EP 112: Resilience & Post-Traumatic Growth | Dr. Pat Ogden

Welcome to Radical Responsibility, the podcast dedicated to ridding the world of blame and shame, where we explore the issues you care about from a unique perspective. 100% ownership for each and every circumstance we face in life, day in and day out. In this episode of the Radical Responsibility Podcast, I'm happy to share an interview I did with Pat Ogden, PhD, one of the leading trauma experts in the world. For our Global Resilience Summit. We explore every aspect of trauma, what it is, how it occurs, how it impacts our lives and how we can heal it. Pat Ogden is well known for her work through the Holcombe Institute and has really been one of the pioneers, along with her colleagues Bessel Vanicol, Peter Levine, in developing the amazing treatments that we have today for trauma, and in particular her model, sensory motor psychotherapy. And here today with Dr. Pat Ogden. Really exciting to be with you again. And how are you, first of all, how are you today?

Good.

You faring okay in the midst of this crazy situation we're in?

That's a complicated question.

Yeah.

So I would say yes and no.

Uh huh. Yeah. Yes and no. It's probably a lot for all of us. Well, maybe we'll go further with that. But first of all, I'd like to let our audience, many of our audience will already know about you and your work, but I want to just go a short bio just so everybody's really familiar with your work, which has really been in many cases groundbreaking and innovative, and you've really been a leader in somatic work and trauma work and so forth. So Pat Ogden, Ph.D. is a pioneer in somatic psychology and both founder and education director of Sensorimotor Psychotherapy Institute, an internationally recognized school specializing in somatic cognitive approaches for the treatment of post traumatic stress disorder and attachment disturbances. She is co founder of the Holcombe Institute, clinician consultant, international lecturer and trainer, and the first author of Trauma and the A Sensorimotor Approach to Psychotherapy. And her second book, Sensory Motor Interventions for Trauma and Attachment, is a practical guide to integrate sensory motor psychotherapy into the treatment of trauma and attachment issues. I'm actually from Boulder originally. Well, I didn't grow up there, but I lived there a long time and I was there when HKOMI Institute was happening and all that. And so I was around that world. And I graduated from naropa back in 79, so I was around all that time and then then later lived there again and was on faculty at Naropa for a while. So I'm kind of familiar with that world in Colorado of sensory Motor therapy and the rest of it, and really important work that's made a huge contribution. And so.

Maybe to start off with, could you just say something maybe about where your work is right now, like, what are you working on right now? And what's. What are you kind of passionate about that you're doing right now?

Well, two projects that I'm doing now that my school, Sensory Motor Psychotherapy Institute has successfully completed, cannabis succession planning. So other people are taking over our trainings now. It leaves me free to focus on other projects. Right now I'm completing a project with, for collaborators.

Another book for W.W. norton on sensory motor psychotherapy. And what we're focusing on is integrating sociocultural.

Issues and application.

Recognizing that most of psychology is a Western European construct, really. So that's nearly done and I'm really excited about that. I've had the help of four very talented people of color with this book. And then the second project is developing Sensory Motor Psychotherapy for children, adolescent families and groups with Bonnie Goldstein, who's a child psychologist.

So those are the two.

Two upcoming. Almost finished. One of them almost finished projects.

Good. Well, that's really an important contribution. And ever the more needed. Here we are in the midst of this pandemic which has got us all in a situation we've never been in before in our lifetime, certainly. And the whole world focused on one thing probably that hasn't happened since World War II, and very different now because of our level of interconnectivity with the Internet, media and so forth. And, you know, it's kind of likely that there's going to be more of this related to climate change and so forth. So we need to, I think, get better at taking care of ourselves and taking care of each other and supporting, supporting people who need more support. And also getting, as I'm really happy to hear about your recent work, getting out of our, you know, kind of white European bubble and realizing the disparity of resources, and that's really obvious in our health care system right now, and finding ways to, you know, deal with all the access issues and, you know, which is a social justice issue, and then also culturally sensitive ways of supporting people and empowering people to support themselves so we can all become more resilient, because I think it's safe to say resilience is no longer a luxury in the world we're living in.

So I thought where we might start is just what is the relationship between, in your view and from the perspective of your work, between.

Trauma exposure or exposure to chronic stress Traumatic stress, primary secondary trauma, that kind of exposure and resilience. And how do we cultivate resilience? How does resilience help us.

Mitigate the potential negative impact of trauma exposure and so forth? So anywhere you'd like to start with that, really.

I don't think of any concept really without thinking of the body.

And I think resilience.

Is both supported and can be cultivated by the way we live in our bodies.

I was thinking about this in terms of the pandemic.

Because.

How we respond to this kind of global trauma can either support our immune system and our relationships and our connections or not. And much of that is how we embody what's happening. Like if we, if our bodies, you know, you can't, I'm gonna move this back so people can see my body a little better. If, if our bodies like slump and pull in and collapse and we think of the coronavirus, you know, right away, like even, even as I'm doing this, it'll take me right to a fear state. And of course, fear is one of the worst.

States for our immunity.

And contrary, if we embody it like this, which we see this on the media sometimes, like this aggressive reaction, it's similar.

So I think for each individual, we want to really consider how our posture and movement.

Can help support resiliency. And I think there are many aspects of this from, you know, self touch and self soothing our nervous systems and our bodies through whatever is right for us, whether it's hands on our heart or stroking or rocking movements. I think self soothing is imperative right now because we don't want to allow our arousal to remain outside of a regulated zone in the window of tolerance for very long. Again, for our own well being, both psychologically and physically, those dysregulated states will contribute to a lowered immunity and a lowered resilience.

So could it be said that then, that.

Just being able to stay within the window of tolerance or a zone of resilience, that regulated zone, to the best of our ability, the more time we spend there as we go through this, the better off we're going to be, both in terms of how we're responding now and where we're going to be on the other side of this. Would you say that's accurate?

I would say that's accurate, but I would phrase it a little bit differently. I would say that.

Maybe we can recognize our own signs of approaching those edges of the window, hyperarousal, going into a collapsed or numb state, or hyperarousal, where we get agitated and panicky about it, because we will go there. This is a trauma. We will go there. And so when we start to recognize those signs, we can catch ourselves and say, okay, what can I do to take care of myself right now? And it might be seeking out contact with somebody. But see, this is the thing. There's a lot of.

Talk about connection, Stay in connection, keep.

Having connection with your friends and family. But that as well, has John Bowlby pointed out, and others, is a physically felt capacity. Like if we don't have really the ability, we never learned that we could reach out for support and connection. This pandemic is going to increase our isolation, and that's literally physical, like reaching out, making eye contact, seeking proximity. Even by zoom, it's a physically felt sense. It's not an abstract idea.

One of the interesting things on Zoom, I find, is that, you know, there's the camera usually at the top of your laptop. Most of us are on zoom with our laptop, or if it's an iPad or wherever the camera's up there. And then you see the picture of the person slightly below. So you want to look at them and see their facial expression and like your, your eye contact, but they're going to see you looking down a little bit, which is probably how you see me right now. And as I'm recording this, I'm actually using a camera which is a little above the laptop. Right. So I'm kind of going back and forth. But you work with the best you can, and I think we can create connection. But I think you're saying it's the quality of that connection. And also in terms of what you're saying, I think we've all been concerned that maybe the negative side of the whole digital age and social media and, and especially young people growing up just plugged into their phones that it's downplaying real, live, personal interconnectedness and maybe kids even growing up less emotional, intelligent as a result is one speculation of possibility. So there's all those possible negatives with our modern world and the way we connect. But now in the middle of this pandemic, we're finding actually there's a lot of wonderful possibilities. There's a positive. You know, I've been connecting with my.

Siblings who live in another state, and, you know, we stay in touch a little bit by text and email, and I go there for Thanksgiving once a year. But now we're getting on Zoom together for the first time ever and being more connected, and it's delightful. So there's. It can really go either way.

Well, see this is, yes, I agree with you in terms of technology, like thank goodness for technology right now because we can really stay connected. And I also think that that's, I agree with you that it's a positive because when there is a trauma like when 911 happened, the first thing most everybody did was reach for your cell phone and call your loved ones. Because that we call it the cry for help that or the cry for connection, that need for connection. When there's trauma, it's just paramount. So I think people are finding that they're staying in closer touch with siblings and loved ones.

And of course that's a good thing.

So what I heard you say then was so we are going to find ourselves at the edges of our zone of resilience, our well regulated zone and we're going to find ourselves outside of it. We're going to get pushed outside. There's nothing wrong with that. But it's our ability to bring ourselves back through with very self soothing kind of touch posture and maybe different self regulation exercises. I use a lot of breath regulation exercises. So you know, the various mindfulness things relating, connecting, doing that phone call, just finding our own ways to get back to that kind of home base where we feel okay.

I think that's the key is finding the way to get back to home base and not pressuring yourself. There's been a lot of.

Talk and articles about now is the time to learn that language you never used or to pick up your guitar or to finally learn yoga or whatever. And there's been almost this pressure. Like if you're not motivated now, it's not because you don't have the time. No, it's just because you don't have the discipline. And I would argue with that because I think when there is a trauma, it's the time to really be gentle with yourself. And especially with a trauma like this, it has two aspects. It has the external threat, which there's a lot of talk about to keep, to keep the external threat out, to wear masks, to wash your hands, to wear gloves, to, you know, stay even more than six feet away is the later.

Idea. But there's also, how do we then also conserve our energies and maximize our immune function. And that doesn't happen by pressuring ourselves.

I feel like, I know you talk a lot about compassion. I think now is the time to really bring that to yourself for your own physical and emotional well being. I mean maybe you want to learn a new language and that's great.

But if you start beating yourself up because you're not making good use of this time. I think that can be damaging. And when we realize that this is a global trauma.

Trauma always interferes with other functions like exploration and play. So if anyone's having trouble learning something new or being playful right now, have a little compassion to yourself, because that would be natural.

Yeah, absolutely. I think self compassion has always got to be the ground and. And I don't think beating ourselves up is ever helpful.

It never is. You're right.

I wonder if you could talk a little bit about.

In your work. I don't know if you. You talk about primary and secondary trauma. We talk about that a lot in the work we do with correctional officers and first responders. So we're watching the news, we're hearing about more cases, more deaths, and somewhere in the back of our brain, our brain's going, that could be me. And so there is then some parallel neurochemical, neurobiological experience we're having that's not the same as the person who just got the diagnosis or whose family members in an ambulance. But there is some correlate of that that we're experiencing. And I'm wondering about the utility of having the awareness of that so that we can be taking care of so we have more awareness of the need to take care of ourselves.

Oh, absolutely. And you know, I mean, we. I tend to call it vicarious trauma, secondary traumas. It's really the same thing, I think.

Yeah, same thing, I think. Yeah.

And it's a very real thing when we feel some of the same biochemical and physical and emotional reactions when we read about or watch the news about trauma happening to somebody else, we feel it in a very similar way so we can become traumatized by that. And one of the things I've had to learn is to kind of put myself on a.

Sensory diet in terms of information right now, not to keep checking how many people have it now and how many people are dying as opposed to recovering. To not watch the news to the point that it gets me dysregulated and especially not to watch it at night, because one thing, trauma does it. It will interfere with your basic functions like eating, sleeping, etc. For myself, I have got to turn. I can't look at the news for at least an hour before I go to bed. So we learn that's another way of regulating. That's another way of taking care of ourselves and not triggering our. Not over triggering ourselves to watch enough to get the information that we feel we need, but not not to become obsessed and really get triggered.

Yeah, I'm wondering because we're all kind of being really stress tested here, individually, personally, as well as all of our systems and our society, but individual, maybe there's an opportunity here to have sort of more self awareness about the rhythms of our day and how can we sort of take care of ourselves like titrating the amount of news, not watching it before we go to bed or you know, when do we do the. And have a little more consciousness around the natural biorhythms and, and the cycle of a day that helps us be in a better place as opposed to just letting the world drive where we end up.

Well, I think that, I think you're right. I think that can be really helpful. And you know, I want to say too, there's a lot of inequality or inequity in how this pandemic is affecting us.

Absolutely.

For me, for you and I probably being members of the privileged class and et cetera, et cetera. I mean, I'm not nearly as concerned about my own financial future. For example, I'm not going to lose my house.

I will survive financially. But many marginalized people are being threatened not only by the coronavirus, but by financial ruin, loss of their home, inability to buy food for their children. So there's very different levels of stress in this. And so.

Something else I think about is that.

People do have their survival resources where they go in times of stress. And it might be important to recognize those right now and not try to necessarily do better. You know what I mean? Like somewhere, I don't know where that about how drinking coffee reduces your immune response, it's not good for your immunity. But if that's one of your resources in the morning and you feel like you need that, you have to balance those things out, right?

Absolutely. The aroma of the coffee brewing in the morning actually might be a real key to your well being in that moment.

Might be a real resource for you. Yeah. And for people that are really struggling on so many levels.

You know, it's so critical to find ways to nurture yourself.

I'm wondering, you know, you talked about the importance of body right at the beginning of our conversation. And so in my experience, both personally working in, you know, some pretty stressful traumatic clinical situations and prison work and the street work I do and.

You know. Well, let me back up in terms of vicarious trauma or secondary trauma. Sometimes we talk about two times the one we've been talking about where we hear about things happening to other people and to some extent, our brain goes, that could have been me or that may be me. And then we start having a correlate neurochemical biological reaction that actually can be traumatic for us. And then the other is actually working around people that have a lot of trauma in their nervous system, which is really important in our correctional systems because the prison population generally is mostly human beings that have had a lot of trauma experience, in many cases their whole lives. And then so people that are working around them all day, and then the staff gets their, you know, their nervous system got a lot of embedded trauma. And then the two just keep, you know, recycling and re. Traumatizing. So I found that I think there's research around in terms of embodiment and activating, you know, greater access to what sometimes we call interoceptive awareness. Just being more awake and alive and present to our body more embodied that the kind of. More awake we are. More embodied we are. We actually.

Will kind of take on, soak up less of that trauma in that way than if we're not kind of awake and embodied. And then also, even when we're going through the other kind of vicarious trauma, when our brain is going that too, we're less likely to get big narratives forming there that could really embed something further. If we're kind of able to be embodied and wakeful and maybe doing some contemplative practices or something. Anything we can do like that. Is that a prevention or something that helps mitigate the impact of trauma exposure?

Just curious about your thoughts about that.

Yeah, I'm trying to wrap my mind around it. About being awake. Being awake in your body?

Yeah, Being more bodied and aware as opposed to distracted, not connected to our body.

Well, I would phrase it in terms of the nervous system. And I think what you're talking about is that if the first signs of traumatic stress is going to be physiological, I mean, we know that, like if you're falling down the steps, your arousal goes up and you. You take actions before it has. Before the information has time to go to your cortex. Don't think about it. So when I think of.

Correctional officers and inmates as well, inmates. I mean, there's a saying in the trauma field. Hurt people, Hurt people. And most inmates are. Suffered terrible traumas. I think more of learning.

The signs of dysregulation and then doing something right away to mitigate that. Have you heard of Hamish Sinclair? I don't know. Hardly anybody's heard of him. Hamish?

Hamish Sinclair? No.

Man who started. He started the Man Alive program with recidivists in the Bay Area. And he showed me this video once where he teaches these inmates to just to recognize the sign of what he called fatal peril. Like when you feel you're in danger and that shoots your arousal up. And that's when, you know, just lashing out, destructive actions can happen. And he's. And they learn the signs. Like some would say, you know, I'm getting tight, my jaw gets tight. And others would say, my heart starts to beat faster. And then he said, okay, when you feel that, just do this. And he would have them place their hands over their heart. And it wasn't any big mindfulness thing. You know, he didn't say notice what happens and this and that. He just said, do this and wait. The brilliance of that very simple intervention of recognizing your physiological dysregulation and then doing something immediately without even thinking about it that will naturally calm that arousal.

So I think what you're talking about, about embodiment to me would have more to do with the ability to regulate. And if we're working with people who, because of their history, they haven't developed those regulatory capacities, simple exercises like that to regulate, I think can be helpful. And I think mindfulness can be really useful as well. Obviously, there's lots of research on it.

I think some people.

Especially.

People who might be highly dissociative or.

Who might need more activity than.

I mean, some people, when they try to become mindful, all they feel is dysregulation and different. Dissociative.

Right, right.

Yeah. So more.

That's what I'm saying is it's highly individual. I never feel like there's one size really that fits everybody.

And maybe, maybe the ground starting point are some of the simplest self soothing or grounding things that anybody can do that have immediate impact because. Yeah, so you're asking people to do too much and you're asking people to be mindful. And various mindfulness paths can be dysregulating for someone until they have a flow with that and so forth. So, you know, obviously it's what's. It's different, what's going to work for everyone.

And contemplative practices, you know, they're called by a lot of other names, prayer and, you know, chanting music. And there's so many ways to, I feel, achieve that state.

Yeah, absolutely. Yeah. I'm very happy that you're part of our engaged mindfulness teacher training. And our students are still really loving and benefiting from the module we recorded with you. And we also did A module with Bessel van der Kolk. And in there he talked about, you know, some of the things that help heal trauma, the impact of trauma, vocalization.

Swaying, being together with others and these things. So where have people been doing that forever? Well, in church. Right. So human beings have kind of intuitively known forever simple things that help heal trauma and release trauma.

Right, yeah. And I think, you know, when we look at indigenous cultures and marginalized communities, we do want to be careful about imposing a white Eurocentric, Western mind.

Rather find out what, what regulates you.

Exactly. So a process of inquiry. What do you do to regulate yourself? And then how can, when there is a need, how can people enhance that? Build on the strengths that they already have.

Right, yeah, yeah.

So actually with the correctional officers, the work we've been doing, we've had, we have this mindfulness based wellness and resiliency program. We are introducing mindfulness. But I'd say the core of we introduce and what gets has the greatest uptake with the officers and other first responders. We are simple self regulation tools. And they find it incredible because previously they just felt themselves kind of buffeted around by life and they're in whatever physiological or emotional state that life seems to push them into. And to find it just a simple little tool like a self soothing tool or a simple thing like straw breathing or something, anything that, that they could actually begin to regulate their own physiology. And that's so empowering. I think like we have any influence over our own physiological state.

You know, I had completely forgotten about this when we first started talking, but I was on a federal grant project with Charles sprigley in the 90s with first responders, firemen, policemen, you know, EMTs, et cetera. And we discovered exactly the same thing, very simple physical actions. And different ones worked for different people.

Exactly. We try to present a variety and we say find the ones that are going to work for here. Develop your own toolkit.

Yeah.

Some.

You know, I was speaking of the news and the need to titrate the news. I do better and worse at that at times. But one night that did leave me kind of shaken, it was a two hour news special basically in an icu. This was maybe five or six days ago. And.

First of all, I'm just so amazed by the bravery of our frontline healthcare workers. It's just amazing. A good friend of mine, her roommate, who lives.

Somewhere, I think in Maine or Vermont, but is a nurse and made the decision to sign on as a traveling nurse and boom, went down to Brooklyn and is there Working in a hospital in Brooklyn, just volunteered to come in and, you know, incredible bravery and watching, you know, them talking about the number of, you know, when they code someone, when, you know, when they have to come in with life support or those kind of things or cardiac arrest or those, you know, that they're used to that happening once on a shift maybe, and now it's happening, you know, five times an hour. And, you know, the thing the PA goes off, you know, or they have different codes for different things. One is, you know, the ventilator. And. And. And they're talking about that and you look at the world they're in, you know, and they're all behind in these gowns, behind the shields, and they got patients. You know, the hallways are filled with gurneys and, you know, and you just. So I'm just trying to imagine, you know, what they're going through, the healthcare workers right now and where, you know, if this, hopefully this is going to subside and we'll get some kind of a break here, you know, before there's another wave of it, perhaps, and we'll be better prepared next time. But I'm just wondering where a lot of our healthcare workers are going to be on the other side of this. And, you know, having been witnesses to one of the. For me, heartbreaking things is seeing so many families are losing their loved ones who are dying in hospitals without their loved ones present and no very little possibility for closure. And I don't even know what happens into. Whether they. Whether the remains are cremated or. I don't know much about what happens, but it's a very tr. And then the healthcare workers are not only at risk themselves, but they're witnessing all this human tragedy. I'm really just trying to imagine where they're going to be on the other side of this.

I mean, I think everybody's dealing with that uncertainty to some degree. Where are any of us going to be on the other side of this? Where are we going to be economically, are we going to, etc. But I think for health care workers, it's really, of course, exacerbated. My goddaughter's a PA and she's working in New York also in attempts and sends me videos and photographs and.

Stuff. Yeah, one of the things that I noticed was that the focus on being able to do something positive is what nourishes her. Like, she called me this morning and she was so excited because she got the virus, she had the virus, she recovered, and the FDA just authorized her hospital to use the plasma, her plasma to save a patient who was. He's on life support right now.

Wow.

She gave plasma and she was so thrilled. And I thought about with any trauma.

The ability to navigate it successfully, whether it's to fight back, to get away, to get help, or in vicarious trauma, to be able to do something to help others can mitigate the lasting effects. And for Giovanna, I could feel how that was strengthening her, even though just having given plasma she was pale and weak. But I think for health care workers, the appreciation and the gratitude that others express to them, you know, adds to that.

And if.

And the fact that they're, you know, they're all sacrificing so much to try to help is such a gift.

Well, I feel like we're, you know, I was watching yesterday.

The name part of my brain is so capricious these days. But Pastor Rick, the pastor wrote A Purpose Driven Life and has a huge international church. And they had him on and he was talking, they were talking about grieving and what families are going through and what we're all going through because there's all kinds of losses and potentially economic losses. And he said following, you know, following the wave of this pandemic, whatever that looks, he feels there's going to be a tsunami of grieving and need for grieving. And thinking of that and both thinking of our frontline health care workers, I'm thinking, you know, we may need like a volunteer corps of therapists and counselors, people you've trained, the kind of people that have trained in your work to come in and support all these healthcare workers on the other side of this because they're going to need support.

Yeah, yeah. I'm just wondering if, you know, I think of some of the international efforts of like, Doctors Without Borders, and I'm sure there's a therapist without Borders. And, you know, maybe we need, you know, some kind of collective effort from the field of counseling and psychology to reach out and provide this support to our frontline workers.

And I mean. And.

Yeah, the other thing that will support them is giving them the equipment that they need.

Oh, yeah, right now, absolutely.

Mine is a hospice worker, a hospice nurse. And.

She texted me that they don't have masks. They don't have. This was two weeks ago. You have masks.

So, you know, I managed to send her 100 masks because the.

The government or whoever's in charge is not providing healthcare workers with what they need. And that's a travesty.

Absolutely, it's a travesty. And speaking of Titrating things, that's the main thing I have to titrate is my response to what just feels almost criminally negligent in terms of our government's very delayed response to this and that our healthcare workers are out there without the equipment they need. It's just terrible. And if I get myself ramped up with that boy, I can. I can get pretty dysregulated. So I have to modulate that.

Yeah. And there might, I mean, I think for us, too, again, taking action. Like, I felt better when I got.

Yeah, you got the 100 maps to them.

And I feel better when I contribute to the restaurants here that are giving food to first responders, etc. So, I mean, that's a known.

Activity to.

Help and to mitigate some of the effects of the vicarious trauma.

Yeah. And that's what you're pointing with your. Was it your daughter, I'm sorry, that was able to give plasma?

My goddaughter.

Your goddaughter? Yeah, your goddaughter. And so, you know, there's a sense of empowerment and contribution and self efficacy, all those kinds of things, which sends the balance out, you know, trauma exposure. Right. Feel any sense of control, empowerment, or any. Anything like that.

That's right. And that's always what it is with trauma, no matter what kind of trauma. So, yeah, I mean, I think a lot of the Serenity Prayer, danger things, we can, and we have to let go of what we can't, and we, you know, we have to know the difference there. So.

To support ourselves in this time.

Absolutely. I mean.

That was during all my years in prison and doing my own recovery work. The Serenity Prayer was really foundational. And I've always thought maybe it could also be called the wisdom prayer because it is just such essential wisdom. Right? It's such essential wisdom.

Yeah.

And you spoke a moment ago about, you know, when we're experiencing trauma and we don't have the ability to run away, we don't have the ability to fight back. We can't, you know, and, you know, at least in my understanding, that's one of the things with aversive childhood experiences and traumatic childhood experiences embed so deeply. Well, one thing, our neurobiology is very plastic at that time, but at the same time, children, you know, get trapped. They can't. They don't have the ability to fight back or run away, and they're trapped in it. So here is, as adults, we're in this situation with the pandemic where we may feel kind of Trapped, obviously, around home, confinement and shelter in place. But we may feel like, you know, and we may want to go into blaming, which I can go into, and the politics. It shouldn't be happening, but it is happening. Here we are, at least for the time being. We're all kind of stuck in it. So I guess in terms of running away, we can do what's prudent to take care of ourselves and try not to get the virus. In terms of fighting back, I guess maybe it is more doing some of the things you were talking about. Where can we contribute? Where can we help? Even if it's going online and contributing to one of the organizations that. Helping frontline workers or something?

Yeah, I think so.

Yeah.

You said something that I wanted to respond to.

Shoot.

And I lost it.

Well, I was talking about that ability to either run or fight back and how things get. Trauma gets more embedded when we feel that way.

Yeah, yeah, I know what it was. I think we have to recognize that this pandemic is going to, like, you know, bring up all the traumas, all the other traumas we've had.

Oh, wow. Yeah.

Lots of. Lots of different traumatic events, but we only have one nervous system.

That's also why I think some people are having a harder time staying centered and regulating, and others, maybe with not so much trauma in their history or else, who've really, really work to regulate the nervous systems are able to navigate it better.

Absolutely. You were speaking before about that window of tolerance or regulated zone, and one of the impacts of trauma exposure. It can make that smaller.

That's right. Yeah. It can narrow the window and then more easily triggered.

Yeah, yeah. So, wow.

Is to be able to widen that window. That's why it's so important to recognize the signs of. When you're at the regulatory boundaries of that window and then do something to bring your arousal down or up if you're hypoarous. Because each time you do that, the window widens a little and your threshold is a little bit.

Not quite so low.

So kind of safely leaning into the edges of that window a little bit can help us gradually regulate our way into expanding. Re. Enlarging again that.

That zone we have leaning into the edges and not letting ourselves go too far.

Where we're, you know, we go into a panic attack or whatever.

Right. And having that home base we can come back to.

Right.

We can lean in a little bit and come back. And maybe that's just something like this or whatever it is for us, that place where we. Yeah.

So I realize this is completely speculative, but I'd like to just from your. You've been working in this field for a long time and your work, I'm sure a lot of your work has been clinical and training people and also one on one patient relationships. But all that's been happening in social context. And you're moving your work into really trying to look at how social context and social justice issues are impacting people in disparate ways and all of that. So just, you know, I'm wondering where.

You know, as a, as a culture, even just in our country here in the U.S.

You know, where are we going to be three months from now, four months from now, and.

What do we need to do? Because to me, there's a huge opportunity here for an awakening. And at the same time, things could get very regressive because of fear. And there will be many people wanting to guaranteeing security if we're willing to trade our civil liberties for that. There'll be demagogic leaders, you know, playing on fear and at the same time, maybe a real awakening among a lot of people wanting to become more engaged citizens and help ourselves take ownership for improving our healthcare system and, you know, so things can go either way. And I'm just curious from what, you know about trauma and trauma reaction, I'm wondering where you think, what do we need to look out for what might be some of the signs for us individually and collectively to be aware of and, and try to get ourselves and each other through this?

I think that's a.

Really, really complex question. No, I think we're dealing with something unprecedented.

I can't predict. And that's part of the uncertainty of it all. We don't know what's going to happen. We don't know what's going to happen economically with the health system, with this pandemic. We don't know when it's going to be contained. We don't know if the containment will return us in any way to the normalcy we've experienced in the past. We just don't know.

I mean, there's a lot of talk about how we're all in it together and that the pandemic is the great equalizer. But you see, it really isn't and we're really not. And I think when we recognize that, hopefully some of the oppressive systemic oppression in this country and throughout the world will shift. But we know from the past that.

That'S up to the privileged people to recognize that and take action.

And since we are not directly affected by systemic oppression, I mean, the only marginalized location I have is that I'm whole woman. I have all the other privileged locations. So it's. But I mean, I feel like that's what needs to happen. And see, we're seeing that right now. We're seeing that marginalized communities, especially African Americans, are affected much more by this virus.

And that's at least in part due to.

Decades of systemic oppression that leaves your immune system vulnerable and not as strong. And I mean, I think, I hope that that will be recognized and that some change will. What happened?

Yeah. Hopefully the awakening here can be not just that we kind of naively think we're all in this together. I mean, we are in some sense and the virus isn't even respecting boundaries of privilege to some degree in some places, but still there's no doubt that many people are much more exposed and vulnerable to this than others. And hopefully that can awaken all of us and especially those of us who, who for whatever reason enjoy privileged locations and status in our lives. That we can awaken the fact that we really are all in this together and that we've got to change and we've got to change the landscape and bring everybody into one shared societal, cultural, humanity where we really are all taking care of each other.

Yeah. Where resources are really shared.

Yeah, absolutely. Where resources are really shared in an equitable way.

And that's a dilemma that feels.

Insurmountable.

To a lot of people.

Yeah. Well, thank you very much, Pat. Thank you very much for your contribution to our teacher training programs and your contribution to this summit and to the incredible work you're doing, which, I mean, you've impacted so many different clinicians and trauma therapists and counselors with your sensory motor psychotherapy work. And so I have no doubt that a lot of those people that you've influenced are going to be out there on the front line supporting all of us and supporting our frontline healthcare workers. And so just thank goodness for the amount of wisdom about embodiment and the reality of trauma and that it is something we need to proactively work with. So just thank you very much for that and thank you for your contributions today.

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