What is it like to live with PTSD? Hard.
When individuals with PTSD are stuck in survivor mode, it is difficult to tend to their relationships, or to focus on anything else. Their relationships and overall functioning suffer.
Intense emotions impact the brain, gut, and heart via the pneunogastic nerve. This is why we feel strong emotions in the visceral areas of our stomach, and chest. These visceral sensations are so jarring that most people will do anything to make them stop.
Individuals who experience flashbacks tend to shape their lives in a way as to avoid the flashback. The more the traumatic memory is replayed, the more the stress hormones carve those memories more deeply into the mind.
When people shut down they may not feel any changes; however, when they are medically monitored, racing hearts and the presence of stress hormones are detected. This shutting down generalizes to other parts of their lives in which they would normally feel joy and connection to others. This lack of connection often leads to the feeling of shame.
At the core of PTSD is that, as a result of the trauma, the person’s threat perception system has changed, and now their reactions are dictated by the past. The trauma from their past is played out in their bodies in the present, often without a conscious understanding of what is happening.
A traumatized person will shape and behave in their life as if the trauma is still going on. Every new experience they have is jaded by the past. After trauma, the person experiences the world with a different nervous system. Their energy becomes focused on pushing down their inner chaos, which interferes with their ability to truly engage in life. The effort to control these internal physiological reactions can lead to further physical symptoms, including fibromyalgia, chronic fatigue, and other autoimmune diseases.
When the brain’s alarm system is activated, and we know that in PTSD it is activated more readily due to the elevated stress hormones, it automatically initiates preprogrammed physical escape plans from the oldest parts of the brain. Remember how our brains form? The older parts of our brain take over when our alarm system sounds.
Not unlike other animals, the nerves and chemicals that comprise our basic brain structures have a direct link to our bodies. When the old brain is activated, it takes over and partially shuts down the higher brain centers, including our conscious mind, and forces the body to run, hide, fight, or possibly freeze. We might not be fully aware of our situation until we are already on the move.
If the fight, flight, freeze response is successful and we escape the threat, then we return to our equilibrium and move on. If a response is blocked, or unsuccessful, the brain keeps releasing stress chemicals and the brain’s electrical systems continue to fire. Being able to take action and protect oneself is a critical piece in whether or not the experience will leave lasting effects. Immobilization at the time of the trauma is at the root of most cases of PTSD.
According to Peter Levine, the immobilization or inability to act successfully during a traumatic event leads to sensations getting stuck in the body. Levine developed a treatment approach called Somatic Experiencing. In Somatic Experiencing, the client is gently guided in moving in and out of feeling the imprints of the traumatic memory left on the body. Moving in and out of the traumatic sensations helps clients build their tolerance to such sensations, as well as start to release some of the physical impulses stuck in the body. If you look up videos of Levine his work it appears almost magic. Without many words he works with the client to feel into their sensations, move into them, and release them.
A more famous case study of Levine’s was on a Marine named Ray who was blown up with two IED’s. Ray presents with a stiff posture and what appears to be Tourettes-type tics. In the video recordings of Levine’s work with Ray you can see Ray’s body physically release what is purported to be the trauma imprint impulses as he moves into his sensations. Really amazing stuff! In a sense, Levine’s work serves to close the loop that was opened during the traumatic event but was not closed at the time due to the person’s response being blocked, or immobilized.
The tuning into those visceral sensations is critical. The road to recover is not necessarily learning to accept what has happened but rather to gain control over one’s internal sensations and emotions. Tuning in, naming, and identifying what is occurring in the body is the first task.
Recovery from trauma can occur only when the brain structures that were turned off during the original experience are turned back on.
Bringing attention to the past trauma should only occur while people are feeling grounded, safe, and calm in the present. Helping a person get rooted in the present while thinking about the past trauma presents the opportunity of recognizing that the traumatic event exists in the past. In order to do this, the frontal lobe and the limbic system need to be on and working together, otherwise the person will continue to be pulled into the past.
The driving force of PTSD comes from the emotional brain, which means that it shows up in physical sensations, gut wrenching, heart-breaking physical sensations. The only way to change how we feel is by tuning-in to what is going on inside our bodies, and learning to befriend our bodily sensations. More on this later. With great care, and compassion. Until next time… Dr. B
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Van Der Kolk, B. (2014). The Body Keeps the Score: Brain, mind, and body in the healing of
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