Peter Levine goes further than Bessel van der Kolk on the importance of body memory.

Peter Levine’s work on body memory of trauma has a devoted following.  His is a more practical, methodical, and focused version of Bessel van der Kolk’s speculations about trauma’s embeddedness in the body.  Van der Kolk wrote the forward to Levine’s Trauma and Memory: Brain and Body in a Search for the Living Past.  It reads,

For well over a century we have understood that the imprints of trauma are stored not as narratives about bad things that happened sometime in the past, but as physical sensations that are experienced as immediate life threats — right now. (loc 90)

Or as Levine puts it,

It is crucial to appreciate that emotional memories are experienced in the body as physical sensations. (p 22)

The practice

Levine works by observing the position and attitude of the body, seeing where the tension lies, and working on that body part almost like a physical therapist, helping it to relax.   “Expand” is his term. The difference is that Levine does this body work while talking with his patient about the trauma he or she experienced.  It’s a good idea: talk about your trauma while your therapist works on your body to help it relax.  In this way, psyche and soma and integrated.  In practice, it doesn’t work so well, primarily because Levine focuses entirely on trauma confined to a single event manifested in a particular bodily contraction, as he calls it. 

The Theory

Traumatized individuals are stuck in a state of chronic contraction, an experience of stasis, in which they feel that nothing will ever change. The result is feelings of helplessness, hopelessness, and despair. “The sensations of contraction seem so horrible and so endless, with no apparent relief in sight, that individuals will do almost anything to avoid feeling their bodies.” (p 55)  The body becomes the enemy.  This is PTSD. 

Focusing on which part of the body seems most contracted, such as jaw, arm, or pelvis, Levine helps the patient relax that part of the body while talking about the trauma.  Slowly, the patient learns he can survive the recollected experience without being annihilated.  The result is the patient expands a little, as Levine puts it, becoming physically as well as emotionally less tense.  

With each cycle — contraction, expansion, contraction, expansion—the person begins to experience an inner sensation of flow and a growing sense of allowance for relaxation. With this sense of inner movement, freedom, and flow, they gradually ease out of trauma’s terrifying and gripping “dragnet.” (p 56)

Levine calls the process “pendulation,” which refers to a back-and-forth movement, like a pendulum. 

The problem

Levine’s approach assumes that trauma is confined to a single incident.  Three cases predominate. 

     Jack’s birth trauma

Levine observed that when his mother was holding him, Jack, eighteen months old, pushed against his mother’s thighs with his legs.  “This movement gave me a quick snapshot of his incomplete propulsive birth movements.” (p 80)  Jack’s birth had been difficult, his movements driving him into the apex of her uterus and wrapping the umbilical cord around his neck, all of which made him push harder.  Jack was trapped in an inner drive to complete the normal birth movements.  He also suffered from gastric reflux. 

Levine treated Jack by pressing against his back and allowing Jack to push back.  He did the same with Jack’s thumb, hoping Jack would fall into a pattern of expansion and contraction.  As he did this he talked with Jack in a soothing tone, hoping Jack would respond to the tone, for of course, he couldn’t understand the words.  He then told Jack’s mother how to put gentle pressure on his thoracic area, whose tightness (contraction) was responsible for his reflux (p 86).  When Levine encountered Jack again at age four, he was a normal child. 

Setting aside the question of whether birth trauma can be remembered, even as a procedural (body-based) memory, Levine’s approach assumes that the troubled relationship between Jack and his mother is reducible to a single incident, one that can be healed by a series of physical reenactments coupled with a soothing voice.  This doesn’t fit what PTSD looks like in young children.  In fact, there is no such thing as PTSD in young children, but a disrupted relationship with the primary caretaker, usually the mother.  Perhaps Levine’s intercession will improve mother’s attunement with her child, but that’s not Levine’s point.

     The convulsed soldier

Ray, a veteran suffering from PTSD, experienced convulsive neck and jaw movements, spreading down into his shoulder.  Ray talked about the explosion of two IEDs (bombs) in close succession and Levine determined that his movements mimicked his original response to the double explosion.  Reenacting these movements under Levine’s direction while talking with Ray about his experience enabled Ray to first contract, then relax his muscles in these areas.  With the restoration of the body’s natural movement, Ray was able to reexperience his trauma without freezing (contracting) into terror. 

A third extended example concerns a young boy’s pelvic retraction, a response to a late circumcision (p 128). 

It’s too reductive

Levine’s attempt to restore the body’s natural oscillation between contraction and expansion through guided physical movements, coupled with talking about the traumatic experience so that it can be integrated with procedural memory, is an interesting idea with limited application.  Moreover, it’s misleading, as most trauma, including that of soldiers, is not confined to a single incident that manifests itself in the contraction of a body part, but a series of experiences that are expressed in the whole body, especially in those parts of the autonomic nervous system not readily manipulated, such as digestion.  Still, one can imagine that some practices aimed at the autonomic system, such as controlled breathing exercises, might be helpful.  But not in the reductive way Levine imagines: relax one body party, heal one trauma. 

Levine’s approach lacks imagination; it’s too literal.  To be sure, he understands that the goal is to integrate procedural and conscious memory, but his examples are prosaic, as though the somatic quality of trauma could be reversed by relaxing the body, as though trauma is not only made manifest in the body, but only exists on the surface of the body, and not somewhere deep in the mind’s links to the body.   

A flawed idea lends insight into false memory syndrome

Because Levine sees trauma as so embedded in body, it’s easy for him to imagine that when the body changes the memory of the trauma also changes.  Recovered memory syndrome doesn’t exist because memory is constantly changing.  In this regard, his approach is superior to van der Kolk’s (see previous post).

Every time we reflect upon the past, we are delicately transforming its cellular representation in the brain, changing its underlying neural circuitry. . . . Bergson in 1908 had it right with the notion that ‘the brain’s function is to choose from the past, to diminish it, to simplify it, but not to preserve it.’ (p 141)

This is why trauma can be overcome by pendulation.  Memories can be changed by recent experience.  Conversely, this is why recovered memories cannot be relied upon.  Levine is more devoted to the body-based character of trauma than even van der Kolk.

Conclusion

Levine has been quietly influential.  His Ergos Institute for Somatic Education claims to have taught his approach to over 30,000 therapists in 42 countries (https://www.somaticexperiencing.com). He has published ten books on somatic experiencing.  Most are marketed as self-help books, even when some are better aimed at practitioners, like Trauma and Memory.  His most popular, Waking the Tiger: Healing Trauma has been translated into 29 languages.  His influence is most widely and directly experienced through the therapists whom he has trained. 

The easiest thing to say about Levine is that somatic experiencing therapy seems relatively benign and unlikely to be harmful, unlike cognitive behavioral therapy, or prolonged exposure therapy.   It’s more plausible than EMDR (eye movement desensitization and reprocessing), and has the virtue of not taking van der Kolk’s path of embracing almost any and every form of bodywork   With Levine, the work is specific, which is both his strength and his weakness.  His approach treats the mind-body connection in a literal fashion (change body = change mind) that fails to appreciate its complexity.    

He concludes with a discussion of intergenerational trauma, suggesting that survivors of a plane crash who “remembered” to “go to the light” may have been programmed to do so via the transgenerational epigenetic transmission of survival techniques from the parents.  It’s possible, but aren’t other explanations more plausible, such as this is just what people do when trapped in a burning airplane?  A lack of skepticism, coupled with a superficial model of the relationship between mind and body, mar an otherwise innovative approach. 

References

Peter Levine, Trauma and Memory: Brain and Body in a Search for the Living Past: A Practical Guide for Understanding and Working with Traumatic Memory.  North Atlantic Books, 2015.