from the foreword by Bessel van der Kolk
A pioneering researcher gives us a new understanding of stress and trauma, as well as the tools to heal and thrive
Stress is our internal response to an experience that our brain perceives as threatening or challenging. Trauma is our response to an experience in which we feel powerless or lacking agency. Until now, researchers have treated these conditions as different, but they actually lie along a continuum. Dr. Elizabeth Stanley explains the significance of this continuum, how it affects our resilience in the face of challenge, and why an event that's stressful for one person can be traumatizing for another.
This groundbreaking book examines the cultural norms that impede resilience in America, especially our collective tendency to disconnect stress from its potentially extreme consequences and override our need to recover. It explains the science of how to direct our attention to perform under stress and recover from trauma.
With training, we can access agency, even in extreme-stress environments. In fact, any maladaptive behavior or response conditioned through stress or trauma can, with intentionality and understanding, be reconditioned and healed. The key is to use strategies that access not just the thinking brain but also the survival brain.
By directing our attention in particular ways, we can widen the window within which our thinking brain and survival brain work together cooperatively. When we use awareness to regulate our biology this way, we can access our best, uniquely human qualities: our compassion, courage, curiosity, creativity, and connection with others. By building our resilience, we can train ourselves to make wise decisions and access choiceeven during times of incredible stress, uncertainty, and change.
With stories from men and women Dr. Stanley has trained in settings as varied as military bases, healthcare facilities, and Capitol Hill, as well as her own striking experiences with stress and trauma, she gives readers hands-on strategies they can use themselves, whether they want to perform under pressure or heal from traumatic experience, while at the same time pointing our understanding in a new direction.
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|Publisher:||Penguin Publishing Group|
|Product dimensions:||6.30(w) x 9.10(h) x 1.80(d)|
About the Author
Read an Excerpt
In the summer of 2002, I worked incessantly to complete my Ph.D. dissertation on deadline. My faculty advisors at Harvard had already set my defense date so I could begin a prestigious fellowship starting in September. Everything seemed on track for a successful start to my academic career. Well, everything except for that one minor detail I'd neglected to share with my committee: Of the ten chapters and appendixes in my dissertation, I still needed to write seven of them.
In mid-June, I finally quit my full-time job to finish it. Early one August morning, after weeks of pushing myself to write sixteen hours a day without any days off, I carried my coffee mug into my study and turned on the computer. I opened my draft, reread the paragraph I'd finished late the night before, and started writing.
I was halfway through my first sentence when I puked all over the keyboard.
After running for paper towels to clean up my mess, it quickly became apparent that my vomit was permanently lodged under some of the keys. (The space bar was especially hard hit.) No amount of wiping it up could rectify the situation.
I brushed my teeth, washed my spew-speckled arms, and found my shoes and my wallet. Outside, I threw the keyboard into the trash can and climbed into the car. I drove to a shopping center and parked. It was seven fifty in the morning. When Staples opened at eight, I was the first one in the door.
New keyboard in hand, I was back at my computer finishing that first sentence of the morning by eight thirty.
SUCK IT UP AND DRIVE ON
To be clear, I didn't have a stomach bug or food poisoning. Rather, I'd been living for years with relentless bouts of nausea and lack of appetite.
Here's a snapshot of me-and my overscheduled, extremely compartmentalized, and rigorously well-organized life-circa 2002: I was compulsively driven to achieve. I was addicted to demanding workouts, to maintain my body's physical prowess. I was incessantly cheerful at work, while experiencing radical mood swings and crying jags at home. My mind raced with thoughts about my never-ending to-do list and "what-if" worst-case scenarios. My body was hypervigilant and tense from projecting an external aura of self-confidence while internally bracing against when the other shoe would drop. I was severely claustrophobic and hypersensitive to crowds, traffic, loud noises, and bright lights. Between insomnia and terrible nightmares, I rarely slept.
In retrospect, I see that the message that my body transmitted to me that morning was clever, dramatic, and spot on: At that moment, I was literally sick of this (expletive here) project and I desperately needed a break.
However, I didn't have the time to think about that right then. I had a dissertation to finish, and I was running out of time.
And so I overrode this rather extreme signal from my body and just kept writing.
I delivered my completed manuscript by deadline. I successfully defended my Ph.D. dissertation and started my fellowship on schedule that fall.
I was also an anxious, workaholic wreck.
So how did I get here? How did I end up literally puking out a Harvard Ph.D. dissertation? Why did my body present me with such an extreme signal that morning? And why was my (mostly unconscious) default response simply to ignore and override that signal and keep pushing?
In many ways, finding answers to these questions has motivated my work over the last fifteen years. Perhaps not surprising, since I'm a political scientist who teaches about international security, in 2002 I made sense of the Keyboard Incident as my body waging an insurgency against my mind's drive to perform and succeed. Of course, inherent in this explanation is its own recommended cure: counterinsurgency. In other words, just dig in, access deep wells of willpower and determination, and power through. Otherwise, it's just mental weakness and laziness, right?
For many decades, I considered my capacity to ignore and override my body and my emotions in this way to be a good thing-a sign of strength, self-discipline, and determination. And from one perspective, it was. But as I'll explain in this book, from another perspective, this default strategy was actually undermining my performance and well-being.
Of course, I'm not alone in this conditioning. It's a common way of relating to experience that many people call "suck it up and drive on" or "powering through." Contemporary American culture in general-and warrior culture in particular-prizes this approach to life. We've all heard and perhaps even admire stories of people overcoming extreme adversity or simply pushing through challenges and setbacks with perseverance to succeed. And, as I'll explain shortly, many conveniences of our modern world exist almost entirely to facilitate our suck-it-up-and-drive-on addictions. Nonetheless, although the self-determination to power through stressors in this way can be admirable-and during certain immediate life-or-death situations is absolutely critical for survival-this way of approaching life can have some dark consequences over the longer term.
In my life, my habitual reliance on suck it up and drive on not only allowed me to meet my dissertation deadline. To name just a few other examples, it also allowed me to achieve a top-5-percent ranking at a physically demanding military qualification course while still recovering from a massive injury to my Achilles tendon; run a marathon in just over four hours (in barely-above-freezing rain, of course!) seven days after accidentally impaling the claw end of a hammer one inch into my right heel; and attain basic proficiency in a new foreign language while working 120-hour weeks before my U.S. Army unit deployed to Bosnia after the 1995 Dayton Peace Accords.
At the same time, I lived for many years an awkward double life: the outward appearance of success (as our society usually defines it) and the inner sense that I was a failure, struggling secretly with symptoms and barely holding it together. As willful as I was, it would eventually take losing my eyesight and leaving a marriage to finally understand that there's an easier way. This book is about how I healed that division in myself-and how you can do the same.
THE GOALS OF THIS BOOK
In the course of my personal quest to understand my self-described mind-body insurgency and the devastating effects it was having on my life, I detoured into a parallel professional quest to understand how life adversity, prolonged stress exposure, and trauma affect us-and influence our decision making and performance. Along the way, I created a resilience training program for people working in high-stress environments, called Mindfulness-based Mind Fitness Training (MMFT), about which I'll say much more later in the book. I also collaborated with neuroscientists and stress researchers to test MMFT's efficacy among troops as they prepared to deploy to combat, through four research studies funded by the U.S. Department of Defense and other foundations. In addition to training and certifying others to teach MMFT, I've taught MMFT (pronounced "M-fit") to hundreds of troops before their combat deployments to Iraq and Afghanistan, as well as many other military leaders, service-members, and veterans. I've also taught MMFT concepts and skills to thousands of individuals in other high-stress environments, including healthcare providers, intelligence agents, firefighters, police officers and other law enforcement agents, lawyers, diplomats, social workers, students, teachers and academics, inmates at a maximum-security prison, disaster relief workers, athletes, members of Congress, senior government officials, and corporate executives.
On my journey to wholeness, I engaged in many different tools and therapeutic techniques, including several kinds of therapy, yoga, meditation, and shamanic and mind training. Since late 2002, I've maintained a daily mindfulness practice. I've also completed many long, intensive periods of silent practice, including time as a Buddhist nun at a monastery in Burma. Finally, I sought several years of clinical training and supervision, culminating with certification as a Somatic Experiencing practitioner, perhaps the best known of the body-based trauma therapies.
Despite this wealth of experience, I often found that no one could explain to me, concisely and coherently, how or why particular techniques worked (or didn't)-or why my responses to them often differed significantly from others'.
Thus, my original intention in creating MMFT-and the first goal of this book-is to share the road map that I discovered with you. I aim to share some of the core scientific and intellectual concepts that undergird MMFT. To be clear, however, this book is not the MMFT course-it covers additional topics not addressed directly in MMFT, but also by necessity it can't replicate all of MMFT's experiential practices. I'll draw on recent scientific findings to explain how to train yourself to be more resilient before, during, and after stressful and traumatic events. My hope is that after finishing this book, you'll understand your own neurobiology better and thereby make better decisions-without experiencing unnecessary anxiety and without criticizing your imperfections or choices along the way.
Part of why my journey took years is that there is no quick-fix way to achieve these transformations. Rewiring the brain and body to improve our performance and build resilience requires an integrated training regimen and consistent practice over time. Just as muscle growth and improved cardiovascular functioning require months of consistent physical exercise, the benefits that can result from mind fitness training require consistent practice over time, too. With consistent practice, we usually see some shifts relatively quickly, while others take longer to manifest. However, you can't just achieve them from reading this book. Thus, I don't want you to take my word for anything in this book-I want you to practice and observe these dynamics in your own life. Rewiring the brain and body is an embodied, experiential process. These are basic laws of nature; there are no shortcuts.
This book draws on a lot of evidence from high-stress occupations, such as the military, firefighters, police, medical personnel, and other first responders. That's because much of the peer-reviewed empirical research about stress, resilience, performance, and decision making has been conducted with these groups. Likewise, at other points the book may seem a little heavy with clinical findings about people who've experienced abuse or trauma. Nonetheless, especially if you don't work in a high-stress profession or don't believe you have a history of trauma-and may not feel particularly connected to either category-I want to emphasize: If you are a human being living in today's world, this book still pertains to you. Scientific evidence about how our minds and bodies work, and how we make decisions before, during, and after stress and trauma, applies to everyone.
However, I don't just want this book to help you understand and manage your stress better. My second goal is to engage you in a wider reflection about the way that we, individually and collectively, approach stress and trauma. As I've noted, the mind-body insurgency I experienced in 2002 was an outgrowth of my conditioning-and thus, it embodied some deep familial, societal, and cultural beliefs, values, coping strategies, and habits. In this book, I hope to expose such underlying structures, which aggravate our stress and trauma and undermine our performance and well-being. These underlying structures not only affect the strategies we individually rely on to cope with our stress-or not. They also affect the way we interact in our families and relationships; nurture and educate our children; train, incentivize, and reward our employees; and organize our companies and public institutions. They even affect the way our nation interacts with the rest of the world.
Are these strategies aligned with and capable of delivering the desired results? Our culture seems to want it both ways: We want better performance, resilience, and even happiness, yet we don't want to examine the wider blind spots that impede their development. Some of this wanting it both ways manifests in how many of us feel like we don't have choice-that we're powerless in the face of job stress, health problems, rapid technological change, or toxicity in the news. Yet it's possible to change how we interact with these things, to relate to them from a more empowered stance. Ultimately, to feel like we have agency requires clear intentions, consistent practice of the skills that help us develop awareness and self-regulation, and deliberate choices about how we prioritize different aspects of our lives.
Table of Contents
Foreword Bessel van der Kolk, M.D.
Part I Life on the Gerbil Wheel
1 Stone Age Physiology in a Digital World 3
2 How We Disregard the Continuum between Stress and Trauma 26
Part II The Science behind the Window
3 Grand Canyons in the Mind-Body System-Neuroplasticity and Epigenetics 53
4 The Body during Stress and Trauma 71
5 The Brain during Stress and Trauma 94
6 Parents and Attachment Styles 116
7 Childhood Adversity 137
8 Shock Trauma 161
9 Everyday Life 176
10 Stuck on High/Stuck on Low 198
Part III Widening the Window
11 The Warrior Traditions 223
12 The Thinking Brain and Survival Brain as Allies 245
13 Building Resilience through Recovery-Micro-Level Agency, Part I 268
14 Accessing Choice with Stress, Emotions, and Chronic Pain-Micro-Level Agency, Part II 292
15 Working Skillfully with Limits and Resistance-Macro-Level Agency, Part I 317
16 Thriving during Uncertainty and Change-Macro-Level Agency, Part II 339
17 Choosing Habits That Widen the Window-Setting Structural Conditions for Agency 355
18 Widening the Collective Window 379