The word trauma has been overused so it can sound meaningless.
However, there are profound effects on the mind and body that are exposed to traumatic events. Our ability to cope with it becomes overwhelmed and we feel helpless as the limbic system, which is the part of the brain associated with fighting escape and freezing, gets into full swing.
This reaction often lasts long after the event itself has been buried in the past, leading to the most typical symptoms of post-traumatic stress disorder (PTSD) – flashbacks, nightmares, and a range of other symptoms associated with the body’s overreaction. However, our personality structure mostly remains intact.
This is not the case when trauma occurs over a long period of time, especially in our formative childhood years, such as child neglect or abuse, including emotional abuse. In this situation, feelings of helplessness and overactivation of the limbic system and body persist, often affecting the personality structure.
Often times, people with this complex form of post-traumatic stress disorder cannot regulate their emotions, leading to impulsiveness, poor self-esteem, and interpersonal difficulties. In these cases, longer and more intense treatment is usually required than in the case of a less complex post-traumatic stress response that Jacqui unknowingly induced in her canine companion.
When Jacqui recently stopped to order coffee, she tied her dog Darling’s leash to what she thought was a stationary metal bench covered with flowerpots as she went inside. As she paid for her cappuccino, Jacqui heard a violent rattle as Darling jumped forward, causing the bank to tip over and the flower pots to fall to the floor. Startled by the noise, Darling tried to run away, but of course the “monstrous” bench continued to follow her while she was handcuffed to it. When Jacqui reached her, Darling was sitting in the street, traffic was raging around her and dogs were having a real panic attack.
With the help of the very nice ladies from the cafe, Jacqui was able to get her inside and eventually calm her down enough to take her home. Back in the house she settled down and Jacqui thought this was the end of a very excruciating morning.
The next time Jacqui ventured out with her, however, Darling immediately became excited and afraid, and as they neared the corner where the incident had occurred, she froze. Her body was trembling, her ears were flattened, and her breathing was faster. She was clearly experiencing a primordial and crippling panic about what she now connected with the environment.
Darling exhibited classic symptoms of acute traumatic stress, along with an associated instinct to avoid the trigger for her anxiety. Treatment involved gradual exposure to the source of the trauma (the street near the cafe), along with plenty of reassurance that she is safe and trying to convey her positive experiences there so that she can separate the environment from the traumatic experience can.
Helping her relax on a physical level was vital in this process because, while overadrenalized, the body remains trapped in a trauma response and cannot process an alternate experience.
Prior to this trauma, Darling was a happy and relatively confident dog who has been raised with love and security since puppyhood and this will help her return to her former state with help.
Additionally, unlike a human, Darling does not address the ethical and cognitive issues often associated with PTSD, such as with returning veterans or the victims of the Lindt cafe. And their treatment could focus more on the body involved in all responses to trauma, complex or acute, including a third trauma state called persistent traumatic stress, in which the trauma is not in the past. as in the two previous examples, but continues in the present.
This stress is usually induced by social conditions such as war, poverty, and social disintegration. The Covid pandemic and its consequences have also resulted in persistent traumatic stress, particularly in vulnerable communities, leading to a global mental health crisis.
The problem with treating persistent traumatic stress is that it is not post- but current. Treatment cannot focus on relieving the person from the effects of the stress in the past but must focus on strategies for managing the stressors in the present and for most countries in the world this currently includes Covid-related stressors Disruptions in family contact, career, education and income and living with uncertainty as we wait for information about the Omicron variant again.
Dealing with any traumatic stress implies a bio-psycho-social approach, and while our focus here is on the body, the psychological and social aspects of traumatic stress are not just additive, but multiplicative. Still, there are some simple strategies that can be used at the body level to calm an overreaction, an overreaction that can suddenly invade us.
Deep breathing techniques with six inhalations and six minutes of exhalation, which are repeated for a few minutes, as well as tensing and relaxing the muscles of the feet and legs, as well as the muscles of the arms and hands, are very helpful. Both exercises can be used inconspicuously and immediately as soon as the overexcitation is felt.
A hibernating body requires some longer-term strategies with the usual suspects like exercise, sleep hygiene and, for a short-term solution, ice on the neck or a splash of cold water on the face.
However, if the overexcitation or underexcitation persists after a hopefully longer-term return to a “more normal life”, more intensive treatments with psychological processing and physiological reprogramming are indicated, as in the treatment of PTSD and complex PTSD.
In his groundbreaking book The Body Keeps Score, Bessel Van Der Kolk describes the crucial connection between the hyperactive alarm system mobilized by trauma, the body’s standard fight, flight, and freeze reaction, the secretion of excess stress hormones and their effects on body sensation, cognitive function and emotional regulation. Van Der Kolk emphasizes that healing can only occur when trauma victims are sure to inhabit their bodies and “tolerate, feel what they feel and know what they know”.
This wisdom applies to acute, complex, or persistent trauma, but the time frame, level of complexity, and prognosis of this process are profoundly influenced by whether the trauma is acute, complex, or continuous.
To end on a lighter note, we are happy to announce that while Darling still approaches the cafe with some level of fear, she is now able to wave her story and take in a treat while waiting for Jacquis’s morning caffeine hit.
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Prof. Gill Straker and Dr. Jacqui Winship are co-authors of The Talking Cure. Gill also appears on the Three Associating podcast, where relational psychotherapists explore their blind spots
