinn and experience a resonant transmission of presence in the presence of such teachers. We can practice becoming more adept ourselves at “presencing” in any safe encounter with an attuned, engaged other, exchanging loving presence with an attentive spouse, a true friend, a trustworthy therapist or mentor, a caring grandmother or grandchild, a loyal pet. Or with any form of existence, becoming fully present to any moment of nurturance and support in nature, the food we eat, the work we do.

In addition:

1. Coming into presence through the body

Somatic Experiencing is one of the premier modalities for treating trauma available today. One basic technique is: to located where the felt sense of a trauma is held in the body, where in the body do we feel the agitation or clutching or steeliness or lead weight. (The anterior cingulate focuses attention: it also processes physical and emotional pain. Locating the stored sense of the trauma in the body “lights up” the neural network encoding it, essential to re-wiring it.)

Then we locate a place in the body that is not feeling any distress or trauma at all. This place in the body is not in the trauma vortex. It feels calm, relaxed, at ease. This could be our left big toe or our right elbow. We focus attention on that calm, not traumatized place in the body, until we can “presence” it.

Then, we intentionally switch or “pendulate” our attention back and forth between the place in the body that is not traumatized at all with the place in the body holding the network of trauma memory. (Switching lateral and medial networks.) When the focus on the place in the body that is not traumatized is strong enough, with enough practice and pendulation, it will re-wire (neural de-consolidation – re-consolidation) the felt sense of the trauma memory.

It’s hard to connect with the receptivity of being and hear the truth inside when you’re anxious or stirred up. How do we sort out the various voices when we must make a decision or choice in life? I sometimes find that taking a break from my mind and getting into my body – going for a walk or taking a bike ride – helps discharge agitated energy, gets me grounded, and clears my mind enough to discern the answer that feels right.
– James Baraz

2. Coming into presence through mindfulness. (Easily done in a group.)

Sit comfortably. Allow your eyes to gently close. Focus your awareness on your breathing, gently in and out. Focus your awareness on your breathing, and then notice your own awareness of your breathing. Awareness allowing you to know you are breathing.

When that awareness of your breathing is steady, begin to notice the breathing of the people around you, no need to do anything, just noticing other people breathing as you are breathing. And noticing your awareness of that. Expand your awareness a bit to know that all the people in the room are breathing; become aware of everyone here breathing together, and become aware of your awareness.

Expand your awareness more to include people you know, who are not in the room, and you know they are breathing in this moment, too. Notice your awareness of your awareness of everyone breathing. Expand your awareness to include people you don’t know, outside the room, perhaps elsewhere in this town, or in this county. Become aware of all kinds of people breathing, breathing together. Notice your awareness of your awareness.

Expand your awareness to include people all over the country, all over the planet, all breathing. Expand your awareness to include all living creatures, breathing, breathing in the parks, the forests, underground, in the lakes and rivers, in the oceans, the sky. All sentient beings breathing, breathing together. And notice your awareness of your awareness of the breathing.

Expand your awareness to include all forms of existence, some breathing, some not. Expand your awareness beyond our planet to all the forms of existence, and the space between the planets and stars. Expand your awareness out as far as you can imagine; and notice your awareness of your awareness expanding.

Now bring your awareness back to being aware of sitting in the room, in this moment, breathing. Notice the sense of calm and peace inside.

3. Coming into presence in relationship. (Done with a partner, in noble silence.)

Turn to your partner. Simply gaze into your partner’s eyes, allowing yourself to see in them the nobility of their true nature. Their innate goodness and radiance of their being, and silently wish them well, sending them expressions of loving kindness: may you know the deepest happiness, may you have ease of mind and heart, and let yourself know that your partner is sending you expressions of loving kindness as well. Taking in that kindness.

Then allow your awareness to shift. Imagine what human sorrows your partner might have experienced in their journey, what losses, what griefs, what pain of the human condition. Silently begin to send them expressions of compassion: May your sorrows be held in loving awareness, may your sorrow ease, may you feel my care for your suffering. And let yourself know that your partner is sending you compassion for your sorrow and suffering as well. Let yourself take in that care and compassion.

Then allow your awareness to shift. Imagine what human joys your partner may have experienced in their journey. What accomplishments and competencies they might have achieved. What blessings of abundance and love they might have experienced on their journey. And silently begin to send them expressions of sympathetic joy, happiness for their happiness. May you fully delight in your delight; may you feel your joy deeply. And allow yourself to know your partner is sending you expressions of joy in your joy as well. Let yourself take in the sweetness of their joy in your joy.

Then allow your awareness to shift again to expressing wishes for calm abiding to your partner, wishes for equanimity: Whatever happens on your journey, may you perceive and respond to it with a calm ease of mind and heart. May you have deep inner peace. And allow yourself to know your partner is sending you expressions of the wish for equanimity, for calm abiding for you as well. Let yourself take in the calming energy of their well-wishing.

Allow your awareness to shift one more time to simply being in your own being, noticing whatever is going on for you right now. Awareness of your inner experience, and awareness of your awareness.

RESOURCES – BOOKS, ARTICLES AND WEBSITES

Books

Coming to Our Senses: Healing Ourselves and the World through Mindfulness, by Jon Kabat-Zinn. Hyperion Books, 2005.

The journey toward health and sanity is nothing less than an invitation to wake up to the fullness of our lives as if they actually mattered. [from the introduction]

Coming to Our Senses is an exquisite exploration of how mindfulness practice is a gateway to aliveness and wholeness, for ourselves, for our planet, for the human community. Blending science, poetry and Buddhist wisdom, a mind-opening, heart-healing gem.

The Mindful Path to Self-Compassion: Freeing Yourself from Destructive Thoughts and Emotions, by Christopher Germer. Guilford Press, 2009.

An easy-to-follow introduction (that deepens and deepens!) to the mindfulness and loving kindness practices that generate the self-compassion that is the ground of all emotional healing, even trauma.

The Presence Process: A Journey into Present Moment Awareness by Michael Brown. Namaste Publishing, 2010.

A well-written, comprehensive guide to the inner journey that leads to steady presence and the well-being of being.

Buddha’s Brain: The Practical Neuroscience of Happiness, Love and Wisdom, by Rick Hanson and Richard Mendius. New Harbinger Publications, 2010.

A very fresh look at the brain, and how we can train our minds to change our brains to change our lives for the better.

ARTICLES

“Attending to the Present: Mindfulness Meditation Reveals Distinct Neural Modes of Self-Reference by Norman Farb, Zindel Segal, et al., 2007. Social Cognitive and Affective Neuroscience 2:313-322.

“How Do You Feel – Now? The Anterior Insula and Awareness” by A.D. Craig, 2009. Nature Reviews Neuroscience 2009, 10(1): p59-70.

“Into the Insula: Interoception and the Feeling Self and…The Insula and Its Role in Therapeutic Transitions” by Kai Macdonald. Transformance: The AEDP Journal, September 2010, March 2011. [note: this journal is available online to members of the AEDP Institute; I can only highly, highly recommend it to interested clinicians. ]

“Meditation experience is associated with increased cortical thickness” by Sara Lazar, et al. Neuroreport, 2005. 16 (17): p. 1893-7.

WEBSITES

The Healing Moments in Trauma Treatment conference at UCLA March 11-13, 2011 brought international leaders in trauma treatment and pioneering researchers in cognitive and affective neuroscience together to present their findings what “moments” in therapy actually help resolve trauma, acute or developmental.

Roster of presenters simply awesome: Diana Fosha, Trudy Goodman, Dan Hughes, Jon Kabat-Zinn, Ruth Lanius, Iain McGilchrist, Pat Odgen, Jaak Panksepp, Stephen Porges, Vilayanur Ramachandran, Dan Siegel, Francine Shapiro, Bessel van der Kolk. Coordinated by Marion Solomon and Bonnie Mark-Goldstein.

CD’s and DVD’s of the presentation are available from the conference sponsor Lifespan learning Institute.

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