The Trauma Response Trifecta

There are three areas of us that get affected by trauma. Do you know that this is happening? 

Transcript

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It's time again for Doc Jock, your addiction lifeguard podcast. I am Dr. Jock DeBerker, a psychologist, licensed professional counselor, and addiction specialist. If you are suffering from addiction, misery, trauma, whatever it is, I'm here to help. If you're in search of help to try to get your life back together, join me here at Doc Jock, your addiction lifeguard, the addiction recovery podcast. I wanted to be real clear about what this podcast is intended for. It is intended for entertainment and informational purposes but not considered help. If you actually need real help and you're in need of help, Please seek that out. If you're in dire need of help, you can go to your nearest emergency room or you can check into a rehab center or call a counselor like me and talk about your problems and work through them. But don't rely on a podcast to be that form of help. It's not. It's just a podcast. It's for entertainment and information only. So let's keep it in that light. All right. Have a good time. Learn something and then get the real help that you need from a professional. What happens when somebody is experiencing feelings of relapse. In other words, their body is signaling there's a sensation that they're uncomfortable with, and it causes them to have this desire to use again. You know, we know through neuroscience that there's a connection between the intellect, the emotion, and the body. And there's technical terms for it. I It's interesting that they don't really differentiate between physical feeling and emotional feeling. But the sensation of fear, because there is a neurological response that's way more complicated than most people would understand or even believe. But the sensation of the feeling of fear or discomfort can happen either in the body first and then the brain and the emotions and the intellect, or it can happen the other way. So top down or bottom up. And when somebody is uncomfortable and they are a traumatized person and they have addiction and that's their way of coping with it, what they're doing is they're trying to shut down all those feelings that are driving these horrible experiences that they have. And so when I'm dealing with a client, for example, and they're sitting in my office and they're talking about things, they're talking about what they're afraid of, they start to have, I can see a physical change, right? They start to have a physical change when they're going into the description of that fear or the discomfort or the anger. And as I'm observing them, their breathing changes, their pace of talking changes. You can see that their blood pressure perhaps is going up or going down. I can see it, their face is getting red or maybe they're getting, you know, that flushed kind of or the white kind of pale look about them. They'll shake. There's a lot of, you know, parasympathetic activity, the shaking of the hands. They lack the ability to control their breathing. You can see muscle tension. You can see a lot of fidgeting, movement. They will move sometimes towards a kind of a fetal curled position in the chair. They start to draw inward, self-hugging kind of behaviors. Sometimes they'll begin the self-soothing behaviors, the rocking in place and that curling fetal type movement. position they'll get into in a chair. That's a self-soothing thing. The hugging or the movement sometimes is to dissipate that feeling. Depending on the response they have is the fight, flight, freeze, or fawn response. They might be those movements that look like they're wanting to run away or preparing to something, right? So there's a whole lot of different responses they have. When the person is uncomfortable, and in my practice as a psychologist, what I'm doing is I'm having them work through the issues of their trauma, and so those feelings of discomfort many, many times are manifested physically. They will lose the ability to describe what's going on in their head. So asking them and expecting responses that perhaps make sense. They're not speaking in full sentences or they're giving just flashes of things that are in their head. It's not that they're reliving necessarily the event that happened. perhaps is being talked about. But what they're doing is they're reliving the feeling attached to the event. And so they'll lose the ability to accurately or coherently articulate and speak with whatever it is that's going on in their head. As a practitioner, watching the experience of that is both helpful and disturbing. You're seeing somebody that's in extreme distress. And if you have the ability to to understand what it is that's going on with them. Because you know their history, hopefully. As a therapist, I would. But what do you do with that? And what is that? What is it that's going on? Is there some form of help they can get when they're like that? Yeah, being in another person's presence when they're there. But certainly when they're sharing it, it's perhaps, in my experience, something that People generally don't get an opportunity to do. And so it takes the power away from it. You know, when we're working with combat vets, for example, the technique of the reframing and the exposure. So what they're doing is they're repeating the trauma. So they're just constantly repeating the same traumatic story over and over again. And helping the person who's suffering from that level of trauma, like in a combat situation. So you desensitize to it. You've been overly sensitized because it's in your head and it doesn't ever come out. You never put words to it. It has that level of power because of that that becomes so disruptive and destructive to the person. But it's only in their head. So the exposure to it, the exposure to the story... And that's one of the techniques that can be used. But being in a person's presence and being able to express emotion that you feel when you're feeling uncomfortable, that expression of emotion, we do that with EMDR. When we're working with EMDR, eye movement processing and desensitization, what you're doing is you're allowing the person to be in that memory And then be able to put words to it. And what's interesting with EMDR is that there's not, you know, it's not talk therapy. You're not inquiring too much into the person's understanding of what is happening. You're just asking them to describe it. And then there's a series of questions, and it's very scripted. We all, you know, when we're doing EMDR, we're using a form. And it's the same questions about, you know, Well, what is it that bothers you about that? How do you see that? How do you see yourself? What does that mean to you? And how would you like it to be seen? How would you like to feel about that? To reframe, right? So it's a reframing process, which is, you know, similar to the exposure therapy. You're exposing the story to the light of day and then trying to reframe it in a way that is not emotionally as damaging to you. Seeing it for what it is. That's kind of like the... the way I would describe it, rather than the monster that you've allowed it to turn into because you keep it bottled up inside. So trying to figure out ways to help somebody who has a high degree of trauma can be a complex and complicated process. All the addicts that I have, they all have severe trauma, and primarily in their childhood, but they all have trauma. And getting to the point where you're able to experience that in a way that's not destructive to you as the trauma victim because it's in your history, but also not let it interfere and intrude on today and damage relationships you have. The things that trauma victims have that are these points of difficulty, if you will, are the difficulty of being able to trust others. That's a huge one. And if you have a high degree of trauma in your life, trust of others when you have been abused and traumatized by other people is a very difficult one. I was watching an old episode of a TV show, and this person on the TV show was a police officer, and he had some kind of amnesia. He'd hit his head during an incident, and he'd been attacked as a police officer, but he couldn't recall what was going on. He had no memory of it. And they were going back to the scene where the crime occurred that he couldn't remember. and there was a car that backfired and he immediately jumped for cover and the other police officers were kind of standing there like what is he doing and it was a demonstration although fictionalized but it was a demonstration of the ptsd type reaction of the unknown response to something that is a stimulus and conditioned in the environment but the brain could not remember because of the trauma because of a concussion But he still, he was in the place where the attack occurred. And so for him, he was experiencing the attack, but he couldn't remember it, right? But there was a part of his brain that did. That's what they were implying. And that's kind of what happens with people who are experiencing through the retelling of a story. They are in a small sense, they are being re-traumatized a bit because it's bringing up the emotion. But the bringing up of that emotion in a safe environment where they can feel and experience the acceptance and the support and care of another human being rather than in front of the abuser, it's a healing process. So you're making the reality something that is just a memory. It's not actively going on. So getting into a place where you can heal from the trauma, And so it's like, well, what does healing from trauma mean? It doesn't mean getting rid of the memory. It's always going to be there. But it's getting to a point where that memory doesn't harm you. However, I'm going to kind of preface that with the idea that given enough of a stimulus, you're going to perhaps be re-traumatized if the memory is just too strong. But it's recognizing when it's happening so you can ease off of it. In other words, you can back away from the situation, the description, the people, whatever's happening that's retraumatizing you. I had an occasion to be sitting at a table with a bunch of different people. I ride motorcycles, so we had ridden somewhere, and there were about eight of us, and we were just going to eat lunch and then get on our bikes and continue on our ride. So they didn't know me. This was the first time I'd been with them. And they were all, you know, approximately my age or a little bit older at the time. I think I was in my late 40s. I was actually early 50s. And two of them or three of them identified themselves as being people who were former military. So that conversation came up. And there are some that weren't former military, but the ones that were. And I, you know, I just asked a couple questions. You know, were you in combat or, you know, were you just stationed here in the U.S. or, you know, whatever your billet was. And a couple of them said, yeah, you know, I was in Iraq and another one was, I think, in Afghanistan. And they asked me what I do. And so I said, oh, well, you know, I'm a psychologist and I specialize in treating addiction, which is for me, is not treating addiction, it's treating trauma, but they just, they happen to be using drugs or alcohol as a coping mechanism. And I'm like, oh, wow, so you deal with trauma victims. I said, yeah. I said, you know, I deal with people that work for the government, former military, things like that. And so the conversation was evolving around that idea. And at one point, somebody in the group was asking one of the guys, well, so where where were you stationed you know and do you think that affected you and so he started briefly talking about it but he was able to recognize that he was starting to get re-triggered uh in the in his trauma and i could see because i'm trained in this but i could see him starting to lose time and place so he was starting to disconnect from the conversation and Uh, it didn't take long for that to happen actually. And, um, I, I was, I'd stopped talking at that point and, and he said, as he's talking, he goes, you know, can we change the conversation? Cause I'm starting to get kind of triggered here. I'm starting to, to feel it. And I, I, yeah, you can see it. I mean, he, I could see the changing in the gaze, the breathing. Actually, his tone, it started to turn more flat. But he was having all the signs of starting to regress into a PTSD state. And so we did. We changed the conversation and he was fine. But it doesn't take much sometimes to get to that place. It doesn't mean that you're going to every time. And certainly his example– and I did not talk to him afterwards to find out exactly what was going on with him that caused him to– what his past showed with that that would– he experienced that would rise to that level of PTSD. But then again, I didn't need to because I know why and I– heard those stories a hundred times um but he definitely was having that experience and he will always have the memory of whatever transpired while he was in the military but the the feelings that are attached to it are the things that drive the the body the functional uh changes and but it's also the emotional change. And so I think it's important if you have trauma and you're successfully healing from it, but it's important to recognize when you are getting activated, when those memories are starting to activate and you're starting to lose time and place. And he did a very good job of calling himself out for that and to putting, trying to make an attempt to redirect the conversation away from it, which I, gladly was able to do for him but it's that's part of it so you're not it's not like you're going to forget because you don't it's your memory um you know if you were extremely traumatized you may have uh repressed memories sure and that is a thing but you know to think that you're going to be healed from trauma and then you're not ever going to have any kind of like recall of the events. No, that's not true. It's whether or not those events can come back from the past and further traumatize you. Yeah, that could happen. The goal of trauma treatment is to get you to be able to be functional and engage in everyday life and not be burdened by the things that are traumatic. I've had clients in the past who They really struggle. They are just locked in on this traumatic time period and they can't get out of it. But I often wonder when they're working with a therapist, and they say they're working with a therapist, I often wonder how effective that therapy is. To me, it seems like that's a therapist that they're working with who perhaps doesn't really understand trauma. They understand what a traumatic event is, but they really don't know what to do with somebody who has severe trauma. They don't know how to treat it. They don't know what to do to direct it or to engage in it. And I've had people who have seen therapists who heard the client who is now my client, describe a severe traumatic event in their childhood and just kind of like note it, maybe write it on their little chart that they have in their hands and say, well, that must have been really awful for you as a kid to experience that. And then they pivot and go to another topic because they just don't know what to do with that. um and and if that is the experience you've had in in therapy and you really need to work on trauma you need to find another therapist frankly because that's not a person who's comfortable with trauma they're not a person as a therapist that's a therapist who's not comfortable with trauma and not doesn't really know what to do with it and that's okay um but it's not going to be helpful to you especially if you have addiction Because you need the help with the things that are traumatic in your life. And that's not going to help you. What will help you is somebody who can help guide you through that trauma experience and the traumatic life that you've lived and self-destructed because you're trying to cope with drugs and alcohol and trying to kill yourself with it. But they need to be able to guide you through to get to that place of healing. And they have to be very comfortable with somebody who is just decompensating right in front of them. They're just really falling apart right in front of them. And that's a tough thing to do, honestly. I experience it, you know, not every day, but, you know, multiple times a month with my clients who get to that place. And, you know, it's a tough... thing to witness it, but it's tough to know what to do with it when it arrives in front of you. So trying to get to a point where you're healing, exposing the information to the air, to the light of day, in the presence of another person, will help you get to that place where you're having that healing experience. So when you're working on recovery, Um, and you take away your primary coping mechanism, drugs, alcohol, food, gambling, shopping, porn, whatever. And there's nothing else there. You got nothing to cope. You're just going to go right back to it. And you know, it's, it's, it's okay that that happens. I get it. Hopefully, um, the people around you get it. Um, because you haven't found the thing that's going to help heal you so when you're really really really in a tough place and you know it's difficult and that's why rehab is a good starting point because it's hard to regulate when you're so deregulated you're so dysregulated in a way that there's nothing that's going to reach you and So there's severity of addiction. The easier addict to deal with is the one that's somewhere in the middle of their addiction, their early entrance into addiction. It's tough because you can't convince the person that that's actually really a problem because it's not yet, but it's going to be. And the person that's in the later stages of addiction, they're very difficult to deal with because they're so entrenched in that coping mechanism. So that's why I keep saying to people, When I talk to them about addiction, you got to go to rehab. And what's the point of rehab? The point of rehab is to give you a physical barrier between you and your drug of choice so that you can work on those things that are causing you to be dysregulated. So the mind, body, and the intellect, the emotion, and the body responses to trauma. are greatly affected by the environment the stimulation of that uh memory perhaps something that parallels the memory but it's also what you're doing to treat it not you individually as the addict treating it no i'm not saying that but what you're doing to get the treatment the treatment that you need and you're using drugs and alcohol but now what are you going to use but I guess primarily what I want to get across today is that you fully understand that there is a very strong, scientifically supported understanding of a connection between the intellect, the emotion, and the body when it comes to how we receive information, how we retain that information, the memories, if you will, the memories, right? I remember things, my body remembers it, my mind remembers it intellectually, and my emotion remembers it. And you have different responses to each one of those forms of memory. So the body memory can be one where you feel sick or you feel pain, ghost pain or pain, repetitious pain in a part of your body that was injured. Bessel van der Kolk and Dan Siegel and Stephen Porges, all the leading... scientific researchers and and theorists and practitioners of of that body retention of memory can speak to that and there's you know there's a lot of books on that there's a lot of things on the internet i can encourage you to look you know on youtube and listen to people talk about it um stephen porges is a is a good source stephen porges is a neuroscientist who talks extensively about the science behind the connection. Dan Siegel is a scientist as well, but he talks more in kind of these a little bit more difficult to follow esoteric type approaches to it, but the connection between the emotion and the body and the retention of that memory in the body. Bessel van der Kolk, a very good... individual to speak to those connections and Gabor Maté also talks extensively about that in his work. So if you really want to understand like the scientific connection there or the application of that scientific theory, Gabor Maté is very good at that and he does a very good job of explaining it. Um, so, you know, I would encourage you if you were traumatized and you want some education or some understanding, that would be a very good way to, uh, try to do some research on that. And I would encourage you to do that because you know what, as an addict, listen, man, it's not your fault that you're having these responses. And until you get that help, the type of response you have is not really under your control and that's okay. Because you can't heal yourself without help. You just can't. You have to participate in the healing, but you're not going to heal yourself. But I'm going to caution you. Reading a book or watching a YouTube video where somebody talks about these things is also not healing. That is just simply exposure to information. But it's the application of of that scientific theoretical approach to treatment that you need to experience so if you um do if you don't get that then you're not ever going to really probably ever get there you're just going to know all about it but you're not going to have it so going to rehab first and then after that getting into some effective treatment for your addiction for the recovery of your trauma That's where you need to go. So I would encourage you to do that. Well, look at that. Another episode of Doc Shock, your addiction lifeguard. In the books, as one of my friends used to say. Really appreciate you listening. And if you would like to be on the show, I'd love to hear from you. I love hearing from people in recovery, people trying to get into recovery, clinicians. Hey, feel free. Reach out to me. I've got some recent inquiries. I'm trying to put some people for you to get more than just my words of advice. But if you need help, go to rehab. Reach out for a therapist. Do something. Because ending your life to save your addiction, that's just crazy. Don't do that, get the help so you can be sane, stable, and sober. So if you do like this podcast, come back. And until the next time, this is Doc Shock saying, see ya.