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A.
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Can you imagine a cowboy getting over a fear of horses by
talking about it in an office?
When we're in the midst of the horror of a traumatic event,
our bodies are thrown into a high state of overdrive. This fight-or-flight
response instantly puts the body into just the right mode for survival -
battle-or-bolt. We need this arousal reaction - it's very handy for
self-preservation, not to mention the survival of the species. But, it has
some disadvantages.
For one, it is easy to get too
trigger-sensitive. That is, the merest hint of danger may ignite you. Say, a
combat vet hearing a sudden noise, or a rape victim approached by a gentle
man just a little too close and quickly. Both of these otherwise calm and
poised individuals are instantly pitched into the same dreaded state.
A second disadvantage is that this
fight-or-flight just shrieks. It's terribly uncomfortable and we'll do
almost anything to avoid it. It’s supposed to be uncomfortable by the
way. Is there any smoke alarm which gives a comforting little melody? The
discomfort puts us on high alert, and trains us to avoid dangerous
situations where we might experience the punishing sensation.
Finally, just as we link the "shriek" of
the full-throttle fear response to the presence of danger, we also link
danger to the response. Pavlov’s dogs hear a bell, therefore, they assume,
it’s chow-time. It's as if we say "I feel like there's a grave danger,
therefore, there must be a grave danger.” The sense of impending doom causes
panic, which increases the sense of doom, and through the roof we go.
Now, you can read many books about
post-traumatic stress disorder. You can talk with friends and therapists at
length and you can perform rituals complete with incense. Actually these
things are important - the support of friends and family, a sense of
belonging, comforting rituals, a consistent structure to the day, a sense of
purpose and meaning in your work and so on. Elements like this in your
day-to-day life may prevent a traumatic event from shaping into
post-traumatic stress disorder, or may soften PTSD and hasten its
resolution. But the instant, patterned reactivity of PTST is in the gut, so
to speak, and might remain untouched. In this case, you have to have the
bodily experience, in a perfectly safe situation, to “unlearn” the reaction.
Think of the cowboy who’s been thrown from
his horse. He can stay away from horses and feel just fine. He walks up to a
horse though, and panic wells up. If he’s sensible like I am (or, uh…try to
be), he’ll walk away from the horse and instantly feel better. But what just
happened? The lesson is “close = danger, and distance = safety”. This has
just confirmed to him that the horse is indeed hell-bent on killing him. He
feels good for the time being, but has strengthened his PTSD.
Let’s go to the rape victim. She might stay
away from a two-mile perimeter of the crime scene, she might avoid unknown
men and will avoid imagining the awful event. Then she sees a therapist, who
in this case is a little like the dentist in that he or she has to create
discomfort to be effective. After plenty of preparation, and when the victim
– wait - she was a victim. Now we’ll call her a client. When the
client can pronounce with confidence that the office is in fact perfectly
safe, she might be instructed to tell the story of the rape. In the
present-tense, with detail. In all likelihood it will bring on that old
terror. Almost like she’s there. “I feel like there’s grave danger,
therefore… hey!” This time she sees that she is alive, safe and intact. She
has started to learn, experientially, that she can afford to
disconnect this particular alarm.
I’ll leave out other details of the process
but if she repeats something like this often enough, very soon she’ll find
that the retelling sparks less and less of a reaction. Keep going, and it
will become downright manageable. She’ll be instructed to go out at night to
safe places with safe people, and so on, to “desensitize” outside the
therapy office in the same way.
The trauma happened in the past.
Revisiting is not re-experiencing; it just feels like it. But feelings
cannot harm you. Saddle up.
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