Another possible response to experiencing trauma is the person going into denial. Their bodies register the trauma, but their mind goes on as if nothing happened. Even though their mind may learn to ignore the signals from the emotional brain, the alarm messages and stress hormones do not stop firing. The continuous firing from the emotional brain and secretion of stress hormones keep the body in a state ready for action or immobilize for collapse. These physical effects on the organs go on until they ultimately result in illness.
A person with PTSD has a malfunctioning thalamus that is not filtering incoming information properly. This results in a state of constant sensory overload. To cope with this state of sensory overload, the person may attempt to shut down, which unfortunately could also lead to cutting out the experiences of pleasure and joy.
Traumatized people feel unsafe in their bodies due to the chronic discomfort of their visceral distress signals. In an effort to function, they become skilled at ignoring their bodily sensations. The more people try to ignore their bodily sensations, the more apt these sensations are to take over. When an individual cannot recognize what is happening inside their bodies he or she can end up responding in extreme ways by either shutting down or panicking in response to even the slightest trigger. The cost of ignoring bodily sensations is not being able to truly recognize what is dangerous and harmful, or what is safe and nourishing.
Our sense of self is housed down the midline of the brain. Severe early life trauma effects this area of the brain in a profound way. On brain scans of people with early trauma and chronic PTSD, it has been found that there is nearly no activation along the midline of the brain. What this indicates is that the person learned to shut down the brain areas that process the visceral feelings and emotions that come along with terror. In doing so, however, they also shut down the ability to feel the full range of emotions and sensations that form the foundation of self awareness. As an attempt to avoid the terrifying sensations, they also lost the ability to feel fully alive. This lack of activation down the midline of the brain could explain why many traumatized people lose their sense of purpose and direction.
The core of our self-awareness is housed in the physical sensations that communicate the inner states of our body. Remembering emotional experiences from the past cause us to feel in the present the visceral sensations that were felt during the original incident. The more we are aware of our sensory body-based feelings, the more able we are to control our lives. Knowing what we feel is the first clue in figuring out why we feel that way. Our gut feelings tell us what is safe or threatening, and help us figure out what is going on around us. If you are connected to your inner sensations, you can trust them to guide and provide you a sense of control.
Brain scans of traumatized people who freeze completely when revisiting their trauma show a marked decrease in activity across the whole brain, and report feeling nothing. This is referred to as depersonalization. The bottom-up approach is essential when working with someone who presents with depersonalization. The goal is to change the person’s relationship to their bodily sensations. Help them notice body sensations by tapping acupressure points or engaging them in rhythmic interactions such as passing a beach ball, drumming, or bouncing.
A main challenge of treating individuals with PTSD is helping them to learn to live in the present. Self-regulation only happens when one has a good relationship with his or her body.
People who have a difficult time knowing and describing their physical sensations tend to register their emotions as physical problems. They may experience being angry or sad as muscle pain or irregular bowels. Recovery from trauma requires becoming familiar with and accepting the bodily sensations. It requires developing awareness of their sensations and the ways their bodies respond to their environment. Physical self-awareness is the first step in letting go of the trauma.
What I have found in working with client’s with PTSD is that there is often a sense of urgency to get rid of the troubling symptoms, to get past it, to get away from it. This instinct, however, does not jive with truly addressing the trauma and how it is impacting the body. To push it away or ignore it, as we have read, only makes it push in more or seep out, as my old supervisor would say, sideways. When working with a client I want to look at how they think about their symptoms. Do they hate their symptoms or see them as evidence of them being faulty or damaged? Are the symptoms something you can truly ignore or push away, and if so, at what cost?? We can see there are major costs physically. Over time, the ignoring of the sensations can lead to deteriorations in health. So I invite you to think differently about the sensations and how to approach them. In my next post we will talk more about this and the idea of making friends with your sensations. With great care and compassion. Until next time… -Dr. B