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What is Dissociation? Risks, Triggers, and Prevention Strategies in Trauma Release Exercises (TRE®)

Tension, Stress and Trauma Release Exercises (TRE®), developed by Dr. David Berceli, aims to activate the body's natural tremor mechanism (or neurogenic tremoring) to discharge stress and promote healing and balance. However, like any therapeutic modality, there are risks to be conscious of, and one risk in TRE® is dissociation.


What is Dissociation?


Dissociation is a psychological defence mechanism characterised by a disconnection between thoughts, identity, consciousness, and memory. It often occurs as a response to overwhelming stress or trauma, allowing individuals to mentally escape from an unbearable situation. While dissociation can be adaptive in the short term, chronic or severe dissociation can interfere with daily functioning and exacerbate mental health issues.

Dissociation can manifest in a myriad of ways, including (but not limited to) excessive daydreaming or zoning-out, clumsiness or lack of spatial awareness (proprioception), feeling detached, feeling disconnected from your body (or parts of your body), feeling foggy or floating away, feeling unsure of boundaries between you and another person, or feeling like reality is unreal, or in some cases having an out-of-body experience and observing yourself from afar.


Triggers and Risks of Dissociation in TRE®


Several factors can trigger dissociation during Trauma Release Exercises, including:


Traumatic Memories: Engaging in TRE® may activate buried traumatic memories, leading to overwhelming emotions and dissociative episodes.


Intense Physical Sensations: The tremors induced by TRE® can evoke strong bodily sensations that some individuals may find distressing, potentially triggering dissociation.


Polyvagal Response: According to Dr. Stephen Porges' Polyvagal Theory, the body's autonomic nervous system plays a crucial role in regulating responses to stress and trauma. Dysregulation of the vagus nerve can contribute to dissociative experiences during TRE®.


Unresolved Trauma: Individuals with a history of complex trauma or attachment disruptions may be more susceptible to dissociation during TRE® due to unresolved emotional wounds.


Prevention Strategies


While dissociation can pose challenges in TRE®, there are practical tools and strategies that I use to minimise its occurrence and ensure a safe therapeutic experience for my clients including the following:


Psycho-education: Educating people about the phenomenon of dissociation, its triggers, and how it may manifest during TRE® sessions. Increased awareness can empower individuals to recognise early signs of dissociation and take appropriate action.


Grounding Techniques: Incorporating grounding techniques into TRE® sessions helps people to stay present and connected to their bodies. Techniques such as slow, deep breathing, progressive muscle relaxation, placing your hands on your face, heart or stomach, and mindfulness can anchor individuals in the present moment and reduce the likelihood of dissociation.


Trauma-Informed Approach: I adopt a trauma-informed approach to TRE® that prioritises safety, trust, and collaboration. Create a supportive environment where clients feel comfortable expressing their experiences and emotions without judgment.


Self-Regulation Skills: I teach clients self-regulation skills to manage distressing emotions and sensations that may arise during TRE®. I encourage the development of coping strategies such as self-soothing techniques, sensory grounding exercises, and emotional regulation skills, and working to a 6 or 7 out of 10 ratio of sensation with shaking.


Slow Progression: I gradually introduce TRE® exercises and monitor clients' responses closely to ensure they can tolerate the physical and emotional intensity without triggering dissociation. By allowing individuals to progress at their own pace I can provide ample support as needed.


Dissociation is a potential risk associated with Trauma Release Exercises (TRE®), but with proper awareness, prevention strategies, and a trauma-informed approach, it can be effectively managed. By empowering individuals with knowledge and tools to stay grounded and regulated, therapists can facilitate safe and transformative healing experiences in TRE® sessions. As we continue to explore the intersection of mind-body therapies and trauma recovery, integrating insights from pioneers like Dr. Stephen Porges and Dr. David Berceli will undoubtedly enrich our understanding and practice of trauma-informed care.


If you’d like any further information or would like to book a TRE® with me, please get in touch.

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