Workbook For The Body Keeps The Score
Workbook For The Body Keeps The Score
Workbook For The Body Keeps The Score
Score
Traumatic Experiences
● Understanding that alcohol and drugs are not and will never solve
traumatic incidents. They only provide a slight good feeling, and the
next minute, your problems are still there staring at you
● If possible, ensure that you aren't making any big or life decisions at that
moment. Put them off until you get much better to make good
decisions.
● Don't try to prevent your reactions to the incident like it never happened.
Accept that it happened, feel the pain, and gradually move past it.
● Do not keep everything you feel to yourself, bottling your feelings will
only make you angry all the time. Talk to someone you trust about it.
Attend meetings and seminars on trauma and share your experience.
See a counsellor or a physiotherapist. These little acts will go a long
way for you.
● Stay busy and try to resume back to your typical day-to-day routine.
● Always set time to rest. Getting busy might make you have an overly
tight schedule. Be careful with this and always ensure you rest.
● Always speak out about what you need. Talk to your parents, siblings,
or guardian about anything you need.
● Exercise regularly. It is more than the regular strains you feel in your
muscle. This is because exercise is a way of soothing your body, mind,
and inner soul.
● Relax a lot. Some relaxation techniques include listening to music,
following your hobbies, breathing exercises, going to the cinema or
comedy shows, meditation and yoga.
● Please talk about your feelings or write them down.
● Confront your memory anytime you remember your trauma incident.
To properly heal and recover from any trauma, you first have to realise that
any incident that poses a serious threat to your well-being, or that of others,
causes the human body to move into a state of intensified arousal. You adopt
the 'emergency mode' that leads to your inner alarms being triggered. The
emergency mode allows an individual to use a ton of energy in a quick
interval to maximise the likelihood of survival. Most people dwell in
emergency mode for a brief time or until the unexpected danger has finished.
Nonetheless, existing in emergency mode consumes a lot of essential power
supplies. This is the reason people always feel very weak, tired, and
exhausted afterwards.
The routine healing and recovery process involves the body coming down out
of a state of heightened arousal. The internal alarms turn off, the high levels
of energy subside, and the body resets itself to a normal state of balance and
equilibrium. Typically, this should occur within approximately one month of
the event.
Usually, when the body is undergoing healing and recovery from any
traumatic incident, the body experiences a reduction in arousal degrees. It
implies that the alarm is off, and therefore, the high level of energy usage is
reduced. The body reacts by resetting itself to the normal state of the body.
At this stage, the body strikes an equilibrium and balance. Healthily, this
should be experienced after a month when the trauma incident happens.
It is also vital that you seek the help of a medical practitioner throughout this
event. It would help if you didn't wait till the matter gets out of hand. You
should seek these health practitioners when you notice you cannot effectively
handle deep emotions or sensations and physical feelings. Also, if you cease
to have feelings, continually feel empty even after a month of the incident,
experience continual physical stress and numbness, experience nightmares
and distorted sleep, or find that you cannot correctly handle relations
healthily again, see the doctor as soon as possible.
After experiencing trauma and its effects, as we have explained above, it is
possible that you are still battling with all these reactions and even
experiencing worse after a month or more. At this stage, such a person has
post-traumatic stress disorder (PTSD). This is because of prolonged
experienced responses, which might lead to a lot of other things.
Relationships with family and friends could be put under strain and slowly,
the capacity to perform any work. In this situation, continuous stress leads to
a higher stress level than we have explained above.
Recovery is also a process that has to be embraced by a trauma survivor
before it can be felt. Survivors must be ready to put in all the work required.
As we will discuss further in this book, having a high sense of responsibility
is also essential. When the survivor efficiently manages the situation and
takes responsibility, the actual healing and recovery process starts. This
recovery steadily continues until the survivor finally gets over it.
CHAPTER ONE: DETECTING TRAUMA
Types of Trauma
Acute Trauma
It is caused by only one stressful event. This type of trauma is an anxiety
disorder that develops shortly after a traumatic event. It might be a matter of
days, but any anxiety or stress you feel shortly after a traumatic event is a
trauma. It is abbreviated as ASD. It usually lasts for about three days and
sometimes lingers on till about a month after. Sometimes, it occurs within a
month and is accompanied by symptoms similar to symptoms felt during
post-traumatic stress disorder.
It has been researched and confirmed that most people who go through
traumatic events develop acute stress disorder. It is worthy to note that
anybody who has passed through a traumatic event can develop acute stress
disorder. But here are the examples of people who have a higher chance of
experiencing it;
● People who have been directly affected by trauma incidents in the past
● People who have a record of Post Trauma Stress Disorder, or people
who have once battled with acute stress disorder before
● People who have once dealt with or people who are dealing with mental
disorders
● People who have once experienced dissociative symptoms when they
face a traumatic event
The prevalent symptoms of acute stress disorder include:
● Dissociative symptoms, which include numb, detached, and insecure
feelings. For emotional matters, you are unresponsive to it.
● Your surroundings or whatever is happening around you don’t matter to
you anymore. You develop a deceased awareness of your immediate
environment.
● Your surroundings seem unreal and strange to you. This leads to
realisation.
● It is a common cause of depersonalisation. It feels like your emotions
aren't yours, and they don't belong to you.
● Occurrence of dissociative amnesia. It occurs because of a short-term
memory activation that makes you forget the vital aspect and points of
the traumatic event.
● Mental replay and recurrence of the traumatic incident.
● Persistence replays of the traumatic event via flashbacks, recurring
images, illusions, thoughts, imagination, and illusions of the traumatic
incident.
● Re-experiencing the trauma incident makes it feel as though you are
reliving the event that led to the traumatic stress.
● Distress and uneasy feeling when you remember the incidents of that
traumatic event or something related to the traumatic incident.
Chronic Trauma
This is because of a repeated and extended susceptibility to this horrible
event. An excellent example of this includes bullying, child abuse, or cases of
domestic violence. People often mistake and interchangeably use complex
Trauma. Even though they share some similarities, they still differ from each
other. One significant difference is that chronic trauma can be referred to as
PTSD, but complex Trauma is even more severe than this. It is known as
complex PTSD or simply C-PTSD.
● Addiction
● Denial
● Social withdrawal is a type of avoidance behaviours
● Rationalisation
All the symptoms associated with chronic trauma survivors are severe and
destructive to the daily regulation of the human body. Together with
maladaptive behaviours, chronic trauma survivors have a high likelihood of
exhibiting the following traits.
● Continuous cases of flashbacks
● Nightmares
● Low self-esteem
● Bad sleeping pattern
● Overreactions to things that are regular incidents
● Impaired memory
● Violent outbursts
● Distress
● Anxiety
● Confusion
● Depression
● Antisocial
When these symptoms are experienced, they can be self-perpetuating. It
makes survivors look for other means to stay sane. Most times, the last
resorts are not usually professional treatments. They include unhealthy and
self-destroying resorts like
● Reckless driving
● Violence
● Unwholesome relationships
● Substance use
● Violence
● High-risk sex with multiple partners, etc.
Task 1
ARE YOU TRAUMATIZED?
AIM: The goal of this exercise is to help you identify a traumatic event you
have gone through and how you have responded to it.
Instructions: Tick the appropriate space in response to the feeling or
experience as found in the first column.
3. Complex Trauma
It results from exposure of a person to different cases of traumatic events. As
described above, PTSD is a common distress disorder caused by a traumatic
incident and experience. Compared to a complex trauma condition, it is a
common condition. Complex post-traumatic stress disorder is abbreviated
with CPTSD, and it is becoming widely known by health practitioners now.
CPTSD happens because of repeated cases of different trauma incidents that
keep on happening over a long period. Compared to chronic trauma, which
invokes the repeated occurrence of just a trauma type, complex trauma shows
the repeated acts of different traumatic incidents over a long-time frame.
The symptoms of complex trauma comprise the symptoms of chronic anxiety
and PTSD plus some additional severe symptoms. These other features
include:
● Presence of uncontrolled feelings because there is difficulty in
regulating emotions. It might be as frequent as sadness and explosive
anger.
● Emotional detachment. It is caused by consciousness change, and it can
involve the feeling of body detachment. It might also make the survivor
forget the traumatic event once in a while.
● Personal guilt shaming. It might even make the survivor develop a deep
negative subjective perception.
If you are suffering from these symptoms, you are prone to bad interpersonal
relationships, whether with family, friends, colleagues, or even society at
large. There are some severe cases where a survivor feels better associating
and demanding relationships with people who would cause them harm. It is
because that feeling and association feel very familiar to them.
It is worthy to note that the symptoms of PTSD and CPTSD are experienced
differently in people. Even with one person, symptoms can continually vary.
Therefore, it is always essential for family and friends or health workers
associated with someone experiencing PTSD to constantly keep in mind that
their beliefs and thoughts will not regularly talk about what they do or how
they feel. A complex trauma survivor could also crave a close connection to
their abusers, or seek abusive relationships. This kind of trauma bonding is
not uncommon, especially for those who experience abuse of some kind from
an early age.
What are the causes of CPTSD?
Different ongoing research is aimed at detecting how complex Trauma affects
the brain. Nonetheless, some studies have been made on animals. It has been
found out that traumas have long-lasting effects and consequences, especially
on areas like the amygdala, prefrontal cortex, and hippocampus. These brain
parts play a huge role in memory functioning and how humans respond to
stressful circumstances. Any trauma that takes place for a long time,
especially over many months or even years, has every possibility to result in
complex trauma. Its common occurrence is seen in people who are abused by
people who are supposed to protect and take care of them. Common
examples include:
● Child trafficking
● Sexual abuse by a family member
● Different emotional and physical abuse
● Slaves or war prisoners
● Being in a war region for a long time
● Maltreatment or child neglect
The risk factors of CPTSD include:
● Severe cases of anxiety and depression or a family history of these
conditions. An underlying mental sickness can also cause these.
● Development of temperament, which is best described as an inherited
attitude trait.
● Mode of hormonal and neurochemical brain regulation. It is most
essential in the brain's response to stress.
● Unhealthy lifestyle, especially not owning a home support system. It can
also be seen as having a dangerous job.
● There is no burning connection, both with one's self and with other
people as well. This will lead to a situation where there is a total loss of
your identity.
● Wanting to spend time alone and withdrawing from the world and
people
● Always wanting to be in control of everything, especially others, events,
and outcomes.
These signs and symptoms are different, and it depends on the individual
embodying them.
The effects of vacation traumatisation on workers are being looked into in
different ways. One way is by creating policies and rules that will be of great
advantage to their staff's well-being. For every form of dealing with vicarious
trauma, some constant things determine the success of each approach. These
continuous factors include connection rate, individual balance, and general
awareness. A set of techniques involves the adaptation of coping strategies.
These strategies include the incorporation of playtime, self-care, rest, and
escape. Another type of approach is the transforming strategy. Transforming
techniques help workers set up a healthy community that will help them find
meaning and fulfilment through their work.
Various researches have also shown that a simple act of kindness and other
show of virtues help to increase happiness and decrease the impact of
vicarious traumas. Socially connected people seem to be less affected. Also,
showing gratitude with a conscious effort increases the satisfaction of these
workers as well, thereby reducing the effect of vicarious trauma. In addition,
acts aimed at self-care will go a long way. Practices like meditation, yoga,
exercises, and music are beneficial to those who practice them.
Vicarious trauma operates on a mechanism of empathy and self-care. The rate
at which this empathy affects individuals varies depending on the experiences
each person has had to go through. However, one thing has been identified,
and these would go a long way to curb vicarious trauma. Workers must stop
putting themselves in the shoes of trauma clients. It makes them prone to
feelings of sadness, worry, frustration, and distress. Instead, if they can only
imagine what these trauma survivors went through doing no self-attachment,
they might feel extra kindness and be moved to support survivors.
Some important tips that will go a long way in looking into symptoms of
vicarious trauma include:
● Reaching out to people that can help. Now, many services cater to the
ability of people to discuss their problems with an online doctor that
you do not know or have never met before. If not, you can contact a
trusted friend, counsellor, or anybody you are sure will listen well to
you and devise a means out.
● Engage physically and mentally with tasks that will boost your emotions
positively. Some of these include reading a book, going to the cinema,
taking days off work for the essence of stability, seeing your friends,
and going for picnics, rides, and walks as well.
● Take enough rest. The importance of rest can never be overestimated.
Just some days off might want you only need
● Play and drink of water. Have fun doing all your hobbies. Opt for things
that interest you and make your path as well.
Secondary Trauma
This form of trauma results from a close association with someone who has
gone through a traumatic experience. This type of trauma can be contracted
by mental health workers and family members of a trauma patient. It is most
common when that patient has PTSD.
Secondary trauma is mostly mistaken with compassion fatigue, job burnout,
the second victim syndrome, and vicarious trauma. There might be some
shared meaning and concepts, but they are all different phenomena.
Compassion fatigue can be best described as the decreased efficiency of
health care personnel to function very well because of the exposure and
contact with the distressed feelings and sufferings of the patients they are
taking care of. It is a natural feeling that plays out when health care
professionals learn about their patient's traumatic experiences. Both are often
used interchangeably, but the difference is that secondary trauma is limited to
only workers who take care of trauma clients. Compassionate fatigue is used
and not limited to trauma cases only. Instead, it cuts across to every person
who specialises in giving treatment to other people.
The difference between secondary and vicarious trauma is the inner change
and experiences of health care or other people prone to vicarious trauma, as
described in the vicarious trauma section. It results from empathy and
emotional connection felt because of direct engagement with the experiences
went through by trauma survivors. This direct contact with their experiences
results in a change in the mental makeup of such a person. Unlike other
similar concepts, vicarious trauma is the most identical to secondary trauma.
The difference between them is that vicarious trauma shows just a subtype
feature of post-trauma stress disorder and negative alterations in the beliefs
and emotions of such a person. It is limited to this, as vicarious trauma does
not address other aspects of post-trauma stress disorders symptoms like
hyperarousal, re-experiencing, etc.
Second victim syndrome, abbreviated as SVC, is used to describe the
essence of a medical mistake on health care providers, especially when the
health care provider feels responsible for the outcome for any medical error
made. Patients and health care receivers are the victims of medical mistakes
made, but health care professionals are affected negatively by these medical
errors, too. They can be best described as the second victims, after the
patients.
Job burnout, the last similar concept to secondary trauma, is the distress
health workers feel due to accumulated stress and lack of fulfilment at one's
workplace. Job burnout is a potential sign and symptom of secondary trauma
stress, but secondary trauma stress is not a symptom of job burnout. Burnouts
have nothing to do with traumatic events and post-trauma stress
disorder.
CHAPTER TWO: COMMON SIGNS AND
SYMPTOMS OF TRAUMA
Symptoms of Trauma
All the signs and symptoms of trauma fall into either the mild category or the
severe category. Whether it is going to be harsh or gentle depending on the
following categories:
● The person's background is a crucial factor, as it affects and determines
how they approach and handle all matters, including emotions, as this
includes Trauma and PTSD.
● What the trauma event entails
● How much trauma a person has witnessed before
● Absence or presence of any other type of mental health disorder
● The behavioural pattern of such a person
Task 2
ARE YOU TRAUMATIZED?
AIM: The goal of this exercise is to help you identify the key pointers to
trauma events and victims.
Instructions: Tick the appropriate space in response to the feeling or
experience as found in the first column.
At this stage, mourning and show of emotions occur. What is mourned are
the losses caused by the trauma incident you have faced.
Neurofeedback
How does trauma influence the cerebrum and body? How does
trauma change the brain?
Trauma removes an individual's feeling of wellbeing and steadiness at a
profound, centre level and initiates the amygdala, nervous tissue which is in
charge of both our survival instincts and our emotions. Here, information is
collected and it is where fear can be detected. When we are affected by a
traumatic event the amygdala detects fear and becomes overly active,
creating an uncomfortable and stressful feeling, making it difficult to relax
and even sleep.
Talk treatment works at the prefrontal cortex, where we plan, learn, and sort
out. However, it doesn't convey too well with the limbic framework. As such,
talk treatment can interest our feeling of thinking and language, yet it doesn't
address the more profound pieces of the mind that experience and stores the
recollections of trauma.
During a horrendous accident, the amygdala alarms the nerve centre, a piece
of the mind that organizes the body's pressure reaction by delivering
chemicals like cortisol. What's more, the autonomic sensory system - which
controls our compulsory body capacities - goes into acute stress mode. This
implies having a quicker pulse, breathing all the more shallowly, perspiring,
and not having the option to think obviously.
Along these lines, trauma can change the body's science. Even after the
trigger has gone, the amygdala can clutch the actual memory of trauma, and
our bodies can stall out in this acute stress mode, leaving us with more
elevated levels of cortisol and indications of hyperarousal.
New treatments for calming the brain and body after trauma
What is neurofeedback treatment?
Neurofeedback is a non-intrusive, proof-based treatment that can support
better mind work through brainwave preparation.
Our synapses convey through electrical driving forces, otherwise called
brainwaves. Ordinary brainwave examples can be disturbed by trauma.
Neurofeedback can assist the cerebrum with becoming adaptable and foster
better examples and reactions, a cycle known as neuroplasticity, bringing
back calmness.
1. Recognize and see the truth about the trauma. Casualties of youth trauma
regularly go through years, limiting the occasion or excusing it by imagining
it didn’t occur or by surrendering to sensations of culpability or self-fault.
The main way you can start recuperating is to recognize that an awful
accident did happen and that you were not answerable for it.
2. Recover control. Sensations of powerlessness can convey into adulthood
and can cause you to feel and carry on like an unending casualty, making you
settle on decisions dependent on your past aggravation to the point when the
past is in charge of your present.
3. Look for help, and don’t seclude yourself. A characteristic intuition that
numerous trauma survivors have is to pull away from others. However, this
will just exacerbate the situation. A major piece of the recuperating system is
associating with others, so put forth the attempt to keep up with your
connections and look for help. Converse with a confided relative, companion
or instructor and consider joining a care group for overcomers of youth
trauma.
4. Deal with your wellbeing. Build up an everyday schedule that permits you
to get a lot of rest, eat correctly and exercise consistently. Above all, avoid
alcohol and medications. These might give impermanent alleviation yet build
your sensations of sadness, uneasiness and detachment and can deteriorate
your trauma side effects.
5. Gain proficiency with the genuine importance of acknowledgement and
giving up. Acknowledging something doesn’t mean you’re saying it’s ok.
Acknowledgement implies you’ve chosen how you will manage it. You can
choose to allow it to govern your life, or you can choose to release it. Giving
up means permitting your awful recollections and sensations of a terrible
youth to deny yourself a decent life now.
6. Supplant unfortunate quirks with great ones. Unfortunate quirks can take
many structures, similar to antagonism and continually doubting others, or
turning to liquor or medications when sentiments become too difficult to even
think about bearing. Unfortunate quirks can be difficult to break, particularly
when they’re utilized as support to assist you with trying not to remember the
aggravation and trauma of your youth. A care group or an advisor can assist
you with learning the apparatuses important to end your unfortunate quirks
and supplant them with great ones.
The more you think about why your body and mind react to horrendous
encounters and updates, the better your capacity to explore them.
Our minds are made of various parts that serve various capacities. At the
point when our mind recognizes a danger, for example, a token of past
trauma, the more seasoned, cruder piece of our cerebrum that behaves like a
caution framework starts the reaction of battle, flight or freeze. When we are
encountering that reaction, the thinking part of our mind is, as of now, not
ready to work how it did before the traumatic experience.
We might wind up becoming suddenly angry at others or begin avoiding
them. While these reactions can be unquestionably difficult, it doesn't imply
that you are "broken" it is the cerebrum doing precisely what it has developed
to do, to guard us in what it sees as dangerous circumstances.
When an individual has encountered trauma, the caution framework in the
mind can become extremely touchy to apparent dangers and lead to these
reactions happening significantly more habitually when there is no longer any
danger. When we can perceive this reaction is occurring, we can all the more
viably deal with our subsequent contemplations, sentiments, and activities.
2. Ground Yourself with Your 5 Senses
Horrible recollections can manoeuvre you into the past, while nervousness
and hypervigilance project dread into what's to come. If you connect with
your body right now, you can get some separation from the contemplations
that don't serve you. The present is the main spot where any of us can make
the change.
You can ground yourself by checking out your environmental factors for
objects attached to your five detects. Attempt to discover:
● Five unique things you can find in the room
Did you see anything you didn't previously? If you are going through a
distressing event or discussing your trauma, have a go at holding an
establishing object (a concern stone, beaded armband, or stress toy) or use a
solid, satisfying aroma like a diffuser or fundamental oils. Zeroing in on the
actual sensations while you talk can assist you with remaining clear and
grounded.
3. Make Body Awareness
Listening to your body’s sensations can assist you with acquiring a superior
comprehension of your triggers, and give you a superior feeling of what
instruments will be best.
Require a moment to check your body. Take stock of specific sensations that
you're feeling:
● Are you holding any strain in your jaw, shoulders, or stomach?
● Does this strain develop when you are in distressing circumstances?
● Do you encounter continuous stomach issues or headaches?
These would all be significant messages that your body is reacting to your
current or past circumstances. These sensations can be truly awkward and
crippling occasionally; however, when you can figure out how to pay
attention to them, you'll be in an improved situation to calm your body and
your brain.
4. Associate with a Safe Person or Pet
While this may not be possible for everybody, safe contact like embracing or
clasping hands with an individual you trust or stroking your pet dog or cat
can be an extremely successful approach to control feelings.
5. Self-care
Treatment approaches
Customary trauma treatments have been founded on the conviction that the
ideal approach to address and recuperate PTSD side effects is to manage it in
the "thinking" part of the mind through talk treatment.
Talking through the occasion was thought to assist an individual with
understanding the trauma and gradually desensitize themselves to its force.
Over the last 18 years, cerebrum check innovation has permitted us to
understand the contrast between what happens when individuals talk about
past trauma and what happens when their body is re-encountering them. It
has been discovered that discussion treatment endeavours to connect with
parts of the mind that are "disconnected" and consequently can't resolve the
trauma when individuals are in hyper-upset states.
Bessel van der Kolk, MD, a main specialist in the trauma field, says, “We’ve
attempted to mend PTSD through talking and making the importance of the
occasion, however, treatment strategies that assist with quieting excitement
frameworks in the further locales of the cerebrum have been useful in
quieting PTSD more than those that attempt to do through talking and
thinking. We hit this 'base up preparing.'
Today we perceive that the front-facing piece of the mind has a restricted
capacity to change, particularly when the body is in a trauma reaction or
trouble. Talk treatment works when the mind is working; however, when the
trauma memory commandeers the level-headed piece of the cerebrum,
individuals may not hear words or think or make the importance of occasions
and encounters. When the more deeply areas of the mind are in this condition
of pain, survivors are back in the trauma, and their cerebrum and body appear
to be in time travel.
EMDR
There are various approaches to carry activity to the body and cerebrum.
Today, one treatment choice that uses activity to immobilize the body and
cerebrum is eye development, desensitization and reprocessing, or EMDR.
EMDR uses reciprocal incitement to connect with the two sides of the mind
in real life. Initially, this was finished by having an individual follow a
specialist's finger back and forth before their vision field.
This respective development causes the horrendous memory circling in the
passionate side of the cerebrum to incorporate with the intellectual part of the
brain. The eye and mind development builds the capacity of the prefrontal
cortex to "get on the web" or discover sanity in an awful accident.
Sensorimotor Therapy
Sensorimotor methods are additionally valuable in limbic quieting. In
sensorimotor treatment, the specialist assists an individual with seeing tactile
body reactions and being on top of their body's messages to address
recuperating. It is a method for drawing in the body and the brain in the
recuperation cycle.
Daniel Amen has recorded that individuals experience quieting in their limbic
designs following EMDR treatment through his neuro-imaging studies.
Different settings for limbic quieting incorporate mitigating music,
supplication and contemplation, careful breathing, yoga, and exercise.
The accompanying basic exercises can support limbic quieting:
● Require 5 minutes toward the beginning of the day and evening to shake
back and forth, or side to side, simply seeing and loosening up the body.
● Discover music or tones of music, with or without words that bring you
into a condition of smoothness.
● Practice profound taking in groupings of three. For instance, inhale,
inhale, and relax. Rest. Inhale, inhale, and relax. Rest.…
● Take part in some type of activity for 12-15 minutes each day to build
serotonin and dopamine.
● Take an interest in 5-10 minutes of the day of supplication or
contemplation, as the profound focus of the mind is a region that can
impact and quiet the more profound areas of the cerebrum.
Self-Responsibility
Do you feel like what happened
1 YES/NO
was your fault?
Self-Healing
Do you understand that
recuperating from trauma doesn't
01 YES/NO
mean failing to remember your
experience or not feeling any
passionate aggravation when
helped to remember the occasion?
Do you understand that
recuperation implies becoming
2 less upset and having more trust in YES/NO
your capacity to adapt over the
long haul?
Are you able to perceive that you
have experienced an amazingly
3 unpleasant occasion, and it is YES/NO
normal to have a passionate
response to it?
Are you willing to care for
yourself by getting a lot of rest
4 YES/NO
(regardless of whether you can't
rest) and normal exercise?
Are you willing to scale back tea,
5 espresso, chocolate, soda, and YES/NO
cigarettes?
Do you understand that you are to
try avoiding the use of medications
6 YES/NO
or liquor to adapt, as they can
prompt more issues long haul?
Are you willing to set aside a few
minutes for unwinding, regardless
7 of whether it's paying attention to YES/NO
music or cleaning up (whatever
works for you)?
Are you ready to invest energy
with individuals you care about,
8 YES/NO
regardless of whether you prefer
not to discuss your experience?
Are you ready to talk about your
sentiments to somebody who will
9 YES/NO
comprehend if you feel ready to do
so?
Are you ready to allow yourself to
rethink and influence how you see
10 YES/NO
the world, your life, objectives,
and connections?
Getting past trauma and successful healing has to do with the tendency to live
your present life without harbouring the thoughts of distress, fear and
frustration when you flashback to feelings and thoughts that have happened
in the past. It doesn’t mean you have to forget the incident entirely. Recovery
from trauma means that you have placed the past before you and are enjoying
the present. Moreover, not letting any negative feelings ruin the present. This
is a deliberate and continual process. This is a sign that the traumatic incident
is not, in any way, controlling your emotions and life.
Trauma, whether psychological or emotional, usually occurs because of cases
of abuse or unusually stressful incidents that tamper with your sense of self
and feel like a threat to your safety or life. Traumatic experiences make it
very hard for you to cope and play with your ability to integrate feelings and
emotions.
You will certainly need time to be able to feel safe again. Nonetheless, it
doesn’t make it a hopeless situation. No matter what happens, you can always
get your life back. Antidepressants can work, but there is no magic pill, it
definitely will not cure you alone. It takes constant work that we will talk
about later and help you recover step by step using small bite-size tasks in the
next chapters.
In the cases of antidepressants, they work on the hippocampus, which is the
known organ that counteracts stress. Some researchers have been carried out
on animals, and some phenomenon has been recorded. These phenomena
work in the same way as human beings as well. One of these findings is that
post-traumatic stress disorder clients usually have some organs in the brain
become smaller than their normal sizes, which is only this way when they
experience PTSD syndromes. These organs include the hippocampal, the
prefrontal cingulate option, the anterior cingulate option, and the anterior
cingulate function. While some of the organ sizes decrease, some other sizes
increase, and an example is the amygdala. There is also an increase in the
norepinephrine and cortisol responses to stress. But note that once a PTSD
client recovers, these sizes return to their natural forms and sizes. Effective
PTSD treatments have promoted neurogenesis, and this was found out during
animal studies.
Neurobiology of PTSD
Post-traumatic stress disorder has some recognisable symptoms, including
meddling thoughts, erratic responses, forgetfulness, memory changes,
distorted sleep, concentration changes, intrusive thoughts, nightmares,
distress, hyperarousal etc., as we have discussed in subsequent chapters. The
result is that all discomfort and symptoms experienced during PTSD result
from the stress-induced alterations in the brain's structural and functional
processes. The symptoms are just behavioural and physical manifestations.
Traumatic stress usually leads to changes in the neurochemical structures in
some specific regions of the brain. The changes might result from chronic
changes or acute changes. This leads to the brain experiencing long term
changes, especially the brain circuits, which are directly or indirectly
involved in stress responses. Two different neurochemical systems are over
important to stress response and they are cortisol and norepinephrine.
Some other systems play an important role in stress response, including the
Hypothalamic-Pituitary-adrenal axis system and the corticotropin-releasing
factor. They are otherwise referred to as the HPA system and the CRD
system, respectively. The hypothalamus first releases the CRF through the
stimulation of the ACTH that the pituitary releases. It results in the adrenal
releasing glucocorticoid, which is the cortisol found in men. This has adverse
feedback on the axis at the pituitary and hippocampus, sites of the central
brain and the hypothalamus. One effect cortisol has is to facilitate survival.
One such effect and role is to trigger the HPA axis. To trigger the HPA, CRF
helps mediate certain behaviours related to fear and are also responsible for
triggering various other neurochemical feedbacks to stress. For example, the
noradrenergic structure through the stem locus coeruleus of the brain.
Noradrenergic neurons discharge transmitters and spread it all over the brain;
this is attributed to an upswing in warning and alertness behaviours,
significant for withstanding with an acute warning.
Some research was carried out on animals, and it was detected that the HPA
axis is usually affected by early stress. It has a long-lasting effect on this
region and the norepinephrine as well. Some medical researchers have shown
different memory function changes and brain circuits immediately after a
traumatic incident—areas like the medial prefrontal cortex, hippocampus, and
amygdala. The medial prefrontal cortex is the region that facilitates changes
in memory, while the hippocampus is an area of the brain that is concerned
with the memory's oral declarative. The hippocampus region is very sensitive
to stress as well. In animals, the CA3 region located inside the hippocampus
is the region responsible for stress. Once there is neuron damage in this
region, stress sets in. This CA3 region is also moderated by neurogenesis
inhibition, increased glutamate level, reduction in brain-derived neurotrophic
factor, and hypercortisolemia. Depletion in fresh learning is also associated
with the stress linked to increased levels of glucocorticoids.
When trauma clients use antidepressants, they help to curb the effects of
stress by stimulating neurogenesis. Asides from antidepressants, other agents
have been proven to curb hippocampal damages brought about by stress.
Phenytoin blocks any damage caused to the hippocampus through the
modulation of excitatory neurotoxicity caused majorly by amino acids.
Tianeptine, fluoxetine and DHEA also have similar effects with phenytoin.
These prescriptions may have a mutual mechanism of action via the
upregulation of cyclic adenosine monophosphate response element-binding
protein. Such medication consequences of trkB messenger ribonucleic acid
and BDNF can lead to long-term impacts on the brain system and processes.
There is recent proof that neurogenesis is vital for the behavioural impacts of
antidepressants, although this remains to be a basis of discussion.
Deregulation that has accumulated over a long time on the HOA axis is
connected with PTSD. The cortisol having a low level and the CRF having a
high level are also associated with chronic PTSD. When you are exposed to
something that reminds you of your trauma stress, there is cortisol release.
Some other few studies have been made on neurology to test traumatised
children. The rare research of the impacts of premature anxiety on
neurobiology performed in clinical communities of traumatised youngsters
has mainly been uniform with conclusions from animal research.
Investigation in traumatised kids has been mixed up by cases associated with
psychiatric diagnosis and examination of trauma. A handful of studies have
not precisely explored psychiatric diagnosis. In contrast, various other
experiments have focused on kids with trauma and depression and others
with trauma and post-stress trauma disorder. Girls who have been sexually
abused in which consequences of specific psychiatric diagnosis is caused by
post-traumatic stress disorder exhibited heightened degrees of Cortisol
assessed in urine that is only 24 hours old. Emotionally neglected youngsters
from a selected orphanage had heightened Cortisol degrees over a diurnal
interval as juxtaposed with other control research. Maltreated school-aged
teenagers with clinical category internalising difficulties had heightened
Cortisol levels as juxtaposed with other control experiments as well.
Depressed children that are yet to start schooling showed an increased level
of cortisol reactivity to stress. Women who have experienced childhood
abuse exhibited a heightened level of suppression to a low dose of cortisol.
The measurement of the low dose was 0.5mg dexamethasone. Women who
have experienced post-traumatic stress disorder because of childhood sexual
abuse exhibited reduced baseline cortisol measured on a day's diurnal
examination of the blood plasma. This set of people also showed an increased
cortisol reaction to traumatic stressors than a cognitive stressor with a neutral
characteristic. Also, it was detected that patients having PTSD once suffered
from deadening of memory function when treated with synthetic cortisol,
which is otherwise known as dexamethasone. Grown-up women suffering
from recession and a past narrative of premature preadolescence abuse
exhibited a raised Cortisol reaction to an aggravating mental challenge
compared to other research controls carried out. These outcomes show long-
term alterations in anxiety responsive networks. During early growth, stress
is correlated with intensified cortisol and norepinephrine sharp response. In
contrast, resting cortisol may normally exist or in low quantity with
adultness, but there will always be a boosted cortisol and norepinephrine
reaction to stressors. Also, premature stress is related to changes as regards
hippocampal morphology that would stay hidden until maturity, plus an
enhanced amygdala role and reduced medial prefrontal objective.
Conclusively, traumatic stress has an extensive span of consequences on
brain role and system, as adequately as on neuropsychological organs of
memory. Brain regions affected in the post-traumatic stress reaction comprise
the hippocampus, prefrontal cortex, and amygdala. Neurochemical structures,
comprising cortisol and norepinephrine, have a very significant function in
the stress reaction system. They also perform an important function in
recollection, accentuating the crucial interplay between the remembrance
organ and the post-traumatic stress disorder response system—preclinical
research exhibits how stress influences these brain regions. Similarly,
antidepressants have aftermaths of the hippocampus, which equalise the
consequences of anxiety. Also, the development of nerve growth referred to
as neurogenesis in the hippocampus might be prominent to the effectiveness
of the antidepressants. Research in post-traumatic stress disorder clients
shows changes in brain regions involved in animal surveys, including the
amygdala, neurochemical stress response systems, prefrontal cortex and
hippocampus. This also includes the regions of cortisol and norepinephrine.
Medications that are productive for post-traumatic stress disorder show the
growth of neurogenesis in animal research. These medications also lead to
enhanced memory plus a heightened hippocampal size in most traumatic
stress disorder clients. Prospective researchers are required to examine neural
means in therapy reactions in PTSD clients.
CHAPTER FIVE: STEPS TOWARDS RECOVERY
● Self-responsibility
● Mindfulness
● Letting go of the past
● Neurofeedback
● Inhabiting your body
● Self-confidence
Task
You don’t have to start with anything overwhelming, just dedicating 15
minutes of your whole day will be enough. It’s important to decide the time
of day to this and stick by it. The most common time of day would be at the
end of your day, either after work or just before going to bed. You need to
buy a dairy or workbook, which you will use solely for this purpose. Then
simply sit down and set a timer for 15 minutes at your decided time of the
day. Begin to write any sentences, words or notes that come up when you
recall your traumatic moments; it’s important to not overthink things.
Repeat this process every day until you feel ready to move on to the next
step and begin writing about thoughts or upheavals that you went through
during the day without overthinking it. It’s important to remember that it
doesn’t matter if you feel that you are not a good writer, the important thing
here is what you write and not how you do it. Things like grammar,
punctuation and spelling are not to be worried about.
Creating a coping strategy and identifying triggers
Unwanted emotions or memories, or even flashbacks can be a part of post
traumatic events, it’s important that we identify what these triggers are for us
and work on a coping strategy to help live our “normal” everyday life.
The things that remind you of you experience, which then cause your mind
and body to react, are called triggers.
Triggers may differ from person to person and there are many different things
that can set off a reaction to your past traumatic event. They can be anything
from a particular smell to seeing a person. Some of the other most common
are:
A particular day (a birthday, Christmas, an anniversary)
A noise that takes you back to the horrific moment
A movie or a tv programme
A place that takes you back to a specific moment
Looking at an object that reminds you of something that happened
Hearing a song on the radio that brings back memories of that moment
or period in your life
For some people, recognising their triggers isn’t such a difficult task, whereas
for others it will take time. Some triggers could seem obvious and others
could be left unnoticed. In fact, many people who suffer from PTSD believe
that their reactions come out of the blue, but that’s not the case. By
improving your awareness of your triggers, you can decrease the impact they
have on you.
Task
A simple way to identify your triggers is to ask yourself these questions after
having a reaction (you could even try to do the same exercise thinking back
to past episodes)
Where were you?
Who were you with?
What were you doing?
How were you feeling?
What kind of situation was it? (a meal, a birthday, a lecture, a walk in
the park)
What did you see?
Take notes of your answers and keep them safe. You will eventually be able
to pint out your triggers.
Coping
Now you have identified your triggers you will already be able to feel an
improvement. You can also try your best to avoid them, however it can be
extremely difficult. Another way to reduce the symptoms of a trigger is to
adopt a coping method.
There are many ways of coping with uncomfortable emotions and reactions
that do not need the help of others. This type of method is called self-
soothing and is something you can practice alone.
Tasks
Finding ways to cope with stress and anxiety doesn’t have to be complicated,
here are some simple things you can try to self-sooth in order to make your
negative emotions, thoughts and feelings easier to tolerate without letting
them escalate into more serious reactions:
If you begin to feel upset or sad then try making yourself a warm tea to
drink on your favourite sofa, maybe watching one of your preferred tv
series. You could also run yourself a relaxing bubble bath. The feeling
of water touching your skin can give you a quick relief. Other things
you could try include (if in summer) simply sitting a safe place under
the sun, feeling the heat of the sun’s rays warm your body. Try some of
these and see which one works best for you.
If your body enters into alert mode and you begin to feel hypervigilant
and sensitive to everything around you, then you should try something
more energetic. Try a game of tennis, football, a quick run or a brisk
walk. If this doesn’t work for you then try the opposite, deep breathing
and stillness.
In all cases, please keep repeating to yourself that this feeling is not
permanent and will pass. Nothing lasts forever, it will stop.
Self-responsibility
Taking responsibility helps towards healing from trauma. If you have ever
lived through a traumatic experience then you’ll know that it’s easy and
understandable to feel like a victim. If you are struggling to recover from any
type of trauma, all you are thriving for is to feel “normal” again. However,
this sensation of feeling as if you were a victim, gets in the way of the healing
process and keeps you prisoner of a victim’s mindset. This kind of mindset
includes feeling helpless and sorry for yourself but at the same time have
feelings of self-blame, which leads to a fragile situation of frustration,
anxiousness and depression. Breaking free of this way of feeling and thinking
is essential for you path towards feeling “normal” again. This can be
achieved through taking responsibility for yourself.
Taking ownership or responsibility for recovery doesn’t imply that
everything that happened is your fault. Neither does it mean that you have to
force yourself to believe that you are at fault. It simply means that you are
taking responsibility of ensuring that this incident does not take control of
your life. With this, you indirectly make a statement that you are in charge of
your life.
Choosing not to be self-responsible or own up to self-ownership can be very
detrimental. When you blame others for what happened to you, or feel sorry
for yourself, it simply means you are transferring the ownership or
responsibility of your attitude to another person. By doing this, you stop
yourself from creating better solutions that will lead to your recovery. Taking
responsibility doesn't imply that others involved in the incident do not hold
the blame, only that this time, you are choosing to forget about them and
focus more on yourself for the sake of your healing and recovery. Putting up
with ownership of our healing implies that you are accepting the situations
for what they stand for. The incident wasn't your fault, but it still happened.
And with those that are battling with addiction, negative outcomes of not
wanting to take self-responsibility and ownership can trigger alcohol, drug or
substance use disorder.
To fully take responsibility, one of the first things to do is to identify the
problem. When the problem is duly identified, you can properly analyze how
you are affected by the event. Accusing others disempowers those who resort
to that alternative. Accusing seizes your time and stamina to envision
rewriting situations we cannot control. Unknowingly, when we dissipate our
energy at accusing others, we lend others the energy to dictate what to do
with our own lives. When we blame others, we assume that the world is a
cruel and unjust place to live. The difficulties we can settle, nonetheless, are
only the terrible incident incited and not the incident itself. There is
absolutely nothing we can do about the past, but we can compose our future
by taking responsibility for our present situations. For those recuperating
from traumatic incidents, do not forget that you can't alter whatever incident
that has happened to you. You can settle the emotions and handle the
consequence the incident has given rise to in our lives. There is a possibility
for transformation and restoration.
After leavening the act of self-responsibility and ownership, another key
point to work on is how to empower yourself by looking for solutions. But
this is after you have successfully convinced yourself that the main cause of
the issue is not about what has happened. But it is the aftermath of the event
that is the issue. While blaming shifts the mantle of ownership and
responsibility to others, self-responsibility and ownership return the power to
you. The moment you are truly convinced, you have made remarkable
progress then it is time to be in search of a worthy solution. It is simple to
fuel and excuse the progression of an addictive attitude by accusing others.
Allow yourself by acknowledging what has occurred and understanding how
to survive the difficulties posed by the incident.
Task
Taking responsibility for yourself and your own well-being takes a lot of
courage, but it will give you back control and a sense of freedom. Try taking
the following step:
Complaining- is always a bad habit and you need to realise and take a
mental note of when you are doing it and try to limit this behaviour.
Complaining about a situation or a person will automatically put you in
the position of being a victim, which we are trying to avoid. You also
get stuck in a rut and whilst concentrating on complaining about a
situation, you fail to find a solution. On the other hand, if you spend
less time and energy complaining, you’ll have more time and energy to
think and act on a situation.
Task
The following steps will assist you further in letting go of the past. It will
help you move forward.
Firstly, you have to feel ready. This can happen at any time to different
people. This is because it doesn't follow any rigid rules and follow a
particular pattern. But once you finally realize this and make that decision, it
is indeed a great step. It is such a necessary overpowering decision.
Second, do not try to evade or skip any feeling. Instead, feel it.
Answer this question to yourself: What emotional feelings does your past
provoke?
While answering this question, feel all the possible emotions attached to the
traumatic incident you went through or are still going through. The feelings
come without control, and just let them arrive, observe, accept it without
overthinking or dwelling. Feel, accept and let go.
After you have accepted how situations have made you feel it is time to let go
and make a conscious decision to leave what does not serve you in the past
where it belongs . How you react is what determines your role in it. This isn't
the best time to start proving what is not, as long as you do not allow these
emotions to determine what you will do or how you react. Memories and
events are indeed really strong, but from time to time, if you allow yourself to
feel these emotions, they become less powerful. This is only if you do not
fight them. It might prove very difficult initially, but some ways to feel good
each time is by seeing a therapist or talking with a trusted person.
Mindfulness
Being mindful is a special ability that enables you to concentrate on present
challenges. This will be a great help to those who are dealing with rumination
or trying to leave the past behind them. An experiment carried out in 2016
suggested people that who practice mindfulness do not experience rumination
thoughts frequently compared to people who do not practice it. In addition,
very mindful people are usually more compassionate to themselves compared
to people who aren't and self-care is essential for the healing process to be
successful. If you haven't consciously practised mindfulness before, this
might be a challenging phenomenon for you. If you see this as a challenge,
here are a few ways to practise mindfulness below:
Task
● Being thankful for the simple things in life; the small wins and small
joys. This might include the joy of waking up. Some small joys include
appreciating delicious food, etc.
● Appreciating nature and spending more time with nature
● Taking part in conscious and intelligent hobbies such as playing the
pianos and other musical instruments, singing, riding, drawing.
● Taking part in concentration activities like meditation.
If you have never meditation before, you can try this approach:
● Pick a location that is quiet and with fewer distractions. If it is possible
to get a place with ZERO interruptions, that will be a very good option.
● Close your eyes and start noticing your breath
● Then begin to Inhale and exhale deeply, brining your attention to your
belly feeling it fill up with air then slowly being emptied.
● Continue focusing on the act of breathing and the movement of your
belly. If your mind wonders and begin to have any type of thoughts,
you can briefly allow it, accept, observe and let go what doesn’t serve
you. Always return back to your deep inhalation and exhalation
concentrating on this process.
● Continue this for as long as you feel necessary
Movement
You may underestimate exercise as a tool for your mental well-being.
However, incorporating movement into your day can have many advantages
regarding your mental clarity and stability, which will help you further along
you path to recovery.
It’s no secret that physical exercise release endorphins. Our bodies use the
production of endorphins to deal with stress and pain. Regular exercise has
been proven to naturally boost endorphin production. A little goes a long
way; getting daily exercise will not only help improve your general mood and
allow you to sleep better, but will also aid the reduction of anxiety and stress,
decreasing symptoms of depression. Studies have shown that daily exercise
has a similar effect on the body as an antidepressant drug.
Task
Finding motivation to exercise at the best of times it hard to do, do not worry
if you are not into sports or do not enjoy exercising. The trick is to start
small; studies have confirmed that a 15 minute moderate run or simply
walking for an hour can have the desired effect. There is no need to spend
hours of your busy day frantically training, five times a week is enough and
you can spend around 30 minutes a time, depending on the type of exercise.
To get the most benefit from your exercise, keep your mind from wondering
and concentrate on your body and how it feels while you are exercising.
Focusing on the sensations you feel whilst taking any form of exercise, will
help your body move out of the classic post-trauma stress response mode.
Firstly, try to set aside the time in the day for the workout when you know
your energy levels are at their highest. Set aside 15 minutes 5 times a week
for a brisk walk, this should be enough to begin with to increase your mood
and clear your mind. You’ll slowly begin to reap the benefits and feel better,
which should automatically motivate you to do a little more each time,
gradually feeling more energetic and less stressed.
If, of course, you have a specific activity you love doing start with that.
Anything from gardening to bike riding. The more you enjoy it, the quicker
you’ll see the results. There are also some small changes to you daily routine
that can be made to increase the amount of movement you get in the day.
Taking the stairs at work, instead of the elevator for example is a simple idea.
Don’t Isolate
Suffering from trauma can cause you to disconnect from the people around
you. Many people are prone to withdraw from society in general and avoid
social activities. A vital part of your recovery is to stay connected, support
systems are important to our well-being on a good day! This could be your
neighbours, friends, colleagues, teachers or family. Social connections
improve your self-esteem and decrease symptoms of depression.
Task
Start with making a point of not spending too much time alone. Make an
effort to participate in social gatherings even if you don’t feel like you want
to, especially with those who were close to you before the traumatic event.
A great way to start connecting with people again is to offer your help. This
week find someone around you that could benefit from your help. It could be
walking a neighbour’s dog or doing some grocery shopping for an elderly
family member. This will not only help you re-connect with others, but will
also make you feel less helpless and more powerful.
CHAPTER SIX: AFTER TRAUMA; WHAT
NEXT?
Types of Stigma
Institutional Stigma: this type of stigma refers to government policies or
privately-owned institutions that purposely or inadvertently reduce a person
or a group of people’s opportunities to have a better life.
Public stigma refers to the negative bias that the general public has to a
particular state of affairs or life choices that a person or group of persons
make.
Self-Stigma: after experiencing stigmatization from various angles for a long
time, those at the receiving end of this barbaric act tend to start internalising
and believing that their actions deserve the censor it receives from others.
Elements of Stigma
Perceptions of weakness: the belief that a person is weak if they do not fit
your standard of a strong person or what that person can withstand. The
belief that members of the male gender are predominantly strong and must
not show any sign of weakness, such as suffering from depression or
receiving counselling, is a good example of this.
Perceptions of being dangerous: this is predominantly thought about in
relation to persons with mental illness. It is perceived that if someone has
mental illness, they are expected to display violent tendencies.
Perceptions of a person’s self-control: this mostly relates to mental illness
matters but can also apply to the LGBTQIA community; they believe that
they can control their illness or who they for in love with, as the case may be.
Shame and Guilt: this simply says that it is not fear or angst of what society
has to say about your issue, but that the person is ashamed of their situation.
For instance, depression, or that they feel guilty for feeling that way.
Social distance: in this instance, a person begins to distance themselves after
suffering from one form of trauma or the other because their friends and
relations have begun to distance themselves from them or they fear them or
do not know how to relate with their friend after the traumatic experience
they underwent.
Accomplishing Recovery
Recovery is achieved by going through these stages listed above. It takes time
and you must be patient. You will gradually see the signs of change and
recovery every day until you achieve a total and final recovery. When you are
not being affected by the emotional pain of the traumatic event anymore, you
easily view your traumatic experience from a healthy view point and
successfully get past this event with no feeling that the trauma experience is
still controlling you.
Summary
While the causes and side effects of trauma are different, there are some
essential indications of trauma that you can pay special mind to. Individuals
who have experienced trauma will regularly seem shaken and bewildered.
They may not react to the discussion as they ordinarily would have and will
regularly seem removed or not present when talking.
One more sign of a trauma casualty is nervousness. Uneasiness because of
trauma can show in issues like night fear, restlessness, helpless focus and
emotional episodes. While these manifestations of trauma are normal, they
are not comprehensive. People react to trauma in various ways. Now and
again, trauma is practically unnoticeable even to the casualty's dearest
companions and family. These cases represent the significance of conversing
with somebody after an awful accident has happened, regardless of whether
they give no underlying indications of unsettling reactions. Signs of trauma
can show up days, months or even a very long time after the genuine
occasion.
Medicine Overdose
Medicine glut happens when somebody ingests a critical enough measure of
the drug to cause actual damage. Excess frequently happens related to
substance misuse; however, it very well might be inadvertent and happen
under customary conditions. Any example of excess ought to be treated
seriously, and expert help ought to be looked at to guarantee that excess
doesn't reoccur and to decide whether the reason is substance misuse.