Trauma, the Body, and the Ego

Thank you to Ryan Van Wyk for inviting me to share on this blog the Pesso Boyden System Psychomotor (PBSP) psychotherapy perspective on trauma. PBSP is a form of therapy which is, perhaps, better known in Europe than here in the United States. Recently, with an inclusion of a chapter on PBSP in Bessel van der Kolk’s newest book on Trauma, The body Keeps The Score, I have noticed an increased interest in knowing more about PBSP. Let me say a brief word about the name, PBSP. PBSP is the invention of two people, Albert Pesso (who passed away in May 2016) and his wife, Diane Boyden Pesso who invented, or discovered, as Diane Boyden Pesso used to like to say (she died a few months ago), this method out of their backgrounds in dance and theatre.

I won’t be able to say everything that I think needs to be said in one blog entry, so in this one I thought I’d focus on theory and then on the method in subsequent entries. I think the most helpful starting point may be to understand one of Pesso's central ideas: ego wrapping. The ego is thought to be a set of dynamic processes inclusive of all the brain processes that help the individual relate to the outside world. Like any one celled animal, a protective filter is needed between the inside of the cell and the outside of the cell. Good things have to be let in and bad things need to be keep out. In this way Albert Pesso sees the ego as our psychological skin. As we go about living we have to learn ways to take in from others what we need, like love, respect, and other such positive interactions and to protect ourselves from interactions that would do us harm, such as physical and emotional abuse. We are born into the world not knowing how to do this and, in fact, are not physiologically capable of doing this. This means that it is our parents who have to do this for us when we can’t. This is why researcher and psychoanalyst, Alan Schore, likes to refer to a mother and baby as a psychobiological unit. The term “ego wrapping” refers to the process where our caregiver’s efforts to be our ego for us, are internalized, or learned and we become relatively independent individuals who grow up to be people who can take care of ourselves. Another way to say this is that we grow up to be people who can take responsibility for meeting our interactional needs.

Trauma represents experiences in our interactions with the world where destructive interactions occur that our ego processes are helpless to do anything about. I think helplessness is the key here. If I sprain my ankle playing soccer, there can be much pain and suffering but chances are it won’t be traumatic. If I suffer the exact same kind of injury while being mugged in a dark alley, the same injury can result in trauma. Often, it isn’t the injury per se, but the degree of helplessness that produces the trauma (PTSD).

Children, being exceedingly helpless, are extremely susceptible to trauma. The only barrier between a small child and trauma is the mediation of the child’s care givers. Children can even be traumatized by their own fantasies. Let me give an example. A client had a key memory from when she was 5 or 6 years old. She woke up hearing a strange noise that terrified her. She called out for her mother. When her mother came she discovered that the noise was a branch tapping on the window. Her mother was furious with my client for waking her up because of a branch tapping on the window. My client now has two overwhelming problems: one, she was not capable of soothing her terror from the noise (otherwise she would not have called out for help) so when her mother left the room she was left with that terror. Two, since her mother seemed to attack her for asking for help, she now associates calling out for help with the terror of an attacking mother. Her helplessness is now complete. This means that as an adult, she has no, or very little, working ego functions that are available to her to help her realistically soothe herself. In fact, when she needs help to soothe her anxieties she mostly feels shame. This memory is what some call a “model scene,” which means that it is one memory that stands for a repeated type of interaction. (This line of thought is derived from the Heinz Kohut who re-defined Freud’s notion of “screen memory.” Kohut defined a screen memory as a particular memory of an event that stands for a chronic pattern of interactions. Some of Kout’s followers began to call such memories model scenes.) In other words, her mother very rarely made herself available to help soothe anxieties.

The end result is that my client’s experiences of “being anxious” were never ego wrapped. For this client, being anxious is a chaotic experience of helplessness. For her, “being anxious” results in a further fear that if she turns to someone for help her anxiety will be made even worse. This is enacted in our therapy sessions all the time. She will have, what seems to me, a minor anxiety, like where should she park for her sessions, that will take weeks for us to figure out because she anticipates a traumatizing response from me if she were to bring it up. Hence, she will be anxious, but neither she nor I will know what is causing the anxiety because her history has taught her to deny and dissociate from her felt anxieties and it takes awhile to figure out the cause of her anxiety.

In this way PBSP views all traumas as a state where the ego (always remembering that the ego is actually a complex collection of processes) is overwhelmed. There is anxiety/terror with no solution. When this happens, the amygdala takes over. The response of the amygdala, as you may recall, is to fight, flee, freeze or appease. When we see these responses in people we can know that their brain has identified a situation as traumatic (overwhelming and not possible to handle the feelings associated with the experience.) Until safety and a sense of control are restored, the amygdala takes over and the “higher” brain responses are short circuited.

We have to add into this picture the fact that consciousness is made out of memory. Literally, when I become conscious of something, I am remembering. When I experience an everyday object, like a tree, I am remembering – in a non-conscious way – what a tree is. Traumatic events are stored in memory as scary experiences with no solution. This means the only “solution” is to avoid similar traumatic events. This is a big problem when everyday normal human needs are stored in memory as leading to potential trauma that can only be avoided.

With a normal “good enough” history, essentially, where we grow up feeling safe, we grow up to be adults who feel like we can be in charge of the risks we expose ourselves to. When hardships and/or traumas occur we carry in our memory the probability that safety and control can be re-established. There is a kind of emotional “home base” that we feel we can get back to. Bessel van der Kolk, in a talk given at the 5th International PBSP Conference, stated that people suffering from PTSD have the sense that there is no safe home base to return to. This is related to their histories.

I believe every therapist will recognize, perhaps in the theoretical language that he or she is more familiar with, the theoretical points I’m making. I think what is unique with a PBSP approach is the focus on the possibility that there is a dimension to the PTSD experience (someone who has not recovered from a trauma) whereby the individual experiences his or her own energies, unconsciously, as a source of the trauma. For example, the client I talked about earlier feels shame (experiences herself as the source of the problem) when she needs help from someone else to soothe her anxieties. Another example might be the person who has suffered sexual violence who cannot reestablish a sexual relationship with his or her partner. In this case PBSP hypothesizes that this traumatized individual may be experiencing his or her sexual desires as being the source of the danger. This is an emotional process, not a conscious choice. It’s like a person lost in the desert, dying of thirst, takes comfort in the thought that they wouldn’t be in this predicament if only they could get rid of their pesky need for water. I believe that it is the emotional equivalent of an autoimmune disorder, where the body attacks itself. In the language of PBSP, we would say that the basic, everyday emotional needs that all humans have, like the need to feel loved, to have sexual experiences, to be able to protect ones’ self, and so on can become unbounded and experienced as dangerous. The ego wrapping breaks down.