As I feel less overwhelmed, my fear softens and begins to subside. I feel a flicker of hope, then a rolling wave of fiery rage. My body continues to shake and tremble. It is alternately icy cold and feverishly hot. A burning red fury erupts from deep within my belly: How could that stupid kid hit me in a crosswalk? Wasn’t she paying attention? Damn her! A blast of shrill sirens and flashing red lights block out everything. My belly tightens, and my eyes again reach to find the woman’s kind gaze. We squeeze hands, and the knot in my gut loosens. I hear my shirt ripping. I am startled and again jump to the vantage of an observer hovering above my sprawling body. Furthermore, I watch uniformed strangers methodically attach electrodes to my chest. The Good Samaritan paramedic reports to someone that my pulse was 170. I hear my shirt ripping even more. I see the emergency team slip a collar onto my neck and then cautiously slide me onto a board. While they strap me down, I hear some garbled radio communication. The paramedics are requesting a full trauma team. Alarm jolts me. I ask to be taken to the nearest hospital only a mile away, but they tell me that my injuries may require the major trauma center in La Jolla, some thirty miles farther. My heart sinks.

— Peter A. Levine

By listening to the “unspoken voice” of my body and allowing it to do what it needed to do; by not stopping the shaking, by “tracking” my inner sensations, while also allowing the completion of the defensive and orienting responses; and by feeling the “survival emotions” of rage and terror without becoming overwhelmed, I came through mercifully unscathed, both physically and emotionally. I was not only thankful; I was humbled and grateful to find that I could use my method for my own salvation. While some people are able to recover from such trauma on their own, many individuals do not. Tens of thousands of soldiers are experiencing the extreme stress and horror of war. Then too, there are the devastating occurrences of rape, sexual abuse and assault. Many of us, however, have been overwhelmed by much more “ordinary” events such as surgeries or invasive medical procedures. Orthopedic patients in recent study, for example, showed a 52% occurrence of being diagnosed with full-on PTSD following surgery. Other traumas include falls, serious illnesses, abandonment, receiving shocking or tragic news, witnessing violence and getting into an auto accident; all can lead to PTSD. These and many other fairly common experiences are all potentially traumatizing. The inability to rebound from such events, or to be helped adequately to recover by professionals, can subject us to PTSD—along with a myriad of physical and emotional symptoms.

— Peter A. Levine

In response to threat and injury, animals, including humans, execute biologically based, non-conscious action patterns that prepare them to meet the threat and defend themselves. The very structure of trauma, including activation, dissociation and freezing are based on the evolution of survival behaviors. When threatened or injured, all animals draw from a "library" of possible responses. We orient, dodge, duck, stiffen, brace, retract, fight, flee, freeze, collapse, etc. All of these coordinated responses are somatically based-they are things that the body does to protect and defend itself. It is when these orienting and defending responses are overwhelmed that we see trauma. The bodies of traumatized people portray "snapshots" of their unsuccessful attempts to defend themselves in the face of threat and injury. Trauma is a highly activated incomplete biological response to threat, frozen in time. For example, when we prepare to fight or to flee, muscles throughout our entire body are tensed in specific patterns of high energy readiness. When we are unable to complete the appropriate actions, we fail to discharge the tremendous energy generated by our survival preparations. This energy becomes fixed in specific patterns of neuromuscular readiness. The person then stays in a state of acute and then chronic arousal and dysfunction in the central nervous system. Traumatized people are not suffering from a disease in the normal sense of the word-they have become stuck in an aroused state. It is difficult if not impossible to function normally under these circumstances.

— Peter A. Levine

One of the paradoxical and transformative aspects of implicit traumatic memory is that once it is accessed in a resourced way (through the felt sense), it, by its very nature, changes. Out of the shattered fragments of her deeply injured psyche, Jody discovered and nurtured a nascent, emergent self. From the ashes of the frantically activated, hypervigilant, frozen, traumatized girl of twenty-five years ago, Jody began to reorient to a new, less threatening world. Gradually she shaped into a more fluid, resilient, woman, coming to terms with the felt capacity to fiercely defend herself when necessary, and to surrender in quiet ecstasy.

— Peter A. Levine

So, what role does memory play in the understanding and treatment of trauma? There is a form of implicit memory that is profoundly unconscious and forms the basis for the imprint trauma leaves on the body/mind. The type of memory utilized in learning most physical activities (walking, riding a bike, skiing, etc.) is a form of implicit memory called procedural memory. Procedural or "body memories" are learned sequences of coordinated "motor acts" chained together into meaningful actions. You may not remember explicitly how and when you learned them, but, at the appropriate moment, they are (implicitly) "recalled" and mobilized (acted out) simultaneously. These memories (action patterns) are formed and orchestrated largely by involuntary structures in the cerebellum and basal ganglia. When a person is exposed to overwhelming stress, threat or injury, they develop a procedural memory. Trauma occurs when these implicit procedures are not neutralized. The failure to restore homeostasis is at the basis for the maladaptive and debilitating symptoms of trauma.

— Peter A. Levine

The door suddenly jerks open. A wideeyedteenager bursts out. She stares at me in dazed horror. In a strange way, I both know and don’t know what has just happened. As the fragments begin to converge, they convey a horrible reality: I must have been hit by this car as I entered the crosswalk. In confused disbelief, I sink back into a hazy twilight. I find that I am unable to think clearly or twill myself awake from this nightmare. A man rushes to my side and drops to his knees. He announces himself as an off-duty paramedic. When I try to see where the voice is coming from, he sternly orders, “Don’t move your head.” The contradiction between his sharp command and what my body naturally wants—to turn toward his voice—frightens and stuns me into a sort of paralysis. My awareness strangely splits, and I experience an uncanny “dislocation.” It’s as if I’m floating above my body, looking down on the unfolding scene. I am snapped back when he roughly grabs my wrist and takes my pulse. He then shifts his position, directly above me. Awkwardly, he grasps my head with both of his hands, trapping it and keeping it from moving. His abrupt actions and the stinging ring of his command panicle; they immobilize me further. Dread seeps into my dazed, foggy consciousness:Maybe I have a broken neck, I think. I have a compelling impulse to find someone else to focus on. Simply, I need to have someone’comforting gaze, a lifeline to hold onto. But I’m too terrified to move and feel helplessly frozen.

— Peter A. Levine

Trauma is hell on earth. Trauma resolved is a gift from the gods.

— Peter A. Levine

Trauma is not what happens to us, but what we hold inside in the absence of an empathetic witness.

— Peter A. Levine