top of page

Complete Healing - Bottom-Up & Top-Down

Recently we have been on the cusp of moving house. Owing to the complexity of our situation, for much of 2022 my own stress levels were much higher than what they usually are.

Without me consciously planning for this, it gifted me with a great opportunity to road test many of the tools and techniques I share with my clients on a daily basis on the path to healing trauma, depression, stress and anxiety.

I reached a point last year when a particular situation would trigger me over and over again, and no matter how much trauma process work I did or how much help I received to heal 'wounds' from my past, nothing seemed to help and I was literally feeling high an dry. I tried to connect with my deepest Core Self awareness. I journeyed back to childhood memories, generational wounds and even a plethora of past life recollections - whether real or simply metaphor I cannot say - yet nothing seemed to budge.

Then I recalled a statement from a mentor years ago when I first embarked upon training in the trauma field - that clearing unresolved memories is important, but even more crucial was shifting the beliefs that we take on as a result of these experiences. Why did he say this? Because when a traumatic memory takes root in our nervous system, the belief we take on can magnify the impact of this memory dramatically, sometimes 100-fold. And so we can't completely heal unless we are fully able to turn around the self-defeating beliefs - such as 'I'm not safe' or 'I'm unloveable' - which have cunningly accompanied the memories themselves.

I also realized that in some people this litany of lethal beliefs can take a life on their own, and in some instances lead to severe depression or anxiety even when their is no obvious history of trauma whatsoever.

So how did this affect my own predicament?

Many years ago I came across a self-help book called Feeling Good - The New Mood Therapy by a brilliant and compassionate psychiatrist by the name of Dr David Burns, who was one of the pioneers in the field of cognitive therapy. This form of therapy - which seeks to dismantle distorted thinking patterns which inevitably underlie most painful emotional states - first originated in the 1960's and grew to become the single most popular and best researched non-drug treatment for both depression and anxiety.

These distorted thinking patterns number ten in all, and include toxic mental habits such as all-or-nothing thinking, generalizing, fortune telling, mind reading and should statements. When these distortions run the show, everything we encounter is filtered through this lethal lens and we inevitably get caught up in a wave of self-defeating beliefs such as 'I'm a failure' or 'I'm not good enough'. I embraced this form a therapy for a while in my own practice but quickly became disillusioned when I saw that for about a third of my clients it didn't really work.

Now feeling somewhat stuck, I sheepishly peered into an old copy of one of Dr Burns' books which had gathered years of dust in a remote corner of my book shelf. A few things resonated, so I fervently poured over his website and discovered there had been major advancements in this field which make current treatments far more effective.

One was a relationship journal - an exercise where you recall exactly what you and another person said in the heat of a challenging interaction, and then write down how you could have steered the conversation in a better direction with skillful disarming and genuine empathy, coupled with assertive and honest 'I feel' statements.

I was shocked to discover how difficult this exercise was when I put pen to paper. It was excruciating, in fact, to slow down the momentum of my habitual need to defend myself, prove I'm right, divert attention or try to solve a problem rather than simply listen. It literally felt like an ego death, yet after completing the journal only a few times I discovered that the same interactions which used to bug me were actually something I could now handle well... and that my relationship was being reborn into a new place where love could again lead the way.

The other technique I warmed to was externalization of voices. Basically this is a role play where one person plays the part of your negative thoughts - for instance 'I'm worthless unless I achieve great things', while the other one counters this, challenges this or comes to a place of paradoxical acceptance which is free from distorted thinking patterns. When there's a win, especially a big one, you immediately write down any new belief which blows apart the old distorted one. Then you switch roles, so the other person gets to challenge these negative beliefs. Going back and forth like this, it literally feels like the thinking part of the brain - the prefrontal cortex - is being rewired from the top down as the new belief becomes increasingly strong and robust. Note that you can also follow this process with an inner dialogue, playing the role of both sides.

Some people hit a ton of resistance engaging in a technique like this; however Dr Burns also has this covered by helping people brainstorm the hidden advantages or awesome qualities that are embedded within their vulnerability to experience depression and anxiety - such as being caring, compassionate folks with high standards, honesty and integrity. By siding with a client's resistance and proclaiming that he isn't sure he should cure their depression or anxiety for fear of wiping out the good qualities that go along with it, as if by magic the resistance will typically melt away. Then techniques like externalizing voices can work much more quickly and effectively.

So having been duly impressed by my recent foray into the world of cognitive therapy, does this mean I am now going to retire from the trauma healing business?

Definitely not.

With all this new learning, I am realizing the beautiful synergy between the bottom-up techniques of trauma processing work - which allows us to release the frozen, trapped emotional energy in the mid-brain which ultimately feeds our negative beliefs - and the top-down methods of cognitive therapy, which help us rewrite these same beliefs so that we have no real need to access this the trapped energy in the first place or can do so in a much gentler way.

I am discovering that folks who identify more with their feelings are more suited to the reprocessing work, while those who lead with their thinking are great candidates for the cognitive work. And that when someone is stuck, the obstacle is usually overcome by using the alternative approach. I love the juicy terrain of trauma healing with all its various nuances and complexities, yet although the cognitive work is somewhat dry and boring by comparison, I am discovering that for most of us it is absolutely necessary at some stage or another.

In the long run, then, I truly believe that healing is more complete if we address both dimensions - bottom-up as well as top-down. That both approaches, together, can help us tap into the blazing, unbridled brilliance of who we really are.

As settlement date looms just around the corner, knowing this little secret has certainly helped me reclaim my sanity on more than one occasion!

1 Comment

Great read and great thoughts. Karen

bottom of page