The word trauma has been so overused that it may seem meaningless.
Yet there are profound effects on the body and mind following exposure to traumatic events. Our ability to cope is overwhelmed and we feel helpless when the limbic system, which is the part of the brain associated with combat flight and freezing, gets carried away.
This response often persists long after the event itself is buried in the past, resulting in the hallmark symptoms of post-traumatic stress disorder (PTSD) – flashbacks, nightmares, and a host of other symptoms associated with excessive responsiveness of the body. body. However, our personality structure generally remains intact.
This is not the case when the trauma occurs over a prolonged period, especially in our formative years, as in child neglect or abuse, including emotional abuse. In this situation, feelings of helplessness and overactivation of the limbic system and the body persist, with the personality structure often being affected.
Frequently, people who suffer from this complex form of post-traumatic stress disorder cannot regulate their emotions, which leads to impulsivity, low self-esteem and interpersonal difficulties. Longer and more intense treatment is usually needed for these cases than for a less complex post-traumatic stress response involuntarily induced in her canine companion by Jacqui.
Recently, as she stopped to order coffee, Jacqui attached her dog Darling’s leash to what she thought was a motionless metal bench covered in plant pots as she stepped inside. In the middle of paying for her cappuccino, Jacqui heard a loud click as Darling rushed forward, causing the bench to tip over and the plant pots crashing to the ground. Frightened by the noise, Darling tried to run away, but of course the “monstrous” bench continued to follow her as she was tied to it. By the time Jacqui joined her, Darling was sitting on the road with the traffic roaring around her, having a veritable canine panic attack.
With the help of the very nice ladies in the cafe, Jacqui was able to get her in and finally calm her down enough to bring her home. Back home, she settled in and Jacqui thought that was the end of what had been a very painful morning.
However, the next time Jacqui ventured out with her, Darling immediately became agitated and scared, and when they approached the corner where the incident had occurred, she froze. Her body was shaking, her ears flattened back and her breathing quickened. She was clearly experiencing a primal, crippling panic about what she now associated with the scenery.
Darling exhibited classic symptoms of acute traumatic stress, as well as an associated instinct to avoid the trigger for his fear. The treatment involved gradual exposure to the source of the trauma (the road near the cafe), as well as a lot of reassurance that she is safe and trying to give her positive experiences so that she can dissociate the frame from. the traumatic experience.
Helping her relax at the bodily level has been crucial in this process, because even though the body is over-realized, it remains trapped in a traumatic response and unable to process an alternate experience.
Prior to this trauma, Darling was a happy and relatively confident dog, raised with love and security from a young age, which will help him return to his previous state with help.
Additionally, Darling, unlike a human, does not address the ethical and cognitive issues that are often involved with PTSD, such as in returning veterans or Lindt Coffee victims. And its treatment could be more singularly focused on the body, which is involved in all responses to trauma – whether complex or more acute – and includes a third state of trauma called persistent traumatic stress, in which the trauma is not in the past, as in the previous two examples, but continues in the present.
This stress is usually induced by social conditions such as war, poverty and social disintegration. However, the Covid pandemic and its aftermath have also given rise to persistent traumatic stress, particularly in vulnerable communities, leading to global mental health crisis.
The problem with the treatment of continuing traumatic stress is that it is not later, it is actual. Treatment cannot focus on freeing the person from the impact of stress in the past but must focus on strategies for dealing with stressors in the present, and for most of the world on time. Currently, these include Covid-related stressors involving interruptions in family contact, career, education and income and living in uncertainty as we await further information on the Omicron variant.
Dealing with any traumatic stress involves a bio-psycho-social approach, and although our focus here is on the body, the psychological and social aspects of traumatic stress are not only additive but multiplicative. Nonetheless, there are some simple strategies that can be used at the body level to calm over-responsiveness, over-responsiveness that can come on suddenly.
Deep breathing techniques involving a six-step inhale and six-step exhale repeated for a few minutes are very helpful, as are the tension and relaxation of the feet, legs, arms and hands. Both of these exercises can be used discreetly and immediately as soon as over-arousal is felt.
A hibernating body requires long-term strategies involving the usual suspects of exercise, sleep hygiene, and – for a short-term fix – ice on the back of the neck or splash of cold water on the face.
However, if the over-arousal or under-arousal persists after a return, hopefully for a longer period, to a “more normal life”, then more intensive treatments which involve psychological treatment and physiological reprogramming are indicated, as in the treatment of PTSD and complex PTSD.
In his flagship book The body keeps the score, Bessel Van Der Kolk details the pivotal link between the hyperactive alarm system mobilized by trauma, the default response to fight, flight, freeze the body, the secretion of excess stress hormones and the impact of this one on bodily sensation, cognitive functioning and emotional regulation. Van Der Kolk points out that only by allowing trauma victims to safely inhabit their bodies and to “tolerate feeling what they are feeling and knowing what they know” can healing take place. produce.
This wisdom applies to acute, complex, or continuous trauma, but the timing, level of complexity, and prognosis of this process are deeply influenced by whether the trauma is acute, complex, or continuous.
To end on a lighter note, we’re happy to report that while Darling still approaches coffee with some degree of trepidation, she’s now able to stir up her story and accept a treat while waiting for the dose. of Jacqui’s morning caffeine arrives.
Professor Gill Straker and Dr Jacqui Winship are co-authors of The remedy by the word. Gill also appears on the podcast three teaming up, in which relationship psychotherapists explore their blind spots