I Can’t Stop Thinking About my Trauma

Question:

Can you explain to me why it helps with post-traumatic stress to revisit the upsetting event or scene?

 

Answer:

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.

6 Responses to “I Can’t Stop Thinking About my Trauma”

  1. Lexi Says:

    Hi,

    After many years of being diagnosed bipolar I feel that the therapy I have been recieving has been adding to my trama. I have had several hospitalizations that I have found to be demoralizing and tramatizing. I have found it impossible to find a psychiatrist or therapist to be able to address my distress about my hospitalizations and other life events. I feel that all my recalling of my experiance has only “sensitized” me further and has made my recall of the experiance only more vivid.
    Is there something that either I or my therapist could change in session so I could head in the direction of “desensitization”?
    Thank you for your article. It was very helpful for me.
    Lexi

  2. Tom Linde Says:

    Thanks for the great question, Lexi. It’s hard to answer without knowing you and so of course, my suggestion has to be very tentative and taken with salt… Some might suggest that you have to be clear on whether it’s the bipolar or the PTSD that is being treated. It might be that stabilizing the PTSD – and anything else in your life that could be much out of balance – is the first priority. So for instance, employment, housing, health, basic relationships and so on. Of course, this includes bipolar mood swings. Not that it all has to be perfect by any means (when is it ever, for anyone?). But with too much instability, there isn’t a good platform of security and routine where you can feel solid enough to take on the PTSD.

    I hope this helps.

    Tom

  3. S Says:

    I was in a critical accident were all my friends were thrown from the vehicle but me. They were all unresponsive. I ran for help, finally help came. Eventually I learnt that my good friend ( and cousin) was thrown from the sunroof and killed. (23yrs old) It has been 10 months. I can not seem to feel better. I have been in councelling and speaking to a psychiatrist, on meds, etc. I feel I am getting worse to the point where I enjoy nothing, look forward to nothing and honestly wouldn’t miss myself if I were gone. What can I do to help myself? I am in desperate need to feel better. it is effecting my job and relationship at this point. thanks

  4. Tom Linde Says:

    S, I’m so sorry about the accident and your loss. I’m not sure you can experience something like that without still feeling badly traumatized for a long time.

    I suggest you ask your counselor what needs to be done to speed your heeling. There are always shifts that can be made in treatment. Also ask what you need to do to ensure you are not mistakenly making your trauma worse. I’m afraid I cannot give you more detailed suggestions from this vantage point.

    Thank you for writing. Please keep us informed.

  5. chad Says:

    i was in a motor severe vehicle accident, I was in the back seat leaned forward in the middle of an extended cab older chevy, no seatbelt, and the driver had cruise set at 75. We went head on to a tree and I died twice. I broke my ankle, thumb, shoulder, neck, rib, and small fracture in my jaw. I collapsed my lung, with my lung bleeding severely. My broke rib ripped my lung and I couldn’t breath. My brain sheered and i had 4 cuts on 4 different brain lobes. I died twice I think. I missed my high school graduation. I didn’t get to go to college. I spent 53 days in the hospital and 99% of my memories are only pictures I see or stories I here. I don’t remember much but the auto accident I was a passenger in, i remember that experience. I remember pain, vision, thoughts, and lifelessness. I was unconscious they say, but I remember everything I think. I didn’t think it was real world. I thought it was a crazy dream. After I was sedated i was only trying to think of why the hell i couldn’t breath, and who are these people (ems members).I remember thinking I was on a dirtbike wreck and the tree we hit was a pile of leaves that I was going to ramp. I thought I was going to a guys house on his bike, and the whole time I was being worked on by medics, I was trying to get them the hell away from me because I just wanted to get in his house. When I first went into the trauma center in Memphis, i was a big counter with black nurses and dr’s, so I was just thinking “why the hell are y’all in dude’s kitchen. I try to remember more and more about the experience daily because everybody would ask me about it when I was released from the med to home, and I never knew the answers. I was all over social media, a video of me trying to talk and say congradulations was played in front of everybody at my graduation, I was on the news, the school gathered at the flag pole and said a prayer for me because I wasn’t supposed to wake up from my coma the dr said. As time goes by, I see a person I haven’t seen since before the wreck and I tell the story. I tell every little detail, I remember everything by the helicopter. i remember what it looked like being carried into the shock trauma enterence. I think about it all the time. All day and every day. I tell people that don’t even ask, every day. I brag about it because I wasn’t supposed to survive. Nobody knows how I survived, but God did it. There’s a reason for everything and I’m assuming that God’s reason for this is for me to join the EMS. But how do I get it out of my head and stop dwelling over it? it has been 1 year, 3 months, 8 days and its only gotten worse. A lot worse, and it’s embarrassing me. Please someone email me an answer, please. It’s getting very depressing but my body and mind love telling people. My conscious hates it and wants it to stop..

  6. Tom Linde Says:

    Chad,
    I’m very sorry you’re so tormented.
    I am not publishing your email here because I would not encourage you from getting help from people you don’t know on-line.
    And you might take care not to simply take on-line the pattern of dwelling and telling which you find yourself in.
    I DO encourage you to get help. I expect what you have is very treatable.
    I won’t steer you toward specific resources, but one place to start is with your doctor. Another, if you have insurance, is to find out who it is you can see in therapy for what you have. Without insurance, go to your nearest community clinic or community mental health agency.
    For now, you can call it PTSD though I won’t suggest a diagnosis from far away.
    Try looking up PTSD on-line, but please stick to reputable websites. Most which end in .edu are reliable. Also reliable is the NIMH, The Mayoclinic and WebMD.
    Mainly, you should see a fully licensed clinician and get treated.
    Tom

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Tom Linde M.S.W.
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