“Please help me know how to protect myself against the hurtful and negative energy of people trying to hurt me!” I exclaimed, exasperated to my therapist. She wasn’t sure what I meant.
I went on. “When I drove past and saw their car there, I knew they had lied to me! It felt a kick in my stomach!” as I emotionally and intensely punched my own stomach while sitting in her office. “I had to park my car because my body started convulsing. I lost physical control of my body and I called [a loved one] for support! I was screaming at them about how much pain I was in! I didn’t know how to stop myself from convulsing!! How to stop the screaming!!! How to stop the pain!!!!”
“Physical reaction to a…..” my therapist whispered to herself and tapered off as I saw a light bulb go on over her head.
“I was fine before this! Before they lied to me, I had been happy!! But now the depression is back and I feel like if I leave this world…this pain, I can’t handle it….I just want to DIE!!!” I was becoming louder as I went on about the episode that I didn’t understand and so had labeled as an energetic attack.
My therapist got me to quiet, considering my volume in the small office with her door next to the building’s hallway. I learned that day that I have PTSD (Post Traumatic Stress Disorder). I was stunned. I had wondered in the past if I had it but when I looked at the DSM-5 (Diagnostic Statistical Manual of Mental Disorders) previously for different types of incidents, I did not think I fit the descriptors. I didn’t recognize that the “energetic attack” I was trying to shield against was a trauma response.
The diagnosis was cathartic. I had been feeling stuck for a very long time, as if my life was going nowhere. I was sure that internalized trauma was part of the reason for feeling stuck. I also knew about a trauma treatment called EMDR (Eye Movement Desensitization and Reprocessing), although I knew little about it. However, it was the beginning of the end. I was excited and called my sister and cried through my explanation that soon I would be able to release the pain of the parental neglect I had growing up and the bullying I was a victim of at school in my childhood. As well as all the trauma I experienced during adulthood through homelessness, divorce, single parenthood, abusive boyfriends, and as a teacher.
Once I received the PTSD diagnosis, I began to piece together how I had regularly experienced trauma response episodes throughout my entire life. These episodes were in varying degrees of intensity set in motion by trauma triggers.
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A therapist is the best person to diagnose whether you suffer from PTSD. How do you know if you even should get evaluated? Inability to control your emotions, called Emotional Dysregulation, is the main indicator of PTSD. Smaller response episodes can be experienced as racing thoughts, thinking a person is out to get you or trying to hurt you, or thinking they are lying to you when they are not. Larger trauma responses can look like an explosive, angry outburst, a loss of body control (can look like convulsions or “hitting the deck” if you hear a loud noise like a door slam), or sometimes addictions or eating disorders. Dysregulation can manifest more passively like lying in bed for days on end, walking around with constant tears in your eyes, depression, and ignoring the world. If you are having any symptoms listed, and they are affecting your relationships in a negative way, it might be a good idea to get evaluated.
Episodes like described above were hurting my relationships. Once I started learning about trauma responses at least I could identify when I was triggered. But often not until after an episode; after I had damaged a relationship or an opportunity because I had failed in the moment to recognize my trauma response had been triggered.
WHY DO TRAUMITIZED PEOPLE RESPOND IN THIS WAY?
As humans, we have a response to possible danger. “Did I hear someone outside my window just now?” Our body gears up and we get an adrenaline rush so that we can deal with whatever might be going on outside our window. This makes our pupils dilate, our heart beat faster, our thoughts race, and our awareness become more acute. Once we discover that it’s just a racoon in the trash, our body calms itself to normal functions.
But what if it is a person who is breaking into the house outside the window?
When a person experiences a dangerous situation or a situation where they are fearful and some other entity is in control, physiological responses are triggered and are maintained for the duration of the experience. These protective responses are often not calmed for an extended period after the traumatic event has ended. Because of this, when a person experiences a reminder, or a trigger, of the previous trauma, their body will again behave physiologically as if it is experiencing the original trauma, even if no real threat exists.
Trauma responses present as maladaptive behaviors. The person who has been triggered might blow up and start screaming (fight). They might storm out of a room (flight). Or they may act fearful, withdraw, stop speaking, cry (freeze). Sometimes the triggered person will become angry for no apparent reason, accusing someone of doing something they are not. This is as a result of the racing thoughts that are associated with being triggered.
After an intense trauma response, the traumatized person will usually be tired and maybe even sore or have a headache. They will sometimes be embarrassed and not understand why they behaved in the way they did, often blaming the situation or another person rather than understanding they were having a trauma response. They can also have memory problems or become depressed after an episode. It is usually not until after a diagnosis of a trauma disorder, and time with a therapist, that a sufferer will begin to understand the nature of their trauma and triggers.
GETTING HELP
There are several kinds of recognized trauma. The best known, Post Traumatic Stress Disorder (PTSD), is outlined in the DSM-5. I had checked the DSM in the past, suspicious that I was suffering from trauma-related responses. But this definition is written in a way consistent for someone who is dealing with trauma that happened from a single life event. Examples are a solider who has experienced war or someone who has been mugged.
There is also Complex PTSD, which is recognized in some other countries but not in the DSM-5 and not in the US. Complex PTSD is a result of many trauma events that were ongoing for an extended period. Examples are a child who was abused throughout their childhood, a prisoner of war who was held for years, people sold into sex trafficking for many years.
Various types of trauma can be treated by EMDR or bi-lateral stimulation. EMDR was the promise to help me heal. I had no idea what it entailed. I would soon learn that it is a process that requires courage. You are asked to revisit the trauma(s) which you have endured. You’re not re-living it but rather you are there as a casual observer in the room, or perhaps the scene plays outside of a train window, or on a movie screen. In any case, safety is established with your therapist before you revisit these trauma events and your therapist makes sure that you know you are safe in their office and perhaps an additional place you can imagine as safe or peaceful like a beach or a meadow.
Traditionally with EMDR, during the revisit of the traumatic events, the client would watch their therapist wave their hand back and forth. Advances in the understanding of how EMDR works has led to not using the eye movement as often and, instead, using any number of various bi-lateral stimuli. This can be hand-held vibrating disks, audio blips through headphones, or a therapist tapping on your kneecaps, to name the most common.
As the client moves through the traumatic event in their memory, the bi-lateral stimulation is ongoing. After visiting the traumatic scene several times (the number of visits vary) the distress associated with the traumatic scene is reduced. The therapist’s goal is to get the client to have little to no distress around the traumatic memories.
There are several theories around why bi-lateral stimulation works to reduce distress in response to a trigger or a traumatic memory. One theory says that the eye movement part mimics REM Sleep and that eye movements are the most important part of treatment. They argue that methods that only use other bi-lateral stimulation are not as effective.
Other theories say that the rhythmic back and forth is relaxing and so relaxation replaces the distress associated with the traumatic memory when it is brought up. It is also thought that bi-lateral stimulation brings together the two hemispheres of the brain (rational left with emotional right) and helps to balance rationality into the distressful memory.
My therapist is of the second camp and has said that walking can be used as an aid for me if I have distressful memories that come up between our sessions. Walking is bilateral; you are using both sides of your body back and forth in a repetitive motion. Exercising in general has often been thought of being good for mental health because of endorphin release. But bi-lateral stimulation is another great reason to walk and participate in other exercises. Exercise is also a great way to improve physical health. Bilateral activity in other activities can also be helpful. Listening to stereo music sitting between two speakers or even drum circles can create calming effects.
Most people experience relief through EMDR treatment, but some people do not. This can be for several reasons, anything from improper engagement by the therapist to unknown reasons that lay within the subconscious mind of the client. EMDR, claims, however, to have an 80% – 90% success rate.
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I took my car to the shop early one morning a week or so ago. The car needed two parts and one of the parts would not arrive until 3:30 pm. The repair was going to cost nearly twice what I had expected. After trying to reach friends in that part of town, I ended up walking around the suburb all day long. In the wrong shoes, getting blisters, and dealing with a wasted day. I was walking back to the shop at 4:30 pm when the call came. “Your part didn’t come. We accidently forgot to order it.” They attempted to put the old part back on so I could have my car overnight. But that seldom works and didn’t in this case either. The assistant manager drove me home and I got home after 7 pm. The next morning, I took a Lyft to an appointment and another Lyft back to the shop because the part had arrived, and the car was completed.
During this experience I did not get angry like I once would have. I did not start screaming. I did not stomp and demand compensation. Yes, I was disappointed but calm and quiet. In fact, my calm demeanor felt so out of character, so unlike myself, that I searched for a reason or a trigger in the situation to make me angry. I looked for a reason to blow up or yell at the shop. But there was no reason I could think of that would trigger me into being angry. It was an honest mistake and blowing up wouldn’t help. And although it felt strange, out-of-character, and not like myself to be calm over a day and a half of disruption, it also felt like a success.
The manager thanked me for my patience around his mistake. I responded, “You should be grateful that I’m in therapy.” I smiled. “And that it’s working.”
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