Trauma

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Fight, Flight, Freeze...

Trauma.

This is a topic that I have been wanting to discuss for some time.  In light of the recent tragedy that occurred in Newtown, Conn., I think it is time to explore a term we are hearing in the news quite often,"trauma." 

The word itself can be a bit scary.  Yet, it is a common experience as part of the human condition.  I would like to help de-mystify, from a more physiological and anatomical view, of what trauma is and what can be done to help alleviate it...to heal.  Sometimes the more we learn about something, the less scary and overwhelming it is.

As a Rolfer, I see the repercussions of physical trauma quite often.  I also sense and work with symptoms of psychological trauma as well.

First, let's discuss what trauma is.  Trauma is an event involving a single experience, or a series or events, that completely overwhelm a person's ability to cope or integrate all that has happened to their body and psyche.  The key word here is overwhelm.  All of our body's ability to compensate and contend with a given threat is simply...overcome.

Trauma can happen quite easily in situations of war, a car accident, abuse, or the death of a loved one.  Yet, trauma need not be, as seen through the eyes of an adult, a catastrophic event.  As children, it doesn't take much for us to experience trauma.  Our nervous systems are not fully developed when we are young.  Because of this, we are much more susceptible to traumatic events.

1.  A Story.
 
I am sure you have heard of the fight or flight response.  This is the body's natural response to any given stressor.  There is another response that is also quite natural, and that is the freeze response.  You will find all three in nature on a regular basis.

A great example of all three responses would be the story of our friend the Gazelle.

Let's say our buddy the Gazelle is minding it's own business, munching on some grass, when suddenly it gets a whiff of a Lion near by.  When a gazelle senses a lion, its innate response is to prepare for fight or flight.  Perhaps it has young ones near by, and might hope to defend it's young, or fight.  More likely than not, being that it is not a fellow predator, it will flee.  The gazelle flees, and the lion gives chase.  Now, let's say the poor gazelle is caught.  At this stage, the gazelle might in fact simply play dead, or freeze.  The freeze response is a state of helplessness, surrender, yet at the same time, one of survival.

If the gazelle is extremely lucky, and the lion is distracted, it may take this opportunity to flee once again.  It does indeed get away a second time, and the Lion is unable to pursue or capture our friend the gazelle.

It is at this juncture where trauma may get a foot hold.  Yet, for the gazelle, it begins to twitch, shudder and shiver.  It's autonomic nervous system is discharging, and its body is seeking homeostasis or balance once again. 

We humans, however, for a variety of reasons, have forgotten or lost our ability to discharge.  This is very important.  It is here that trauma takes hold.  Our response is not homeostasis or balance, but one of numbness, disassociation, and or constant hyper vigilance..  It is essential for our bodies to respond to a threat and then return to homeostasis afterwards. 

In other words, it is essential that our bodies are able to respond to a threat, and then after the threat has passed, have the ability to find balance.  With trauma, homeostasis or balance, feels and becomes out of reach.

(Thanks to Peter Levine for this story.)

2.  Biology.

One of the primary objectives of our brain and body is quite fundamental, and that is survival. 

When we talk of emotions, sometimes I think we assume that "feelings" are these ephemeral things that have no basis in physical reality.  On the contrary, emotions are physical.  Fear, joy, sadness, despair, love, and even terror are the result of our mind and body synchronizing or fragmenting from one another.  It is a dance of our endocrine, nervous, cardiovascular, lymphatic, skeletal, visceral, and muscular systems ... and then some.

A whole novel could be written on the physiological actions and reactions that take place in our body when we feel frustration for just a few minutes.  So very complex and intricate.

Let us look at what happens on a physical/biological level when we experience danger, and then . . . trauma. 

To deal with threats, our body has a command center, and it is called the HPA axis. 

The HPA axis contains the following:  hypothalamus, pituitary gland, and adrenal glands.  This axis produces finely tuned chemical messages that connect the central nervous system, endocrine and immune systems. HPA is the coordinator for our body's ability to defend itself.

The next time you get spooked, perhaps an angry dog getting to close to you, know that the HPA axis has just been turned on.

Time to introduce you to the HPA's main players.

The hypothalamus is located pretty much right in the middle of your brain.  If you were to place one hand on your forehead and the other at the base of your skull, it would be located roughly between your two hands.  The hypothalamus helps coordinate the autonomic nervous system.  The autonomic nervous system has two branches called the sympathetic and parasympathetic, which I will introduce you to later.

The pituitary gland is located in front of and just a little bit south of the hypothalamus.  It's roughly the size of a pea.  Even though it is a small little guy, it is a major player in our body.  It is responsible for creating 9 hormones that regulate balance in your body.  One of these hormones triggers the adrenal glands.

Last, but not least, are our friends the adrenal glands.  You have probably heard of these guys before.  They are perched right on top of your kidneys.  If you take your hands, and are able to reach behind to roughly lower mid back, they are located right about there.  They are the power players who release hormones in response to stress.  You have heard of adrenaline, which is essential to survival.  Another key hormone here is called:  cortisol. 

Cortisol is a bit of a counter balance to adrenaline.  It serves to control the stress response and calm the immune system.  It helps temper your body's fight and flight response, but not dampen it.

The whole of your sympathetic nervous system, "fight or flight", is put on red alert if the HPA axis senses danger!  Where does the sympathetic nervous system originate?  Nerve fibers from pretty much the whole front of you spine, touch on most every organ as it prepares you for survival.  If you were to take your hand and draw a line from your belly button to your throat, this is the area from which the SNS originates.

These are the players that create the HPA axis, the command center that deals with any unwanted threat or attack.  What is essential, is that the HPA axis is eventually able to "chill out" once a threat has passed.  Remember our friend the gazelle?  After it has discharged pent up energy, perhaps with shaking or running around, it may go about it's business once again of eating grass...  In order for this to happen, it's parasympathetic nervous system is activated.

Once a threat has passed, and the HPA axis believes all is clear, the parasympathetic nervous system comes on board to calm every thing down.  The parasympathetic nervous system is also referred to as the, "Rest and Digest" system.  I am a big fan of this one!  :) 

Where does the parasympathetic nervous system mostly reside?  Well, parasympathetic nerve fibers arise from the cranium and your sacrum.  Like the sympathetic nervous system, remember "fight or flight", they touch on and effect many glands and organs in your body.  If you place your hand on your sacrum, and later on both sides of your head, you have just found where the PNS originates.  No wonder downward facing dog in yoga can feel so good!  

The HPA axis exists for our survival.  Obviously, toxic stress can wreak havoc on our minds and bodies when the HPA axis is utilized too much, and we never allow ourselves to rest, to find balance.

Yet what happens when we experience trauma?

3.  Askew.

The HPA axis is also triggered by toxic stress and a traumatic event(s).  Trauma gets a foot hold when the energies in your body that are culminated for fight or flight become trapped.  The various systems that I described above that are primed for action are also simultaneously dampened from discharging.

Remember how I mentioned how important it is for the body to "chill out" after a threat has passed?  With trauma, our bodies are getting ready for fight/flight AND to calm down at the same time.  Our sympathetic and parasympathetic nervous systems are now firing simultaneously. 
 
Our parasympathetic nervous system is supposed to help sloooowly bring us back down.  With trauma, our nervous system isn't allowed to coast to neutral, but is instead suddenly switched OFF.  In our bodies, this switch is called the vagus nerve.  It is one of the cranial nerves I introduced to you earlier.

Two systems are now at war with one another.  One is meant to follow the other.  The gas peddle is not to be pushed down at the same time as the brake.  In other words, we are indeed overwhelmed!

The HPA axis becomes confused, and various maladaptations may follow.  We might feel "checked out" more often than not, as if in a continuous daze.  Or, we might be all too quick to anger and lash out.  Sometimes our psyche is trying to integrate all that is happened, and we might experience ongoing nightmares. 

Our soma and psyche do the very very best it can at this point.  But these options are fairly limited.  We remain in a state of hyper arousal, shut down, or vacillate between both.

4.  To Heal.

It is important to understand at this point, if you have indeed been traumatized, that there is nothing wrong with you.  As scary as all this might seem, and it can be, your mind/body is simply doing the best that it can.  Sometimes though, we all need a little help.

What is beautiful and amazing, is how much we have advanced in our understanding and treatment of trauma.  There are many many new ways in which to address trauma that weren't available, say, even 10 years ago.

Here are a few modalities that might help out. 

Play Therapy for Children.

As I mentioned before, children can be the most susceptible to traumatic events.  Play therapy is used with children aged 3 through 11 and provides a way for them to express their feelings and experiences through a guided healing process. As children begin to communicate their lived experience through play, the events that were once simply overwhelming, become better known and understood.  They become whole once again.

Psychotherapy

Psychotherapy can be an absolutely wonderful modality in dealing with trauma.  I would highly recommend working with a trained professional who is wise to the treatment and symptoms of trauma.  If you ever need a referral, please let me know.

EMDR

Eye movement desensitization and reprocessing (EMDR) is a very powerful tool used in a therapeutic context.   The goal of EMDR therapy is to process traumatic memories, which helps reduce their lingering and overwhelming influences.  

Body Work.

As a Rolfer, my goal is to help bring your body into alignment.  I am not personally trained to deal with trauma and it's effects per se.  Yet, throughout the course of Rolfing, old trauma does come up.  Rolfing can help your body find homeostasis once again. 

For those of you that have worked with me before, you may have noticed times where you suddenly feel cold for no reason, or your body might shake and shiver a bit.  These are good signs.  Remember the story about the gazelle?  Well, your body is finally finding the room and space to discharge.  It might not be trauma in of itself, but perhaps an overly activated autonomic nervous system.

Also, Rolfing can help you reconnect with your body.  When we are traumatized, we disassociate or become divorced from our own bodies.  With body work, we can explore, in a felt sense, the myriad of sensations that exist in our body, and re-connect with them.Rolfing using osteopathic and visceral techniques, can be very helpful.  Even though I might be dealing with an adhesion in your stomach, I am also touching and working with your nervous system.  The conflict between your sympathetic and parasympathetic nervous systems can be alleviated with some amazing results. 

Self Care. 

This is key.  Find ways in which to calm and sooth yourself every day.  You cannot push through trauma or "get it together."  But you can show yourself the kindness, love and compassion that you so very much deserve.  Find some quiet every day.  Listen for and feel the various sensations throughout your body.  Yoga and tai-chi are a few practices that can be very helpful in this regard.