A project dear to our hearts
 Raising Our Voices
 Writing Our Lives
Stories That Want To Be Told
 The Calming Breath

 A simple technique


Adverse Experience

Traumatic Stress – medically induced

After finishing a grueling year and a half bout of treatment for colon cancer, Elizabeth (not her name) began having some very bizarre symptoms (to her). She was emotionally erratic, explosive, anxious, and afraid to leave home, easily startled, had nightmares and was paranoid – afraid everything would hurt her. She didn't sleep well and she, who was/is a very social being, was not interested in seeing her many friends. Yes, she was depressed but it was more than that. Her husband, a Vietnam vet recognized her symptoms as fitting the profile of PTSD.  She looked for and received trauma treatment because traditional counseling is not a good fit with PTSD. Traumatic Stress symptoms are created by a brain locked into survival -- telling the story in a prescribed way ameliorates or eliminates symptoms.  And why?  You will learn that in our class.

Years ago, there was an article in our local paper in St. Paul, MN by a reporter who periodically interviewed a man who had been shot and had gone through an emergency room where the reporter encountered him.   Over the months, the reporter tracked him as his interviewee developed some strange symptoms that now we would now call PTS but then were a mystery to anyone but a combat veteran where PTSD had been identified. There was little awareness that PTSD existed in many of our populations.  This article stuck in my mind for years.  Then when I had a brain hemorrhage 21 years ago, I developed those same symptoms but because I was already working with Vietnam vets with post-traumatic stress, I recognized what was wrong with me and addressed it. I wrote and wrote and wrote about the stroke and allowed other traumatic incidents to emerge from memory and wrote and wrote and wrote about them as well until the symptoms dissipated and disappeared and my life returned to normal.

Writing using a very specific process is just one way to address PTSD – it is the process of the writing and repetitive telling of the story – this has been done, can be done and is being done.   We adapted several evidence based remediation methods and created our own:  the narrative Arts approach is an amalgam of “ours” and “theirs.” It is easily learned and can be seamlessly worked into a debriefing conversation when it is inappropriate to create a more formal context. The experience of my brain bleed and my own recovery from the resulting PTSD, stuck as I compared my experience with the cancer and gunshot survivors. My question became: If this has happened to me and these others, it must happen far more frequently than we currently know.   Over the years I have found isolated incidents of medically induced PTSD including a recent article that states that 23% of stroke or heart attack victims will develop these symptoms within a year.  This, I believe, is the tip of the iceberg and the beginning of awareness that medical events can be seriously traumatizing. In another article, sedation of ICU patients is blamed for hallucinations and PTS symptoms –, a body attacked internally by a brain hemorrhage or stroke or whatever other medical emergency, can and probably will produce in dreams, nightmares or fantasies, images of rape and assault.  The body experiences the events that way and the unconscious produces images appropriate to those experiences from its storehouse of information. 

I currently believe Ashlar education and teaching programs can provide the necessary assistance  to the medical community in helping their patients as they anticipate  the possibility for PTS and thus, eliminating that before the symptoms begin.

I also learned that staff needs help with their own Contagious Trauma (often called “burn-out”).  The current method of avoiding this phenomenon is for staff to distance themselves from patients. This strategy is not the best long term: for staff and patients  I experienced the dissonance of my very frightening condition with interactions of those cool emotionally uninvolved medical staff in the Hospital Culture are creating a kind of disconnect for me where I did not feel seen or safe. In my interviewing of other former patients, I run into this same experience.

I am available to present my story and the stories of others to staff and volunteers and talk about their own contagious trauma and how to avoid it. From there our services can be engaged.

 Andrea Steffens, PhD Executive Director of Ashlar Center.


Associates of Ashlar Center are available to educate and demonstrate methods of working with potential PTS with hospital staff and volunteers:

  • a very short course on the neuroscience of PTS
  • identifying and educating patients who might develop PTS symptoms
  • providing the patient and staff with educational materials about symptoms of PTS
  • teach staff, volunteers, social workers, chaplain, simple remediation methods for the patient before she/he is released and strategies embodied in our Self Care program that can be continued at home
  • Provide staff with methods to avoid: burn-out/ contagious traumatic stress
  • helping staff to avoid PTS, formerly called Burn-out and currently called Contagious Traumatic Stress

The steps are simple and involve building the medical story into conversations between patients and staff.   We believe that these directed “debriefing” conversations with patients that utilize very specific methods will accelerate healing and certainly make a hospital stay less frightening.  As I said, from my own experience, I found the dissonance between what was going inside me and the approach of staff made me feel very isolated and thus, unsafe. A more helpful response to medical emergencies requires that the hospital staff and some volunteers who have contact with Emergency department patients, oncology or ICU be educated in the conditions that create PTS, how they can easily amend behavior toward patients with a simple shift in perception/ understanding what it is like and why some patients are going to experience PTS and others are not. Then, what to do about it. It helps patients when hospital culture includes understanding of the terror that can exist in their patients – sufficient enough to create the brain changes even though they may appear placid on the surface.    

Our training involves about 8 hours and can be spread over several days.

We will leave you with educational materials for your staff and patients – especially useful in an Emergency Department.

The Disposable Military: "The Tumor of The Unknown Soldier" - HuffPost


Recently, the Chaplains at Walter Reed Army Medical Center in DC who houses 800 ill and recovering soldiers at a time, has begun weekly tributes at their mass formations for soldiers who have died at WRAMC. Honoring the fallen soldiers---they read their BIO and cause of death. In the last three weeks they have saluted three soldiers who have died at WRAMC from Cancer. No one questions this. Not Congress, not our elected officials, not the brigade of medical staff who care for these soldiers returning from the war torn country of Iraq.

Some soldiers feel the DoD would rather these soldiers die silently of Cancer---then pay costly medical treatment for soldiers deemed non-deployable. To acknowledge this as a war wound---the military must also assume financial responsibility for these ill soldiers. And why shouldn't they. They were good enough to send to battle when they were healthy. But now that a percentage are returning with Stage II, III and IV Cancers---and some dying. It's more cost effective for the military to turn a blind eye long enough for them to die. Their Cancers unrecognized as a casualty of war. They own you once you become part of the military.  And it's their prerogative to treat these courageous men and women as guinea pigs---exposing them to depleted Uranium and contaminants at wartime. Maybe so, but not to inform the soldiers of the toxic environment in which they live, bleed and fight. Is callous, inhumane, and against the credo of a warrior. And then to abandon them in their darkest hour because their wound is Cancer and not shrapnel---is soulless. This is the new plight for the 21st century's unknown soldier.... In January 2005, 33 year-old Army Specialist Gregory Anton left for Iraq in perfect health. His horrors wouldn't begin until his tour ended.  SPC Anton's journey began at Camp Shelby, Mississippi with 20 other soldiers in his Unit. When the 14 year National Guard active duty E-4 soldier walked onto the bus in the still hours of that January morn. His Army Combat Uniform would take him to the desert of Kuwait.

Read more ...

The Calming Breath

The Calming Breath (calms the Breather in minutes and builds resiliency at the same time).

Breath is the gateway into the body and the unconscious. Aside from being relaxing,  the Calming Breath has many health and mental health benefits including lowering blood pressure, alleviating feelings of stress, anxiety and depression because it lowers production of stress hormones.  If you are stressed long enough, then you will soon be living in the survival mode which means functioning from the mid-brain: reactive, aggressive or withdrawn, poor sleep, irritable, depressed.  If the stress has been more intense as it is with many of  our combat vets or those who live in the inner city war zones or whose direct descendants suffered Adverse Events, you are more likely than not to have brain changes/suppressed DNA that you will pass on and/or have inherited yourself.  

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Spirit Houses - application

If you want to create a Spirit House or learn about the tradition, see Steve Kinne's article.  

Here's how one of us did this.  We will call her Barbara, who didn't want to build a spirit house from scratch (some people will) so she looked around for an appropriate structure.  Nothing there in her house but while walking in the pasture she found/remembered a birdhouse...perfect, that would do.  Only not that specific bird house. It was occupied and she didn't want to evict the birds that were already living there so she took the idea and went to yard sales and feed and garden stores and looked on line until she found a bird house that fit for her Spirit House.

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An Offering of Beauty to Life

Giving gifts to life. 

Consider this -- Balinese make beautiful handmade offerings every single day to entice, appease and appeal to the Spirits -- to keep the world in balance.  To bring good fortune.  To show appreciation and gratitude. 

When we seek for connection, we restore the world to wholeness and our seemingly separate lives become meaningful

Yesterday was a day of contact with vets  and a reminder of the meaning of what we do at Ashlar: giving hope and experience in resolving the all too often debilitating symptoms of Post Traumatic Stress.  It is such an honor to be a "player" in supporting people to re-inhabit their lives. Hurricane Sandy was  such a metaphor illuminating the devastation and destruction of home and community and a very literal vision of the work that lies ahead-- both with the metaphor and the reality.  Making art, making peace.  Rebuilding devastated lives.   

Who We Are


We make art in order not to die from the truth.

Ashlar Center for Narrative Arts is a U.S. 501c3 non-profit organization designed to serve the personal story and address the trauma it may contain. Our work is educational and skills driven -- grounded in thirty years of community based experience.

We use photos, interviews, and teach guided writing (Writing Through the Body).  For those people for whom revealing identity is unsafe or who are non-literate, they are offered an opportunity to  build a multi-media piece to contain and share the story in an abstract or symbolic form. Our goal is Witnessing and facilitating the creation of a coherent narrative for our students as they move with us toward well-being and resilience. 

Following from our initial work with Story, we collaborate with students to create a culturally relevant Self-Care program facilitated by them.


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