Acute Stress Disorder Tag

Trauma; Honor For Your Healing Journey

Honor your healing journey

The four things your therapist wants you to know about your healing journey. When you’re healing from a grief, trauma, or resultant PTSD, you must be thinking about ‘how will I ever move on from this horrible, unexpected, agonizing reaction to the traumatic situation that I have experienced?’ Remember, PTSD is a reaction to witnessing or experiencing a sudden and unexpected event which caused one to feel powerless by delivering, threatening, or witnessing harm. How can I rise above these feelings and thoughts and create meaningful and complete healing? Maybe you want to go backwards in time and undo all of the harm that you have experienced. A common and reasonable response to all of these above disorders, particularly PTSD, is to try to avoid all triggers associated with the situation which evoked the trauma, hypervigilance, intrusive memories, nightmares, flashbacks and an increased risk for anxiety and depression. This disorder presents a mountain to ascend, and whether you have spend years in therapy or are only beginning to acknowledge the depth of the effects this has had on you, these are some points to keep in mind. These are the 4 things that your therapist wants you to know about healing that are not immediately evident.

Healed but not Forgotten

Some people have the unrealistic expectation that when they reach the end of their healing journey  they shouldn’t have any emotional reaction to their memories of the traumatic event which led to grief and loss. That is not how healing works. It is quite likely that you will always have some sort of reaction to the memories and thoughts associated with your grief or trauma. In fact, according to a 2011 study published in NIH by Sherin and Nemeroff, and according to all of science and psychology support the fact that there is potential for long term neuroanatomical and neurochemical changes to the central nervous system resulting  from trauma. These changes are especially evident in the way we respond to triggers or trauma associated stimuli. What we should be striving for in the healing from trauma is a ‘new normal.’ Healing means that you are able to function in professional or personal settings and that you are practicing resilience and positive coping when waves of thought and emotion do come.

Healing means Acknowledging Feelings

One of the ways that therapy works is by creating an intentional space for healing warriors to be honest with themselves, to create an understanding of their emotions.  After an awareness has been formed adaptive responses to feelings and thoughts can be generated. We create psychopathology by being critical and attempting to repress our internal honest responses. For some people like first responders, police, and paramedics, there may be an extra layer of difficulty and stigma attached to acknowledging ones feelings and seeking mental health support to manage trauma. This can cause further damaging denial of the effects of traumatic experiences, One of the core tenets of psychological theory present in every form of therapy is that the more we repress, judge or avoid our feelings, the more we cause problems. Repression elicits tangled feeling constellations, blocked energies, incomplete and unintegrated shadows. Mindfulness based stress reduction, EMDR, Cognitive Processing Therapy, Cognitive Behavioral Therapy, and Exposure Therapy, have shown efficacy in treating PTSD. Our feelings can turn into psychopathology that are bigger and sometimes socially unacceptable forms of the original emotional response.

Healing Happens in Relationships. Find your Healing Tribe.

It is especially true for trauma that happens in relationships, that this same trauma is healed in relationships. When trauma survivors open up to those people who they consider to be safe, there is an incredible potential for healing to happen. Healing relationships are those that resonate compassion, gentle acceptance, warmth, and non-judgement. Think about it, we become close to those who we can be really honest with, those who ask about our feelings and can share in a compassionate interchange, (Mgrath, 2001). Sharing trauma should be exercised with caution. However well-intentioned our healing tribe may be, its members may inadvertently respond in less constructive ways that judge, shame, or put down the survivor for having the pain or scars of trauma. Another risk is not being able to hear or understand what is being shared. What is really needed is non-judgmental acceptance, understanding, and compassionate warmth.

Find your healing tribe

Positive Psychology, Pop Culture and Non-Reality

You may have survived a trauma but that doesn’t mean you have to fall victim to meme reality. Scroll through a social media forum and you will see many posts and memes which declare that everyone should be happy all the time. That isn’t honest or possible. The healthiest among us are those who are honest with themselves about what they experience and then respond to their vulnerable reality in a constructive way. According to a 2016 study by Elizabeth Kneeland, pop cultures layman positive psychology is damaging. When pop culture got its hands on positive psychology its representatives distorted the message, and now laymen perpetuate unrealistic and uninformed messages which imply that we can think our way into a good mood.  It suggests that if we blink our eyes we can make trauma and psychological distress evaporate. Your therapist knows differently. Its ok to be outraged, disgusted, sad, hurt, angry, confused, and it is important to acknowledge where you are in your healing journey today.

No matter where you are today, the best we can do is to risk opening to ourselves, to create an honest internal dialogue that we are eventually able to share with others. We should unabashedly honor our own processes, giving relentless permission to feel, think and be; in reverence of joy, in honor of glorious fury, to the fullest expression of gaiety, to the utterance of insuperable hurt, to fully hone in on repugnant disgust. Keep developing your divine awareness, and eventually you will have created the unique meaning which understands with a lens of compassion, acceptance, and self love all that has happened to you.

With love and hope for resilience,

Stephanie Wijkstrom, MS, LPC, NCC

For More Reading

Kneeland, Elizabeth et al, Positive thinking Newsweek, 2016

https://www.newsweek.com/2016/09/23/positive-thinking-myth-498447.html

McGrath, Ellen. Psychology Today, published November 1, 2001 

https://www.psychologytoday.com/us/articles/200111/recovering-trauma

Post-traumatic stress disorder: the neurobiological impact of psychological trauma

Sherin, Jonathan E, Charles B. Nemeroff

Dialogues Clin Neurosci. 2011 Sep; 13(3): 263–278.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3182008/

Trauma Informed Care; We Have Evolved to be at risk for Trauma; Here is Why

Trauma Informed Care

We have fantastic and astonishing memory abilities, the human mind and its processes, particularly in the way we store and retrieve the effective memories which then effect the way that we store and respond to our other memories and sensory input. Evolutionary psychology examines the way some things that can be problematic are often helpful to us in the past and as we evolved. This is especially true for trauma survivors. According to the American Psychological Association, Trauma is an emotional response to a event like an accident, rape, or natural disaster, abuse or assault. Immediately after the event, shock, emotional upheaval, loss of ability to function, and denial are typical. Trauma is especially present in situations where a person feels powerless and their sense of control are taken. Long term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea, nightmares, inability to rest or calm down, feeling tearful, experiencing fear and heightened startle response. While these feelings are very universal response to the paralyzing fear that is associated with trauma even if the survivor reports feeling neutral in the moment. Biology offers some rational for how we can feel afraid but work through it in the moment of the traumatic situation, but it is later when we are safe and comfortable that the panic can emerge, generally emotions are something that can be seen and felt most when everything is alright around us, meaning the traumatic event is over and we are safe. Some people have difficulty moving on with their lives because trauma can result in long term effects such as PTSD, acute stress disorder, anxiety, depression, and addiction.

There are so many events that we experience which are traumatic, whether these develop into the more complex constellation of behaviors which we identify as PTSD, really depends on an interplay of biological, social, and other environmental factors. Some of the situations which can cause a trauma response include, domestic violence, sexual violence or assault, car accidents, national tragedies, serving in war, robberies. It is possible that we can experience a traumatic response my witnessing these events even if we are not the direct recipient of the threatening attack.

People who later feel the emotional and physical effects of trauma may wonder, what is wrong with me? Also, even if the event seemed manageable in the moment, it seems bizarre that they keep seeing flashes of it months or years later. The answer is while the effects of trauma  can be debilitating, our cognitive processes are primed to be traumatized. Evolution explains that we and our ancestors are wired to hold tight to frightening or threatening experiences, imagine what happened to all of the humans who did not startle and produce massive amounts of cortisol and adrenaline at the sight of the saber toothed tiger just through the northern passage on the savannah. They died and did not evolve to have offspring in our gene pool. Having memory of dangerous events, people, situations, and gearing up to flee or protect one’s self is a sign of an evolutionarily healthy adaptation, it allows us to stay safe by avoiding possibly dire situations. In fact, our Vagal nerve which communicates directly to our bodies, without having to yield the advice of our logic, there are long term changes in the way that our Vagal nerve responds to triggers after we have experienced trauma. The vagal nerve is what allows healthy people to experience the ‘startle response’ for example when someone sneaks up behind you, usually we respond with a physical jerking motion in our bodies, and literally jumping. In domestic violence survivors, being ‘jumping’ and easily startled when a person raises their hand, is a well noted phenomenon that may last an entire lifetime.

We are wired to remember traumatic events. Survivors of trauma know that the sight of the perpetrator of their violence, even a coat that’s the same color as the one their attacker had worn can evoke the fear response. ‘Triggers’ are any stimuli which we associate with the traumatic event. These triggers and their associated memories can and do produce a jolt to the vagal nerve resulting in heightened, panicked, and anxious response in the person who is perceiving them. The biological response when we encounter a trigger are a plenty, our bodies enter a state of hyper-arousal, respiration becomes more shallow, heart beat rises, and fear settles in, even cognitive function is impaired as our higher order reasoning is impeded and all neurological resources are yielded to the hind brain and its motor and autonomic functions. The one and only thought becomes fight, flight, survive, and in some cases freeze. Remember, just like on the savannah in the seat of civilization, the extra energy our bodies create allow us to escape danger.

Cognitive processing therapy, systematic desensitization, and exposure therapy, and some therapies which aim to change the tone of the vagal nerve are recommended ways to work through the trauma and empower the survivor to be able to withstand exposure to triggers and regain emotional wellness. It is recommended that trauma survivors do their best to limit exposure to triggers as they heal from the event and associated memories. If you feel that you may be experiencing long term effects from a traumatic situation, it is recommended that you work with a therapist who is specifically trained in trauma informed care. Healing will allow the processing of the entire event, client and therapist will identify triggers, developing the capacity to respond to triggers with mindful balance, and work through the effects of any other psychological effects from the trauma.

Counseling and Wellness Center of Pittsburgh, Serving Western Pennsylvania with Individual Therapy, Couples Therapy, Family Therapy and Wellness Services.

Acute Stress Disorder

Acute Stress Disorder 

Acute stress disorder is a form of anxiety disorder which develops shortly or immediately after exposure to a traumatic event in which real or threatened harm or injury was experienced or threatened to the self or other. Acute Stress Disorder differs from Post-Traumatic Stress disorder in the time from in which the associated symptoms are exhibited. To reach the diagnosis of Acute Stress disorder symptoms should be exhibited less than one month after exposure to a traumatic event. Similarly to PTSD, symptoms involve flash backs, re-imagining, dreams, distress or anxiety at exposure to visual stimuli related to the traumatic situation or event, including hyper-vigilance, and anxiety about the possibility of the event or danger happening again. The duration of the traumatic event and time of exposure or repetitiveness of the exposure effect the likelihood that the person will experience Acute Stress disorder as there are certain internal risk factors which may affect resilience to the development of the trauma. Treatment for Acute Stress Disorder often involves trauma focused therapy, EMDR, short term psychotherapy, mindfulness based therapy approaches even including meditation, acupuncture, all therapy and counseling services should be performed with a licensed professional counselor or mental health specialist.

Anxiety; Pills and Possibilities, A Psychotherapists Musings

Who among us has not suffered from feelings of anxiety at some point in his or her life, it is common enough to be among the more often seen symptoms which bring an individual into a therapist’s office. Even for the most staunchly healthy psyches anxiety is a typical benchmark which exists in a range of degrees within the human emotive process. Depending upon you as the individual and the technical approach of your clinician you may be offered a multitude of conflicting remedies to intervene upon that which is ailing you.

There are the wildly popular pharmacological interventions such as Xanax or Valium, while widely popular these interventions do nothing to examine the “how’s” or “why’s” of an anxious feeling. These interventions assume that an increased cardiovascular response, heightened worry, tense muscles, sleepless nights, feelings of agitation are all in the physical realm yet quite mysterious. Indeed anxiety in its more insidious form is a grave health concern so it is with accolades that I note the vast number of humans seeking treatment to escape its grips. There is something inexplicably disconcerting about the hyper arousal of anxiety which compels one towards a greater risk for many other issues health issues such as addictions, depression, coronary heart disease, even eroding the erectile function of both the male and female, to name but a few.

 Most of us recognize that there are yet other forms of anxiety which are our “bon amie,” the kind which compels our actions for good causes such as self and social betterment. Without a touch of anxiety one may hit the snooze button each and every morning and drop out of society all together. Yet for our purposes we will consider the more sinister form with its wanton undesirability which causes many to seek its avoidance at all costs. There are vastly varied approaches within the medical community in terms of treatment of anxiety, there are folk remedies, homeopathic remedies, new age methods, each with their unique utility. Yet most all of these interventions lavish attention upon the amelioration of physical symptoms but may from sheer neglect, fail to examine the psychological underpinnings of anxiety itself. For those who do experience the necessity of utilizing anti-anxiety medication it is an empirically validated fact that the best therapeutic outcomes exists for individuals who make use of psychotherapeutic settings simultaneously. It is within the psychotherapeutic setting that the focus is cast specifically upon the unique psychology which may be breeding and offering sustenance to an overabundance of anxiety.  Allow the remainder of this small essay to offer a rudimentary overview of some of the more typical sources of psychological anxiety.

Significant Life Changes

This form of anxiety is a reaction to some looming occurrence which has skated its way across your horizon, it may be adaptive and is completely natural. Many of us thrive upon constancy, as much as this tendency is at odds with the nature of the universe, inevitably we experience some anxiety while changing jobs, graduating, marrying, divorcing etc. While it is normal to exhibit some emotional reaction to such transitions be mindful to give extra care to yourself even during those joyous transitions. For any anxious feeling that continues to gnaw at your innards, give yourself some time to thoroughly examine  all of your thoughts surrounding the (fill in blank) transition. This reflection affords the opportunity to hone in on any ways your emotional self may be beckoning you towards a closer look at something that your conscious awareness is not seeing completely.  

Emotional Expression

 The more that we attempt to repress our emotional experience the more that they tend to rupture forth in greatly unmanageable ways. Perhaps you are a product of early learning which valued emotional repression and lack of expressiveness. In some way you may have learned early or later in life that it is dangerous or taboo to talk about feelings or even notice that they exist for you, yet the vast and unstoppable torrent of the feeling state will not be escaped. This form of anxiety or panic urges the person towards understanding and experiencing of inner awareness and emotional expression.

Time

The exactitude and finite nature of time is stated by some to be the source of all anxiety. What is it that you will you do with your precious earthly allowance? By becoming more aware of lapsing time, acknowledging that life proffers beauteous opportunity, love, and abundance still too, how will you cope with mounting defeats, losses, and unrealized potentials? Ones highest hope is to make father time ones friend, utilizing our human energies to compel feats which contribute to human progress. For you that may mean many things, to raise a family, build computer software, tend the forest, love deeply, the myriad meanings for the human riddle.

Control

For some of us it is alarming to consider doing something that risks ones perceived control over ones surroundings. That could mean riding in an airplane, making interpersonal changes like developing new relationships, people are the ultimate unknown variables full of competing needs and possibilities.  Will you be able to extend the risk of letting go of the known order to enjoy the potentials?

While this is in no way an exhaustive exploration of that powerful human indicator named anxiety it is something that may compel one to begin to relate to it in a slightly different manner. Perhaps it is time to consider its possibilities, its latent messages, it may one with greater respect for behoove one to not simply extinguish an anxious feeling with a pill or an exercise but to sit with it, even for just a moment, entering its heart palpating, dizzying sensation, in reverential respect for its utility and possibility as an psychic indicator. There is an understanding that in most cases, under the layers of any symptom are a fortunate beckoning towards the best version of yourself, the unrelinquishable layers of consciousness which insist that ideals will be felt and known.

In good health and energy,

Stephanie McCracken MSPC

412-215-1986

Reviving Minds Therapy

1010 Western Ave

Pittsburgh Pa 15233

*This article does not intend to diagnose, treat, or in any way address an anxiety disorder or supplant psychological or medical advice. This is intended for your consideration only.