In this section …
Treating Trauma
When are overwhelmed by an experience, our brains can process the experience in a very different way to normal, which can cause difficulties for us later.
We have an automatic physiological response to address danger called the fight-flight-or-freeze response. This response is extremely valuable in maintaining our survival. Imagine that a tiger jumped into the room your are in. Your fight-flight-or-freeze response will automatically kick in. Your heart will beat faster and your breathing will speed up to supply oxygen and blood to the large muscles that you may need to protect yourself from the threat. You will also become highly sensitive to your surroundings, and see more clearly, and time can seem to pass more slowly, as you address the threat.
Fight: If you think you have a chance of subduing the tiger, perhaps you have a weapon, then you will stand your ground and fight. Your dominant feeling will be anger, and you will focus on fighting off the threat.
Flight: If you think the tiger has a better chance of subduing you, then you will focus on flight. Your dominant feeling will be fear and anxiety, and you will focus on escaping as quickly as you can.
Freeze: If the tiger pounces and pins you down, then you may freeze. You may have seen mice or lizards in this situation if you have ever had a pet cat. In a freeze state, your dominant feeling is numbness and disconnection from yourself and your surroundings, and you submit to the threat. If you are lucky enough to survive, because the tiger takes you for dead, or loses interest in you, then you have preserved your body from harm, and the harm of experiencing the terror of the event. Freeze is often a child's best friend in adverse circumstance because children are usually smaller, slower and weaker than the people around them.
Normally, once the threat has passed, another part of your nervous system is engaged to help you to settle back down to your normal levels of arousal, and you can go about your business. For a while after the threat has passed though, your nervous system will jump right back into fight-flight-or-freeze, just in case that tiger comes back.
Sometimes when people experience severe or repeated overwhelming experiences, their bodies remain in fight-flight-or-freeze. This is known as chronic hyperarousal, and people in this state can experience the following symptoms:
- anxiety and restlessness
- insomnia
- nightmares
- intrusive recollection of the event(s)
- episodes of feeling frozen or detached from the world
- irritability
These symptoms can develop into post traumatic stress disorder (PTSD), and can be very disruptive to the people who experience-s them. People will often go to great pains to avoid any reminders of the event, which further increases the anxiety. Some people report feeling like they are “going crazy” because the intrusive memories can seem so real, and can take over the present moment completely.
Treatment
Fortunately, a great deal of research has gone into finding ways to help people with trauma reactions, and there are a number of effective treatments. Treatment involves 3 phases:
- Safety and Stabilisation
- Processing the Trauma
- Reconnection with Life and Community
Phase 1: Safety and Stabilisation involves learning skills to soothe yourself, so that you can start to manage the anxiety you are experiencing, and teach your body how to settle down and turn off the fight-flight-or-freeze response. You may also need to learn strategies to connect with the present moment to end episodes of freezing or of vividly recalling the threatening event. You may also need to consider whether you are using any strategies to cope that are putting you in danger, and learn alternative coping strategies so that you can heal safely.
Phase 2: Processing the Trauma when you and your therapist think that you are sufficiently sable, your treatment will involve thinking about the threatening event in a safe and controlled way, assisted by your therapist. Being able to think about the event while maintaining your awareness of the present, in which you are safe, can help your brain to process the threatening event in its normal way, so that the memories of the threat become “normal” bad memories. Through this process, your brain will learn to put them in their appropriate place in the past, and you will no longer re-experience them intrusively as memories or nightmares.
Phase 3: Reconnection with Life and Community. Once you have finished processing the event, your treatment may be complete, or you may wish to work further on any other concerns that have come up for you during the treatment.
Academic References
Herman, Judith Lewis (2002) Trauma and Recovery. New York: Basic Books.
Rothschild, Babette (2001) The Body Remembers. London: WW Norton and Co.
Zayfert, C and Becker, CB (2007) Cognitive-Behavioural Therapy for PTSD: A Case Formulation Approach. London: Guildford Press.