Trauma, imagination and sensation
Modern neuroscience advocates the use of the imagination and attention to bodily sensations as treatments for the long-term effects of trauma, but this approach is nowhere near as novel as it might sound, argues Chris Krall SJ. In fact, very similar ideas can be found in the 16th century Spiritual Exercises of St Ignatius Loyola, who celebrated the power of imaginative contemplation and the application of the senses.
Trauma is a human reality. ‘By definition it is unbearable and intolerable.’ Trauma affects every human person, whether directly or indirectly. The statistics about the prevalence of trauma paint a gruesome picture. ‘One in five Americans was sexually molested as a child; one in four was beaten by a parent to the point of a mark being left on their body; and one in three couples engages in physical violence. A quarter of us grew up with alcoholic relatives, and one out of eight witnessed their mother being beaten or hit.’ These statistics do not even take into consideration the trauma experienced from a culture of violence, the devastating effects of war, the impact of being involved in random accidents, or even the psychological scars that the media can leave. In response to trauma, the natural coping mechanism of the body is quite often to shut down, eliminate sensory stimuli, repress the extreme negativity, and to numb the pain. The consequences and ripple-effects that result from this form of isolation coping can leave the person at a loss of his or her fundamental identity.
Dr Bessel Van Der Kolk, the past President of the International Society for Traumatic Stress Studies, found in his research and through his patient-care that toxic permeations of trauma are hidden deep within the person and can lead to chronic illnesses decades after the original traumatic experience. He says, ‘It’s hard enough to face the suffering that has been inflicted by others, but deep down many traumatized people are even more haunted by the shame they feel about what they themselves did or did not do under the circumstances.’ At its worst, the weight of this shame drains the person of all feelings, both physical and emotional, and this cannot be fixed simply by taking a pill. The imagination and the physical sensations, two of the most basic and yet profound elements of the human person, are often the first capacities a person unconsciously represses as a defense mechanism against trauma. Van Der Kolk seeks to treat trauma patients who have responded in this way by intentionally re-integrating these two human elements back into a patient’s self-understanding and conscious actions, which, he finds, allows for remarkable therapeutic benefits in some cases.
A light in the darkness
Van Der Kolk and modern neuroscience were certainly not the first to grasp the healing powers of the imagination and sensations. St Ignatius of Loyola, in the sixteenth century, also tapped into the transformative capacity of these integral aspects of the human person. This article explores the power of the prayer method developed by Ignatius in his Spiritual Exercises as a light in the darkness, a rock to find footing, a shelter from the storms and most of all, a refuge where one can find one’s identity and become a sensitive, loving, alive person. In this way, perhaps Ignatian prayer has the potential to be a therapeutic remedy, a way out of trauma not unlike that recommended by Van Der Kolk.
Ignatius, born in Azpeitia, Spain in 1491, was himself no stranger to trauma and the loss of his hopes, dreams and personal identity. He was a man with ambitions for military excellence, which were drastically altered when at the age of 26 he was struck by a cannonball during a battle against the French forces in the city of Pamplona, shattering his leg. The healing from this life-altering injury was by no means easy, and Ignatius chose to go to even more painful lengths in order not to be left with permanent damage. In order for his leg to be straightened, ‘All the doctors and surgeons who were summoned from many places decided that the leg ought to be broken again and bones reset…and once again this butchery was gone through.’ He was confined to bed rest for months and because of the infections that were a consequence of primitive surgical techniques, he did get quite close to death. ‘But Our Lord kept giving him health.’ In the absence of other reading material, Ignatius read about the lives and wisdom of the saints during his recuperation. And, with these, ‘He derived not a little light, and he began to think more earnestly about his past life and about the great need he had to do penance for it. At this point the desire to imitate the saints came to him, though he gave no thought to details, only promising with God’s grace to do as they had done.’ This intentional thinking under the guidance of God’s grace about his past life, including the trauma he had experienced and the shame of past mistakes, is what eventually lead to the formulation and writing of the now well-known Spiritual Exercises.
Just as Dr Van Der Kolk advocated for body-awareness and the use of the imagination in the healing of trauma, Ignatius, as a means of moving a person undertaking the Exercises to ‘the conquest of self and the regulation of one’s life in such a way that no decision is made under the influence of any inordinate attachment’, also advocates for and develops a method for the use of the imagination and the engagement with the physical sensations of the body through prayer. Van Der Kolk posed the challenging question in his research, ‘As long as [trauma patients] are frantic and locked up in the horror of the present, they cannot move beyond it. The whole issue is: how do you create a mindful brain that can be opened up to imagining new things?’ The use of the imagination and the application of sensations, as employed in the Exercises, can be one way of doing this.
Imagination: our greatest asset
The Spiritual Exercises are a compilation of guided contemplations. Reading the text is like trying to read the instruction manual for a complicated machine, but the Exercises are not meant to be read: the text itself is for spiritual directors accompanying a person making the Spiritual Exercises. The Exercises must be enacted, practised and lived. Ignatius gives specific guidance on how to perform each exercise. An exercise involves a mental representation of a place. Thus, the Spiritual Exercises require the use and creativity of the imagination. He says, ‘When the contemplation or meditation is on something visible, for example, when we contemplate Christ our Lord, the representation will consist in seeing in imagination the material place where the object is that we wish to contemplate.’ Different examples of this mental representation of physical places include, ‘the length, breadth, and depth of hell’ (Spiritual Exercises §65), ‘the synagogues, villages, and towns where Christ our Lord preached’(§91), or ‘the holy sepulchre’(§220).
A further use of the imagination that Ignatius emphasises is the concluding component of each contemplation, what is known as a ‘colloquy’. In this colloquy, Ignatius challenges the exercitant to formulate words to express the feelings, ideas, fears, or hopes evoked during the contemplation and imagination of the place. Such emotional responses need to be formed into concepts and expressed in spoken words, otherwise the ideas remain abstract and simply stir within one’s inner consciousness without release. The colloquy, again, requires the use of the imagination as Ignatius guides the exercitant to ‘pour out my thoughts to [God], and give thanks to Him that up to this very moment He has granted me life’(§61), or to engage in dialogue ‘with our Blessed Lady… make the same petitions to her Son… make the same requests of the Father…’(§63).
Lastly, Ignatius explains how to use the imagination even for contemplation of abstract concepts. He explains, ‘In the case where the subject matter is not visible, as here in a meditation on sin, the representation will be to see in the imagination my soul as a prisoner in this corruptible body, and to consider my whole composite being as an exile here on earth, cast out to live among brute beasts. I said my whole composite being, body and soul’(§47). This imaginative contemplation of places, dialogue partners and even one’s self from a third-person perspective becomes the means by which the goal of the Exercises – putting one’s self in right relation with God to follow God’s will perfectly – becomes attainable and corresponds closely with the exercises that Van Der Kolk uses with his trauma patients. One of the first ways that Van Der Kolk suggests to process the trauma is to re-imagine the traumatic experience, but from a new perspective, as an older self or in the context of a safe place. By invoking and through the use of the imagination, the trauma that had been debilitating the person for years can be put into a larger context or shifted perspective, seen in a radically new way, and the person can gain a sense of control and, ultimately, peace. The imagination opens up new perspectives, releases inner tensions, allows for radical new understandings, and provides the opportunities to understand situations, contexts, or even one’s own self from alternative viewpoints.
Moreover, Ignatius urges the mental imaginative formulation of a specific place because this action necessarily involves the composition of one’s very self: getting one’s self together; establishing right order within one’s self; doing an inventory on how one is, what issues one is struggling with, what flaws and mistakes one is dealing with, and what hopes and desires one is reaching towards. As described by Michael Ivens, a commentator on the Spiritual Exercises, ‘the “place” represents an aspect of one’s situation before God. Thus, at the outset of the Exercises, and before considering the effects of sin in history, one puts oneself into a situation of loneliness, irrationality and disharmony with both self and creation, which is the situation of every human being in so far as he or she is under the thrall of sin.’ By the end of the Exercises, however, Ignatius says one is to imagine one’s self ‘in the presence of God our Lord and of His angels and saints, who intercede for me… [then] to ask for an intimate knowledge of the many blessings received, that filled with gratitude for all, I may in all things love and serve the Divine Majesty’(§232-233). From loneliness to intimate communion within the Kingdom of God, from fearful numbness to becoming attentively aware of the abundance of grace and goodness, the Spiritual Exercises can promote a radical transformation. Through this use of the imagination, the negative effects of trauma, such as the repression of feelings, the denial of mistakes, the shame of past actions, or the imprisonment within disordered thought patterns, can be intentionally addressed and slowly released. These age-old Exercises can continue to foster a healing and therapeutic remedy for trauma.
Van Der Kolk commented, ‘Imagination is our greatest asset as human beings, and as long as you can imagine other realities, you are okay. If you are in jail and you can imagine learning to do new things and skills – if you can imagine Shakespeare playing in your mind as you’re locked up – you have alternative realities, and you’re not really a victim of the present. What’s so hard about trauma is that it tends to kill the imagination.’ Applying this understanding of the imagination to the Spiritual Exercises, Ignatius does offer a radically alternative reality, that of the salvation of the human soul in the Kingdom of God. For Ignatius, all people are in the jail of sin. However, through grace and the gift of the imagination, humanity can begin to see the divine perspective offering a way out of sin, darkness and despair. Death and destruction are not the final end when there is imagination-filled hope.
Application of the senses
A second integral element of the Spiritual Exercises is what Ignatius calls the application of senses. As Ignatius explains, ‘it will be profitable with the aid of the imagination to apply the five senses to the subject matter...’ (§121). By doing this form of spiritual exercise, Ignatius pushes against the human tendency to numb sensations due to the past pain and suffering that may be associated with them. As a wise and challenging coach, Ignatius explains to the exercitant exactly what can be gained through an intentional and careful contemplation of each sensation. ‘Seeing in the imagination the persons, and in contemplating and meditating in detail the circumstances in which they are, draw some fruit from what has been seen’(§122); or ‘hear what they are saying… reflecting on oneself to draw some profit from what has been heard’(§123); ‘smell the infinite fragrance, and taste the infinite sweetness of the divinity. Likewise to apply these senses to the soul and its virtues…’ (§124); finally, ‘to apply the sense of touch, for example, by embracing and kissing the place where persons stand or are seated, always taking care to draw some fruit from this’(§126). This exercise of the application of senses, which neuroscience is advocating for today, comes from age-old wisdom and urges the person numbed by suffering or choosing to ignore the fruitful insights that come from sensations, to break out of such unfreedoms, fears and protection-seeking rigidity. As Ivens explains, ‘The subject matter is now myself as sensate. The ways I lead my life as sensate are examined in the light of a developing appreciation of this dimension of human existence, a perfect understanding of the fact that precisely as sensate, we are made for God’s glory and praise.’ Because human beings can sense and are capable of becoming acutely aware of all of the elements of creation, they can glorify the creator of all of existence in living fully. To deny the gifts and human powers of sensation is to deny the total quality of life.
Imagining a better world
Van Der Kolk put forth the sad reality that ‘Trauma remains… the greatest threat to our public health… We seem too embarrassed to mount a massive effort to help children and adults learn to deal with the fear, rage and collapse, the predictable consequences of having been traumatized.’ Therefore, what are the best ways to treat this threat? Van Der Kolk advocates for alternative methods from pharmacological treatments, such as body awareness techniques and invoking the imagination for treatment. Ignatius, too, encourages exercitants to use the creative power of the imagination and to engage in exercises involving an application of the sensations.
As helpful as these exercises seem, do they have measurable beneficial effects? Many experiments have been done on the effectiveness of meditation in general. Kieran Fox et al. in 2014 examined over 300 meditation practitioners, some long-term and some novice practitioners, and found multiple significant, measurable, physical morphological changes, as well as a heightened sense of self-presence with a regular meditation practice.  The efficaciousness of specifically Ignatian Contemplation has also been considered with a preliminary study by Andrew Newberg et al. in 2017, which analysed fourteen individuals before and after a seven-day Ignatian Spirituality-based retreat. After a mere seven days of engaging in the techniques of imaginatively contemplating a particular place, engaging in colloquys through the imagination, and practising applications of sensations, the fourteen retreatants did show ‘significant changes as a result of participating in the spiritual retreat’. Further self-administered survey results also showed a perceived increase in physical health and religious beliefs, and a decrease in tension and fatigue.
Are these measurements ‘proof’ of the effectiveness of the Ignatian Exercises as a treatment for trauma? No. However, the number of people who continue to seek out and practice these Spiritual Exercises after 500 years of their existence is significant. Clearly, these ever-ancient, ever-new practices continue to transform those who undertake them. All people, directly or indirectly, deal with trauma; nevertheless, Dr Van Der Kolk asserted the truth that ‘Our capacity to destroy one another is matched by our capacity to heal one another. Restoring relationships and community is central to restoring well-being.’ The healing and restoring relationships are fostered not by each person turning inward and building inner walls of isolation. Rather, as Van Der Kolk and Ignatius both advocated, by having the capacity to imagine a better world and by becoming ever-more attuned to the sensations of our bodies, healing does become possible.
Chris Krall SJ is a Jesuit priest currently pursuing an interdisciplinary doctorate in theology and neuroscience at Marquette University in Milwaukee, WI, USA.
14-20 May 2018 is Mental Health Awareness Week, an initiative to encourage discussion about and reduce stigma around mental health issues. The Jesuits in Britain want to take this opportunity to help our readers and listeners to pray, think, learn and talk about life’s uphill struggles, whether they are associated with diagnosed mental health conditions or other circumstances. Across our online platforms, there are a number of different resources about situations in which people struggle to find peace of mind and heart. Our written and audio content will explore some of the causes, effects and manifestations of anxiety, and look particularly at the dynamic between faith and mental health. We will be considering ideas, offering prayerful support and sharing experiences at https://www.pathwaystogod.org/mental-health-awareness-week. However, please seek professional help if you are concerned about yourself or somebody else.
 Bessel Van Der Kolk, The Body Keeps the Score; Mind, Brain and Body in the Transformation of Trauma, (New York, NY: Allen Lane, 2014), p. 1.
 V. Felicia, et al. ‘Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study’, American Journal of Preventive Medicine 14, no.4 (1998): 245-58.
 Van Der Kolk, The Body Keeps the Score, p. 13.
 See the work of Dr Brené Brown on shame, especially chapter three of Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead (2012).
 George Ganss SJ, Ignatius of Loyola; The Spiritual Exercises and Selected Works (New York: Paulist Press, 1991), p. 69.
 Ibid., p. 70.
 Ibid., p. 71.
 Ignatius of Loyola, Saint, and Louis J. Puhl. The Spiritual Exercises of St Ignatius: based on studies in the language of the autograph, (Chicago: Loyola University Press, 1951), p. 11, §21. (From here onward, the references from the Spiritual Exercises will be made by giving the annotation number as designated in the Spiritual Exercises).
 Elissa Melaragno, ‘Trauma in the Body: An Interview with Dr Bessel van der Kolk’ (2018).
 Spiritual Exercises §47.
 Ivens, Michael, and Ignatius, Understanding the Spiritual Exercises: Text and Commentary; A Handbook for Retreat Directors (Leominster: Gracewing, 1998), p. 48.
 Elissa Melaragno, ‘Trauma in the Body: An Interview with Dr Bessel van der Kolk’ (2018).
 Ivens and Ignatius, Understanding the Spiritual Exercises, p. 184.
 Elissa Melaragno, ‘Trauma in the Body: An Interview with Dr Bessel van der Kolk’ (2018).
 Most of this research is to do with meditation not in the Ignatian tradition, but in the traditions of, for example, yoga (using some simple element on which to focus to keep the mind clear), or Zen (maintaining a moment-by-moment awareness).
 Fox, Kieran C. R., et al. ‘Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners.’ Neuroscience and Biobehavioral Reviews 43, 48-73. PsycINFO, 2014 (accessed April 13, 2018).
 Andrew B. Newberg et al., ‘Effect of a one-week spiritual retreat on dopamine and serotonin transporter binding: a preliminary study,’ in Religion, Brain & Behavior, 2017, DOI: 10.1080/2153599X.2016.1267035, 6.
 Van Der Kolk, The Body Keeps the Score, p. 38.