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Post Traumatic Stress Disorder

June 26, 2014

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Submitted by James Naughton, MA, LPC, LISAC, Advanced Trained SE, Level II EMDR Practitioner

Post Traumatic Stress Disorder (PTSD) was first introduced into psychiatry in the 1980s and was originally viewed as something rare, affecting only combat soldiers. Today, we understand that just about anyone at any age can manifest symptoms of PTSD, and that the sources of trauma are various and uniquely impact an individual’s own capacity to respond to threat – whether it be emotional or physical.

Fortunately, not everyone that has experienced, witnessed, or been confronted with “an event or events that involved actual or threatened death or serious injury” and felt “intense fear, helplessness, or horror” develop PTSD, and those that live with the intrusive thoughts, emotional numbing and avoidance are discovering that their own bodies hold the key to healing the mind and through undiscovered natural and organic resiliencies that reside in all of us.

Peter A. Levine, Ph.D. the originator and developer of Somatic Experiencing®, and a senior fellow with The Meadows, characterizes trauma and the symptoms of PSTD not as “a disorder”, but as “thwarted instincts” i.e., incomplete self-protective responses (fight, flight, and freeze), held within the body and the autonomic nervous system in a state of complete or partial immobility. When an individual has to face a “perceived” or actual life-threatening crisis (the movement from the perception of threat into active defense may happen in milliseconds) our nervous system develops a plan for escaping it; however, “If we are overwhelmed by the threat and are unable to successfully defend ourselves, we can become stuck in survivor mode. “ And, adds Dr. Levine, this highly charged state of arousal “is designed solely to enable short-term defensive actions; but, left untreated over time, it begins to form the symptoms of trauma.”

A useful visual metaphor, that is demonstrated in Somatic Experiencing training seminars, is the Slinky® toy – normally the nervous system flows energetically like the metal helical spring moving between two hands (sympathetic activation to parasympathetic deactivation, “on” to “off”, “accelerator” to “brake” or physical expansion and contraction, etc.), but when internal resources are marshaled quickly within the body, the slinky is energetically and physically stretched and moving faster, demonstrating full escape and/or fight response to the event.

However, when the nervous system senses these self-protective plans are overwhelmed i.e. escape is not possible, it’s hardwired to protect us from this overstimulation, and sometimes we shift into a state of freeze or dissociation – and the Slinky® is clamped down and compressed tightly, and consequentially our bodies have to use resources and strategies to keep this flight/flight energy contained. In addition, according to Dr. Bessel van der Kolk, Ph.D., overseer of the non-profit clinic in Boston, The Trauma Center, and senior fellow at The Meadows, these un-integrated responses, thoughts, and feelings left untreated and/or “completed” make it difficult for anyone “to be fully present in the here and now.”

This may explain why after weeks, months, and even years after a traumatic experience, persons with un-discharged traumatic stress feel like their stuck in the “on-position” – feel anxious, panicky at times, hyperactive, unable to relax, restless, digestive problems sleeplessness, emotionally flooded to feelings of hostility/rage and hyper-vigilant, or stuck in the “off-position” – depressed, exhausted, at times disoriented or dissociative, a loss of vitality or feeling of “deadness”, chronic fatigue and emotional flatness. Living in our bodies, like being inside running a car with one foot on the accelerator and one simultaneously on the brake, can dramatically impact the natural experience of “connectedness” – a sense of being a part of and engaged with the world, and like many of patients that arrive at The Meadows, can eventually resort to chemicals and/or behaviors (i.e. sex, gambling work, food) to just dampen down or feel alive or as it’s been said, “Just do time on planet earth.” But today, with what has been learned about the human brain and nervous system over the last ten years, bringing to bear multiple disciplines of examination (neurological, psychological, sociological, and biological), the capacity and the resources to heal and “recapture” innate resiliencies/resources, after a traumatic event, resides within us and eventually manifest as a return “home” to ourselves and the world of humanity.

Trauma healing focuses more on honoring and acknowledging a nervous system’s injuries, vulnerabilities and strengths, and “holding a space” of safety as the body and mind gradually move from constricted states of immobility and low energy “I can’t.” to increased mobility and engagement “I can”. Modalities of care for trauma like Somatic Experiencing, EMDR, EFT – Emotional Freedom Technique, Psychodrama, and Expressive Art Therapy, can not only help survivors of trauma complete these natural self-protective responses but eventually come to believe that they are “the heroes of their own story.”

At The Meadows, we attempted to “create a safe space” in our newly developing “Brain Center” that not only offers the aforementioned modalities but also has a “drop-in” center where patients can have access to Cranial Electro Stimulation (CES), Heart Rate Variability systems (HRV) and Hemoencephalography Biofeedback (HEG), to strengthen bilateral communication in the hemispheres of the brain and increase blood flow to the pre-frontal cortex to foster mood stability and a greater capacity to observe emotions, thoughts, and experiences without feeling overwhelmed. Ultimately, for the patients, instead of coming to a place to feel safe, in time they can discover and learn to cultivate a safe and resilient space within themselves, and return home with more choices in their own recovery.

Tips to Enhance and Promote Resiliency

There are activities all of us do to in our own self-care that can promote our nervous systems innate capacity to restore itself and remain “elastic” as we recover from illness, depression, anxiety, and addictions:

  • Expand and develop a support system: Social support helps with meaning in life – feeling loved and cared for releases oxytocin and counteracts the effect of stress hormones.
  • Moderate exercise, Yoga, and Tai-Chi: Releases endorphins, a natural opioid, that heightens the reward system, improves sleep and one’s sown sense of ability. Also, it can promote “neurogenesis” in many areas of the brain, i.e., the hippocampus and prefrontal cortex.
  • Meditation and prayer: Enhances mind-body connection, quiets sensitized structures in the limbic system, and strengthens connections to executive functioning, for an increased capacity for mindfulness and access to “moral self”. Fosters healthy humility.

Trauma, Resiliency & Spirituality (Summed-up in an inspirational quote)

“Each individual has their questions about life, about the purpose of their existence, the meaning of it all. There are those who would allow others to influence their answers to life. There are those who believe there are no answers, so why bother? And then there are seekers. The seekers are the ones who will become co-authors of their lives. They are the ones who will live life to the fullest, understand a need to experience all emotions, stay open to the truth of who they are, and embrace the gifts of choice and change.”

Barb Rogers: Twenty-Five Words- How The Serenity Prayer Can Save Your Life