Adaptation To Trauma
Our brains and minds have a natural inclination to gravitate towards familiar patterns, even when those patterns are negative. This tendency often leads people to unconsciously repeat maladaptive behaviours, sometimes without even recognizing it. Breaking the cycle of abuse and trauma can be an arduous task, and preventing the perpetuation of the negative or toxic effects of such experiences is equally challenging. While it is important to note that not everyone who experiences abuse goes on to become an abuser themselves, it is extremely rare for someone who has endured abuse not to exhibit some form of adaptation that affects their interactions with others and their perception of the world.
These adaptations need not necessarily manifest as pathologies, but they often influence how individuals form and maintain relationships. However, adopting a neurodevelopmental, trauma-aware perspective can provide us with valuable insights into how the traumatized brain develops and organizes itself. Armed with this understanding, we gain essential tools for addressing the impact of trauma on the brain. Once we have identified the source and extent of the problem, we are better equipped to offer experiences that serve both educational and therapeutic purposes. These experiences can effectively jumpstart and reorganize the systems that have been disrupted by neglect, adversity, and trauma. With this knowledge, we are better positioned to select and sequence appropriate adaptive interventions.
In broad terms, there are three levels of providing adaptive responses to trauma. Bottom-up approaches primarily focus on regulation, working to help the body deeply and viscerally experience emotions that counteract the feelings of helplessness, rage, or collapse often associated with trauma. Additionally, medication may be employed to mitigate inappropriate alarm reactions. Some practitioners also utilize technology to reconfigure how the brain processes information. The final approach involves top-down therapies, which are most effective when the individual is regulated and has formed an appropriate connection with the therapist. Engaging in dialogue and establishing connections with others can help individuals share and process traumatic memories, ultimately leading to a better understanding of their experiences.
No one can erase the scars left by war, abuse, rape, molestation, or any other horrifying experience; what has happened cannot be undone. However, what can be addressed are the imprints of trauma on the body, mind, and brain. The journey to recovery involves the challenge of feeling free to acknowledge your emotions, to experience them without becoming overwhelmed, enraged, ashamed, or emotionally collapsed. For most individuals, this journey requires finding a way to attain a state of calm and focus. It involves learning to maintain inner peace when confronted with images, thoughts, sounds, or physical sensations that trigger memories of the past. It also entails discovering a way to fully embrace life in the present moment and engage with the people around you.
To repair the faulty alarm system dealing with the hyperarousal effects of trauma, it is crucial to recognize that. If individuals remain in a state of hyperarousal or shutdown, they are unable to learn from their experiences. This can result in inflexibility, stubbornness, and depression. Fortunately, a range of practices, originating from both the East and the West, have proven beneficial in training our arousal systems and helping to regulate the physical and mental system.
This includes a range practices, including breathing techniques, neurofeedback, yoga, drumming, and various martial arts like tai chi, qi gong, Akido, judo, Tae kwon do, and jujitsu, all sharing the common goal of regulating both the body and mind. They achieve this through various means, such as rhythm, focused attention, breath control, coordinated movements, and the cultivation of purposeful actions. By doing so, they effectively apply the brakes to sympathetic arousal and address the challenges of hyperarousal.
Through these regulatory practices, individuals can find the tools they need to regain control over their autonomic nervous system, paving the way for healing and growth. These methods offer a path towards flexibility, resilience, and a renewed sense of well-being, allowing those affected by trauma to rewrite their narratives and embrace a brighter future.
Recovery
In the realm of trauma, sensory integration plays a pivotal role since none of our sensory inputs - whether it be vision, hearing, touch, or smell - enters the brain through the cortex. This phenomenon becomes significant as sensory input often becomes heightened when the cognitive part of the brain switches off, amplifying the power of sensations. In such instances, the role of rhythm, chanting, and movement becomes pronounced as they are known to enhance the integration of these heightened sensations, thereby helping attune both the body and mind. Body-based therapies, sensorimotor psychotherapy, and somatic experiencing aid in restoring the body to a baseline state of safety and relaxation.
One of the most effective approaches in trauma treatment involves providing a safe space for individuals to explore and experience sensations and emotions. Bodywork practices such as therapeutic massage, Feldenkrais, and craniosacral therapy have proven to be exceptionally effective in reaching the core of the brain. Through mindful touch and movement, individuals become grounded and begin to identify long-held tensions they might not have been aware of. When touched, they awaken to the part of their body receiving attention. As physical tension is released, emotions are allowed to surface, tension can be expressed, and unspoken sounds can be discharged. Touch, in its essence, makes it possible to fully inhabit one's body.
In our modern world, filled with incessant texting, tweeting, posting, and an ever-growing array of distractions, we find ourselves continuously bombarded with new stimuli. This constant monitoring consumes emotional bandwidth, activating stress-response systems for extended durations. Consequently, it becomes increasingly crucial to reconnect with nature and engage in various sensory-integrating activities. Whether one has experienced trauma or not, the significance of rhythm and touch has never been more relevant. Various methods of sensory integration are evolving into an integral part of trauma treatment. In a world that seems to demand more from us by the day, these practices offer a lifeline to reconnect with our inner selves, fostering healing and resilience amidst the sensory overload of the modern age.
Sensory Integration
When we are triggered into states of hyper or hypo arousal, we find ourselves pushed beyond our window of tolerance, venturing outside our range of optimal functioning. In such moments, we become reactive and disorganized. In the throes of a trauma response, the rational, human mind often goes offline, emphasizing the vital role of emotional regulation techniques in managing the effects of trauma and neglect. This process revolves around restoring the delicate balance between the rational and emotional aspects of our brains, enabling us to regain a sense of control over our responses and the way we navigate life. Recovery from trauma, as well as many aspects of emotional regulation, involves the restoration of executive functioning. This restoration not only brings back a sense of confidence but also reawakens our capacity for playfulness and creativity.
Emotional Regulation
Support Networks In Trauma Recovery
If and only when a traumatized individual is regulated can meaningful connections form. Only when the body and mind are restored can the traumatised brain embark on the journey of building relationships. Yet, having a robust support network stands as one of the most powerful safeguards against falling victim to trauma. The presence of someone with whom they feel safe and secure is instrumental.
Recovery from trauma necessitates a reconnection with our fellow human beings. Traumatized individuals often find solace and healing within the framework of relationships—with family, loved ones, support groups like AA meetings or veterans’ organizations, religious communities, or professional therapists. The primary function of these relationships is to provide both physical and emotional safety.
Within a supportive network, individuals find protection from the shame, abandonment, or judgment that can exacerbate their trauma. These relationships offer the strength and courage needed to confront the harsh realities of their experiences. True relief often remains elusive until they can openly acknowledge what has transpired and recognize the invisible demons they are wrestling with. Human contact, attunement, and closeness provide a haven for individuals to explore the fragmented pieces of their often-hidden experiences. Feeling connected and secure is an essential precondition for facing one's fears and anxieties head-on. In supportive relationships, individuals are given the space to gradually piece together their shattered narratives, fostering resilience and enabling them to move beyond the grip of trauma towards a brighter, more connected future.
Trauma-Related Support Groups
The Centre for Complicated Grief
This centre offers resources and support for individuals dealing with complicated grief after traumatic loss.
Survivor Support Network
Survivor Support Network is an online community that offers support and resources for survivors of various forms of trauma.
The Befrienders Worldwide
This organization offers emotional support to individuals experiencing distress, including those dealing with the aftermath of trauma.
The VictimConnect Resource Centre
VictimConnect provides confidential support and resources for victims of all types of crime, including trauma survivors.
The Childhelp National Child Abuse Hotline
This hotline offers confidential support and resources for individuals who have experienced child abuse or neglect.
The International Society for the Study of Trauma and Dissociation (ISSTD)
ISSTD provides information, resources, and support for individuals dealing with dissociation and trauma-related disorders.
The Anxiety and Depression Association of America (ADAA)
ADAA offers resources and support for individuals dealing with anxiety disorders, including those related to trauma.
The Association for Addiction Professionals (NAADAC)
NAADAC provides support and resources for individuals struggling with addiction, which can be intertwined with trauma experiences.
CPTSD Foundation
This organization focuses on supporting individuals dealing with complex post-traumatic stress disorder (CPTSD) and offers resources and online support groups.
The Blue Knot Foundation
Based in Australia, the Blue Knot Foundation supports survivors of childhood trauma and abuse, providing resources and workshops.
The Recovery Village
This addiction and mental health treatment centre offers a blog with informative articles and resources related to trauma and addiction.
The Mighty is an online community and support platform featuring stories and articles about mental health, trauma, and chronic illness.
Psychology Today Support Groups
The Psychology Today website features a directory of various support groups, including those focused on trauma and related issues.
This organization provides support and resources to combat veterans and their families dealing with post-traumatic stress disorder (PTSD).
National Domestic Violence Hotline
While not a traditional support group, the National Domestic Violence Hotline offers confidential support and resources for individuals experiencing domestic violence, which often involves trauma.
RAINN (Rape, Abuse & Incest National Network)
RAINN provides resources, support, and an online hotline for survivors of sexual assault and abuse.
Sidran Institute
Sidran focuses on helping people with traumatic stress conditions, including dissociative disorders, through education, support, and treatment resources.
Adult Children of Alcoholics (ACA)
ACA offers support groups for adults who grew up in dysfunctional families and
may have experienced trauma related to addiction or abuse.
Survivors of Incest Anonymous (SIA)
SIA is a 12-step program that provides support for survivors of childhood sexual abuse.
MaleSurvivor
MaleSurvivor is an organization dedicated to supporting male survivors of sexual abuse and assault, offering resources and online support groups.
The International Society for Traumatic Stress Studies (ISTSS)
ISTSS provides information, research, and resources related to traumatic stress and its treatment.
Gaining body awareness is a pivotal step in understanding our inner experiences and reshaping automatic reactions. It allows us to delve into our emotions, thoughts, and sensations, offering a fresh perspective and expanded choices. Mindfulness is a practice that enhances body awareness by focusing on bodily sensations, helping us understand the transient nature of feelings and regain control over them. For trauma healing, it is crucial to observe and tolerate physical reactions, as revisiting the past safely relies on this ability.
Cultivating calm breathing and physical relaxation is invaluable for recovery. Deliberate, deep breaths activate a sympathetic brake on heightened arousal, with extra benefits when attention extends to the end of each out-breath. Mindfulness encourages us to explore the role of oxygen in nourishing our bodies and connecting us to the present moment. This journey of self-discovery and healing through mindfulness offers tools to navigate trauma's impact, empowering us to heal and thrive.
Mindfulness
People have turned to psychoactive substances as a coping mechanism for dealing with traumatic stress throughout history. Each culture and generation have had its preferences, be it gin, vodka, beer, whiskey, hashish, marijuana, cannabis, cocaine, opioids, or tranquilizers like Valium, Xanax, and Klonopin. In times of desperation, individuals are willing to try just about anything to regain a semblance of control.
Mainstream psychiatry has employed a range of psychotropic drugs, including antidepressants, antipsychotics, sedative hypnotics, and other controlled substances, to manage the effects of trauma. However, it is important to recognize that drugs cannot 'cure' trauma; at best, they can only temporarily dampen the expression of a disrupted physiology. They do not facilitate self-regulation; instead, they function by interfering with the chemical systems responsible for regulating engagement, motivation, pain, and pleasure. Some of these drug’s work by resetting the fear circuits in the brain.
Certain groups of psychotropic agents have shown some efficacy in addressing specific aspects of trauma. Selective serotonin reuptake inhibitors (SSRIs) like Prozac, Zoloft, Effexor, and Paxil, for instance, work by reducing the intensity of a person's feelings, making them more manageable. This can help traumatized individuals feel calmer, regain a sense of control, and reduce feelings of being overwhelmed. Medications targeting the autonomic nervous system, such as propranolol and clonidine, aim to decrease hyperarousal and reactivity to stress. Tranquilizing drugs like benzodiazepines function similarly to alcohol, calming individuals down and alleviating anxiety. Anticonvulsants and mood stabilizers, including lithium, have shown mild positive effects in mitigating hyperarousal and panic. Second-generation antipsychotics like Risperidone and Seroquel are often employed when patients feel completely out of control, unable to sleep, or when other treatment methods have proven ineffective. However, it is worth noting that disassociation, self-mutilation, fragmented memories, and amnesia typically do not respond well to these medications.
In addition to these pharmacological approaches, some individuals have explored mind-altering substances to safely access and address trauma. LSD, for example, has been used in the treatment of Holocaust survivors, and MDMA (ecstasy) has been experimented with as a safe adjunct to therapy. In a trial in the United States, 83% of patients who received MDMA in conjunction with psychotherapy were considered completely cured. By enabling individuals to observe their trauma from a calm and mindful state while under the influence of these substances, they can integrate the effects of the trauma through therapy. MDMA is particularly known for allowing individuals with trauma to remain within the window of tolerance, enabling them to revisit traumatic memories without becoming overwhelmed by physiological and emotional arousal.
Psychoactive Substances For Trauma
The crucial role of talk therapy in trauma recovery revolves around the integration of traumatic memories to bring closure to those harrowing experiences. This essential process encompasses two fundamental components: telling the story and processing the trauma.
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Telling Your Story: Unveiling the Shadows
Telling your story involves an intricate dance with the past. It is about summoning the memories, revisiting them, and working through the events that have left indelible marks on your psyche. It is a journey of remembrance, repetition, and profound introspection. This process gradually leads you to the point where you can acknowledge what transpired and recognize the invisible demons that have silently haunted your soul.
Your story is more than just a recounting; it is a lifeline to your past. By revisiting your experiences, you breathe life into the trauma, making it tangible and real. This act of telling your story unfreezes the memories, allowing you to immerse yourself in the pain and anguish as if they were happening in the present. It is a challenging path that is essential for your healing journey. In confronting the past, you can imagine how things could have been different; in that imagining, you discover the seeds of transformation and resilience.
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Processing Trauma: Integrating Memories into the Past
The other vital aspect of telling your story is the successful processing of trauma. This phase involves weaving the traumatic memories into the past where they belong. It is about recognizing that these memories are an integral part of your trauma, and in doing so, you can begin to lay them to rest.
By integrating these traumatic memories into your history, you take away their power to haunt your present continually. They become part of your life experiences, no longer overshadowing your daily existence. It is a profound act of reclaiming control over your journey your own life.
Telling your story and processing trauma are not easy feats. They require courage, patience, and the support of a skilled therapist who can guide you through this challenging terrain. However, they are the vital steps that lead to healing, resilience, and restoring your sense of self. In the act of sharing your experiences and processing the trauma, you rewrite the script of your life, allowing you to emerge from the shadows of the past into a brighter, more hopeful future.
Talk Therapy
Eye Movement Desensitization and Reprocessing (EMDR) uses sequences of eye movements, with each sequence uncovering some of the trauma. Through bilateral stimulation through auditory tones or side-to-side movements that are thought to mimic the Rapid Eye Movement Sleep (REM) phase, individuals are asked to focus on a distressing memory. As the individual focuses on the traumatic memory and the bilateral stimulation, they are asked to process the memory in a way that rescues less emotional charge before ‘installing’ new thoughts to replace the negative belief or feelings related to the traumatic memory.
EMDR helps individuals reprocess traumatic memories and reduce the emotional distress associated with them. The therapy is based on the idea that traumatic experiences can get "stuck" in the brain, leading to ongoing emotional and psychological symptoms. EMDR aims to unblock and process these memories so that they can be integrated more adaptively allowing the traumatised person to access their memories without being overwhelmed by them. In this unique therapy, the brain areas whose absence is responsible for flashbacks and traumatic memories can be kept online while remembering what has happened, allowing people to integrate their traumatic memories as belonging to the past.
EMDR International Association (EMDRIA)
EMDR
Neurofeedback (also known as EEG-electroencephalogram) is a non-invasive therapeutic technique that aims to help individuals regulate their brain activity and improve brain function. It involves real-time monitoring of brainwave patterns and providing feedback to the individual to help them learn how to self-regulate their brain activity.
Neurofeedback is used in various clinical contexts, including the treatment of trauma and trauma-related conditions. During neurofeedback sessions, individuals are connected to a computer or EEG machine that provides real-time feedback on their brainwave activity. Typically, this feedback is presented as visual or auditory cues. Through repeated sessions, individuals learn to recognize and modulate their brainwave activity. They receive positive feedback when they produce more balanced or desired brainwave patterns and negative feedback when their brainwave activity deviates from the target state. Neurofeedback is particularly effective for children and adults who are so hyper-aroused or shut down that they have trouble focusing and prioritising.
International Society for Neurofeedback and Research (ISNR)
Biofeedback Certification International Alliance (BCIA)
Association for Applied Psychophysiology and Biofeedback (AAPB)
Neurofeedback
Cognitive-behavioural therapy (CBT) is based on the premise that thoughts, feelings, and behaviours are interconnected, and by addressing and changing negative thought patterns and behaviours, individuals can improve their emotional well-being and mental health. The therapist aims to help the individual understand the physiological and psychological responses to trauma, normalizing their experiences and reducing self-blame through psychoeducation, the process of identifying and challenging negative or irrational thought patterns that can result from trauma, reframing and restructuring these thoughts and developing more balanced and realistic ways of thinking.
Trauma often leads to intense and overwhelming emotions. CBT teaches individuals emotion regulation skills, such as identifying and labelling emotions, understanding the connections between thoughts and feelings, and developing strategies to manage emotional distress. It involves controlled and gradual exposure to trauma-related stimuli, helping individuals confront and process their traumatic experiences in a safe and structured manner. CBT often teaches grounding techniques to help individuals manage dissociation and stay connected to the present moment. CBT also focuses on building long-term resilience by equipping individuals with skills to prevent relapse and manage potential triggers or stressors effectively.
CBT can be delivered in various formats, including individual therapy, group therapy, and online or self-help resources. It is a highly effective approach for trauma treatment because it empowers individuals to take an active role in their recovery, provides practical skills for managing distress, and addresses both the cognitive and emotional aspects of trauma.
Association for Behavioral and Cognitive Therapies (ABCT)
Beck Institute for Cognitive Behavior Therapy
Academy of Cognitive and Behavioral Therapies (ACBT)
National Association of Cognitive-Behavioral Therapists (NACBT)
British Association for Behavioural and Cognitive Psychotherapies (BABCP)
Australian Association for Cognitive and Behavior Therapy (AACBT)
Cognitive Behavioural Therapy (CBT)
Dialectical Behaviour Therapy (DBT) is a highly effective approach for individuals living with complex trauma. Originally developed by a survivor of borderline personality disorder (BPD), DBT has proven to be particularly valuable for those navigating the challenges associated with this trauma-driven condition, which is prevalent in our community mental health services. Often referred to as the Trauma Condition, BPD is characterized by recurrent emotional dysregulation, leading to intense and often tumultuous interpersonal relationships.
Given the dysregulated state of the trauma-affected brain, a significant component of DBT centres around accessing the "Wise Mind," a concept that encourages the utilization of the rational mind. In the context of a trauma background, BPD can be likened to a persistent state of disassociation, one that inevitably exerts a profound influence on emotions and relationships.
DBT offers a structured and holistic approach to addressing the complex interplay between trauma, emotions, and interpersonal functioning. It equips individuals with practical skills to regulate their emotions, improve impulse control, and enhance their ability to communicate effectively, fostering a path toward emotional healing and healthier relationships. Working with a qualified DBT therapist can be instrumental in helping individuals with complex trauma find stability and resilience in their lives.
Dialectical Behavioural Therapy (DBT)
Given the profound and pervasive impact of trauma on a significant portion of the population, adopting a trauma-informed perspective is vital throughout the entire community. Yet, there exists a dedicated group of professionals who confront the effects of trauma daily, potentially in every moment of their professional lives. This Endeavor demands not only remarkable resilience but also the ability to remain present and self-regulated in the face of adversity, a task that truly calls for extraordinary individuals. Considering the extensive reach of trauma in our society, specialized teams must be in place to address its widely pronounced effects comprehensively. These teams must have the capacity to support the holistic needs of individuals grappling with trauma, as well as their families, friends, and communities, ensuring that physical, mental, emotional, and psychological needs are met.
At a fundamental level, collaboration between psychologists and psychiatrists is essential to meet an individual's therapeutic needs. Psychologists employ evidence-based approaches like cognitive-behavioural therapy and dialectical behavioural therapy to help individuals process and heal from traumatic experiences. Psychiatrists often serve as the medical professionals who diagnose the extent and effects of trauma, prescribing medication when necessary. In addition to these roles, counsellors may offer referrals for counselling and therapy, using therapeutic techniques to address trauma-related issues. Specialized trauma therapists bring expertise in trauma treatment, often possessing advanced training in trauma-focused therapies like EMDR (Eye Movement Desensitization and Reprocessing) or TF-CBT (Trauma-Focused Cognitive Behavioural Therapy).
Beyond the realm of mental health professionals, practitioners in various community roles, including nurses, doctors, educators, occupational therapists, and social service workers, adopt a trauma-informed approach. These individuals receive training to understand the impact of trauma and provide care and support while considering an individual's trauma history. Occupational therapists, for instance, concentrate on aiding individuals in regaining functional independence and enhancing their quality-of-life post-trauma. They collaborate with clients to develop skills and strategies necessary for performing daily activities and engaging in meaningful occupations. This can involve addressing issues such as sensory processing difficulties, emotional regulation, and reconstructing daily routines. Some occupational therapists specialize in sensory integration therapy, which proves particularly valuable for individuals contending with trauma-related sensory sensitivities. Through sensory-based interventions, they assist clients in managing sensory overload and cultivating self-regulation skills.
Trauma-Aware Clinical Team
The Trauma Pandemic
In our collective journey to address the trauma pandemic, each of us has a role to play, even if we may not all have the same level of resilience, stress tolerance, or the ability to work directly in trauma-focused fields. Here are some ways we can contribute to reversing the trauma pandemic:
Educate Ourselves
To be part of the solution, we must first understand the impact of trauma on the body, brain, mind, and society. Knowledge is a powerful tool for change, and awareness can lead to empathy and informed actions.
Prioritize Relationships
Being truly present and engaged in our relationships is essential. By nurturing connections with friends, family, and colleagues, we create a support system that can help us and others cope with the effects of trauma.
Build Resilience
Strive to enhance your personal resilience and stress tolerance. Resilience can minimize the impact of trauma on your life and enable you to support those around you better.
Learn Self-Regulation
Develop the skills necessary to self-regulate and learn how to support others in regulating their emotions. This is especially important during stress, when cognitive functioning may become compromised.
Embrace the Wise Mind
Try to engage your rational mind, often referred to as the Wise Mind, as much as possible. By doing so, you can prevent stress from reaching a point where you lose access to this valuable resource.
Remember, the trauma pandemic is not the fault of any individual, family, community, city, nation, generation, or society. It is deeply embedded in the collective history of humanity, stretching back to the dawn of creation. You are not alone in the confusion and trauma you may be experiencing; it is imprinted in the ledger of our shared past.
While we cannot change the past, we each are responsible for shaping the future. Start by focusing on one person, whether you, a friend, a family member, or a colleague. Ask yourself to be more present, engaged, resilient, and wise. Approach interactions with a continuum of engagement, understanding that many around you are also dealing with trauma. Recognize that their capacity for reasoning may be compromised. Be patient and empathetic.
By adopting this approach, we can collectively imprint a new path on the ledger of our shared history, one that leads us toward healing, resilience, and a brighter future.