16 Dec 2018
Trauma is often referred to as Post Traumatic Stress, Post Traumatic Stress Disorder (PTSD) and Complex Post Traumatic Stress Disorder. The term was originally identified as ‘shell shock’ after the First World War when war veterans returned home reporting experiences of flashbacks to past events (visual, auditory and kinaesthetic memories of the past). These experiences are so real it is considered a real attack and/or fear of attack. These flashbacks can repeat on a daily basis for years and create a huge interruption of daily life. Often war veterans cannot live their lives fully and need long term therapy and support. Other experiences can lead to flashbacks and have devastating effects on people, such as rape, childhood sexual abuse, natural disaster, domestic violence, neglect, control, imprisonment, slavery, divorce/separation, moving house, workplace bullying, school yard bullying,racism, homophobia, sexism, transphobia, misogyny, high stress environments, unrealistic expectations, alcohol/drug abuse, hospitalisation, surgery, terminal illness, bereavement and loss. The list is longer.
Trauma is a normal response to challenging experiences, sometimes life threatening. The brain reacts in a way that attempts to manage the impact of the trauma emotionally, mentally and physically. Often trauma is not experienced under normal consciousness. When you are relaxed, safe and grounded you experience things in a way that is holistic where all 5 senses are integrating the external experience and bringing the messages inside to your own awareness. When something unusual or life threatening occurs the automatic fear response is triggered and the amygdala becomes activated. All normal, rational and logical thinking at the front of the brain in the frontal cortex is deactivated and all energy responses are centred in the amygdala, an almond shaped structure in the centre of the brain. All responses are quickly assessed against past memories of similar experience so the fight, flight, freeze and fawn responses are enacted in order to keep one as safe and un-traumatised as possible. You have no control over this response and reaction. It hijacks normal consciousness and one goes into fight, flight, freeze and fawn. When one experiences PTSD for example quite normal experiences, stressors and situations can trigger this past reaction again, even in non-threatening situations and the brain triggers the same fight, flight, freeze and fawn response:
- Fight response – self-defence and protection
- Flight– escape
- Freeze– play dead
- Fawn – submit and comply to external demands to keep the peace and avoid harm
These conditions are often triggered in many of us in normal life because the amygdala can be highly activated due to low or high levels of certain chemicals and hormones in the body. People’s rational and logical thinking is often not stimulated so much as in more healthy people so they spend more time in their fear centre. People suffering trauma symptoms often experience high levels of anxiety and depression, self-harm and suicidality. Medication,diet, encouraging more healthy sleep patterns, reducing negative external stimulus, physical exercise and relaxing hobbies and pastimes can help reduce the fear state and promote more healthy mental states. Talking therapies can help address negative thinking and introducing more healthy thinking patterns that promote healthy feelings. Self-compassion, self-counselling and mindfulness practices can help with keeping a healthy mind.
One of the other effects of trauma is dissociation where the individual has to cope with difficult events or memories of events by literally drifting away. This is a natural response to these experiences so as to minimise the emotional and mental pain. People may find themselves focusing on something around them like a picture and shutting down to all events around them. They may simply glaze over and disappear into a day-dream like experience. This response is common and allows the person to protect themselves from more inner trauma. It’s like the internal systems shut down to external harm – the individual is not there.
A flashback can be as traumatic as the original event because it feels like the event is replaying again. When this happens it is important to soothe yourself by saying, ‘I am no longer in the past being harmed. I am safe and in a safe place.’ Comforting oneself with focusing on the surroundings and feeling one’s feet and body grounded in the present environment also reminds the mind that it is safe and no longer under threat. Likewise a friend, relative or therapist provides this reassurance and reminds when and where the individual is and is no longer under threat.
Flashbacks reduce with therapy so we work through strategies and techniques to manage these events. Therapy doesn’t necessarily mean going back to the events to describe them and relive them. This can be more traumatic and deepen fear and vulnerability. What is essential in the initial stages of trauma processing is being able to manage the fear and anxiety by self-soothing. We often overlook this need in all of us so we talk about using hobbies and pastimes to focus the mind on something in the here and now. Art, painting,pottery, drawing, crafts, knitting, dramatic arts, sports, exercise, outdoor recreation, yoga, Tai Chi, Qi Gong, playing a musical instrument, listening to music, socialising with people, joining groups, team games are all methods of self-soothing and relaxing. They are essential because they begin to soften your approach to yourself and generate self-understanding, self-worth, self-awareness, self-value and self-compassion. It is something we often neglect and is something that when we reintegrate into our life the results bring a great sense of self-wholeness and belief in oneself. The differences are profound. All of these strategies are intended as a preventative measure to further flashback and dissociation but can be useful when a flashback or dissociation returns.
Skills of self-counselling are explored in therapy. This can take along time to learn because the mind is well-versed on very negative and long used strategies of self-talking. Loops of negative thinking and emotional echoes in response to this negative thinking create bouts of depression,anxiety, fear and self-loathing. Survivors of trauma often have very negative views of their self. If an abuser was involved their strategy to control may have been to belittle, bully, minimise, undermine self-belief, destroy a sense of self-worth and value and generally create a vulnerable and weak person that they could abuse even more. This treatment has very deep effects in the psychology of the individual and therapy explores these effects of abuse and how they create an internalised critic inside. People might find they need to question these beliefs they have of themselves and realise they are not weak and useless or are to blame for what happened (which is what abusers do to them) in order to take control. The process of healing means placing the blame for the trauma where it truly is, not in themselves but in the circumstances of the traumatic event or the person who inflicted the trauma. New loops of positive thinking, self-belief, self-worth and self-compassion begin to heal the process and a period of time is experienced where these positive and negative loops are playing out a battle, if you like, for dominance and this is where patience and repetition of the techniques and strategies is required both in the therapy sessions and in the individual’s life and work between the sessions.
Often we need to explore how flashbacks and memories have been dealt with in the past by self-medicating strategies like alcohol, drugs, sex,escapism fantasies and avoidance. Sometimes self-harming strategies are used as a coping mechanism and time needs to be taken to move away from harmful strategies to healthy strategies. This may need to be done gradually and carefully and may require supervision from a professionally trained therapist or healthcare worker. More challenging still might be feelings of suicidality which are very normal responses to trauma and emotional and mental pain.
Working through trauma is essential and achievable to move from a life of just surviving to a life of thriving. When I worked with clients in a rape and sexual abuse centre I was struck with the courage and tenacity of them to deal with their traumatic pasts and move into more fulfilling and happier lives where they actually liked themselves compared to how much they hated themselves before. When flashbacks become rare and manageable we can get on with our lives and be happier and more productive and satisfied. Right now someone may be feeling far from ok but they need to hear someone say it doesn’t have to be always like this and there is a way forward and hope and prospect of better days.
© Martin Handy 2018Google+