It’s hard to fix a problem you don’t identify correctly. Years ago a car repair company ran an ad where people made the sound their car was making and the mechanic had to figure out what that meant. “Whippety whippety whippety fzzzzzz, brrrt brrt pop pop pop.” “Ah yes,” say the mechanic. “It’s the regulator. We can fix that.” When it comes to healing trauma, that might be more the case than we suspect, and part of the reason we gain so little traction in this field. This study points to some of the issues, and if we aren’t diagnosed properly, how do we expect outcomes in the right direction? It wasn’t long ago I watched a webinar, and the host asked most of the presenters what trauma was. I was and wasn’t surprised that no two had the same definition. Some hemmed and hawed, as if they had no definition. How then can we expect to get better?
Let me offer then, my definitions. These are amalgamations of what I’ve read from Drs. Scaer, Levine, Berceli, van der Kolk, Heller, Badenoch, and others over the last seven years.
What is stress? Why am I starting here you might ask? Because the stress response is the root of trauma. The T&S of PTSD. The stress response has many names - mobilization, sympathetic nervous system, activation, arousal, fight/flight. I prefer the to use “threat response,” because that was it’s actual primary acute use for millenia. You’ll see as we put the two halves together how this works. I want to point out just a few things from this rather full definition, and if you have questions or comments for discussion, please ask.
To start with, stress is a cycle. It has a clear beginning, and ending. It’s hard wired in us. However, I have heard a medically trained professional say there is no off switch. Give that a thought for a second, and the possibility of a species to survive as long as we have with no off switch? That’s kinda what I thought, too. Stress is a cycle. The start of that is when the brain perceives something as a threat. In other words, the brain’s smoke alarm goes off, and mobilizes the body for fight/flight. All well and good. However, what happens when the event is over? Do we demobilize, or are we still at the ready? The body has a process for demobilizing, and that is by and large forgotten in our species. Or suppressed. Either way, the consequences have been serious.
Second facet I’ll mention is that stress is autonomic. Once the smoke alarm goes off, a whole bunch of things happen that you have no control over with the exception of your breathing. There are cerebral, cardio, digestive, endocrine, hematological, hearing, immune, myofascial, reproductive, respiratory, and vision changes. All starting at once and occurring in seconds. Ninety nine percent of which we have no control over. Because it’s autonomic. It’s meant to make you go from standing still to Usain Bolt in a heartbeat, or from Clark Kent to Superman without time consuming thinking. Time in which we end up being dead. That is a good reason to cut cognition out of the process!
Lastly I’ll mention (I have to think you noticed), that this experience is by and large, physiological, not psychological. The body shunts blood to the muscles, so hearing is effected a little bit, and one of the places it’s shunted from is the frontal cortexes of the brain. That’s called hypofrontality. That means more or less that the cortexes are on a dimmer switch once the threat state is activated, and the more intense it gets, the dimmer the cortexes are. Emotions get narrowed, and the organism is now prepared for life saving flight or threat termination fight. All automatically. Of course we know that in the millisecond of history that the last 1000 years represents at the very least, the things we perceive as a threat have changed quite dramatically. It’s no longer sporadic lions and tigers and bears, oh my. It’s chronic worry about pink slips, student debt and a health crisis, oh my. Yet the response by the human organism is exactly the same. What was once acute, has now become chronic, yet it is still for the most part, physiological.
What then is trauma? Let’s look back at stress, and ask what happens when a stress cycle is not completed? As Peter Levine (PhD in psychology and biophysics) explains in his book In an Unspoken Voice, it accumulates in the body. It’s like pulling on a spring, and then holding it rather than letting it go. The next stress activation, we pull a little more, and again, don’t let go. Keep adding the cycles up and I think you’ll see what happens to the tension of the spring, and, what would happen if you let it go all at once. This happens over time of course, and I want to draw your attention to a couple aspects here.
One is that these accumulated, incomplete threat cycles (trauma) become rupturing. These ruptures happen to our sense of safety, they happen to our relationships, and as they go unrepaired, they rupture the very physical process of the organism. First in the body, and then as the chronic state of rupture remains, into the psyche. The imbalance of hormones and myofascial constriction and cardiovascular changes and glucose/insulin reactions over time leaves little choice of the organism’s normal functioning to be ruptured, as Robert Sapolsky points this out in his book, Why Zebra’s Don’t Get Ulcers. Secondly, a chronic threat state will become what the brain re-wires around since it’s firing there. What then of beliefs, and thoughts, and emotions? Living in a chronic threat state means we come to see the world is a dangerous place and that people are threats, and the circle of safety gets mighty small indeed. Even close relationships become threatening as our calm turns into irritability, our irritability into annoyed, and then into anger and our tone matches our mood and we isolate and those are the ruptures of relationships because the chronic threat state is the new normal. Is it any wonder the divorce rate is near 50%, the “little blue pill” is a huge seller, and “I’m better off alone” is a common refrain and even though I might not like living with myself all that much, it beats the static of a constant state of anger and conflict in a relationship. My cynicism increases, my sarcasm, my shortness, how can people be so damned stupid, and my thoughts are the same as my tone and words because the threat state in-forms the emotions that in-forms the beliefs that in-forms my actions and words. That is what it means to be traumatized. And because I don’t like being with my own craziness that has no label on it, no diagnosed description, I choose maladaptive behaviors to get the love I want and/or to kill the pain. I attempt many times to change, to put this on, to take that off, to transform myself. Yet in the end, again and again, my emotions, my cognition, my beliefs, my social life are all one big dumpster fire that seemingly gets bigger all the time. That’s also what it means to be traumatized. So on top of the physiological disordering and potential issues that arise there, I now have a psyche effected as well because the stress cycles I’ve experienced for 60 years were by and large never completed. Where I couldn’t fight/flight or maladapt, I dissociated. It gets labeled as all kinds of things like personality traits, which become family traits, which become culture and political systems, and the reality is, this is what it means to be traumatized. Supersized.
The upside is that ruptures can be repaired, which means that if we complete the stress cycles, we can heal. And the body contains the process to do that very thing. And that is another post….