May it move through you

When I saw the ambulances parked outside my apartment building I started to wonder. And then, while walking into my complex, I saw little ruby splatters of blood, like a trail of gumdrops leading me into the courtyard.  There was a crumpled body with clothes soaked through red.

Allow me to fast forward and say that eventually, everyone was ok.  While I was not in the true sense of the word traumatized, the experiences of one strange night last week helped me to better relate to the Post Traumatic Stress Disorder (PTSD) research I’ve read and the people with trauma who I work with.

In recent decades trauma research has directed itself towards body-based therapies. In Bessel van der Kolk’s 2015 work The Body Keeps the Score he highlights the growing value  among clinicians on “allowing the body to have experiences that deeply and viscerally contradict the helplessness, rage, or collapse that result from trauma.”

PTSD is defined by disruptive ongoing memories of past terror that the memory, hormonal, and nervous systems continue to react to as if the source of fear were still present.  Flashbacks, nightmares, and hypervigilance characterize the condition. The lifetime prevalence of PTSD is 6.8% in the US, with a striking differential of 9.7% for women and 3.6% for men.  Remarkable (and hopeful too) is that while 90% of the US population will be exposed to a traumatic event, only a small minority of those who have such an experience will develop PTSD .

The therapist in me couldn’t help but notice my own reaction to a shocking situation that night. What surprised me was how non-cognitive it was. Mid-conversation while watching the paramedics take over, I felt light-headed and I sat down on the courtyard cement.  Cognitive-Behavioral Therapy (CBT) is a modality I use frequently which relies on analysis of thoughts and the assumptions underpinning them, but in that moment I could understand that CBT has its limits when dealing with bodily systems this unconscious and primitive.

Fifteen minutes later I was washing dishes to decompress, and I felt another strange wave. A surge of nausea built up and I was dizzy, and had to lay down before finishing the dish.

One of the components for diagnosable PTSD in the Diagnostic and Statistical Manual is that the person undergoes or witnesses an event that is perceived to threaten the physical or mental annihilation of themselves or someone else. In this way it makes sense that trauma is less cognition-based than many other mental health conditions. It is a felt sense of threat to the body that the body is responsible for processing and discharging.  In a strange way I don’t completely understand, I believe that the nausea and dizziness I experienced were horror and shock expressing themselves in my own body.

It follows that some of the best treatments for trauma involve bodily components beyond the brain and the voice.  Modern trauma treatment is moving towards integrating verbal talk therapy with such body-based approaches. These include Eye Movement Desensitization and Reprocessing (EMDR) Therapy, Sensorimotor Therapy, Somatic Experiencing Therapy, and yoga-based strategies.

The next morning I was determined to have a good day. I meditated. I did a short yoga practice. Before leaving for my office I remarked to my husband, with astonishment, just how flippin’ good I felt.

The events of the night before had moved through me and been digested. My exposure had been slight, but the uncanny disruption of the experience and its effects on my body gave me renewed compassion for those who experience true PTSD symptoms.  May they find a way to let their past move through them as well.

References

Gradus, J. (2017).  Epidemiology of PTSD. Retrieved from https://www.ptsd.va.gov/professional/PTSD-overview/epidemiological-facts-ptsd.asp

Kilpatrick, D., Resnick, H., Milanaka, M., Miller, M, Keyes, K. & Friedman, M (2013).  National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria.  Journal of Trauma and Stress, 26(5): 537–547.  Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4096796

Van der Kolk, B. (2015). The Body keeps the score: Brain, mind, and body in the healing of trauma. New York, NY: Penguin Books.