Keeping personal accounts in the black

In life we all have moments of sadness and moments when we feel down. Sometimes, we rationalise in our minds the things that we could have done differently, the things we might have to have landed ourselves in a bad situation, and the things we could do to break out of this funk. All of these take up tremendous mental resources, leaving us fatigued, sometimes unable to find the energy to perform daily functions such as work, or keep up social commitments, which impact on other areas of our lives. Before we know it, we have slowly slipped into a depression-like state, and it is very hard to climb out of.

How do we define depression? I have sometimes looked at it from the perspective of a bank account. Depression is when you are in the red for many bank accounts. Physical energy? Low. Happiness? Low. Enthusiasm? Low. Money? Possibly low. The problem when you have many of such “Low” accounts is that when you try to fix one such account, you end up having to withdraw from another. When you need a change of scenery, and perhaps work is bothering you, maybe you need to spend funds you do not have to go on a holiday. Perhaps when your enthusiasm for life is low, and you need to do something about it, you have neither the energy of time. And when you do perhaps, splurge in order to meet an impulse need, you end up withdrawing a large amount from one of your accounts.

How did you get into that state and what can you do to avoid that? It is like sinking into a deep hole and trying to climb out of it. You can only slowly dig the sides of the hole around you, and then try to pile up the debris you have dug, to stand on, so that you are incrementally getting higher and higher and out of the hole. But digging takes energy which you don’t have, and some how you need to find the will to keep going.

But more importantly it would be better if you never got into the hole in the first place. If there is an area of your life that needs attending to, channel all the other resources into addressing it, so that it does not slide and drag the other areas along with it. And if you know someone who is depressed, just offer your time to listen, to let them talk. Often when you give suggestions, it is like asking someone to do things, drawing resouces from already depleted accounts. Depression is like a mental wall and talking to someone else is like removing a brick of the wall at a time.

Managing change

Change is something we all have to embrace. Some of us are more welcoming of it, while others are more resistant. There is nothing right or wrong about these attitudes, they are normal human reactions.

Why do some people welcome change? For some people, change brings variety and a new scenery – whether physical or mental – and being in a new situation creates a buzz of some sort. Being in a new situation brings new stimulus – mental and physical – which they enjoy.

For the others, the new stimuli is what they seek to avoid. They do not enjoy the new stimulus that comes with change.

But that does not mean we ought to criticise these people. When you look at why people avoid change, it may give you some insights into their life.

Let’s say you are a busy mother with three children, trying to balance a part-time job with running your family. Change for your children is good and exciting, but for you, the logistics of going to new places and clubs and doing new things may cause you stress. And if you move your children to a new home or school, this brings about new concerns that you may not have the capacity to deal with at the point in time.

So change is good, as long as you have the energy to deal with it. If you are in a stressful moment in life, then change is obviously not the thing to strive for. Try to adapt to a sense of calm normality in order for your inner spirit to equalize. There is nothing wrong to avoid change at that period in time. What we must avoid is to make over-generalisations about situations and our reactions to them.

Sometimes you can’t help but face change – and if you tend to react less positively about it, then focus your energies on changing the way you view the situation. Change the way you think, rather than fight the change – it may be less draining and less of an energy spend. Focus on building the new rather than fighting the old.

And if you are the sort that loves change and variety – enjoy it!

Change is inevitable. Life is full of changes, some big and some little. If there was none, we’d still all be babies in nappies. So we can’t go through life hating change and wishing there was none, but we have to see it as a natural progression of life, and manage it appropriately. If you like change, embrace it. If you dislike it, learn to manage it, and your reaction to it. Let that be your thought for the coming days.

Expressing gratitude

Gratitude makes sense of our past, brings peace for today, and creates a vision for tomorrow.

Have you noticed how people seemed to have forgotten how to say thank you properly these days? When you have a done a favour for someone, or gone out of your way, sometimes the only response you get is a curt “cool”.

This is not a rant at changing times or the slang of modern vernacular, or how the use of the words “thank you” are decreasing.

Rather, it is a look at how we have to be mindful of the way we express thanks.

Imagine this scenario. You have forgotten your phone and someone from your home has to bring it to you, knowing that perhaps it is an important element you cannot leave home without. If they make a big trek to your location, and all they get for the efforts is the phrase “cool” or “nice one”, how do you think they feel?

The problem with phrases such as “cool” or “nice one” is that they are sometimes uttered unthinkingly out of embarrassment, but they are so ungracious that it almost normalises the efforts of others, almost as if the extra mile they have gone was an expectation.

Be gracious for the things in your life and around you. And try expressing it fully to your fellow human beings.

Recognising trauma symptoms can help deal with trauma

To fully understand the impact of trauma and complex trauma, practitioners will need to familiarise themselves with the primary symptoms of trauma. While each survivor’s reactions to trauma are unique and will vary from person to person and depend on the type of trauma, age, the frequency and duration of the abuse, and the relationship to the abuser(s), there are a number of commonalities.

It is crucial that survivors are helped to recognise that the physical and psychological reactions to trauma are normal responses which serve to protect us, and are elicited outside of conscious awareness or control. These reactions are like an emotional immune system, which instead of fighting invading bacteria or viruses, fights to protect us from harm.

To help survivors understand their reactions to trauma, practitioners need to be able to convey the following information in a way that is easily understood by the client and that makes sense to them. This can be supported with directed reading or self-help books such as The Warrior Within (Sanderson, 2010c). Persistent re-experiencing of trauma can be triggered by both internal and external cues. This means that even if the survivor is currently not in actual external danger, inner feelings and sensations can trigger a range of PTSD reactions. Given that they may already be in an elevated state of anxiety, it is easy to set off an already highly sensitive alarm system on the basis of internal physiological arousal. This is potentially dangerous as it prevents the survivor from recognising actual external danger and makes it hard to assess objectively the degree of safety.

To help survivors understand the neurological and physiological responses to trauma it is helpful to explore their knowledge of how the body reacts to danger. When in the presence of danger primitive biological mechanisms such as the alarm system are activated to aid survival. As a result the brain releases a cascade of neuro-chemicals which start a complex chain of bodily reactions, all of which are designed to protect us from the harmful effects of trauma.

Although the alarm system does not stop the emotional pain, stress or trauma from happening, it does cushion the trauma and helps us to deal with it.

The alarm system acts as an emotional immune system, which like the physical immune system, is activated outside of conscious awareness and is therefore not under our control. It is vital that survivors understand that whatever their reactions during the trauma, these were outside of conscious control and therefore they are not to blame or at fault for how they responded. Recognising this can dramatically reduce any crippling feelings of shame, self-blame, or guilt.

When the body’s alarm system is tripped and goes on red alert it sends signals to the brain to prepare for fight, flight or freeze. This sets off two crucial biological defence systems: the sympathetic nervous system and the parasympathetic nervous system. The sympathetic nervous system mobilises high level energy necessary for fight or flight, while the parasympathetic nervous system slows down the heart and metabolic rate which results in the freeze response.

The two structures in the brain that regulate the alarm system are both located in the limbic system, the amygdala and the hippocampus. The role of the amygdala is to detect threatening information through external senses such as touch, taste, sound, smell or vision. The amygdala is responsible for determining whether incoming stimuli are desirable, benign or dangerous.

To maximise survival, this evaluation is instantaneous but crude and primitive in that it does not use deeper analysis, reason or common sense. This is why it is often referred to as the ‘fast and dirty route’. If the stimulus is life threatening, stress hormones such as adrenaline and cortisol are released, which send messages through the nervous system to the muscles and internal organs to either attack, run or play dead.

The amygdala is highly sensitive to any danger and is easily activated to increase readiness to attack or defend (fight), run (flight) or submit (freeze). In contrast to the ‘fast and dirty’ route of the amygdala, the hippocampus is a much slower route in that it evaluates the external threat through deeper analysis using conscious thought, memory, prior knowledge, reason and logic. The hippocampus is also critical in laying down new memories and experiences. If the danger is truly life threatening, the hippocampus will send messages to continue with appropriate responses. If however the deeper analysis concludes that the stimuli are not dangerous it will send messages to deactivate the responses.

In most cases of threat these two structures work in harmony to balance appropriate responses to the situation. When the trauma is prolonged and repeated such as in complex trauma, the feedback loop that controls these two systems malfunctions and floods the body with high levels of stress hormones.

While these stress hormones are critical for survival, they are highly toxic and only designed to circulate for short periods of time so that the individual can get to a place of safety or remain safe until the threat is over. In the case of certain traumas such as CPA or CSA where the child cannot fight or run to safety, the only option is to freeze. This means that the stress hormones cannot be discharged and remain in the system, which can have a number of negative consequences, not least forcing the alarm system to remain on red alert, or ‘online’(Sanderson, 2010c).

Evidence shows that high levels of cortisol that are not discharged can lead to the destruction of brain cells which can affect the function and size of the amygdala and hippocampus (Gerhardt, 2004; Teicher, 2000). Such malfunction leads to increased arousal, fear and anger responses, as well as memory impairments. When the brain and body are flooded with chronic levels of stress hormones the hippocampus goes ‘offline’and is unable to accurately evaluate the degree of threat or danger. It is also not able to assess whether the danger is internal or external, or whether the traumatic incident is over or on-going, and cannot send the appropriate messages to the amygdala to deactivate the alarm system. This leads to the alarm system remaining on constant red alert and the continued release of stress hormones.

As a consequence the body responds as though the trauma is on-going, even after the threat is over. Over time the alarm system is reset on a default setting of ‘on’, with survivors feeling as though they are being repeatedly traumatised. This leads to a heightened or continuous state of danger, known as hyper-arousal.

This hyper-arousal forces stress hormones to continue to flood the body and brain, and the tyranny of post-traumatic stress responses. Since the hippocampus is not able to regulate the alarm setting, or halt the release of chronic levels of stress hormones, its ability to store new memories is reduced. This means that the trauma is not stored within context or time, making it seem as though it is continuous and never ending.

This in turn prevents the processing of the trauma keeping it ‘online’ with the same vividness and intensity as when the actual assault happened. Not being able to process the traumatic experience makes it harder for survivors to store it in memory or to recall it leading to amnesia, or incomplete or fragmented memories. A crucial goal in recovering from complex trauma is to bring the hippocampus back ‘online’ so that its function can be restored to regulate the alarm system to evaluate danger, and differentiate between internal and external threat.

Prolonged release of high levels of stress hormones impacts on physical well-being leading to a range of physical problems such as hypertension, physical exhaustion, chronic fatigue syndrome (CFS), sleep impairment, and digestive, respiratory and endocrine problems. In addition, chronic fear reactions and high levels of adrenaline evoke waves of overwhelming anger which survivors cannot release for fear of consequences, thereby creating even further stress. Hyper-arousal also affects concentration and the ability to reflect on or process experiences, preventing survivors from making sense of their experiences.

While the alarm system can activate three alternative reactions – fight, flight or freeze – in most cases of complex trauma, especially when it occurs in childhood, there is only one option: to freeze. The freeze response is designed to conserve energy so that the individual can escape when the danger is over. Young children are not able to outrun or fight an adult effectively, and are thus left with no option but to freeze.

While the freeze response protects the individual from the greater threat of the consequences of fighting back or running away, it is often experienced as passive submission. This can make survivors feel as though they were weak in not fighting back or running away, which can lead to shame, self-blame and guilt. It is important to convey to survivors that realistically children are not able to escape, especially if the abuser is a significant figure in the child’s life such as a parent, relative or priest. In that moment they are both powerless and helpless.

However, the sense of submission can often haunt them and leave them feeling ashamed that they did not do more to prevent the abuse. This is also true for adults who are in thrall to an abuser who has power and authority over them. The freeze response also protects individuals from the full impact of the pain of the abuse.

As the parasympathetic nervous system kicks in, a sense of calmness descends on the brain, slowing everything down, and the body begins to feel numb in order to cushion the anticipated pain and the emotional terror of the trauma. Once the danger is over, these reactions fade and the stress hormones are discharged through movement.

Understanding the responses to trauma and conveying them to individuals suffering from them can help them recognise their own reactions and how to deal with them. This will empower them and give them the confidence to break free of the hold traumatic experiences have on them.