Beyond Body Awareness: Anshin, Kansho, and Returning to Life
PTSD and Recovery
In my daily clinical practice, I work with clients who have experienced trauma, using trauma-focused therapies such as EMDR and TF-CBT. When appropriate, I also incorporate approaches that support body awareness, including Movement Therapy. EMDR is recommended by the World Health Organization as one of the psychological interventions for adults with PTSD (World Health Organization, 2023).
I often ask my clients:
“What does it mean to you for therapy to end, or to recover from trauma?”
Sometimes, they answer:
“Does it mean that my PTSD will be gone?”
Traumatic experiences can affect far more than symptoms alone. People may experience difficulties with sleep and appetite, irritability, low mood, anxiety, and other trauma-related responses. These difficulties can also affect relationships, work, concentration, and everyday functioning (American Psychiatric Association, 2022; World Health Organization, 2024).
But this leads me to another question.
Until the symptoms of PTSD disappear, does that mean a person is “not recovered”?
And what happens if, during the course of therapy, life brings another loss or source of distress? A person may lose a job, experience the end of a relationship, lose someone they love to illness, or encounter another traumatic or stressful event.
One traumatic experience does not necessarily end with one event.
Trauma can continue to ripple outward into many areas of a person’s life.
Returning to Life Does Not Have to Wait Until Recovery
Trauma recovery has been understood not only as the reduction of symptoms, but also as a process of rebuilding connection with oneself, with others, and with the wider world (Herman, 2022). I once worked with a client who had been the victim of a crime. Even after the crime itself, she continued to experience significant trauma responses while also having to remain involved in criminal proceedings as the victim. Her sleep and concentration were affected. She began making more mistakes at work and eventually faced the possibility of losing her job. Changes in her weight, related to stress and medication side effects, also affected her self-image. Trauma responses such as fight or flight, dissociation, and fawning began to appear in her relationships. The suffering that began with one traumatic event gradually spread, like ripples in water, into her work, relationships, self-respect, and everyday life.
At the time, I found myself thinking:
“If the only goal of recovery is to reach the day when she no longer meets the criteria for PTSD, or the day when she can fully regulate her emotions, perhaps that goal is simply too far away for her right now. Life does not stop. Her life is still happening. Yet she is being pulled into one difficulty after another. Perhaps asking her to focus only on some future day when she will finally be ‘recovered’ is asking too much.”
Alongside EMDR, I therefore incorporated Morita Therapy, Naikan Therapy, Zen-informed art therapy, and Movement Therapy.
She particularly connected with the Morita Therapy concept of arugamama—allowing things to be as they are.
I am allowed to be as I am now.
I do not have to add an emotional interpretation to every situation.
I can look at what is there, as it is.
I do not even have to force myself to accept it.
She also connected deeply with Naikan Therapy and its process of reflecting on past relationships, exploring who she had become through those relationships, and reconsidering her relationship with gratitude and life.
Through Movement Therapy, she began reconnecting body, mind, and thought.
As these approaches were incorporated alongside EMDR, therapy gradually progressed, and she became increasingly able to recognise her trauma not as something that was still happening now, but as something that had happened in the past. EMDR aims to support the adaptive processing and integration of traumatic memories that continue to be activated in present experience (Shapiro, 2018).
At one point, I said to her:
“Even if it is only for one second each day, I hope you can have a moment when you think, ‘This food tastes good,’ ‘This shower feels nice,’ or ‘The sky is beautiful.’ Because your life still exists, right here, in this moment.”
She later said to me:
“I realised something incredible! I don’t have to wait until I recover from trauma. Even though my life is such a mess right now, I’m alive. I’m living!”
As she said through tears, “I’m living,” I felt something that, for me, resonated with the Zen concept of Daishi Ichiban.
Here, Daishi Ichiban does not refer to physical death. It refers to a fundamental transformation in which an old understanding of oneself or an old way of living falls away, allowing another way of being to emerge.
Her PTSD did not disappear in that moment.
But something else changed.
The assumption that had held her—
“I have to wait until I recover before I can live my life”—
began to collapse.
“I am alive now.”
I believe that this realisation began to change her relationship with her trauma.
She continued therapy while gradually rebuilding love, dignity, and trust in herself. Little by little, her daily life became fuller.
Six months later, she told me:
“I don’t need therapy anymore. I no longer have panic attacks or nightmares. When I encounter a trigger, I consciously try to understand what is triggering me and remind myself that I am not necessarily in danger. Because of that, I no longer react in the same way. And even if a PTSD response does come up, I know how to respond to it quickly.”
When I heard her words, I found myself asking another question.
Did her recovery suddenly begin six months later, on the day when the panic attacks and nightmares had disappeared?
I do not think it did.
Her recovery had begun much earlier.
“This food tastes good.”
“This shower feels nice.”
“I am alive today.”
In those moments, she had already begun returning to her own life.
What matters, perhaps, is not only the complete disappearance of symptoms.
Noticing bodily responses matters.
Understanding emotions matters.
Learning how to respond to triggers matters.
These are all deeply important.
But there may be another dimension of recovery beyond them.
It is the realisation that our lives are not made entirely of trauma.
Even while carrying trauma, there can be a moment when food tastes good.
Even on the morning after a nightmare, there can be a moment when the sky looks beautiful.
Even while the body is trembling, a person can live today with that body.
We do not have to wait until recovery is complete before returning to life.
Even while we are recovering, life is already here.
This clinical experience later became one of the questions that contributed to my development of the Mud Lotus Trauma Integration Model:
Trauma recovery does not end with noticing the body. It may begin there, but it does not have to remain there.
In Mud Lotus, feeling the body is not the final goal.
Nor is fully feeling every emotion the final goal.
Awareness of the body and emotions can become an entry point into a broader understanding of the self—and into returning to one’s life.
Feeling the Body Without Becoming Only the Body
To feel the body without becoming only the body means noticing bodily responses without treating those responses as the entirety of reality. For example, if my body is trembling, this does not necessarily mean that I am in immediate danger. An increased heart rate is important information. It tells me that my body is responding to something. But I do not necessarily have to use that bodily response alone to determine everything that is happening in the present moment. The same is true of emotions.
To notice an emotion without becoming only the emotion.
This means acknowledging what I feel without denying it, while also not treating that feeling as the whole of who I am or the whole of reality. If I feel afraid, it does not necessarily mean that the person in front of me is actually going to hurt me. At the same time, I do not need to ignore the feeling of fear.
I can ask:
Why am I afraid?
What is my body responding to?
Is there an actual danger right now?
Or is something happening in the present that is activating a past memory or an existing Belief System?
Bodily responses and emotions are both meaningful parts of our experience.
But neither, on its own, is the entirety of reality.
The body gives us information.
But the body’s response is not the whole of reality.
Emotions are also important experiences.
But the emotion I am experiencing right now is not the whole of who I am.
This is why, in Mud Lotus, after becoming aware of the body and emotions, we gradually widen the field of awareness.
Beyond Body Awareness and Emotional Regulation
This does not mean that Body Awareness or Emotional Regulation are unimportant. Many trauma-informed approaches emphasise developing awareness of bodily responses and building the capacity to respond to intense emotions and triggers without becoming completely overwhelmed by them (Ogden et al., 2006; van der Kolk, 2014).
In clinical practice, treatment goals may include:
“Learning to regulate my emotions.”
“Becoming more aware of what is happening in my body.”
“Learning ways to calm myself when I am triggered.”
These capacities are extremely important in trauma recovery. Emotion regulation itself is a complex psychological process through which people influence how emotions are experienced and expressed (Gross, 1998, 2015).
But through years of trauma-focused clinical work, I began to ask another question:
What comes after that?
I can notice my bodily responses.
I can gradually regain stability when emotions overwhelm me.
I can respond when I am triggered.
Does recovery end there?
In Mud Lotus, these capacities are not understood as the final destination. They are an important foundation from which a person may move toward broader self-understanding and re-engagement with life.
Imagine that I notice tension in my body:
“My chest feels tight.”
“My heart is beating faster.”
“My body is freezing.”
Through Body Awareness, I first notice these bodily responses.
Through Emotional Awareness, I may recognise:
“I am afraid.”
“I am anxious.”
Through Emotional Regulation, I may gradually regain enough stability not to be completely overwhelmed by these responses.
Mud Lotus then widens the questions.
What is actually happening right now?
What is my body responding to?
What am I feeling?
How am I interpreting this event?
Is a Belief System shaped by my past experiences influencing that interpretation?
What do I actually need right now?
And what do I want to do next?
At this point, awareness begins to expand beyond the internal experience of the body into the wider experience as a whole.
Feeling the body without becoming only the body.
Noticing emotions without becoming only the emotions.
Seeing reality.
Seeing the body.
Seeing emotions.
Seeing thoughts and interpretations.
Seeing the Belief Systems shaped by past experiences.
Seeing relationships and the environment around us.
And seeing the life we are living now—and the life we may want to live from here.
Rather than becoming consumed by one part of our experience, we begin to see the whole experience from a wider perspective.
This is what I call Whole Experience Awareness within the Mud Lotus Trauma Integration Model.
Kansho: Seeing the Whole Experience
In Mud Lotus, Kansho（観照） does not mean observing only the body.
Nor does it mean observing only emotions.
It means observing reality, bodily responses, feelings, thoughts, Belief Systems, interpretations, and the world around us without becoming completely captured by any single one of them.
In other words:
To be in the body, while also observing the body.
To feel an emotion, while also observing the emotion.
To have a thought, while also observing the thought.
And at the same time:
To observe what is actually happening in reality.
Mud Lotus conceptualises this stance of observation as Whole Experience Awareness.
Kansho does not mean disconnecting from the body or emotions.
It means honouring the body and emotions as meaningful parts of our experience without allowing them to occupy the entirety of our field of awareness.
My body is part of me.
My emotions are part of me.
My past is part of me.
But no single one of these is the whole of me.
This widening of perspective can create space for new understanding to emerge.
Anshin: Not Absolute Safety, but a Small Space Within
When, then, can a person begin to observe their experience from even a slight distance?
Within Mud Lotus, this is where I place the concept of Anshin（安心）.
Anshin is not a guarantee that nothing bad will ever happen again.
It is not about repeatedly telling ourselves:
“You are safe.”
“There is no danger anymore.”
Rather, it may be something much smaller:
Maybe, in this moment, I do not have to run.
Maybe I do not have to fight.
Maybe I do not have to keep protecting myself every second.
Maybe I do not have to rush out and rescue someone.
Maybe I can simply remain here, just for a moment.
Anshin is this small space within us.
There is a reason I use the word Anshin here rather than simply Safety.
For someone who has experienced trauma, being told “You are safe” does not necessarily create a felt sense of reassurance.
When the body still perceives danger, there can be a profound gap between the words “You are safe” and what the body is actually experiencing. For some people, such reassurance may even feel as though their fear or vigilance is being dismissed.
For others, particularly those who have experienced Adverse Childhood Experiences (ACEs), prolonged trauma, or other forms of chronic adversity, the difficulty may be even more fundamental:
“I don’t really know what feeling safe means.”
Research on Adverse Childhood Experiences has demonstrated the far-reaching relationship between early adversity and later physical and psychological health outcomes (Felitti et al., 1998).
This is why Anshin, within Mud Lotus, is not a declaration of absolute safety.
A person does not have to force themselves to believe:
“I am safe.”
Anshin may simply be:
Maybe, just in this moment, I can stay here for a little while.
A small and gentle space.
From the perspective of Mud Lotus, I propose that when this small experience of Anshin becomes possible, a person may gain enough space to move even slightly away from automatic Reaction and begin to Kansho their experience as a whole.
Trauma
↓
Anshin
↓
Kansho
Whole Experience Awareness
↓
New Understanding
↓
Response
↓
Re-engagement with Life
Recovery is not only about returning to the body.
It can also be about returning to life, with the body.
“Why Do I Always Have to Be the One Who Helps Everyone?”
In trauma-focused clinical work, conversations such as the following sometimes emerge.
One client said:
“Recently, I don’t want to get out of bed. In the past, I would go out with friends, listen to my friends’ and family members’ problems, and help people whenever they needed me—even when I was struggling myself.
“But recently, I’ve started wondering:
“Why am I always the one helping everyone when nobody helps me?
“Maybe I’m allowed to use my own time for myself.
“But then I hate myself for thinking that. I feel guilty.”
Just as the first client in this article began to realise that she did not have to wait until recovery before living her life, this client was beginning to develop another new understanding:
Perhaps constantly rescuing other people is not the only way I have to live.
His life did not begin to change because all his symptoms had disappeared. His relationship with himself—and with his own experience—had begun to change. I do not consider the state of “not wanting to get out of bed” itself to be recovery. But I do believe there can be great significance in the question that has begun to emerge.
Previously, the person may have automatically followed the belief:
“I have to help.”
Now, another question appears:
“Wait. Why do I always have to be the one who helps everyone?”
Perhaps this is the moment when a person begins to see, from a slight distance, a role they have been carrying unconsciously.
From the perspective of the Drama Triangle, this could also be understood as beginning to step away from the role of the Rescuer and becoming more aware of one’s own needs and limits (Karpman, 1968).
I sometimes say to clients:
“This may be a very important change.
“In the past, whenever someone needed help, you went to help them, no matter how exhausted you were.
“But now another question is appearing:
“Why do I always have to be the one who helps?
“What is wrong with using my own time and energy for myself?
“Perhaps this does not mean that you have become uncaring.
“Perhaps it means that instead of automatically repeating the same role, you are beginning to ask how you actually want to live.”
In this moment, the person is not merely observing the body.
They are observing their exhaustion.
Their guilt.
The belief:
“I must help other people.”
They are observing their relationships.
The behavioural patterns they have repeated.
The reality of their present life.
And they may also begin looking toward the future:
“Do I want to continue living in this role?”
This is what I call Whole Experience Awareness within Mud Lotus.
Through Kansho of the whole experience, a new question may emerge:
How do I want to live from here?
When that question becomes possible, perhaps a person begins to move from a world governed only by automatic Reaction toward a world in which Response can be chosen.
From the Body, Back into Life
The body may be one of the places where trauma speaks.
That is why listening to the body matters.
But the body is not the entirety of our lives.
Our emotions, our past, and our trauma may all be parts of our experience.
But they are not the entirety of who we are.
Mud Lotus does not aim to move away from the body.
It does not aim to eliminate emotion.
To feel the body without becoming only the body.
To notice emotion without becoming only the emotion.
Within the small space of Anshin, we can observe the body, emotions, thoughts, Belief Systems, the past, and the reality that exists here and now.
This is Kansho within Mud Lotus.
This is Whole Experience Awareness.
And from that wider field of awareness, New Understanding may emerge.
From New Understanding, a different Response may become possible.
And gradually, we may begin to re-engage with life.
Trauma recovery does not end with noticing the body. It may begin there, but it does not have to remain there.
Trauma recovery may begin with awareness of the body. But it does not have to remain only within the body. We do not return to life only after we have recovered. Even while we are still recovering, life is already here. Recovery is not only about returning to the body.
It is also about returning to life, with the body.
The aim of Mud Lotus is not to leave the body, emotions, or past behind in order to move forward.
It is to carry the body, emotions, and past with us without allowing any one of them to become the whole of who we are—and, from there, to begin walking our own lives again.
Note. The clinical examples presented in this article have been anonymised and adapted to protect client confidentiality.
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