Post Traumatic Stress Syndrome

What do car accidents, abuse, falls, surgery, rape and combat
have in common?

Thousands of people each year experience motor vehicle accidents, have surgery, are raped and physically abused, fall and suffer an injury or are emotionally abused. Traditional medicine addresses the resultant symptoms of these scenarios with medication and rest. Too often, the symptoms of post traumatic stress syndrome are overlooked, yet they contribute to, and are part of the individual’s larger health condition.

So, what do all of these experiences have in common? They can all result in a trauma response by the nervous system. A trauma response can best be described as the response a person has to situations perceived as threatening to life or self-integrity. For example, if a person is attacked she has 3 options: fight or run for it. Both of these choices are attempts to protect her life. If neither of these appear as though they will succeed, a third option is to freeze as prey does when a predator is about to pounce. The freeze option, know as shock, is a brilliant strategy by the nervous system’s lower or primitive centers to feign death since many predators prefer a live kill. It also numbs the individual to the overwhelming intensity of emotions and physical sensation. As the shock wears off and the heart rate and respiratory rate normalize, the “almost” victim gets up, orients itself, staggers as it finds its walking legs, shakes out the locked up energy; then it moves on, back into its normal routine.

While humans demonstrate the same responses, we don’t always come out of the shock state so easily. We don’t actually remain frozen or paralyzed as far as our ability to walk, talk or function routinely or even at work. However, traumatized individuals often use descriptions such as, “I can’t think straight,” “I feel paralyzed in my decision making,” “I feel shaky,” “I can’t go back there yet,” “I see the (event) over and over in my dreams,” “I’m always looking over my shoulder,” “It’s like I’m still there (at the scene),” “I can still feel his hands on me.” The result is known as Post Traumatic Stress Syndrome, with variations in stress and anxiety related problems. Victims of car accidents, abuse, falls, rape, surgery, combat and other situations perceived as threatening or frightening may respond similarly: Freeze in shock to prevent overwhelm emotionally and sensorial. These results may last for years. In fact, 25% of people who have had whiplash injuries have diagnosable post traumatic stress disorder or acute stress disorder. Many people with chronic pain have significant trauma histories, which are often overlooked in the course of treatment.

Many people who suffer from panic attacks have histories of experiencing or witnessing traumatic events. Why don’t humans discharge the energy of trauma so easily? There are a number of factors involved. The feelings of helplessness and hopelessness are often at the base of freezing and result in the belief that “I can’t do anything to save myself.” Anger, fear and other high intensity emotions can overwhelm the nervous system and “lock” in trauma. Usually, these feelings are unconscious but guide conscious behavior.

Commonly, the physical signs of discharging energy are not recognized as connected with the response to the traumatizing event. Socially, shaking or tremoring, as a person often experiences in her body after feeling threatened, is not consider appropriate behavior and may feel embarrassing. Depending on the severity, it can affect vital functions of the body and, so, is inhibited medically in the emergency room. Repetitive trauma can cause the nervous system to remain in a hyper aroused state, thereby making it harder to return to homeostasis or a normal state.

People suffering from stress and anxiety related problems and post traumatic stress syndrome may experience it somatically with chronic pain, gastrointestinal problems, fibromyalgia, neck and back pain, dissociation, etc. They may have flash backs to the event. Emotionally, a person may feel detached from the present moment, forgetful, stressed-out, wondering when the next “attack” or accident will occur, difficulty sleeping, irritability, difficulty in relationships, etc.

These challenges can be overcome. Relaxation and meditation techniques go a long way in reducing the symptoms of incomplete trauma responses. However, these techniques only quiet the nervous system. The nervous system wants to finish what it started: feel, hear or see the presence of threat, orient toward it to decide to run or fight, dissipate the energy stuck form freezing, then move on its way in life. This way, the five components forming a person’s gestalt of everyday life, sensation, image, behavior, affect and meaning can come together once again.

The language of the body, the felt sense (physical sensation) is a key to moving through the incomplete trauma response. In a slow, facilitated process called Somatic Experiencing, a client is helped to consciously re-connect with the physical sensations of her body, reintegrate the 5 components of experience and overcome the freeze response. Somatic Experiencing is a systematic method of unfreezing out of the feelings of helplessness and hopelessness. The process is gradual, not cathartic in nature, allowing a time frame for healing that does not overwhelm the nervous system and throw it back into shock. It allows for individual situations and histories rather than protocol for a diagnosis. It facilitates the body’s natural healing abilities using the individual’s own felt sense with the skilled facilitation of a trained practitioner.

One might wonder about using the felt sense in the healing process when it was exactly that sense that caused freezing initially. Felt sense is used because it is a building block of all developmental progressions in life and because dissociation from felt sense is a common resultant in a trauma response. It is not uncommon for someone with post traumatic stress symptoms to be afraid when consciously experiencing her body. However, this is the gateway to healing. Learning to discern symptoms from good sensations allows strong, inner healing resources to be developed. These, in turn, allow the individual to move through the trauma response and symptoms.

Dave Berger, LCMHC, PT, MA is a Psychotherapist, Physical Therapist, Somatic Experiencing 
Practitioner and Rosen Method Bodywork Practitioner. He specializes in trauma and life transitions and works with individual and couples. This article was published in “Convergence Magazine,” Fall 2000, Vol. 13, Issue 4.