Life, Cancer, Etc.
Life, Cancer, Etc.
Coping with Trauma with Sharon Dunbar, LCSW
As promised, we are back from our summer break and ready to tackle another difficult topic.
These past couple of years have been traumatic for so many of us. What does trauma look like, both in our brains and in our bodies? What's the difference between "big T trauma" and "little t trauma"? Sharon Dunbar, LSCW -- who's awesome, BTW -- helps us unpack these questions and more about trauma and how to cope with it.
Here's a link for the mental health resource information mentioned in the podcast: https://www.211.org/get-help/mental-health
And here's the link to Sharon's first episode about anxiety: https://www.buzzsprout.com/1468990/episodes/7980835
NOTE: I am not a medical professional. Everyone on the "Life, Cancer, Etc." podcast is sharing their own experiences, not giving medical advice.
PC: Sharon Dunbar
Keywords: trauma, trauma from cancer, big T trauma, little t trauma, COVID trauma, trauma resources, coping with trauma
You can also find some episodes on our YouTube channel: https://www.youtube.com/c/LifeCancerEtc
I'm Heidi Bragg and this is Life, Cancer, Etc. My goal with this podcast is to connect you with stories and resources that help you feel happier, more resilient, and less stressed, especially when you're going through hard times. It's great to be back with you. We made that cross-country move and we're settled in our new home in Oregon. I recorded this interview with Sharon Dunbar, licensed clinical social worker, a couple of months ago when we were still living in Florida. Sharon's going to talk today about coping with trauma, and given how traumatic the last year and a half has been for pretty much everybody in the world, I hope you can find some comfort and some guidance and some understanding as you listen to what Sharon has to teach us today. For today's podcast, we're going to be talking some and answering some questions about coping with trauma. And I'm with my go-to expert, Sharon Dunbar, who's a licensed clinical social worker in private practice in Florida. Morning, Sharon. Good morning. So I was listening to an interesting podcast recently. It was with Bruce. What's his last name? I think it's Bruce Perry. Yeah. And Oprah did the foreword for it. And they were talking about trauma. And it was an interview with Brene Brown. They were talking about trauma and that trauma is not just what was done to you, but what wasn't done for you. And I had never thought of it in that context before. So given that, I'd like to read a question we got about trauma from one of our listeners. And then maybe can we use that as our jumping off point? Sure. Okay. She said, I would love a discussion about the different levels of trauma. I think a lot of people associate the word trauma with a huge event, but I'm wondering about the small events that cause trauma. For example, I felt traumatized after an emergency C-section. In my mind, I thought I was being a huge wimp, feeling anxious.
SPEAKER_02:Okay. That's an excellent question and an excellent point. In our field, we we call or identify trauma sometimes by the big T and the little T traumas.
SPEAKER_01:Yeah. They actually use that phrase in the podcast I was listening to. Okay.
SPEAKER_02:Okay. Yeah. So, um, so a big T trauma is something where, um, you either witness or you are, um, actually the victim of serious physical injury or death or sexual violence something that is really life-threatening however we all go through what is called little t traumas as well that include non-life-threatening events however we are impacted by those events because they're they're personal to us and because of our history create disturbance. So those are and can be just as debilitating as a big T trauma, but they might not necessarily be a life-threatening event. It could be anything, even like a loss of a pet, being bullied or harassed. No, go ahead, sorry. Yeah, those are some examples.
SPEAKER_01:So do those little T traumas cause the same response in the body and the brain that the big T traumas do?
SPEAKER_02:Yes, they can. Absolutely. Okay. Yeah.
SPEAKER_01:So what are some of those effects that trauma has on the body and on the brain?
SPEAKER_02:Well, so if we're talking about what we're usually talking about is post-traumatic stress disorder. When a trauma affects us, it, in a longer term. So we can get exposed to a trauma and within a relatively short period of time, we can process that. We have the memory of it. We might have some emotional reaction to it. and um it kind of passes through us and um we have the memory but it doesn't affect us on a daily basis uh that's that's what we hope you know for and you know a lot of a lot of times people can do that it's not necessary that we actually have ptsd after a trauma however it's also not unusual that we might have PTSD after a trauma. So, you know, this is not an all or nothing thing. It's not an absolute. Like a spectrum kind of. Yeah. Okay. In some ways, yeah. You know, the natural response for the mind and body is to process what has happened and be able to move on from it. Now, I'm not talking like the next day. I'm talking within, you know, a couple weeks, few months kind of thing. Not, you know, I witnessed a murder and tomorrow I'm fine and just pretend like nothing's happened. I don't mean like that. I mean, there is some reaction, but it's not long term. So long term would be what we would consider post-traumatic stress disorder, where you would have the symptoms of Such as difficulty sleeping, having nightmares, being irritable, hypersensitive to danger, tension and anxious is prevalent. The memory of the event is fuzzy. Sometimes you don't remember a lot of what happened. Some people experience detachment where they feel like they're just kind of walking through the world, but they're not really there and present. They have decreased interest and difficulty concentrating. They can have physical symptoms like headaches and dizziness and stomach issues. Their immune system becomes weak. less effective. And like I said, sleep disturbances, they also might ruminate. Think about the event quite often throughout the day. They might have intrusive thoughts about it where they don't want to think about it, but they can't stop. They... might have what we call flashbacks, which are feeling almost like you're reliving the event, like it's actually happening in the moment again. Now,
SPEAKER_01:is that with, like, you feel like you're going through the experience again, or you have the physical sensations of what that experience was like, or either or, or both? You can have both.
SPEAKER_02:It's a horrific thing for people. And they also might avoid anything that has to do with the trauma. So if something happened in a specific place, they may never, you know, want to go back to that place again. They may not want to think about it or talk about it. So yeah, there's, there's lots and lots of, you know, they may, you know, if something happened with, you know, a specific person, they may avoid the person altogether. Like there's just lots of, uh,
SPEAKER_01:it's, it sounds like a lot of, um, self-protection built, you know, your body and your mind trying to, like the avoidance and all those kinds of things in the, not necessarily the flashbacks, but ways of your body just trying to cope with this thing and help you with this thing that you're kind of stuck in. And can you speak to what's happening for psychologically, physiologically, biochemically, whatever, what's happening when you're feeling all those things, when you're going through that PTSD? And then can you talk about ways to help process those experiences so that hopefully these PTSD symptoms become less of an issue?
SPEAKER_02:Certainly. Okay, so For the first part of that question, a lot of what happens in the brain with anxiety happens with PTSD, kind of almost like on steroids. So before we were talking about the fight or flight response, and there is also a freeze response to a traumatic event happening. So that mechanism... kicks in when the trauma is happening. So you'll either, your brain is gonna be activated, the amygdala is gonna be activated, that section of the brain, the oldest part of our brain that they call it, a lot of times they'll call it the reptilian brain, gets activated with other parts of the brain. in order to produce physiological response. It will either trigger hormones and blood pressure in order to get stronger and be able to flee if necessary. Our muscles may become stronger because of blood flow, because other parts of our body have been deactivated, like our digestion. Our pupils dilate so that we can see better, focus in on what we need to focus in on, those kind of physiological things. occur so that we can either get away from what's happening or we can fight through and and survive what's happening the other response that can happen is the freeze response which is when we the organism realize that there's no escaping so we just shut everything down and almost play dead trying to avoid whatever's actually happening to kill us. So hopefully it'll just go away because we're almost feigning death. That's a biological response. It's not a logical response. So it's not logical that if somebody is being attacked, that we think playing dead is actually gonna work because somebody can tell whether or not we're breathing. But our brain isn't thinking in a logical manner, it's thinking in a survival manner. So everything shuts down. That's why sometimes we can't remember what has happened because our mind goes somewhere else. Or sometimes people will feel like they're actually watching What's happening. So they're actually, you know, above the, whatever chaos is going on. And so they've like, I don't, is the word dissociate. Is that the right word? Yes. Dissociate.
SPEAKER_01:Okay. So your brain's doing all this stuff to just, because that's the almost like instinctive amygdala led reptilian brain response to whatever this thing is. Exactly. Okay. So, then when you're experiencing a flashback can we talk about like what triggers that and then um and then talk about maybe some coping mechanisms or whatever you feel like the next logical step is in this conversation
SPEAKER_02:sure so if there's a flashback and flashbacks are um you know i i Technically, a flashback is reliving the incident, but you can relive the incident emotionally. As far as I'm concerned, it doesn't necessarily have to be like you're actually seeing and experiencing everything as if it were happening, although that's the real definition of a flashback.
SPEAKER_01:But like a smell. Yeah. That comes to you and all of a sudden your, your emotions are heightened. You're in that fight or flight, whatever. Yeah. Right. That would be a trigger.
SPEAKER_02:So anything that had happened or anything that's similar to what had happened during that time can be a flashback. So we can have PTSD in like a little T trauma with an emotional reaction to long-term abuse, emotional abuse as a child. So if we had a parent who was hypercritical, and that usually affects children, and it affects us, when we get into a circumstance like that as an adult, if we haven't been able to heal that traumatic reoccurring response, we can get triggered by that. So if somebody is criticizing somebody at work and you feel like you wanna just lash out or you blow up at them or you cower, those are responses and those are triggers. Now with a big T trauma, if there's something that's happened that is life-threatening, you could have, like you said, a smell could come by and trigger. um a noise can happen that sounds similar you know the the classic is uh you know a war veteran that you know has heard explosive and seen horrible things um during uh fourth of july when fireworks are going off and feel like they're right back on the battlefield so uh those are Those are things that happen to people, not just in wartime, but also, you know, happens with people who have experienced things like fires and floods. I've experienced things like, like rape, you know, just things that have been life threatening. So, yeah.
SPEAKER_01:This is a really little tea. Well, it wasn't a little tea at the time. But when we first moved from Oregon to Georgia, the week we were there, our son Eric got sicker and sicker and sicker. And So, you know, the first we got there on a Friday and that night we're taking him to the local ER and they thought, well, it could be meningitis, but it looks viral because it's cancer. Fine. And by the next Saturday, we were taking him into the children's hospital and he was there for a week with a form of bacterial meningitis and osteomyelitis and, you know, came really close to dying. And that, you know, we got through it. And I'm always surprised. usually great in the middle of the crisis. But then when I went back to work after he was better, and I mean, he came home, he was on a PICC line. We were doing his antibiotic infusion things into his PICC line for a couple of weeks. And he was on antibiotics for like three months and lost a lot of school. But anyway, once he was out of danger and went back, I think it was after he went back to school and I found myself not sleeping and And not able to concentrate on work. Like it was just like I was in this brain fog that just couldn't, I couldn't shake. And I finally figured out, oh, you're finally processing all this. Right. Your brain has realized, okay, it's safe for you to process it. And so you're falling apart now. And then I realized, you know, I've done that many times throughout my life.
UNKNOWN:Right.
SPEAKER_01:when, when you're in the crisis, you're good, you know, your body and your body works the way it's supposed to. Your brain gets that heightened sense of awareness. You do all that, all the stuff. But when the danger's over and it's quote unquote safe, you just kind of fall apart for a while. Right. Is that kind of the same, the same kind of trauma response, I guess.
SPEAKER_02:It is. And that is, That is a healthy, quote unquote, non-diagnosable reaction to trauma. So if you were to continue that for more than three months, if you were going to avoid the hospital because it was so uncomfortable for you, if you weren't able to talk about that without going into hysterical crying or you just couldn't talk about it at all, then we would say you're actually having a post-traumatic stress disorder response. Okay. So your brain was able to incorporate that traumatic event in a way that it's part of your history and you've, you know, been able to take what you need to out of it, what lessons you need to out of that event for future reference, but you don't have that intense emotional response to the event that you
SPEAKER_01:did when it was. Well, I, I like that you said it's a normal response because it's, It did take some work or acknowledgement or whatever else it took being a little kinder to myself than maybe I would normally be. Because it was... What was I trying to say? It was... I had to experience those feelings. Stuffing them down wouldn't have done any good. And when people are like, well, he's healthy now. You should be glad. Get over it. Not that anyone said that to me, but I've heard people say that to their kids. Just get over it. And it's like, but you got to give me time to get over it. And that time is going to be different depending on the event and the person, right? Absolutely. Absolutely. Yes.
UNKNOWN:Okay.
SPEAKER_02:That's a great point. And what you're saying about being extra kind to yourself after realizing how that impacted you is really some of the really good coping that needs to happen after a traumatic event. So sometimes you don't go right back to work. Sometimes you do, depending on whether that's the right thing for you. But certainly, you know, being conscious of what you're eating, being conscious that you might be losing sleep and you might need to take a nap instead, conscious that, you know, your brain's not going to be completely online. Like, you know, sometimes you're going to forget things, not to beat yourself up about those things to make things just worse. You know, maybe taking an extra break. yoga class or doing an extra you know art project those kind of things that people use to revitalize themselves um sometimes is the right thing sometimes just sleeping for a couple of days is the right thing you know we process a lot during um REM sleep and so you know that might be what you need to do certainly talking about it crying about it getting angry about it whatever those emotions are in a safe and appropriate place are all ways to help process through and allow your mind to catch up and to allow your mind to store the events in a way that is not going to create more havoc later. But that's not always possible for people. And that's not always even possible going to take care of what you need to take care of. And sometimes we wind up with,
SPEAKER_01:like I said, PTSD. And just feeling kind of stuck, like in a loop almost. So, excuse me, one, sorry, were you going to say something else on that subject? I had another question for you. No, I'll take a question. Excuse me. So, For the listeners who don't know, when I was, I have to give them a little bit of backstory here. When I was recovering from cancer and going through chemo and radiation and everything, at one point, one of the drugs they gave me to help with nausea and a little bit of anxiety was Ativan. And I was on Ativan and Zofran and I don't share and I don't remember what the other one was. But anyway, three different drugs that I would cycle through. to help with the nausea, particularly during chemo. And at one point I went in the hospital, at a hospital where my regular oncologist didn't have privileges and did not have that Ativan for a period of about five days, I think.
SPEAKER_00:And then
SPEAKER_01:came home and didn't take it anymore because I wasn't having the nausea. And about 10 days later, maybe I had this, I was just hit with this wave of over, overwhelming anxiety. It was all I could do to take breath in and let breath out. It was so bad. My chest was so tight. It was in my throat. I can't even describe. So trying to get off the Ativan was really, really hard for me. And it took months to taper off. And I had to take another drug that helped level out some of those hormones and chemicals in my brain and then taper the Ativan and then taper off the other drugs. So it was this big process. And in the middle of that process, here's why there's the backstory. Sharon helped me with using hypnosis and I'd never had hypnosis before and it wasn't what I expected. It would be, I mean, she didn't have some big watch or a swirly thing in front of my face, but she took me through kind of a mental exercise. And after two sessions of that, it really, really helped. When I would start to feel anxiety, I would do kind of the same thing she and I had done together. And it was very, very interesting to me, but it really helped me. like kind of break that cycle as I was going through the loop. Is that a decent explanation? Yeah. So what, what does, can you explain a little bit about what you do when you do hypnosis and, and why that helps or how it works?
SPEAKER_02:Sure. And it doesn't work for everybody. So that's why there's so many different treatment modalities because not everything works for everybody. We're all different. We all come with different experiences and slightly different brains and constitutions. But one of the things that hypnosis can do is access your unconscious, So the things that you're not really aware you're thinking that are underlying some reactions, you can access with hypnosis. The other thing- Like
SPEAKER_01:it lets them float to the surface type of thing.
SPEAKER_02:Yeah, yeah, you just become aware. And that's because your mind and body are relaxed. It's really, it's a- It's just a deep relaxation, but you don't have to have all of the defenses that we normally walk around with. You know, you can kind of just shed those in a safe place. And so it also, that mechanism that creates, you know, all of the defenses to defend the body against threat are also calmed, so your breathing becomes more slow and deliberate, and that takes everything, all of that heightened sense down to a state of homeostasis. And homeostasis is a state where we feel connected and we feel safe and everything is okay. We're able to connect with others and have a sense of emotional well-being.
SPEAKER_01:Well, and you and I had been working together for a while before we did this. It wasn't like I walked into Sharon's office and this is what she did. I trusted you. So I was like, I'll try. Yeah, I'll try that. And it kind of felt like for me, the end of a good yoga session when you're in Shavasana and you're or Shavasana, depending on the teacher you have, whether it's in Texas or not. When you're in rest pose at the air corpse pose at the end and you're just you're letting your mind sort of slow down. It felt like that on steroids. It is that. It is that. Okay. It's just a level of that. Yep. It is that. It was, and it was really interesting, but it was, I don't know that something we did in that session and it was just a guided imagery. I mean, it just felt like a guided imagery exercise with some talking really. It, it either unlocked or unblocked or changed or purged or whatever the right word is something for me. And like I said, after two sessions of that, it, I don't know. That made a huge difference for me. What are some other, maybe, I don't know what you call them, treatment modalities or something for this PTSD? And you're saying, if I understand correctly, if this stuff is persisting for over three months, then you really ought to go talk to somebody.
SPEAKER_00:Yeah.
SPEAKER_01:And it's interfering.
SPEAKER_02:Yeah. And I don't see how it couldn't interfere, but yeah, it's interfering with your... with your life for sure. Another treatment modality that I use and that's very, very popular with EMDR and has been, you know, clinically proven to be effective. I just said it is EMDR.
SPEAKER_01:Yeah. What does that stand for again? Eye movement something?
SPEAKER_02:Eye movement, desensitization and reprocessing. Okay. And when Shapiro first you know, um, was using this and, and, uh, realized that it was, you know, working really well. It was the reason why it's I, I movement is because she used eye movement, but nowadays, a lot of times we won't use eye movement in the, in the process. We'll use any kind of dual sense sensation. So, um, So basically what it does is we reprocess the trauma and we reprocess it in a way that the brain can incorporate it into memory without the emotional charge. Oh, so you're separating those two, the memory from the emotional charge. Right. So like you can, you know, talk about that experience with your son in the hospital and not feel all of those intense emotions. somebody with PTSD wouldn't be able to, but EMDR can create that sense of being able to speak. You know, you can speak about it, use the memory, but not have that emotional reaction. And so therefore, if you don't have the emotional reaction anymore, you can't get triggered and re-experience it. Right. So that's another one. Some people use Cognitive behavioral therapy, which I have used and it can be effective, less effective for a lot of people. Usually cognitive behavioral therapy is used better after we've been able to process some of that trauma and also to be able to support people through that process because sometimes it can be, living with it is painful. healing from it can be painful, but temporary painful.
SPEAKER_01:Kev calls that stage of things, the crappy with a purpose stage instead of just the crappy. Yeah, exactly. Yeah, it is. That's good. I like it. Yeah. Any other treatment methods that you might suggest people would look into?
SPEAKER_02:Well, some, and this is, this is, new and old at the same time. They're using hallucinogens now. Now this, I don't mean go out and, you know. No, but I saw like, is it psilocylic mushrooms? Yes. Yeah. Okay. Yeah. And that seems to be creating a lot of healing as well. So that is definitely, it's newer on the horizon here, although we were using it long time ago in the 60s. and seventies, but, um, it's, it's reoccurring. It's, it's pretty rare to find. Um, but I think it's going to become more and more mainstreamed and that there is a specific process. Um, and it is not, you know, you, you don't just do this. You have a psychiatrist, you have a therapist that goes through, um, you have a setting, uh, you know, seriously a setting with music and ambiance and everything that you go through that healing process. So it, it does, it's, it's.
SPEAKER_01:Don't go get your own shrooms. This is, this is. Thank you. Yes. Exactly.
SPEAKER_02:Managed, et cetera. Definitely. Definitely. Definitely. Yes. But it is, it is proving effective. So.
SPEAKER_01:Yeah, there was a I saw a study a couple of weeks ago. I think it was a study and their outcomes were really good. It might have just been anecdotal things. But anyway, it was very interesting to me. So before we finish up here, anything else you think people should know about coping with trauma, whether it's big T trauma or little t trauma?
SPEAKER_02:I would just say that don't let anybody poo-poo what your experience is. Don't let anybody tell you, get over it. That's not helpful. And don't beat yourself up about what is happening. Be aware of what's happening. Be aware that you are All of a sudden, what we call more hypervigilant, you're feeling that there's danger everywhere you turn. Be aware that you're not sleeping. Be aware of the symptoms. Try and take good care of yourself. But if you're suffering, don't suffer alone. Get some help. Get some help from somebody who's a specialist in trauma. that can help you through and get you to the other side of it um sometimes you know sometimes just like you did heidi you can do that with support and love from a family from family and friends and you know taking good care of yourself but sometimes it's not not going to be effective and you need to get help so I think that's, you know, just be kind to yourself because it is a very, very difficult, difficult thing to go through. And you've already gone through a difficult thing and now you have to keep repeating it. It's just horrible.
SPEAKER_01:Right. It's horribly traumatic. And having been on both sides of the equation where it kind of with friends and family's help and, you know, prayer and thank God I got through it on that side of it. But I've also been on the side of even when I'm doing all those things, I can't get at this by myself. Right. And having somebody good to help is... critical and uh there are and i'm i will um sharon do you mind sending me if you know of any uh resources for people who are looking for mental health help that may need financial assistance or whatever do you have a list of those or can you tell me where i could find those i can post them in the show notes
SPEAKER_02:i would be happy to um send those to you i um depend yeah depending on A lot depends on a lot. So I'll do my best to kind of break it down for you. And I'll send that to you.
SPEAKER_01:Okay. Or even just if you know of a few different websites where they can start looking, just I wouldn't want people to feel like if therapy is not something that's included on their insurance or if they don't have insurance. I would love to give people some options of places to look for help, if that's okay.
SPEAKER_02:Yeah. And I can tell you right now that depending on where you are, because different states, different counties all have different-
SPEAKER_01:Like resource lists or whatever.
SPEAKER_02:Right, right, right. Thank you. So depending on where you are, one of the best things to do is to- Google number one, but also a lot of, a lot of places. If you just dial in two, one, one, it's a United, United way resource that you can get, you know,
SPEAKER_01:911, you dial two, one, one. Right. Oh, okay. Yeah. And then they'll have, they'll let you know, cause they'll be partnered with all the, community agencies that provide those kinds of services.
SPEAKER_02:Correct. And most places do have community agencies that will, or nonprofits that will, you know, help. We have several in our area that, you know, are, are there to help people. So
SPEAKER_01:awesome.
SPEAKER_02:But my area is not everybody's area. Right. So running on where you're listening from.
SPEAKER_01:No, I'll do that. And so I'll just, I'll post that. And, um, And look for a couple of other things. And if you think of something else, let me know. But just thank you for your time again. You always make this stuff so accessible. And I can't tell you how many people have said, oh, my gosh, that podcast on anxiety. I just love that. I learned so much and it helped. So thank you for doing these.
SPEAKER_02:I am so happy to hear
SPEAKER_01:that. You're
SPEAKER_02:so welcome. It's my pleasure.
SPEAKER_01:Sharon has such a good way of taking complicated concepts and breaking them down in a way that gives me something actionable to do. And I'm so grateful for her generosity with her time. This week, if you have a chance, please like and subscribe to the podcast or give it a rating on whatever service you listen to it on. That helps us appear in more people's feeds and hopefully it will help us help more people. And as you go around the world, please look for the good. Do something nice for somebody else. Count your blessings and make it a really great week. Thanks for listening.