One of the wonderful things about TRE® is its strong international community. Last week Steve Haines, the Certification Trainer of TRE London, was in the Los Angeles area teaching a craniosacral therapy training. He stopped by our offices and after a delicious meal at a local restaurant, Steve interviewed our Certification Trainer, Nkem Ndefo. Take a listen (or a read) of their thoughts about TRE® practice, certification, and several points in between.
Steve: Hi, Nkem. I’ve just flown over to Los Angeles, and I’ve taken the chance to meet you, because I’ve read some of your stuff, seen your website, and I’ve enjoyed talking to you in the background around TRE®. I’m really curious how you got into TRE® and what you find exciting about TRE®.
Nkem: I often tell a story that we all have our issues, and back issues aren’t mine. But several years ago, I was working with a patient and moved a chair and had a spasm in my back. I was laid up in bed, saying, “I know this is the psoas,” so I started researching different methods of psoas release. I came across two, and I downloaded and read both.
When I got into the TRE® material, I said, “There’s something more here,” and I almost had a giddy feeling, like a kid who has found a treasure. Like: “Does anybody else see what’s here?”
So, I started to practice. Not only did my back release, but all kind of changes happened over about six months. Interestingly, in my holistic practice I was hearing over and over again that a big stumbling block for people was toxic stress and trauma, and I didn’t always feel like I had enough tools to combat this. So, finding TRE® was a perfect dovetailing of those two things: addressing both my own personal experience, and my clients struggles with the downstream effects of toxic stress and trauma.
I went and got certified, and I really haven’t looked back. TRE® has taken up more and more space in my private practice. I don’t think that TRE® does everything, but it does an awful lot.
Steve: What do you use it for now? Hopefully your back is better these days?
Nkem: Yes, no back problems. Very nice.
Steve: Apart from the excitement of teaching, spreading the word, and understanding the TRE® model, how might you use it for your own health?
Nkem: Having complex PTSD and chronic fatigue, TRE® has been instrumental in my own recovery. I’ve done a lot of mainstream, not-so-mainstream, maybe even fringe things, looking for relief and help, and TRE® was that missing piece–that place to really reset my nervous system. I maintain a very regular practice, personally, and I swear by group practice. I attend a group every single week, like religion. The benefits of that carry me and I feel my body settle in in a place of safety that I don’t think I had ever experienced for as long as I can remember.
Steve: One of the things I frequently hear people say after doing TRE® is: “I found my body,” or, “I didn’t know. I wasn’t in a body, and now I have a body.” Does that speak to your experience?
Nkem: It does, in part. I’m close to five years of personal practice and teaching, and there was a moment in my TRE® practice where I realized that maybe my body had not left me or betrayed me. I realized that my body was there all along; I had left my body, and it was waiting for me to return. (It allowed) me to settle more and more deeply into my body as it was a safe place to be. I felt like it was okay to be here, like I could be here all the way down to my feet. Yes, in a roundabout way, I did feel that.
Steve: I like this, it’s a very interesting question: I leave my body, where’s the I? Something about being integrated – spirit, mind, body, as a unit that functions harmoniously. I know you’re teaching some great programs here. What’s the hardest thing for you to teach around TRE®?
Nkem: Self-regulation. The therapeutic tremor is actually fairly easy to turn on. I’ve taught close to 1,500 individuals, and some of them I’ve taught many, many, many times, and really only one person didn’t have the therapeutic tremor turn on the first time.
Steve: I love that story. I say it’s at about 700 people that I’ve taught over the last few years, and I have one person who didn’t shake, either. What was your one persons’ experience?
Nkem: It was the first time, and it just wasn’t safe enough for her to shake yet. The numbers are pretty good that people can turn on the therapeutic tremor. What’s really hard to learn is how to self-regulate. We live in a culture that tells us to push through everything, and we lose our barometer. We lose our ability to even say when we’re comfortable or not, because we live uncomfortably. That is such a different way of approaching things. It really is a paradigm shift. People can get it intellectually, but it takes time for it to really sink and land in the body, and to say: “You know what? I can stop here. I’m not comfortable. I can back off.” That translates not just into the TRE® experience, but into their whole lives.
Steve: Very nice. What’s the difference between self-regulation and control, then, for you?
Nkem: Self-regulation is acknowledging that you have a window of tolerance in which you feel comfortable and in which you feel safe. It’s from that place that healing proceeds best, because when we don’t feel safe and we don’t feel comfortable, we contract and we hold. We can use cognitive tools to tell ourselves to relax, but the non-cognitive, more primitive parts of ourselves – if they don’t feel safe, they’re not going to relax.
Self-regulation is the ability to recognize that window of tolerance and stay in that window of tolerance. If we rise to the top of that window of tolerance and then settle to the bottom of that window of tolerance, and then repeatedly go back and forth in there, up and down, that rhythmicity actually increases the window of tolerance.
Steve: Nice, so you get more resilience. Often, “control” can be quite a loaded word for people. “I need to stay in control,” or they’re meeting a body unconscious, and that becomes scary actually. You can almost see why people describe demons and entities being inside us. Somehow, in my history around TRE®, control becomes a little bit of a loaded word. Self-regulation softens that, and implies a skill that isn’t about repression, but is a negotiation to help you have an ability to cope with more.
Nkem: Right. It’s a self-awareness, and then a self-acknowledgement, and a self-acceptance. Control and acceptance usually don’t fall in the same sentence very well.
Steve: Good. I know you’re involved in some of the research around TRE®. First off: How do you think TRE® works? What are the key things that happen in that shaking process?
Nkem: I have theories. I don’t think we really know, because I don’t think we understand the body as well as we think we do. We just found out that there’s a whole new circulatory system in the fascia. There’s a whole new third circulatory system. We’re finding out things all the time. They found a new ligament in the knee just a year ago.
My theory is that for the autonomic nervous system, TRE® is a reset button. The shaking, which we often associate with a lot of adrenaline/epinephrine as a discharge, actually is larger than that. It’s a reset of the autonomic nervous system from a state of high activation to a baseline. If you think about the autonomic nervous system as intimately involved with hormonal systems, central neurological systems, and pretty much every system in the body, as these are the controlling systems, that reset resets all of those systems.
Steve: Very nice. Sometimes it’s not much simpler than a rebootable computer; you turn it off, you turn it on again, and it just seems to work better.
Steve: Yeah, this is an enormous waking up of the body through TRE®. I describe it much more, or at least as much, as a releasing process. It’s a meeting of the body and waking up of the body. Does that fit with your view at all?
Nkem: It does. I use the word “regulation,” but I think it’s pretty similar. I don’t believe people can release something, if they can’t experience it while being present. Somebody has to be regulated first, and their window of tolerance has to be large enough for whatever it is that they’ve experienced, so that it can be released. If what you’ve experienced is larger than your window of tolerance, you can’t release it yet; you have to grow the window of tolerance to be able to release it.
Steve: Being present, what does that mean for you?
Nkem: Being aware of yourself, somatically, of what’s happening in the body, being aware of the emotions and the thoughts. It’s an integrated awareness of your internal and external experience at that moment.
Steve: Great. There was a committee in the background around research and trying to coordinate that. I remember being very impressed the first time I talked to you about some of the focus, and trying to get at least three pieces of research out there as a kick start to the community. Anything happening around that?
Nkem: We have copious amounts of anecdotal evidence around the world, but we live in a culture that demands evidence-based practice, especially if we’re looking at incorporating TRE® into organizations, governmental agencies, and the like; they demand that level of randomized, controlled trials.
TRE® has just completed a beautiful randomized control trial of East African (primarily Sudanese) women refugees, looking at PTSD. It was a randomized control trial with a crossover, meaning that one group received TRE® and the other group received just talking in a group, and then they switched. That just completed on July 11th, and there are preliminary results that look very positive for a significant decrease in trauma symptoms.
What’s important about the research is that a lot of times, we want to believe. We want to please our provider, we want it to work. It’s really important that we show that we have a controlled study where there is that control group, so we can say: “Yes, TRE® really was the difference here. It wasn’t wanting, it wasn’t placebo. It really was the TRE®.” I think that’s important for TRE® to gain the credibility to break into organizational work. There’s a small trial on restless legs that was just completed in Australia. There’s one in the preparatory phases on fibromyalgia in Brazil. We’re looking at TRE® for different clinical entities.
I would like to see the direction move toward looking at TRE® for symptoms, rather than the clinical entities. For example, sleep disturbance is really common across a lot of different diagnostic criteria. It’s one thing we hear frequently, that people sleep better when they use TRE®. It would be really interesting to look at sleep, because if we know TRE® can help sleep in that formal research setting, then we can look across all the different diagnostic criteria that are affected by sleep, and then TRE® becomes applicable across a lot of diagnoses.
Steve: Do you know much about the American War Veterans? David trained a bunch. Did anything happen with that?
Nkem: There was a very large study with more than 5,000 soldiers who were trained in TRE® and several other modalities for stress reduction, and then they were deployed to Afghanistan. They were allowed to self-select whatever method they found useful, and they were interviewed on return. What they found is, hands down, of all of the methods–breathing, visualization–[it was] the TRE® [that] the soldiers chose because they found it to give immediate relief for anxiety, and, interestingly, back pain. Those have not yet been published.
Steve: One last question, if I can. People who graduate, certified providers, how are they doing in terms of running groups or networking? What’s your feedback for the people who have gone through the certification program, and are integrating TRE® into their practices? Therapists, they’re running new practice. How does that work around here?
Nkem: If somebody already had a clinical practice, so they were in a private practice or they were working at an agency, it’s much easier for them to take TRE® and integrate it. If you’re a massage therapist, it’s easier to put TRE® into that. If you’re a clinical social worker and you’re already running groups, and you get your supervisor’s approval, you can put TRE® into that system. One thing I really, really love about TRE® is the commitment that to be a TRE® provider, you do not have to be a professional. However, those people who aren’t professionals then have to create a profession. That would be true with anything that they would do, so it’s not TRE®-unique.
A couple of things that I think are bright stars and will be very helpful for future TRE® providers is: one, as we reach evidence-based status, it will be much easier for agencies to adopt TRE® and seek insurance reimbursement. In that way, it’s much easier if you’re a social worker or a therapist in that agency. If the agency says: “We can bill for this, go ahead and do it.” If they can’t, it’s much more difficult. That’s one place the research will really help the dispersion of TRE®, and help the individual TRE® providers.
The other thing is I’m building an agency model where providers contract with TRE Los Angeles, and we handle all of the central administration and paperwork, and they do individual sessions. We have the web presence, we can do the marketing for them, and, of course, we take a percentage for those services. What is also nice is they then become the staff. As we gain organizational contracts, they will be sent out to this hospital, to this organization, to fulfill those contracts and provide TRE®, and be paid a salary.
Steve: Talking to you, it’s very inspiring how you’ve really gone for working with caregivers and trying to embed in organizations as a way of spreading the work. I wish you luck with that. It sounds like amazing stuff. You’ve got so many great ideas.
I’ve really enjoyed meeting you, instead of talking over Skype.
Nkem: It’s much nicer in person, I will agree.
Steve: Great. Thank you.
Nkem: Thank you.