Trauma Informed Herbalism
Imagine yourself walking through a field of flowering daisies in the soft sunlight while cedars and firs tower nearby. A gentle stream meanders through the meadow to a small alpine lake. You lay your head back in the tall grass and feel the warm sun bathing your body. Imagine how you feel in your in your chest, in your stomach and legs. Hopefully there is a feeling of calm and gentle relaxation.
Now consider yourself walking alone late at night down a dark alley. You see shadows moving towards you quickly. Or think of yourself caught out in the open in the midst of a lightning storm as the lightning gets closer. How would you feel in your chest and stomach? Likely fear, tightness, sweaty palms and a fast heart beat
When we go through these experiences our body stores them as physical memories. If we experience enough challenging experiences or horrific trauma such as an abusive childhood or war, we can lock in these memories as frozen somatic states. Our shoulders become permanently tense, or we can’t digest well because our gastric system is tight and immobile. Or we react to the slightest sound or perceived slight with an immense endocrine and nervous system response.
When the body is overwhelmed by a perceived dangerous trigger, an enormous amount of changes occur internally. The hypothalamus sends signals to the pituitary gland in the brain which then signals the adrenals atop the kidney to go into action. The adrenals secrete cortisol and epinephrine as a way to respond to the perceived danger. This is known as a sympathetic nervous system response. These chemicals cause a vast change in the body, stimulating a release of sugar into the blood stream to provide energy, raising the blood pressure and the heart rate, enlarging the pupils and distributing blood to the muscles. For mammals, all of this is in preparation to either flee or fight a predator and makes perfect sense evolutionarily.
We may freeze like a deer in the headlights, dissociating and appearing to be lost, confused, unreachable emotionally. This is one of the oldest ways the nervous system responds. The act of freezing can help a wild animal appear dead to a predator, or may be a way of surrendering before a final death blow.
While this is a necessary adaptation for most animals as a way of responding to threat, in humans it has become a deeply challenging part of modern existence. Our threats are no longer due to predators, but due to tax collectors, a landlord when we can’t pay the rent, an abusive boss, racist or homophobic threats, etc. Our body not only stores these threats in our body, we store those memories as well so that we can easily be triggered into a hyper-alert or dissociative state.
When this happens repeatedly, our body is pumping out endocrine hormones such as cortisol that eventually threatens to make us sicker and sadder. Repeated exposure to threats or simply being triggered into remembering them will eventually cause the immune system to not work properly, the stomach to be unable to digest and absorb food properly, the heart to pump too hard and fast leading to cardiac problems and the greater potential for diabetes and inflammatory conditions.
Adverse Childhood Experiences
If we look at the modern bible of psychiatry, the DSM (Diagnostics and Statistics Manual) there is only one major diagnosis that mentions trauma and that is PTSD. There is a provisional diagnosis of C-PTSD for people who have suffered extensive and horrific levels of neglect and abuse but that has not been codified as of yet. It is increasingly evident that trauma plays an enormous and primary role for most anyone who is suffering with poor mental health. Many people with experiences of trauma will be give a number of other diagnoses primarily such as major depressive disorder, generalized anxiety disorder, borderline personality disorder, dissociative identity disorder and somatization disorder, etc.
PTSD has very strict specific criteria for its diagnosis, such as directly or indirectly experiencing violence or the threat of violence and sexual abuse. However, trauma comes in many different forms and can have strong lasting impact on our physical and mental health. In the 1990’s researchers at Kaiser hospital were working with people who were trying to lose weight. Soon a strong percentage of them dropped out, even though they were losing weight. This perplexed the researchers and they started to take long histories of the participants. They discovered that there is a strong correlation between childhood trauma and present day poor mental and physical health. The term they used for childhood trauma was Adverse Childhood Experiences, or ACE’s. ACEs include a far wider range of categories than what we see with the criteria for the diagnosis of PTSD. They include:
1- Parental emotional abuse
2- Parental physical abuse
3- Parental sexual abuse
4- Parental emotional neglect
5- Parental physical neglect
6- Parental separation/divorce
7- Witness to abuse between parents
8- Parental addiction
9- Parental mental illness
10- A parent has been a convict
The more ACEs one has experienced, the higher the correlation with a host of physical, emotional and behavioral issues later in life. In essence trauma is directly linked to chronic physical diseases, mental illness and addiction. This is a much broader understanding of trauma but I believe it does not go far enough. Trauma can also come in a variety of other forms, including societal oppression, prejudice, ongoing poverty, poor work and substandard home environments, homelessness and disconnection from our environment. In essence we are all likely to experience various levels of trauma though people of color, the poor and marginalized populations experience the brunt of the blow and are likely to have the highest incidences of trauma and associated mental illness in their lives.
Genetic and inherited predisposition of mental illness has largely been the primary factor in assessing mental illness but we are moving to a model of mental illness that sees trauma as a primary factor. If we add in the role of a poor diet, lack of exercise, and not getting enough sleep, many common mental health issues can be attributed to these factors. Certainly genetic predisposition to mental illness is one factor, especially when it concerns susceptibility to more complicated psychotic and manic experiences, but I believe it is vastly over emphasized while trauma and lifestyle concerns have not been given greater credence.
Addressing Trauma and the Body
In the early 1900’s and the dawn of modern psychology, early childhood trauma was thought to be at the core of mental illness and what they deemed as neurosis. Freud, Jung, Adler and others developed theories around how early childhood issues could turn into adult issues such as ongoing anxiety, depression and even psychosis. Until the 60’s, the emphasis was placed on lengthy talk therapy and “analysis” in order to discover these root issues, explore and understand them better as a way of cathartically releasing unhealthy mental health patterns.
That changed in the 60’s when a number of different types of therapy developed. Instead of focusing on past trauma, cognitive and behavior therapies focused on how to improve life in the here and now through interventions based on changing how we perceive and act in life. Exploration of the roots of trauma were deemed fruitless and the state of how we are feeling, thinking and acting in the present moment became far more important to address. Interventions often include analyzing situations rationally and having homework out in the world that involves challenging our fears and perceptions. Behavioral approaches would include integrating coping skills and conditioning the body not to overreact to stressors.
Cognitive and behavioral approaches developed in the 60’s are the forerunners of a number of modern psychotherapeutic models such as cognitive behavioral therapy, dialectical behavior therapy (DBT) and Acceptance Therapy. Many of these stress “exposure” as key to overcoming our fears and overreractive nervous system to triggers often rooted in trauma. For an example, imagine someone with a fear of bridges, perhaps due to a scary experience as a child. Instead of deeply reviewing that early scary experience, someone in CBT may have the person slowly expose themselves to the idea of crossing a bridge, first through visualization, then through gentle practice out in the world until the fear is vanquished.
One of the most common ways of working through trauma these days is the practice of EMDR (Eye Motion Desensitization and Reprocessing). In this therapy, an individual recalls traumatic events while the practitioner slowly waves a finger, a pen or a device in front of the person’s eyes. Through this practice the theory is that the individual’s traumatic experience will no longer become triggering and cause a sympathetic nervous system response.
CBT and EMDR models of working through trauma are the most popular form of therapeutic interventions. EMDR has been especially helpful for a wide range of people though some feel it can actually be quite triggering and make a person feel more sensitive and overwhelmed.
As our understanding of trauma has advanced in the last 30 years, a number of therapeutic techniques and styles have developed to address the body and how it is impacted with anxiety, tension and depression. Body centered therapies generally see that we store trauma and memories as imprints that can leave lasting emotional challenges. Addressing the body means working with it in ways that allows for release and activation of the parasymapathetic rest and relax response. In general this means a greater focus on teaching ways to help the body to find greater ease, calmness and resilience to triggers.
Mindfulness is perhaps the most popular form of body centered therapy that focuses on quieting the mind, often with breath work as key to finding emotional stability and resilience. Rooted in Buddhism, mindfulness emphasizes the importance of the individual regularly practicing techniques to help the person feel calm, centered and grounded. Mindfulness can be challenging if an individual is already in the midst of severe crisis, with thoughts going a million miles an hour. Sitting to try and quiet the mind can prove impossible.
Emotional Freedom Technique is a practice that borrows from the traditional Chinese practice of qi gong. In EFT, or “tapping” one repeats a series of statements designed to alter one’s perceptions and nervous system response while tapping numerous points on the head and the body. In essence, this a type of neurological reprogramming designed to somatically and energetically improve the individuals reactions to triggers.
A variety of other approaches include traditional Eastern techniques such as yoga, meditation and qi gong. These methods of “sacred movement and practice” are ways of addressing the somatic feelings of distress and transforming the body by both releasing stress and tension and building greater strength and resiliency. Numerous teachers have developed tools for helping those who have experienced trauma using these tools.
While these techniques are commonly used, many people find that they need larger help in addressing underlying patterns of anxiety and depression. This is the role that psychiatry has largely filled in the modern world. Drug therapies directly address the somatic and emotional sensations of severe distress, panic, sleeplessness, mania and deep melancholy and do so in a way that is often quick and direct. A benzodiazapene such as valium will directly relax the body. A stimulant such as adderall will quickly cause immediate increased focus and concentration. An opiate med med will drop pain levels within 20 minutes. Medications can be incredibly helpful and even lifesavers for folks going through severe crisis and manias.
At the same time, drug based medications generally cause a host of complications when taken regularly- especially if they are taken in large doses or as polypharmacy (multiple medications). There are lawsuits and warnings on every major class of medication for the potential harm they can do as side effects, when weaning off them and in terms of long term health effects. Many who take medications are willing to trade off the potential side effects for the benefit of feeling improved, especially in life or death situations. If a strong tranquilizer will ward off a very damaging manic episode, that is indeed a very useful and important tool to have.
The problem comes in that we have almost entirely replaced traditional ways of healing from distress, anxiety and depression with drug therapies that can have serious complications. Only 50 years ago, almost no one was taking a drug for distress and now around 20 percent of us are. One has to ask how much of that is a good thing for us or mainly a good thing for pharmaceutical companies?
What I hope for is a return of some balance; that medications are readily available to people but that more traditional remedies are integrated as well. And that fundamentally includes herbal therapies. Traditionally throughout the world, plants have been one of the first ways that distress is addressed. Whether that means bathing with aromatic oils, drinking infusions of relaxing tea, taking stronger sedative and stimulant herbs or eating meals filled with nourishing plants, phytotherapies have long played a deeply important role in addressing the physical manifestation of distress, depression and anxiety.
Herbalism and Trauma informed Therapy
When a person goes to see an herbalist, they may be surprised at the length of inquiry, the desire to know much about a persons history, their health, their diet, the stressors and supports in their life today The reason for this is that herbalists view all of these various facets as interlinked and forming a whole picture. They may see early trauma leading to stomach problems, poor absorption and malnousrishment as well as underlying anxiety, poor sleep and intermittent dissociative states. The herbalist wants to address all these concerns and looks to plants to help soothe, strengthen, nourish, vitalize and encourage the body’s own healing process. Plants become the conduit and doorway for addressing and healing those physical and emotional scars of trauma.
The sheer complexity of each unique person, their health history, emotional state, constitution and persona history make it impossible to offer cookie cutter herbal advice. While depression generally is treated with antidepressants, an herbalist may treat depression due to trauma with a wide assortment of plants that each do something unique and different. For some individuals it may be key to nourish and strengthen someone with tonic mineral and vitamin rich plants. For others it may be more important to directly offer relaxant herbs to help soothe intense anxiety. For others it may be key to address digestive and absorption issues that are making it challenging to assimilate nutrients. One may do better taking gentle calming teas while another may do well with aromatic baths or taking stronger tinctures or bitter herbal decoctions. Finding out what works is often a winding conversation that is unique to each individual.
One of the key things that is often missing in the mental health field is the importance of addressing the somatic issues that develop from trauma. Generally it is treated by either drug therapies or by techniques such as mindfulness and EMDR. What we miss is the need to address the underlying story of how the body has been shaped and hurt by trauma.
And often that means that the long term impact of trauma has affected multiple internal systems. Persistent cortisol may have suppressed our immune system. Persistent sympathetic nervous system reactions may have slowed your gut, caused greater inflammation leading to the stomach lining being compromised. This in turn may lead to cytokines leaching out into the blood stream to cause inflammation throughout the body. Trauma may lead to persisted elevated heart rate and blood pressure which then leads to worsening cardiac conditions. Stress levels can also cause blood sugar to be elevated and be part of the reason for early onset diabetes. Muscle rigidity, feeling frozen or deeply anxious in the belly and the chest many become commonplace. The internal suffering could lead to a desire to stop the pain through a variety of methods such as cutting or burning oneself, leading to actual visible scars on the body. Trauma can also lead someone to choose to soothe or erase that pain through drugs and alcohol that further damage the body.
Though our modern focus in mental health treatment tends to be about adjusting neurotransmitters and addressing a “chemical imbalance”, the effects of trauma often show up throughout the body. This is where herbs can play a profound role. Instead of just taking something to feel better, they can address these myriad embodied trauma symptoms. They are healers at this core level when early abuse, deprivation and neglect have scarred the heart and the belly, have frozen our throats and tightened our musculature into armor.
So when we talk about trauma informed herbalism, this can mean a whole host of things, It means understanding the role that trauma plays in shaping an individual’s life and not only impacts their emotional life but their physical life as well. Trauma informed herbalism also implies a change in power dynamics. A person who has been abused does not need one more person telling them what to do or telling them how to feel. Models of care need to be collaborative where the individual who has experienced trauma is seen as the expert in their own life and the care they need. The role of the herbalist is to offer information and wisdom garnered by study and experience, but ultimately it is the individual who has experienced the trauma that knows best how to tend and heal themselves.
For too long the mental health field has been dominated by a model of experts and patients. Treatment programs and drug regimens are prescribed with little to no information about side effcects and potential long term health efects. Short doctor visits leave little time for deep and thoughtful collaborative care, an emphasis on slow and gentle approaches including multiple options, and a careful tending to the needs of the body. The path of trauma informed herbalism is to right those scales so that the individual “patient” has the greater power and say, the scars and suffering in both the mind and the body are given deep care and that no “treatment” is done without full consent and understanding.
We are all Unique.
One of the basic tenets of herbalism is that we are all unique, with very specific histories, backgrounds, constitutions, stressors and health conditions. One person’s depression is very different from another persons. Herbs are geared to that specific individual, not to a diagnosis. For example, one person with depression may be elderly, absorbs food poorly and appears weak and frail. For that individual, it might be best to offer gentle warming soups and teas that are both uplifting and help strengthen digestion and the gut. For another who is young and robust with a history of using amphetamines, sleeping little and in a state of overheated exhaustion and intermittent panic atacks, it might be better to offer some cooling, moistening, nourishing and relaxing herbs while counseling quite a bit of rest, time walking in the forest and engaging in quieting activities. Trying to find just the right approach, the best herbs in a form a person is likely to continue regularly can be challenging and its often best to see a good herbalist who can really tune into what is needed.
Larger Patterns of Oppression stemming from Colonization
On a greater level, it is key to see trauma through a larger systemic lens. African Americans, Latinos, Asian and Indigenous communities all experience greater degrees of stress and potential for trauma than their white counterparts. From racial profiling, police stops, work and housing discrimination, income and economic disparity and inequality to historic patterns of severe oppression, slavery and colonization, people of color are born into a society that naturally discriminates against them. Many also carry genes (epigenetic modifications) where they literally inherit the effect of depression, anxiety and suffering carried by previous ancestors. Trauma is not only coded into one’s genes, it is also part and parcel of living in a society run primarily by white people for white people’s benefit.
When trauma exists at this scale, it is etched into the health and wellbeing of people of color in the form of lowered average lifespans, poorer physical health and the greater possibility of mental illness in the form of depression and anxiety. Epigenetic underpinnings of historical trauma along with ongoing systemic oppression can induce heightened adrenal hormonal secretion that over times can impair the body as well as the mind. These larger struggles must be addressed systemically in order to reduce the burden upon people of color.
When looking at struggles such as depression, anxiety and addiction, there are often roots that go back to trauma. Addressing that trauma often means taking a multi-pronged approach. Trauma informed therapists are often adept at helping people with tools such as mindfulness, EMDR, DBT and Tapping. Getting help with the physical expression of trauma is also key. For some that means somatic release work through qi gong, yoga, dance and other sacred movement. For some that also means addressing the physical imbalances that trauma causes to the body, the invisible scars of poor gut absorption issues, poor immunity, anxiety, restlessness, muscle tension, rigidity and dissociative states.
Herbs are uniquely tailored to help those somatic expressions of trauma, those physical representations of shock, neglect and abuse that have been experienced. Instead of just thinking of reaching for one plant to make it all better, its often best to think of working with a number of different herbs, friends really, that can help bring greater physical, emotional and spiritual healing and transformation; to unwind those feelings of deep distress.
Herbs have a wide variety of actions. Some known as adaptogens build strength and resiliency. Nourishing tonics bring needed vitamins and minerals to undernourished parts of the body. Antispasmodics can help the body to relax and find greater ease. Sedatives can help a person to sleep. Analgesics can reduce pain in a variety of ways through improving circulation, reducing inflammation and targeting pain receptors. Taken together, these herbs can act as a multimodal symphony, helping to nourish, soothe, relax and heal at a core level. Herbs don’t just work at a symptomatic level to cause a change. They also can build, strengthen and transform us so that one is strong enough to handle the triggers and stressors that can cause a nervous system overreaction in those who have experienced trauma.
For those who have experienced trauma, it is key to not just expose and test a person’s nervous system, it is key to essentially rehab it, to literally rebuild and heal it so that it is stronger and more resilient in the future. That means working with a wide variety of plants, not just those that bring symptomatic relief. That is why I heavily emphasize the tonic and adaptogenic herbs and those recipe sections for those who have experienced trauma.
Imagine you own a potted plant that has grown in a pot and has started to outgrow it. The plant starts to wither as there is not enough room to grow and receive nourishment. Then something happens. Perhaps the plant falls and loses a whole branch. The plant is in shock and needs to be tended for it to survive. In this situation we would often choose a better larger pot and fill it up with lots of nourishing and mineral rich soil. If it enjoys sunlight we might then place it near a bright sunny window with other plants and water it regularly. Hopefully soon in time it will start to thrive again. The process for helping an individual who has experienced trauma is often the same. They need good nourishment, plenty of time to rest and heal, enough good care and attention, fresh clean water, plenty of sunlight and a safe and cozy home. Herbs can play a key role as that key nourishment that can help a person to heal at a core level.
Working through these deep states of trauma is not just a personal task, it is a collective and global one as well. We are living in a time of intense ecological and societal trauma that touches everyone. Finding ways to personally heal intersects with the larger need to treat the planet with far greater respect, to change how we grow and distribute food and how we treat those who are oppressed and marginalized. This is big work, and plants are part of this story. They have long been conduits for healing if we take a listen, open our hearts and return to work with them with good intent.
There is a lot of extra reading about this and I want to start with an amazing herbalist who focuses her practice on this area. Her name is Kirsten Hale and here are just a few of her articles on the subject.
In terms of books I would reccommend starting with these
by Bessel Van Der Kolk
Trauma and Recovery by Judith Herman
Waking the Tiger: Healing Trauma by Stephen Levine
by Pete Walker