Post-traumatic stress disorder (PTSD) can follow an extremely threatening or horrifying event, and shows itself in reliving the event, avoiding reminders of it and a constant sense of present danger. Complex PTSD, now recognised by the World Health Organization, adds lasting difficulties with emotions, self-worth and closeness to others, and usually follows prolonged or repeated trauma that is hard or impossible to escape. Therapeutic Shamanism understands much of what we call trauma as soul lossSoul-loss. The sending-away of parts of the self in order to survive: through shock or trauma, or (the chief modern cause) exiling our own parts to fit in. With Power-loss, one of the two root causes of shamanic illness. Read the full answer, and shamanic work can be a real help alongside good therapy, but it is no substitute for that therapy.
What is PTSD? #
A condition that can develop after exposure to an extremely threatening or horrifying event. In the World Health Organization’s International Classification of Diseases (ICD-11) it has three core features: re-experiencing the event in the present, through vivid intrusive memories, flashbacks or nightmares; avoiding thoughts, memories, places or people that bring it back; and a persistent sense of heightened current threat, such as hypervigilance or an exaggerated startle response. The symptoms last for at least several weeks and cause significant harm to everyday life.1
Not every strong reaction to a terrible event is a disorder. The trauma therapist Arielle Schwartz points out that confusion, fear, sadness and physical symptoms are normal after a traumatic event and usually settle within weeks; ICD-11 deliberately treats such an acute stress reaction as a normal response rather than a mental disorder. PTSD develops when the effects persist, typically when an event has threatened a person’s survival and overwhelmed their ability to cope. She also describes a dissociative form, marked by numbness and a sense of being disconnected from the body or from reality.2
What is complex PTSD? #
PTSD that follows long, repeated trauma, with deeper effects on the self. The psychiatrist Judith Herman, in her book Trauma and Recovery (1992), proposed the name ‘complex post-traumatic stress disorder’ for what happens to people after prolonged, repeated trauma.3 ICD-11 now includes it. It describes complex PTSD as following events of an extremely threatening or horrific nature, “most commonly prolonged or repetitive events from which escape is difficult or impossible”, such as torture, slavery, prolonged domestic violence or repeated childhood sexual or physical abuse. All the requirements for PTSD are met, and in addition there are severe and persistent problems in regulating emotions; beliefs about oneself as diminished, defeated or worthless, with feelings of shame, guilt or failure; and difficulties in sustaining relationships and feeling close to others.4
Herman also described recovery as passing through three stages: establishing safety, then remembrance and mourning, then reconnection with ordinary life and other people.3 Treatment for complex PTSD still follows that shape, and Schwartz notes that the first phase, stability and safety, is often the longest and most important.5 See What can trauma therapy offer shamanic work?
How does Therapeutic Shamanism understand PTSD? #
As soul loss, very often, with a part left holding the fort. From a shamanic point of view, much of what we call trauma is soul loss. When something is more than we can bear, a part of us leaves and often stays stuck in the time and place where it happened. That is a pretty good description of a flashback. Meanwhile another part of the soul stays and soldiers on, holding the fort.6 Contemporary shamanism often focuses on the lost part and ignores the fort-holderFort-holder. A protective part of the self that stayed behind to ‘man the fort’ when we were wounded: the inner critic, perfectionist, pusher, pleaser: the loyal soldier still fighting a war that ended long ago. Usually the part that sent an orphan away, so no deep healing holds without its consent; befriended, never extracted. Read the full answer, who has been coping as best they can, and both need help. See What is trauma, and how does Therapeutic Shamanism understand it? and What are child, orphan, fort-holder and protector parts?
Paul Francis knows this from his own family. His father fought behind enemy lines in Burma in the Second World War and never spoke about what he had seen and done; in shamanic terms, a large part of him never really came back from the war, but stayed stuck there. Unacknowledged, his PTSD affected the whole family. Only in his eighties, when he was still waking up screaming at night, did he seek specialist counselling, and as he began to talk about it he began to get better.7
Traditional shamanism knew trauma as one of the main causes of soul loss, alongside bereavement and illness, and its soul retrievalSoul retrieval. Finding an exiled soul-part and inviting it home. In the modern psyche the fort-holder who sent it away must consent first, and the retrieval itself is a beginning: the real work is integration. Read the full answer could be fairly simple, finding the lost part and bringing it home. Modern life adds layers that hunter-gatherer shamans never faced, which is why the old practices do not always work as they used to and why Therapeutic Shamanism brings shamanism and psychotherapy together.8 See What is soul retrieval?
Can shamanic work help? #
Therapeutic Shamanism holds that it can be part of the healing, though it is not offered as a treatment for PTSD on its own. Its teaching on soul loss and the fort-holder points to what it brings: a way of finding and returning parts of a person left behind in a trauma, help for the parts that have been holding the fort, and allies in a Lower-WorldLower-World. The realm of Mother Earth: pure, unspoilt, wild nature, with no technology and no agriculture. Home of the Peoples and of our own Soul, and completely safe: feeling threatened in a journey is a reliable sign of not having reached it. Read the full answer that is a place of safety, love and healing. See What can shamanism offer trauma therapy?
It may have something particular to offer where trauma goes back to before we had words. The earliest wounds, around our first attachment, are embodied and unconscious and hard to reach through talking therapies alone. Louis Tinnin and Linda Gantt, researchers in trauma treatment and art therapy, hold that pre-verbal memory is kept by the right hemisphere of the brain, which can best be reached through physical and symbolic expression. Because shamanism draws so heavily on the right hemisphere, and is largely non-verbal and symbolic, it is potentially well suited to healing pre-verbal trauma; their work may back up how effective shamanism can be here. A journey to be nurtured by a Lower-World Mother, being non-traumatic, somatic and sensory, can begin gently to release those early wounding patterns.9 See What are the mother wound and the father wound?
Paul’s own recovery went this way. A series of events left him with severe post-traumatic stress disorder. Therapy cleared the rubble and dug into the foundations of his childhood; he then found he needed to dig deeper still, through the layers of his ancestors and of the FallThe Fall. The catastrophe at the root of the whole diagnosis: the shift from animist, egalitarian hunter-gatherer life to owning, agricultural Taker culture. In domesticating other species we domesticated ourselves, cutting ourselves off from Mother Earth (Power-loss) and from parts of our own nature (soul-loss). When dated precisely, the Fall begins with the first city-state cultures, around 4000 BCE (Domestication begins earlier, with the Neolithic). A sickness, not our true nature. ‘Fallen culture’ is used interchangeably with Taker culture; the Great Rupture is a looser alternate name. Read the full answer, to find his Soul.10 See What can trauma therapy offer shamanic work?
Is shamanic work safe for someone with PTSD? #
It depends on the person, and safety comes first. Journeying for oneself means being able to go into a trance and come back at will, so it needs a reasonably good grip on ordinary reality. For people prone to things such as moderate to severe dissociation, or anything else that makes it hard to keep hold of everyday reality, journeying for themselves could make matters worse; shamanism may still help, with an experienced practitioner who understands mental health journeying for them, and groundingGrounding. Returning fully into the body and physical reality; the bedrock of safe practice, and how every journey ends. More about this comes before journeying.11 Shamanic work is a companion to good trauma-informed therapy and medical care, not a replacement for them. See Is shamanic work safe if I have a mental health condition?
What does the research say? #
On established treatments, a good deal; on shamanic work, very little so far. A 2018 review by Laura Watkins, Kelsey Sprang and Barbara Rothbaum found that two PTSD treatment guidelines published in 2017 both strongly recommended Prolonged Exposure, Cognitive Processing Therapy and trauma-focused cognitive behavioural therapy, each with a large evidence base.12 For shamanic healing there is a small case series. Helané Wahbeh and colleagues offered a shamanic treatment to six veterans with PTSD and reported that it was acceptable to them and suggested that it may reduce the intensity of their symptoms. The researchers themselves caution that an uncontrolled study of this size is not definitive evidence, and see it as a first step towards larger trials with proper controls.13
