Stress and the traumatic stress reaction

Stress and the traumatic stress reaction

We are all stressed at some time or other.

Other words we might use to describe how we feel might include: feeling pressured, under strain or tense.

So what is stress?

According to the online Oxford Dictionary, stress means “a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances.”

Factors affecting the facility with which we are stressed include: the situation/circumstances we are facing (whether internal or external) and their meaning to us; our physical and emotional state at the time; our character and associated personality traits, such as frustration tolerance; our history and the extent to which we are sensitized or primed to respond when triggered; whether we have someone we can share the burden with or feel alone with it all.

What can we do when beginning to feel stressed?

Granted that, like anxiety, some stress is good for us, as it keeps us on our toes and challenges us to step up the pace or do better in some way, other things being equal, it is better to nip a mounting sense of stress in the bud than to allow it to spiral and get out of hand.

One of the best ways to do this involves being attuned to our felt sense, and regularly identifying sources of tension and constriction in our daily lives. We can pick a specific incident or situation and localize the associated tensions and constrictions in our body. It is important to choose one sensation of constriction at a time, and discharge it, for example via the techniques SE has provided (e.g., such as focusing and the rhythmicity of pendulation between constriction and expansion), techniques which mimic how the body works, and are geared to remind it to do so, when it falters.

Traumatic stress reaction

When the stress is related to events or traumatic experiences that overwhelm our nervous system, we have the makings of a traumatic stress reaction. We may appear anxious or nervous, we fret, we worry and we tend to overreact.

According to Levine (1997), we may identify four main components in the traumatic stress reaction:

Hyperarousal

Constriction

Dissociation and disavowal

Freezing (immobility), associated with a feeling of utter helpless and paralysis.

Symptoms of hyperarousal that appear during times of conflict or stress include: increased heart palpitations i.e., rapid heart beats, a pounding heart; breathing difficulties; difficulty in sleeping; tension, psychomotor agitation, racing thoughts; an anxiety attack. Hyperarousal cannot be controlled at will, and indicates that the body is gathering its energetic resources to mobilize against a potential threat. This is also manifested in hypervigilance, when all change, even internal one, is perceived as a threat. Some of the undischarged, excess biological energy is consequently channelled into the muscles of the head, neck, eyes and ears, affecting the orienting response. The person does not feel safe, and is constantly on the lookout for an external sense of threat, even when there is none.

Constriction

Constriction can be experienced as a tightening or tension, affecting every function and part of the body. It also limits our perceptual awareness of the environment— once we orient to the potential threat, it commands our full attention, and we ignore less salient aspects of the surroundings.

Dissociation

Dissociation may be mild (e.g., feeling “spaced out”) or pervasive, affecting the entire personality, as in multiple personality disorder, or as it is referred to today, dissociative identity disorder.

It reflects a breakdown in the continuity of our felt sense, and includes distortions of time and perception.

It may involve a disconnection from our body, such as the experience of looking down at ourselves from above, in an altered state of consciousness; a disconnection between one part of the body, such as the head or limbs, and the rest; a split between the self and emotions, thoughts or sensations; or a divide between the self and the memory of the event, in part or in whole.

Denial and disavowal may precede dissociation.

As above, there is a disconnection between the person and the memory of, or feelings regarding a specific event.

In denial, that which is denied disappears from consciousness, as if it doesn’t exist. The person unconsciously refuses to recognize some painful attribute or perception of his inner or outer reality.

In disavowal, the actual event may not be denied, but its significance is.

Generally speaking, these mechanisms come into play to protect the self from being flooded by anxiety and other intolerable affects (Solan, 2015).

At the time of the traumatic event, “denial helps preserve the ability to function and survive.” (Levine, 1997, p. 165). However, it can become a maladaptive symptom of trauma, when chronic.

Helplessness and Freezing

Imagine a car where both accelerator and brakes are pressed down at the same time. This is analgous to what happens during a traumatic reaction. Complete immobilization ensues, accompanied by a sense of paralysis so profound, the person collapses and unable to move, is utterly helpless. An echo or remnant of this feeling will remain, even when the immobilization relents and wears off.

Although we have all experienced some form of each of these components, when they appear together over an extended period of time, we have the makings of a residual traumatic reaction to threat, whether internal or external, real or imagined, and the person becomes symptomatic. Symptoms emerge when these processes remain chronic and habitual. Thus, processes that initially came into being to protect us and serve a protective function, can become maladaptive and indicate that the nervous system is still activated, behaving as though our very existence is at stake.

Traumatic Anxiety

When the sense of impending danger will not go away and continues to nag at us constantly, we remain in an elevated state of arousal that feeds itself. The more aroused and activated we become, the greater our sense of danger; the greater the danger, the more activated we become. Constant hypervigilance brings in its wake an ongoing sense of fear, paralysis, a sense of victimization associated with helplessness. There may be feelings of impending death, which can be intensified by other feelings, such as panic, terror, rage, and utter helplessness. This is the recipe for traumatic anxiety.

Traumatized people may lash out, fueled by the energy contained in their traumatic symptoms. Thus, someone who was hit as a child may feel compelled to hit as an adult, re-enacting his own traumatic experiences. Moreover, we tend to be unconsciously drawn to situations that replicate the trauma. For example, a driver may be involved in repetitive car accidents. Certain events may be re-enacted in close relationships.

It is thought that much of the violence in our world is a result of unresolved trauma, which is repeated and re-enacted in futile attempts to gain mastery and re-establish a sense of empowerment. Without appropriate discharge and the completion of what Levine calls “renegotiation of trauma,” it is believed that the cycle of violent re-enactment is doomed to repeat itself.

According to Levine, in renegotiation of trauma, “the repetitive cycle of re-enactment is transformed into a healing event.” (1997, p. 179). Consequently, the need for blame or revenge dissipates.

How this transformation comes about is beyond the scope of this article. Suffice it to say it is possible because a counter-vortex to that of trauma, what Levine (1997) and Ross (2008) metaphorically call a “healing vortex” arises spontaneously. The healing vortex provides us with the resources needed to successfully renegotiate the trauma vortex which tends to draw us into its swirling turmoil. We access our resources through the felt sense and the positive sensations and healing images that we allow to emerge.

According to Levine: “By moving between these vortices, we release the tightly bound energies at their core—as if they were being unwound. We move towards their centers [from the periphery] and their energies are released; the vortices break up, dissolve, and are integrated back into the mainstream. This is renegotiation…” (p. 199, my brackets).

Three levels of stress management

According to the Merriam-Webster dictionary (see online for full definition), stress refers to: “a physical, chemical, or emotional factor that causes bodily or mental tension and may be a factor in disease causation.” (my emphasis).

In everyday parlance, we understand it to mean tension, worry, distress, pressure, strain, tightness, nervousness and the like.

Stress is part of life. The big question is: how do we choose to deal with it? Some responses can alleviate it or mitigate it, others may intensify it.

Picture the stream of life as a river with rocks, boulders, tree trunks and waterfalls along the way. These obstacles are stressors to be reckoned with throughout our lifespan and its ever-moving flow of time. It is important to acknowledge that as long as we live, new stressors will keep cropping up and challenge us.

Thus, we need to develop a stress management tool kit, to learn how to deal with and overcome these stressors in the best possible way, hopefully becoming the stronger for it. There are various levels of intervention along the way. We will look at three.

1. The objective circumstances

First, we need to establish what the objective circumstances are: what is actually going on? If it’s possible to circumvent the problem we are facing or nip it in the bud—this may be easier than to actually meet it head on.

At this level, managing stress involves changing our situation. Sometimes, minor adjustments, such as deciding to cut corners to lighten our work load, or taking on less responsibilities, may suffice. At other times, a major change, such as finding another job, switching schools or moving, may be warranted.

It pays to tackle the problem when you feel rested, when you aren’t hungry or thirsty. Remember to first access your inner resources or engage external ones.

For example, if you need to summon up the wherewithal to ask your boss for a raise, it may be helpful to first recall a time when you were able to go after what you wanted, meanwhile noticing the effect this has on your body, at the level of physical sensations. Metaphorically holding this resource close to you, visualize the situation as you get psyched up to talk to your boss. This mental/emotional/physical preparation may allow you to feel more empowered when you actually meet.

2. How we think and feel about a situation

When it is not possible to change the objective circumstances, we may nonetheless adjust or tweak our thoughts and feelings about them. We may be able to reframe the situation in a constructive way, look for the silver linings in the cloud looming above.

For example, the lockdown due to the Corona virus, while a major burden that derailed our life as we knew it, may also have created time to do something we’ve always wanted but was beyond our reach, such as learning a new language or developing a fun hobby; being able to spend more time with our partners and/or children.

As we seek for meaning in our world and our experiences, the stories we tell ourselves about who we are and our place in the world, can ramp up our stress level, especially if we tend to become judgmental and self-critical.

But this can change—if we allow ourselves to embrace a less self-denigrating and thus less stressful story. Chances are we would be more compassionate if the story were about a good friend. It is important that we learn to respond with compassion to ourselves—accept that for the most part, we actually are doing the best we can, even though we aren’t perfect, acknowleging that we can learn from experience and in thus doing, improve our ways.

At times, we may get upset because we attribute a certain motivation to someone else. It may or may not be accurate.

For example, when driving, we may exclaim, “What a jerk—he cut me off on purpose!” This may get us into a sympathetically-driven, “Fight or Flight” mode. Instead we might think, “He’s an inexperienced driver. It’s not worth getting upset, even though I missed the light because of him. It’s not the end of the world. The A/C is working, and there’s a great song on the radio.” This will engage our para-sympathetic system and help us wind down.

It is important not to get caught up in black-and-white, all-or-nothing thinking. Most occurrences, upsetting as they may be, are time-limited and have short-term consequences—they are not going to last forever. Instead of responding as though the upsetting occurrence will ruin your life, remind yourself that whatever it is that is upsetting you will pass—it has a beginning, middle and end.

3. What we choose to do in tackling or responding to a problem

What do we do to deal with a problem? Are there any self-limiting beliefs or self-defeating behaviors getting in our way? For example, do we tend to procrastinate and wait till the last minute, instead of starting earlier so we don’t get stressed by impossible deadlines? Do we avoid doing certain things because we believe we don’t have what it takes (e.g., negative beliefs about ourselves)? Do we reach out and let others know what we need from them? Teach them how to behave towards us? Seek out someone to simply hear us out?

It is important to find a healthy balance between reflecting and regrouping—which may include enlisting our internal and external resources—versus doing, taking decisive action.

Helpful resources may include: breathing exercises, meditation or mindfulness, Tai Chi, yoga.

An additional resource might be psychotherapy.

References

Levine, P. & Frederick, A. (1997) Waking the Tiger. Healing Trauma. Berkley, CA: North Atlantic Books & ERGOS Institute Press.

Ross, G. (2008). Beyond the Trauma Vortex Into the Healing Vortex. A Guide for Psychology and Education. Los Angeles, CA: International Trauma-Healing Institute.

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