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Article: The Power of Radical Acceptance: Healing Trauma through the Integration of Buddhist Meditation and Psychotherapy

Jul 1, 2011

by Tara Brach

When I was in college, I went off to the mountains for a weekend of hiking with an older, wiser friend of twenty-two. After we set up our tent, we sat by a stream, watching the water swirl around rocks and talking about our lives. At one point she described how she was learning to be “her own best friend.” A huge wave of sadness came over me, and I broke down sobbing. I was the farthest thing from my own best friend. I was continually harassed by an inner judge who was merciless, relentless, nit-picking, driving, often invisible but always on the job. In the eyes of the world, I was highly functional. Internally, I was anxious, driven and often depressed. I didn’t feel at peace with any part of my life. I longed to be kinder to myself. I longed to befriend my inner experience and to feel more intimacy and ease with the people in my life.

These longings drew me to psychotherapy—as a client and then clinician—and to the Buddhist path. In the weaving of these traditions I discovered what I now call “Radical Acceptance,” which means clearly recognizing what we are feeling in the present moment and regarding that experience with compassion. Carl Rogers wrote: “The curious paradox is that when I accept myself just as I am, then I can change.” In my own inner work, and in working with my psychotherapy clients and meditation students, I see over and over that Radical Acceptance is the gateway to healing wounds and spiritual transformation. When we can meet our experience with Radical Acceptance, we discover the wholeness, wisdom and love that are our deepest nature.

Buddhist meditation practices and psychotherapy contribute to Radical Acceptance in distinct and complementary ways. With Buddhist mindfulness training we learn to be aware of what is happening inside us with a clear, non-judging attention. Specific practices to develop compassion cultivate our capacity to hold with kindness painful or intense experiences that are arising within us. Although taught and practiced in groups, these trainings of heart and mind are primarily a solitary, intrapsychic endeavor. Especially when there has been childhood trauma, “going it alone” in this way can be frightening and disorienting. Mindfulness practices can unleash buried emotions that might re-traumatize the unskilled practitioner. Or, rigid and habitual defenses against raw feelings may impede the ability to focus or relax. In either case, meditation feels discouraging or impossible, only deepening a sense of unworthiness.

When there is deep wounding, the presence of the therapist and the tools of psychotherapy provide a safe and supportive container in which memories and associated feelings can gradually come into consciousness. But in my experience, if the process of including difficult emotions in awareness stops at the level of cognitive understanding without a fully embodied experience, the genuine acceptance, insight and inner freedom that are the essence of true healing will not be complete. Also, if the client can only access and open to strong feelings in the presence of the therapist, he or she will not have the tools or confidence to continue on a path of personal and spiritual transformation. The work with my client Rosalie is an example of how, through a combination of psychotherapy and meditation practices, Radical Acceptance can lead to profound healing and spiritual transformation in a traumatized client.

As a child, Rosalie had been severely abused by her father. When he was drunk he would reach into her underpants or climb into her bed at night and rub his body against hers until he climaxed. When she resisted him, he’d hit her and threaten her with worse. If she tried to run away and hide, he would become enraged, chase after her and mercilessly beat her. On two occasions during the year before he and her mother divorced, Rosalie’s father had forced her to have intercourse with him.

When Rosalie came to see me, she was thirty-five years old, single, and mildly anorexic. She’d already been through several forms of therapy, but was still going on and off starvation diets and suffering from regular anxiety attacks. Her body was thin, rigid and tight; and she was mistrustful of everyone she knew. Most basically she mistrusted and hated herself—she felt she was fundamentally flawed, “damaged goods,” as she put it.

Rosalie assumed that anyone who appeared to like her really just wanted to take advantage of her. She told me she thought one person she hung around with was a friend only because she didn’t want to go to parties alone. Another woman, who was attractive and popular with men, must like to be around her because it “boosted her ego” to compare herself with the loser Rosalie considered herself to be. While Rosalie had no trouble finding dates, intimacy never lasted for long. Not wanting to feel the humiliation of being dropped, she usually broke off the relationship at the first signs that things were going downhill. Even with people she’d known for a long time, Rosalie kept her distance. When she was going through one of her regular bouts of anxiety she’d either act as if she “had it all together” or disappear for a while.

Often the only way Rosalie could spend time with people was by getting stoned. Marijuana made everything seem okay for the time being. But, she told me, now she needed to get high every night before bed in order to sleep through the night. If she didn’t smoke a joint or take sleeping pills, she’d wake up in the middle of the night in a fit of terror. The dream was always the same—she was hiding in a small dark place and someone beastly and insane was about to find her.

Traumatic abuse causes lasting changes in our physiology, nervous system and brain chemistry. In the course of normal development, memories are consolidated as we evaluate each new situation in terms of the cohesive worldview we have previously formulated. When there has been trauma, this cognitive process is short-circuited by the surge of painful and intense stimulation. Instead of “processing the experience” by fitting it into our understanding of how the world works and thereby learning from it, we revert to a more primitive form of encoding—through physical sensations and visual images. Even years after the actual danger is past, the trauma, undigested and locked in our body, randomly breaks through into consciousness. A person who has been traumatized may continue to relive the same event as if it were occurring in the present. For Rosalie, traumatic memories surfaced in her dreams, and the effort of repressing them in daily life kept her body and mind in a constant state of anxiety.

Unprocessed pain keeps our system of self-preservation on permanent alert. In addition to sudden intrusive memories, a wide range of situations, many non-threatening, may activate the alarmingly high levels of pain and fear stored in our body. Our partner might raise her voice in irritation, and the full force of our past wounds—all the terror or rage or hurt that lives in our body—can be unleashed. Whether or not there is any present danger, we feel absolutely at risk and compelled to find a way to get away from the pain.

In order to make it through such sudden and severe pain, victims of trauma typically dissociate from their bodies, numbing their sensitivity to physical sensations. Some people feel “unreal,” as if they have left their body and are experiencing life from a great distance. They do whatever they can to keep from feeling the raw sensations of fear and pain in their body. They might lash out in aggression or freeze in depression or confusion. They might have suicidal thoughts or drink themselves senseless. They overeat or starve themselves, use drugs, obsess and in other ways try to numb or control their experience. Yet the pain and fear don’t go away. Rather, they lurk in the background and from time to time suddenly take over.

Dissociation, while protective, creates suffering. When we leave our bodies, we leave home. By rejecting pain and pulling away from the ground of our being, we experience the dis-ease of separation—loneliness, anxiety and shame. Author and psychotherapist Alice Miller lets us know that there is no way to avoid what’s in the body. We either pay attention to it, or we suffer the consequences:

The truth about our childhood is stored up in our body, and although we can repress it, we can never alter it. Our intellect can be deceived, our feelings manipulated, and conceptions confused, and our body tricked with medication. But someday our body will present its bill, for it is as incorruptible as a child, who, still whole in spirit, will accept no compromises or excuses, and it will not stop tormenting us until we stop evading the truth.

When Rosalie and I started working together, it was clear that her time had come—her body was presenting its bill. During our first few sessions she poured our her life story. While she was very bright and could easily articulate her problems and their causes, it was as if she were talking about someone else’s life. She let me know that when we were talking she wasn’t aware of feelings in her body, yet outside of therapy she was sometimes besieged by panic or rage. At those times these feelings in her body were so intense she wanted to die. “I can’t do it right, Tara” she told me. “I’m either out of touch or out of control. No wonder I can’t meditate and therapy never helps.”

I suggested we might work together to help her gradually feel safer in her body, and let her know that this could make a difference in a way that her previous therapies hadn’t. She readily agreed, and over the next few weeks we laid the groundwork. I wanted to understand Rosalie as deeply as possible, and she needed to feel safe and comfortable with me. During these sessions she talked about her longings and fears, as well as her shame about always being the “patient,” the one with a problem. When she was ready, I suggested that in our next meeting we do a guided journey, exploring parts of her inner life that might lie outside her conscious awareness.

On the day of the journey I invited Rosalie to sit comfortably and close her eyes. I guided her with the hypnotic imagery of slowly descending a long winding staircase that ended facing a closed door. I suggested that with each step she leave behind distracting thoughts and become increasingly relaxed and curious. By the time she had reached the bottom of the stairs, Rosalie’s body was very still, her eyelids flickering, her face slightly flushed. She nodded when I asked if she saw a door, and I suggested that behind it she would discover something important to her healing, some gift from her unconscious mind. I reminded her that no matter what she experienced, she was safe. We were here together, and she could come back whenever she wished. Then I told her she could open the door whenever she was ready.

Rosalie stiffened. “What do you see?” I asked softly. Her voice was barely a whisper. “A little girl. She’s in a closet…hiding.”

When I asked what she was hiding from, Rosalie shook her head slightly. After a few moments I asked how old she was. “She’s seven,” she responded and went on quickly, “It’s her dad. He’s going to find her and hurt her.” I reassured her that the little girl was safe right now, and suggested that by relaxing and just noticing what happened next, she would discover some way this girl might be helped. When I saw her breathing more easily, I asked what the little girl was doing now. “She’s praying. She’s saying it hurts too much, that she can’t take it anymore.”

I waited for a few moments then asked her gently, “Rosalie, what might help that little girl handle all that pain?”

She frowned, “She’s all by herself…there’s no one there.” Then her words came slowly: “She needs someone to take care of her.”

“Who could best do that?” I asked. Again she paused, intent and focused. Suddenly her face filled with a look of surprise and amusement: “A good fairy! I can see her there with the little girl…She’s with her in the closet.” Rosalie waited for a moment and then reported, “The fairy’s surrounded by a shimmering blue light and she’s waving a golden wand.”

“Rosalie, does the fairy have a message for the little girl, something she wants to say?”

She nodded: “She’s telling her she can do something to help. She can do something that will let her forget for a while about the horrible things going on, so she can grow up and handle it when she’s stronger.

I paused for a bit and then speaking softly asked how the fairy was going to do that. Rosalie’s tone was calm and deliberate: “She says she is going to touch different parts of her body with her magic wand and they will change and be able to hold all the terrible feelings for her.” She paused, listening inwardly, and then continued, “The good fairy is saying that even though it’s hard to be so bound up, it will be her way to survive, to be quiet and control what’s happening inside her.”

After a long silence, I asked Rosalie what had happened. “Well, the fairy put the little girl’s rage and fear into her belly, and then she bound it up so it could stay there. And then she put a magic lock on her pelvis and vagina so her sexual feelings couldn’t get her in any more trouble.” Rosalie took a few shaky breaths, and I gently asked, “What else?”

Tears began rolling down her cheeks as she said, “She told her she’d have to let her rib cage tighten so she wouldn’t feel the pain of her heart breaking.” Rosalie was quiet and then she went on, her voice a little stronger. “She said her neck would be a fortress with very thick round walls so that she wouldn’t cry out for help or scream out in anger.” Rosalie fell quiet and I just sat with her in silence.

“You’re doing beautifully,” I told her, and then added gently, “Is there anything else the fairy wants you to know?” Rosalie nodded. “She says some day the little girl will no longer be able to hold all this in, and her body will start unwinding its secrets. She will let go of everything she has been holding for so long…and she will do this because most deeply, she wants to be whole and real.” Rosalie was softly weeping, her shoulders shaking. “She just told the little girl not to worry. She would find people who cared and would hold her as she finds herself again.”

Rosalie sank back in her chair, and I asked what was happening now. “The good fairy is putting her arms around the little girl and taking her to bed.” After a few moments she continued, whispering, “She’s telling her that when she wakes up, she will forget what happened, but she will remember when she’s ready.” Rosalie was quiet and when she continued her voice was tender: “The good fairy just told her, ‘Until then, and for always, I love you.’”

As if she had just finished the last page of a cherished book, Rosalie reached for the shawl I leave on my couch, wrapped it around her and lay down, curling herself into the cushions. “Is this okay?” she whispered. “I just want to rest for a few minutes.” Her face looked serene, as if these were the first real moments of ease she had touched in a long, long time.

In the weeks that followed her inner journey, Rosalie slowly emerged as if from a cocoon. I noticed that even her physical movements were lighter, more fluid. She felt better about herself: Rosalie was beginning to accept that, all those years, she had been doing the best she could. It wasn’t her fault that she had never chosen to face the intensity of her feelings. It wasn’t her fault that she had tried to control her body with anorexia and armor her heart against intimacy with others—this was her way of defending herself from more pain. There had been something intelligent and loving guiding her.

I asked if she would mind if I shared her “fairy story” in one of my meditation classes. That made her happy—she gladly wished for others the new inner freedom she felt. When I told the story, a number of people cried as they realized how they too had pulled away from their bodies, how they had locked up their energy and were not fully alive. It opened up the possibility of forgiving themselves for not facing their own deep wounds, and it helped them understand that it was natural to seek relief by hiding and defending in the face of unbearable pain.

While there are times in our life we might have had no choice but to contract away from unbearable physical or emotional pain, our healing comes from reconnecting with those places in our body where that pain is stored. For Rosalie, as for all of us, moving toward freedom requires bringing Radical Acceptance to the pain that has been locked away in fear. By dialoguing with the good fairy, Rosalie began bringing to consciousness memories and feelings that had been a hidden source of deep suffering. Through this process she also became aware of her deep yearning to be whole and real. No matter how deeply we have been wounded, we begin our spiritual journey when we listen to the inner voice that calls usback to our bodies, back to wholeness.

Healing our Wounds: Returning Home to our Body

In addition to the safety provided by the therapeutic relationship, psychotherapy focuses on the historical story in a way that allows it to become a gateway to living experience. By paying attention to memories, we tap the related emotions and feelings that are locked in the body. Once the psyche is open to what the body holds, the only way to face those feelings wisely and successfully, and in a way that leads to deep healing, is to be able to stay present with the pain when it arises. This can be very difficult, especially when the habit of recoiling or hiding from intense and unpleasant sensations is deeply entrenched. In my work with clients, this is where I see the tremendous value of meditation practices in training the mind. With Rosalie, once her defenses began to lift, it was important that she learn tools she could use to face the pain of trauma whenever it might arise.

In several subsequent sessions with Rosalie, I introduced her to the practices of mindfulness and compassion. We began with a meditation in which she moved her attention slowly up and down her body, focusing on each region—feet and legs, torso, shoulders, arms and hands, neck, head. I encouraged Rosalie to imagine breathing energy and light into the part of the body she was attending to and totally letting go and relaxing as she breathed outward. As she deepened her attention in each area, I suggest that she simply notice whatever sensations she felt there, accepting them exactly as they were.

In one session when Rosalie told me she was having a hard time feeling sensations inside her stomach and pelvic area, I asked her what color felt healing to her. She immediately remembered the shimmering blue that had surrounded the fairy. I suggested that she imagine feeling those areas of her body bathed in that blue, letting the color wash through her with each breath. After some moments Rosalie nervously reported, “I do feel some movement, some tingling,” and then, “That’s enough for now.” While she wasn’t able to sustain her attention in that newly awakening area for very long, Rosalie was proud of her first efforts. It had taken courage to re-enter the places that had felt so dangerous.

Rosalie arrived at our next session excited about a new man she had met. But by the following week excitement had turned to anxiety and her body looked rigid with fear. She really liked this guy and didn’t want to pull away: “If I can’t make peace with this fear, Tara, I won’t hang in there.” Rosalie knew she needed to meet her body’s experience—the harsh gripping of fear—with Radical Acceptance.

I suggested she pause and, feeling into her body, sense what was most asking for her attention and acceptance. This was new for Rosalie. Up until now she had only explored a mindful presence in her body when she was relatively relaxed. That was safe, but to feel raw fear had many painful associations. Closing her eyes she became silent and still. After about a minute she put her hand on her stomach. “In here,” she said. “I’m really scared…I feel like I could throw up.” I encouraged her to let the warmth of her hand, her own gentle touch help her bring her full awareness to the unpleasant feelings. I asked her if she could feel that area from the inside and just notice what was happening.

Rosalie took several full breaths and sank back into the couch. For the next few minutes she named what she was experiencing: the soreness and squeezing tightness in the center of her belly, the feelings of her chest rising and falling with several deep breaths, loosening and dissolving of the hard knot in her stomach, a quaking and jumpiness spreading throughout her stomach, the thought “Maybe he’s the right one,” stabbing fear, shaking, the image of a young child alone in the closet, the thought “I can’t stand this,” heat spreading up into her chest and throat, a strangling feeling in her throat, breathing in blue, opening and softening in her throat, an upwelling of sadness. When she finally looked up, her eyes were glistening: “Tara, all this is happening inside me, and I’m just holding that little girl in my arms.” After a few moments she went on: “I feel like I can accept this pain, I can handle whatever I’m feeling.”

Rosalie’s experience with the fairy had revealed her own inner wisdom, her urge to protect herself and her longing to be awake and whole. Taking the risk to open mindfully to sensations was now giving this trust its deepest roots. Each time Rosalie could sense her body from the inside and accept the sensations that were arising, even the most frightening ones, she felt more confidence about her capacity to be at home there. She could handle whatever came up. This was the gift of Radical Acceptance: As she stopped resisting pain and instead opened to regard it with compassion, Rosalie was directly dismantling her identity as an abused, weak and worthless person.

Learning to bring Radical Acceptance to physical and emotional experience is usually a gradual process. If there is a large reservoir of fear locked in the body, it is important to begin as Rosalie did, with the support of a healer or therapist, and with a gentle exploration into the life story that carries such charged energy. Then, guided and accompanied by a trusted other, the client learns to mindfully “put a toe in the river,” feeling the sensations and then stepping back when necessary.

In both Buddhist psychology and Western experiential therapy, this process of experiencing and accepting the changing stream of sensations is central to the alchemy of transformation. Emotions, a combination of physical sensations and the stories we tell ourselves, continue to cause suffering until we experience them where they live in our body. If we bring a steady attention to the immediate physical experience of an emotion, past sensations and stories linked to it that have been locked in our body and mind are “de-repressed.” Layers of historic hurt, fear or anger may begin to play themselves out in the light of awareness. When we feel and release the past pain held in our body, we become increasingly free to meet our present feelings with a wakeful and kind heart. We discover, as Rumi writes, “The cure for the pain is in the pain.”

For all of us, the path of befriending our experience requires great gentleness and patience. As I recognized on my trip to the mountains in college, the deep and persistent tendency to think that something is wrong with us is a prison that prevents us from living and loving fully. Yet as we learn to meet whatever arises in our body, heart and mind with Radical Acceptance we discover a precious freedom. Rather than being identified as a defended and insufficient self, we come to trust what Buddhists call our Buddha nature—the awareness and love that are our true essence.


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