Trauma impacts both the mind and body, so counseling must go beyond talk therapy.
Dr. Cheryl Paulhus is the Clinic Director for The Steven A. Cohen Military Family Clinic at Endeavors, Killeen. She oversees the clinic’s operations, making sure the programs run smoothly on a day-to-day basis.
But Dr. Paulhus’ career didn’t start out in the mental health field—at least, not in the traditional sense. Instead, from a young age, her passion was dance.
“Human development was a fascination that I had,” explained Paulhus. “But I really was more interested in dance.”
Paulhus received her B.S. in Dance from Skidmore College in Saratoga Springs, New York, and spent years performing and choreographing professionally across the country.
Eventually, her passion for helping people merged with her love of dance: She founded an after-school dance program for at-risk youth.
“I began creating programs like after-school programs for high-risk kids and then, slowly, over time, incorporated various types of psychoeducational things like how to manage stress and how to deal with difficult peers. The dream of dancing really evolved into a gift that I could give to children and adolescents and people in the mental health community,” says Paulhus.
Eventually, Dr. Paulhus went on to earn her Doctorate in Counseling Psychology, becoming a Licensed Professional Counselor (LPC).
Trauma lives in the body.
While the fields of dance and psychology may seem relatively disconnected, Paulhus is adamant that the two are intimately woven together. She says that dance, as a way of moving and expressing emotions through the body, can be a tool to access, process, and heal unresolved trauma.
“We know that trauma lies in the body, and that there are lots of things that happen to folks when they’ve experienced very traumatic events,” says Paulhus. “When it comes to trauma, the scene of the crime is ultimately the body.”
The consequences of trauma are complex and far-reaching, according to Paulhus. They may include complete disruption of life, isolation from others, anxiety, depression, PTSD, dissociative disorders, addictions, eating disorders, and a range of physical illnesses, as well as a loss of identity.
For years, traditional Western psychotherapy, behavioral health, and the medical field abandoned the idea that thoughts and emotions had such a profound effect on the body.
However, over the last several decades, researchers have come to find that trauma, depression, and anxiety are in many ways a biological issue. One of the most influential studies, The ACE (Adverse Childhood Experience) is being discussed worldwide, revealing groundbreaking findings that demonstrate the long-term effects of childhood traumatic experiences on adult health risks, mental health and life expectancy.
The revival of the mind/body approach has come about in part by some of this latest research in biology and neuroscience. Thanks to the work of many great practitioners and scientists, we have collectively developed a solid understanding of how traumatic experiences impact our minds, our bodies, and our relationships. This has widened the scope of effective and evidence-based care both from the “top down and the bottom up.”
Movement as a tool for healing.
Because trauma impacts both the mind and body, Paulhus explained it’s important to approach clients holistically—therapy is not a one-size-fits-all model. “We have to really look at the whole person,” she said.
Paulhus explained that, for this reason, sometimes talking isn’t the only (or even the best) approach. She advocates for counselors to bring their own creativity and passion to the process.
As a dance instructor and registered yoga teacher, Paulhus integrates somatic interventions, such as yoga, movement, meditation, and artistic expression into her work.
“Techniques like this can help people learn how to sense their body and begin to work with hyperarousal (startle responses and things like that) to befriend their body,” she said.
That’s why it’s important to have different methods and intervention points to work with people. The single most important issue for traumatized people is to find a sense of safety in their own body.
Paulhus explained that being present with music and dance can serve important purposes, like breaking through the intrusive and “splitting” thoughts that occur when PTSD is present and helping people stay mindfully in the present moment, rather than living in the past or the future, which can bring up feelings of fear, worry, and regret.
On another level, using artistic expression or other types of creative expression can assist in integrating and transforming trauma into a story to share with others, enabling the person to discover the meaning of this experience.
“For me, my love of dance as a kid was really important. I was experiencing how to work through things without having to really talk about it and being able to say really hard stuff, without opening my mouth.”
Ultimately, body movement can help bring us into a state of mindfulness, which challenges limiting beliefs that arise from trauma, quells anxiety about future events, and simply helps one stay grounded in the present. It can play a significant role in helping individuals who have been traumatized observe their experiences, increase awareness, and tolerate uncomfortable emotions and cognitions.
“The body speaks its own language and releases the suppressed voice and emotions hidden deep within their bodies and minds, and dance and movement therapy has the ability to free an individual from turmoil,” said Paulhus.
Talking isn’t always the answer.
All that to say, talking isn’t always the answer—in fact, in some cases, it can cause increased anxiety or panic.
“People living with trauma often don’t have the words to express their feelings, or find that their voices have previously been undermined or taken away,” said Paulhus.
“Sometimes, if a client doesn’t want to talk about their trauma, it’s not that they’re necessarily being resistant. They really may be reliving it through their body—through nightmares, flashbacks, feeling sick, having pain, etc., but they can’t quite understand where it comes from. They just know that they suffer a lot in their daily life,” she said.
Paulhus explained that, sometimes it’s not as important to really get all the details of exactly what happened.
“Reliving the trauma through talking about it can leave people walking around feeling really numb, spaced out, disassociated, not in touch with their body, feeling lots of pain and things like that.”
It’s not that talk isn’t important—but it can’t always be the first (or only) approach to healing. Paulhus says talk is still a vitally important piece of therapy for those who don’t know what happened to them, who were too young to understand, who weren’t listened to or believed, or who still can’t make sense of what happened.
However, on a fundamental level, words can’t integrate the disorganized sensations and action patterns that form the core imprint of the trauma…and this is where treatment needs to integrate the sensations and actions that have become stuck so that people can regain a sense of efficacy in themselves as a whole person, sometimes referred to as embodied.
In other words, our movement and body makes visible all of who we are: moods, personality, history, family, and culture. So invisible wounds do come through visibly if you know what to look for. Integration is key: healing the mind, body, and spirit.
Stepping into counseling is courageous.
Paulhus acknowledged it can be difficult to step into counseling for the first time. “It’s still a tough thing, breaking through some of the stigma,” she says. “But it’s just absolutely unnecessary to suffer anymore. Going to therapy could make all the difference in the world to your quality of life.”
She recommends learning to befriend your body. “It brings a tremendous amount of wisdom. It can really make you feel more whole.”
Thinking about visiting the Cohen Clinic?
The Steven A. Cohen Military Family Clinics at Endeavors® in San Antonio, El Paso, and Killeen provide in-person and virtual high-quality, accessible, and integrated mental health care to Veterans, regardless of role while in uniform, discharge status, or combat experience, active duty service members (with a TRICARE referral), and military families.
All clinics use evidence-based practices, provided by credentialed staff trained to work with military populations and we believe cost should never be a barrier to care. Life skills, wellness events, support groups, case management support, and local referrals to help with education, employment, financial assistance, housing, and legal issues are also available via the Cohen Clinics. You can learn more about the Cohen Clinics here!
About The Cohen Veterans Network
Cohen Veterans Network is a 501(c)(3) national not-for-profit philanthropic network of mental health clinics for post-9/11 Veterans and their families. CVN focuses on improving mental health outcomes via a network of outpatient mental health clinics for Veterans and their families in high-need communities, in which trained clinicians deliver holistic, evidence-based care to treat mental health conditions. The network currently has 19 clinics in operation serving Veterans and their families across the country. Learn more about Cohen Veterans Network.
About Endeavors
Endeavors is a longstanding national non-profit that provides an array of programs and services in support of children, families, Veterans, and those struggling with mental illness and other disabilities. Endeavors serves vulnerable people in crisis through innovative personalized services. For more information, please visit www.endeavors.org.