A Somatic Perspective on the Trauma of Growing up Gay by Payam Ghassemlou MFT, Ph.D.

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For almost three decades, I have immersed myself in the life stories of many people of the LGBTQ community who had painful homophobic and transphobic upbringings. Many of the gay men’s personal narratives that I have heard are not very different from my own. Regardless of national origin, we are part of a tribe with similar stories of growing up in a homophobic and heterosexist world where our gayness was repeatedly assaulted. We are everywhere, and unfortunately so is homophobia.

Many gay men have shared with me that as long they could recall they always felt different. They were unable to articulate why they felt that way, and, at the same time, they did not feel safe to talk about it. Some knew this feeling of being different was related to something forbidden. “It felt like keeping an ugly secret that I could not even understand,” described one person. Other gay men have disclosed to me that this feeling revealed itself in the form of gender nonconformity, which could not be kept secret. Therefore, it made them more vulnerable to homophobic mistreatment at school and often at home. Gay men of color reported even worse experiences due to the additional stress of racism and racial bullying.

Many school-age children organize their school experiences around the notion of not coming across as different, in particular, queer. Any school-age child’s worst nightmare is being labeled faggot, which was commonly experienced by many gay individuals who did not flow with the mainstream. Educational institutions felt like a scary place for many of them who were scapegoated as queer growing up. Therefore, they had to cope with a daily assault of shame and humiliation without any support. This is a form of child abuse on a collective level, and it needs to stop.

So much has been written about the devastating impact of homophobia on gay people’s psychological functioning but not enough on the biological impact of it. It is important to understand how repeated hateful acts toward gay youngsters can impact the way their bodies and minds function, including the functioning of their nervous system. Unfortunately, this also applies to any child who is a target of hate and abuse. As Peter Levine, the founder of Somatic Experiencing, stated, “Trauma is not in the event, but in the nervous system.” Based on my personal and clinical work, I also concur that trauma becomes embodied during a person's life and can affect the working of the autonomic nervous system (“ANS”). Much of the healing from this trauma needs to happen through the body. In particular, the nervous system needs to be regulated.

The ANS is the part of the nervous system that governs the fight, flight, or freeze instinct and  is responsible for the unconscious bodily functions like breathing, digesting food, and regulating the heart rate. It also plays an important role of supplying information from our organs to our brain. The ANS can become dysregulated due to the thwarted responses of fight, flight, or freeze in the aftermath of trauma.

The ANS is central to our experience of safety, connection with others, and our ability to bounce back from life’s overwhelming experiences. This ability to recover defines resilience and requires the help of our ANS to keep us in our “window of tolerance”, which has been defined in the book Nurturing Resilience by trauma specialists Kathy Kain and Stephen Terrell “as the zone where we effectively process environmental signals without becoming too reactive or too withdrawn, given the circumstances.” The window of tolerance as a frame work is very helpful to understand where we feel safe, unsafe, and how to expand our optimal arousal zone.

Stephen Porges’, Bessel van der Kolk’s, and Peter Levine’s research and writings have significantly reworked my understanding of how the nervous system responds to threat and trauma. Drawing from their work and my decades of experience, it is my understanding the ongoing stress from homophobia can activate a youngster’s nervous system and “unresolved activation will be stored in the body as bound energy and manifest as trauma symptoms.” In other words, under a daily homophobic assault, a child’s sympathetic system (“stress response” or “fight or flight” response) gets overly activated. Often during such stressful situations, neither fighting nor fleeing can resolve the overwhelming situation, and the thwarted or incomplete fight and flight responses can become “trapped” within the body and dysregulate the nervous system. Such a dysregulated nervous system is more likely to get stuck on “high” or hyper-arousal. Anxiety, panic attacks, rage, hyperactivity, mania, hypervigilance, sleeplessness, exaggerated startle response, digestive problems, and many other symptoms are the result of a dysregulated nervous system that is stuck on “high” or hyper-arousal.

According to many studies, gay individuals who experienced homophobic related stress showed increased production of the stress hormone cortisol compared to peers in safer environments.  This experience of being stuck on “high” continuously activates a person’s stress response system, which leads to the release of stress hormones. Research in this area has shown overexposure to cortisol and other stress hormones leads to numerous health problem including headaches, oversensitivity to touch or sound, weight gain, heart disease, concentration impairment, and sleep disturbance.

On the other hand, there are gay men whose nervous systems are stuck on “low” or hypo-arousal, which can result from being terrorized growing up with no hope of protection. Faced with isolation, confusion, physical violence, not being valued, and carrying a secret that the youngster connects with something terrible and unthinkable is too stressful for any child to endure, especially when there is no empathic other to help him sort it out. Such experience is often beyond the youngster’s “window of tolerance.”  This is when the dorsal vagus can shut down the entire system, and the mistreated youngster can go into freeze. In other words, the youngster suffers in silence with numbness or dissociation as his only available survival mechanism.

Stephen Porges, the founder of Polyvagal Theory, has expanded our view of the vagus nerve, one of the largest nerves in the body and a major part of the Parasympathetic system. The word “vagus” means wandering in Latin. The dorsal vagus is a branch of the vagus nerve which is a much older part of the nervous system. Dorsal vagus regulates organs below the diaphragm. Dorsal vagus is instrumental in activating the “shutdown” of the body as discussed in cases of overwhelming fear which can result from homophobic mistreatment. This automatic survival mechanism can become a long-standing pattern of how individuals might cope with fear and stress in life. For example, people whose nervous system is stuck on “low” or hypo-arousal when faced with life stresses can default to shutting down, disassociation, chronic isolation, detachment, numbness, and suicidal thoughts.

In my counseling work, I have noticed when the nervous system gets stuck on freeze, when numbness and detachment become a gay man’s dominant state, he is more likely to engage in risky behaviors as a temporary relief from inner deadness. Thrill seeking behaviors such as sexual acting out, excessive gambling, and crystal meth (crystal methamphetamine) use are ways some gay men escape the emotional flatness that results from experiencing the hypo-arousal state. The same behaviors can also be used to cope with ongoing activation of the fight or flight response. One person might turn to substance abuse to escape his inner deadness and another person might use it to dampen his anxiety that often results from being stuck in a state of hyper-arousal.

As Peter Levine stated, “Trauma is a fact of life. It does not, however, have to be a life sentence.”  For those of us who have had painful struggles with homophobia, life after the closet needs to include dealing with memories of homophobic mistreatment that can lie dormant in our body. Recovery from it needs to start with resourcing and then progressing to completing the thwarted responses of fight, flight, or freeze. Such healing can reset the nervous system and restore inner balance. In Body Keeps the Score, Dr. Bessel van der Kolk writes about a body-centered approach to healing which allows “the body to have experiences that deeply and viscerally contradict the helplessness, rage, or collapse that result from trauma.”

How far the LGBTQ community has come in our struggle for equal rights reflects how brave we are as a community. Our bravery can continue by facing traumas we experienced growing up in oppressive environments that did not nurture our true essence. Not every LGBTQ person felt traumatized growing up, but those who did can benefit from the vitality and the sense of liberation that comes with incorporating somatic work as part of the healing process.

The Somatic Experiencing Trauma Institute offers trainings and seminars on the biology of traumatic stress reactions including tools on how to bring the body-mind-spirit back into balance. Participating in their trainings has enhanced my ability to help others who are interested to tap into the wisdom of their bodies for healing and growth.  There are many other institutes that offer body-centered approaches toward healing which reflect the increased popularity of such work.

For more articles by Dr. Payam, please click on the following link:  https://drpayam.com/articles_and_book

© Dr. Payam Ghassemlou MFT, Ph.D. is a Licensed Marriage and Family Therapist (Psychotherapist), in private practice in West Hollywood, California.  www.DrPayam.com

A Somatic Approach on Working with Depression and Negative Self-Talk By Payam Ghassemlou MFT, Ph.D.

Depression is common and treatable. It can strike anyone at any age. Consulting with your physician or a licensed mental health provider is the best way to find out if you are suffering from depression and the type of depression you might be having.

A person with depression can experience a few or many of the following symptoms:

Feelings of sadness and emptiness

Feelings of anxiety

Experiencing restlessness or irritability

Losing interest in all or most activities

Problems with appetite that can lead to weight gain or weight loss

Sleeping problems

Loss of interest in sex

Low energy that can include feeling tired much of the time

Difficulty with concentration or making decisions

Feeling negative towards oneself including worthlessness or excessive guilt

Feeling hopeless or helplessness

Crying spells

Increased use of alcohol or drug use in order to cope with a depressed mood

Thoughts of death/suicidal ideation

Many people might not have the awareness that the underlying cause of the above-mentioned symptoms is depression; therefore, they cannot get the treatment they need. It is difficult to treat something that one has not identified yet. Over time, serious levels of depression that are not addressed get worse and can lead to other health-related issues. It can even lead to suicide.

There are different kinds of depression; hence, one person’s needs will differ from those of someone else. Psychotherapy is the most common treatment for depression. Psychotherapy can help on many different levels including integration of the clients’ body experiences in relation to their thoughts and emotions along with resolving or coping with issues that may contribute to their depression. Most mental health providers agree treatments for depression with suicidal ideation or other serious symptoms require a combination of antidepressants and psychotherapy. Some patients who might not show progress with standard treatments for depression might need additional resources.

In my counseling work with people who suffer from depression, I often notice that they have an inner critic which constantly makes them feel discouraged, inadequate and in many cases worthless. When the inner critic is the dominant voice inside a person, depression is likely to be present. Identifying the inner critic can be done by encouraging clients to pay attention to their body and their nervous system activation. For example, when Jack noticed his neck and shoulders curved forward, his head looking down, and unpleasant tension in his jaw, he was invited to become curious about this body language. The body language is a voice that does not use words and always tells the truth. He discovered an inner dialogue associated with this body posture, and it involved the following thought, “I am going to lose my job.” He realized how often he tells himself that his job is at jeopardy. When he was invited to examine all the reasons that he won’t lose his job, and all the resources that can help him to find another job in case he was let go, he noticed a shift in his body. He started sitting up straight with his shoulder pushing out, his jaw loosened, and he reported feeling more confident. He was encouraged to embody this new level of confidence by noticing all the positive shifts in his body including his deeper breath and feeling more relaxed in his shoulders. By tracking his pleasant bodily sensations that he was experiencing as result of identifying helpful resources, he was creating a physiological event in his body which led to regulating his nervous system. This can be a powerful approach to help someone suffering from negative self talk to use their body as a resource to modify such self-defeating dialogue.

There are many ways to work with negative inner dialogues and painful emotions that accompany them. It is helpful for clients and therapists to explore different treatment options as they work together. A collaborative therapeutic approach helps people to feel empowered and  in control of their recovery from depression.

Working with a mental health therapist to explore treatment options for depression is an important step toward healing. I hope anyone who is suffering from depression reaches out and gets the help they need. Everyone’s pain is unique, and no one deserves to suffer in silence. Reaching out and asking for help is a courageous act that people can do in response to suffering from depression.

© Dr. Payam Ghassemlou MFT, Ph.D., is  a marriage and family therapist in private practice in West Hollywood, California. www.DrPayam.com    www.SomativAliveness.com 

Resource is Power in Dealing with COVID-19 By Payam Ghassemlou Ph.D.

COVID-19 is the uninvited guest that has crashed our daily lives. This virus has forced us to take a collective “time out,” and shelter in our homes. Most of our plans are now on pause, and we are living with a great deal of uncertainty. For many of us, fear, helplessness, and confusion are among the common reactions to the coronavirus outbreak. It feels scary to deal with an invisible enemy that can attack the respiratory system and jeopardize our well-being or the health of our loved ones. No one should feel judged for having an emotional reaction to this pandemic. It is important to have empathy for our painful feelings, and our struggle dealing with this situation. Everyone’s pain is unique, and no one deserves to suffer in silence. Reaching out and asking for help is a courageous act that we can do in response to our need for support.

When it comes to asking for help, it is important to notice where we experience our distress. We often notice our overwhelming emotions and our intense thinking patterns when it comes to stressful situations. It is important to start with how our body experiences the threat of the COVID-19 pandemic, particularly its impact on our nervous system. Everything that happens to us starts with how our nervous system receives it. Our body comes with a built in autonomic nervous system (ANS) that provides many vital functions including helping us experience safety. Relying on neuroception, a term coined by Porges, the ANS helps our body differentiate between safety, danger, and a life threat. Our nervous system gets affected by what happens around or inside us. For example, the cues of danger that many of us sense by just making a short trip to our neighborhood grocery store is enough to dysregulate our nervous system. It is very difficult to function optimally when we are in a constant state of dysregulation caused by the threat of the coronavirus. As human beings, we need a sense of safety. We can’t thrive without it.

At times like this, we need to help our body feel safe and learn how to regulate our nervous system. We need to protect ourselves from getting infected by the virus or recover from it without getting paralyzed by fear and stress. Luckily, by providing the right resources, our body can become a vessel of safety to settle ourselves. A settled body can become a protective container during these turbulent times.

Our best ally to help our nervous system deal with the COVID-19 pandemic or any life challenge is accessing resources. What is a resource? A resource is power. It is anything in the universe that can empower us, support our wellbeing, help us feel safe and create a healthy connection with others. A resource is not only about what can help us thrive but also how helping ourselves can positively impact others and the Earth. A resource can be as simple as listening to calming music that can relax us or practicing physical distancing with others that can reduce our exposure to the coronavirus. We all have resources, and some of us might need support to identify them. It is very difficult to identify resources if we feel anxious, overwhelmed, or dealing with chronic habits of negative thinking.

We can start accessing  our resources by being present in our body. When we identify a helpful resource, we can notice our body’s reaction to it. For example, when we witness and slow down our breathing, along with silently repeating a meaningful mantra, we might be able to help our nervous system shift toward the experience of calmness. According to many scientists, slow breathing can stimulate the vagus nerve and help us go into the parasympathetic mode.  Moreover, for some of us by having body awareness during slow abdominal breathing, we can track positive sensations such as relaxation or calmness. Such tracking can help us  befriend our internal sensations and contribute to our nervous system regulation.

It is important to note not everyone finds meditation or slow breathing helpful. One size does not fit all. A resource needs to be tailored to the needs of the individual. For instance, some of us find certain dances or movements helpful. Our body might respond positively to such  experience by releasing tension. Other people might notice feeling lighter in their body after watching a comedy. No one should feel judged for not finding certain resources helpful.

The right resources can help with nervous system regulation and help our body experience safety. A regulated nervous system helps with creating a strong foundation to cope with the stress of the COVID-19 pandemic. In addition, there is magic in a breath that flows from a person with a regulated nervous system since it can add harmony to the collective nervous system. Everyone has a nervous system and embracing the oneness of our humanity can include awareness of our collective nervous system. Since we are all part of one humanity, our attempt to create inner peace is good for everyone’s nervous system.  If a virus can be spread so quickly and globally, peace can too.

We can create a list of the resources that can assist us dealing with the impact of this pandemic. We can create it on our own, with the help of a therapist or a trusted person. Again, it is okay to reach out and ask for help even when it comes with resource making. As we make this list, we can bring awareness to what it is like on the inside knowing we have resources. For many, resource-making can be an act of self-care that can lead to a sense of aliveness. It can also be empowering and help our body experience a sense of safety. Peace, serenity, and a sense of safety can be very empowering for the immune system. In addition, resources can help us collectively. For example, a collective breath is a resource that can help us pause and change our old way of living. As our life story with COVID-19 unfolds, let’s reflect and realize a crisis is not always about danger but also the opportunity to transform.

© Dr. Payam Ghassemlou MFT, Ph.D. is a Licensed Marriage and Family Therapist (Psychotherapist), in private practice in West Hollywood, California.  www.DrPayam.com    www.SomaticAliveness.com  

Breath & Love: A Different Kind of Intoxication by Payam Ghassemlou Ph.D.

The word intoxication often gets associated with substance use. Even though some people do experience a physical high through drinking or drug use, such behaviors have nothing to do with the real desire of the soul for elevation. There is a different kind of intoxication that comes from certain body-mind practices. Such practice draws breath and love together with the intention of a journey into the heart, which is into an inner place you can call “home.” 

Every journey has a beginning.  The journey into the heart starts with awareness of breath, which is one of the most accessible paths to the present moment and has the potential for transformation. Breathing is an automatic bodily function that you can consciously work with.  For instance, you can infuse each breath you take with a silent mantra, which can be performed anytime and anywhere. A mantra can be given by one’s mentor or can be found through personal research. A conscious breath that is combined with a deeply personal mantra has a different quality than an automatic one. It is a beautiful breath with a potential to connect you to a deeper place within yourself.  

There are many ways of breathing. Each with their own physiological impact on the body including the impact on the nervous system. For example, when you witness and slow down your breathing going out and coming in, along with silently repeating a meaningful mantra, you can help your nervous system shift toward the experience of calmness. According to many scientists, slow breathing can stimulate the vagus nerve and help you go into the parasympathetic mode.  Moreover, by having body awareness during slow abdominal breathing, you can track positive sensations such as relaxation or calmness. Such tracking can help you to befriend your internal sensations and contribute to your nervous system regulation. A regulated nervous system helps with creating a strong foundation for your personal or spiritual journey along with deepening your connection to your body, mind, and soul. In addition, there is magic in a breath that flows from a person with a regulated nervous system since it can add harmony to the collective nervous system. Everyone has a nervous system and embracing the oneness of our humanity can include awareness of our collective nervous system. Since we are all part of one humanity, your attempt to create inner peace is good for everyone’s nervous system. 

As you journey into the heart with awareness of  breath, you need to invite love into this process. Love is more than an emotion. It is an experience, and you can access it through your imagination. For instance, as you notice your breathing, imagine a moment in your life when you  felt real love and kindness. Notice the bodily “felt sense” of this pleasant experience as you imagine it. Let the pleasant sensation(s) that can come up infuse every part of your body. Take all the time you need and dive into this heartwarming experience. Such a practice can become a doorway to an inner space where a mystical dance of breath and love give rise to an intoxicating experience. This is how you can connect with your heart and immerse your mind into the energy of love. This is how you can  “go home.” 

When such  practice is done not just for the sake of personal growth but to add more harmony to life, it can expand beyond yourself and help the world. Breathing with the intention of a union with love can add more love to the web of universal connectivity and increase  participation in creating balance within the universe. Currently, the world needs more love, and our personal journey needs to include compassion for the Earth and each other.

The combination of breath and love is a free elixir that is available to everyone and is the fuel needed to “go home.” However, for some people with unresolved past traumas it might be challenging to benefit from such combination. The sense of bliss that you can experience when love merges with breath is difficult to access in a body frozen by trauma. That is why in order to “go home” one needs to claim the body from unhealed trauma. Since unhealed trauma can affect the working of the autonomic nervous system, it can be difficult for many trauma survivors to feel safe enough to let go and experience such a deep inner journey. The nervous system has many functions including helping us experience a sense of safety. Since trauma is in the body,  particularly the nervous system, somatic psychotherapy can be a helpful approach toward healing from trauma.  

The practice of combining love and breath can help you journey into a sacred place within your heart you can call “home.” This practice helps you  realize love is more accessible than your past wants you to believe. Such a practice can be an inner container for love where its intoxicating magic can transform you.

© Dr. Payam Ghassemlou MFT, Ph.D. is a Licensed Marriage and Family Therapist (Psychotherapist), in private practice in West Hollywood, California.  www.DrPayam.com , www.SomaticAliveness.com