Stress, Trauma, and Healing

An Interpersonal Nuerobiology and Life-Focused Communication Perspective

By Gloria Lybeckerwww.HealingWithHorseTherapy.com

lifefocused@gmail.com1

Stress: Force exerted on a System

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Introduction to Your Brain

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Relationship of amygdala to prefrontal cortex

•With only 25 watts of energy available to the brain, the amygdala grabs the fuel as it is considered of more importance to survival.

•When the stress or trauma is intense enough, nothing is left for the prefrontal cortex.

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What is stress?

• ANY activation of the HPA axis (ANY sensation/feeling that indicates needs not met)o Anxiety (worry, concern)o Irritation (anger, rage)o Fear (fright, panic, terror)o Overwhelmo Surprise (startle, disappointment, shock)o Sadness (grief, mourning)o Hopelessness (disconnection, despair)o Etc.

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The Purpose of Stress

•To give us the ability to react quickly to an unexpected threat

•Our systems were not designed to worry about the environment, world poverty, constant debt, pleasing the people we work for…

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A Safe or Calm Place

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What is trauma?

We become traumatized when our ability to respond to a perceived threat is in some way overwhelmed. Trauma is about loss of connection –to ourselves, to our bodies, to our families, to others, and to the world around us.

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Obvious Causes of Trauma Include:

• War

• Severe childhood emotional, physical, or sexual

abuse

• Neglect, betrayal, or abandonment during

childhood

• Experiencing or witnessing violence

• Rape

• Catastrophic injuries and illnesses

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Less Obvious Causes of Trauma

Include:• Minor auto accidents, especially those that result in whiplash

• Invasive medical and dental procedures, particularly when

performed on children who are restrained or anesthetized

• Falls and other so-called minor injuries, especially when children

or elderly people are involved.

• Natural disasters, including earthquakes, hurricanes, tornadoes,

fires, and floods

• Illness, especially where there is high fever or accidental poisoning

• Being left alone, especially in young children and babies

• Prolonged immobilization, especially in children

• Exposure to extreme heat or cold, especially in children and

babies

• Sudden loud noises, especially in children and babies

• Birth stress, for both mother and infant13

Listen to Your Body

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A New Understanding

We have learned that trauma is not just an

event that took place sometime in the past; it is

also the imprint left by that experience on

mind, brain, and body. This imprint has

ongoing consequences for how the human

organism manages to survive in the present.

Trauma results in a fundamental reorganization

of the way mind and brain manage

perceptions. It changes not only how we think

and what we think about, but also our very

capacity to think.15

Listen to Your Body

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Symptoms and Order of Appearance

1. Hyperarousal: 1. Hyperarousal: 1. Hyperarousal: 1. Hyperarousal: increase in heart rate,

sweating, difficulty breathing (rapid, shallow,

panting, etc.), cold sweats, tingling, and

muscular tension. It can also manifest as a

mental process in the form of increased

repetitious thoughts, racing mind, and worry.

If we allow ourselves to acknowledge these

thoughts and sensations, let them have their

natural flow, they will peak, then begin to

diminish and resolve.

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Symptoms and Order of Appearance

2. Constriction: 2. Constriction: 2. Constriction: 2. Constriction: Hyperarousal is initially

accompanied by constriction in our bodies and

a narrowing of perception. Our nervous system

acts to ensure that all our efforts can be

maximally focused on the threat in an

optimum way. Constriction alters a person’s

breathing, muscle tone, and posture in order to

promote efficiency and strength. Blood vessels

in the skin, extremities, and internal organs

constrict so that more blood is available to the

muscles, which are tensed and prepared to take

defensive action. 18

Symptoms and Order of Appearance

3. Dissociation and denial: 3. Dissociation and denial: 3. Dissociation and denial: 3. Dissociation and denial: This protects us from being

overwhelmed by escalating arousal, fear, and pain. It

“softens” the pain of severe injury by secreting

nature’s internal opium, the endorphins. In trauma,

dissociation seems to be a favored means of enabling

a person to endure experiences that are at the

moment beyond endurance.

Denial is a lower-level energy form of dissociation.

The disconnection may occur between the person and

the memory of our feelings about a particular event

(or series of events). We may deny that an event

occurred, or we may act as though it was

unimportant.19

Symptoms and Order of Appearance

4. Feelings of helplessness, immobility, and 4. Feelings of helplessness, immobility, and 4. Feelings of helplessness, immobility, and 4. Feelings of helplessness, immobility, and

freezing: freezing: freezing: freezing: A sense of overwhelming helplessness

is the nervous system’s brake. It is the sense of

being collapsed, immobilized, and utterly

helpless. It is not a perception, belief, or a trick

of the imagination. It is real.

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Our Prefrontal Cortex

Once we have built the fibers of

self-regulation

Our Prefrontal Cortex calms our

Amygdalae so that our

Hippocampi can work to learn

–to make connections between,

store, and retrieve memories

Our Prefrontal Cortex gives us

wisdom, mindsight, empathy

and our soul. It is the part of

our brain that makes us human,

and is capable of creative

solutions.

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Symptoms Deliver a Message

Symptoms can and will disappear when the

trauma is healed. In order to heal, we need to

learn to trust the messages our bodies are giving

us. When we learn how to listen to the

messages, how to increase the awareness of our

bodies, we can begin to heal our traumas.

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Stress vs. PTSDAmygdala activates stress axis, which increases hormone flows temporarily

Amygdala activates stress axis, amygdala and stress axis don’t turn off

Hippocampus temporarily off-line, then comes back on line and turns off stress hormones

Hippocampus is eventually damaged by stress hormones, neurogenesis ceases, amydgala’s neurons sprout new branches, strengthening hypervigilance.

Surge of cortisol, turns off somatic reactions caused by stress

Chronically low cortisol, chronically high norepinephrine – HIGH AROUSAL

We make sense of the experience, it stays in place

Timeless sense of re-experiencing situation

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Reclaiming time: unresolved stress

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Polyvagal Theory

•There are three general states that we exist in:o Social Engagemento Fight or Flighto Frozen

•They are managed by the vagal nerve, which connects brain, facial muscles, heart and gut.

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How Trauma Affects the Body

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Dysregulation

• Any activation of our stress response: o Vulnerability, Sadness (up to grief, mourning)o Disquiet (up to distress)o Anxiety (up to panic) o Nervousness (up to fear, panic)o Concern (up to terror)o Embarrassment (up to shame, mortification)o Irritation (up to anger, lividity)o Resignation (up to hopelessness, despair)o Deadening (up to dissociation)

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Noticing the Effects – Feeling the Positive

Emotions, Thinking the Word,

and Noticing the Breath

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The Good News about Circular Causality

•You can start anywhere and get improvement

• Empathy works on everything

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How do Observations decrease stress?How do Observations decrease stress?How do Observations decrease stress?How do Observations decrease stress?

• The mindful approach to determining your observation moves you from “low road” limbic response to “high road” cortical response.

• Importance of observations in identifying the moment of transition from implicit to explicit (exactly when did your amygdala begin to run the show?)

• And so, what is the leverage point at which empathy will be most effective to widen the window of tolerance?

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Feelings and Needs: Naming ExperienceFeelings and Needs: Naming ExperienceFeelings and Needs: Naming ExperienceFeelings and Needs: Naming Experience

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Matthew D. Lieberman, Ph.D, UCLAMatthew D. Lieberman, Ph.D, UCLAMatthew D. Lieberman, Ph.D, UCLAMatthew D. Lieberman, Ph.D, UCLA

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How does naming feelingsHow does naming feelingsHow does naming feelingsHow does naming feelingsstart to relieve stress?start to relieve stress?start to relieve stress?start to relieve stress?

•Naming the feeling activates the prefrontal cortex to send calming GABA to the amygdala

•As feeling and body experience are identified, the information from the right hemisphere becomes available to the whole brain.

• The calming of the amygdala allows the hippocampus to come back on line to do the work of contextualizing.

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How does naming needsHow does naming needsHow does naming needsHow does naming needsstart to relieve stress?start to relieve stress?start to relieve stress?start to relieve stress?

• Naming experience continues to calm amygdala• Connects left hemisphere (answers the essential question 'why?') for hippocampus

• Allows hippocampus to contextualize as part of life story

• Allows one to realize one “makes sense”, the incredibly calming experience of “being gotten” for the right hemisphere

• LIVING ENERGY OF NEEDS- changing the emotional tone of the experience

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How does making requestsHow does making requestsHow does making requestsHow does making requestswork to relieve stress?work to relieve stress?work to relieve stress?work to relieve stress?

•Moves us away from isolation - establishes connection between two brains (we are social animals – interpersonal integration) and activates our social engagement system

•Opens the door to community and support

•Begins to facilitate locating ourselves in time –temporal integration

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The role of Empathy in coming back to calm

• Immediate: Empathy calms the amygdala after stress activation, freeing the brain’s energy for mindsight and creativity, moving us from fight/flight or freeze back into self-connection and social engagement.

• Long-term: We are disarming neural networks that are fueled by stress states and hooked into the amygdala.

• Life-long changes: We are modeling holding the self with compassion, helping the person receiving the empathy, or ourselves, grow new neural connections between pre-frontal cortex and amygdala, improving our ability to regulate.

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Attachment and Stress/Regulation

• Securely attached children successfully use other people to modulate their stress (when they are under stress, their physiological stress response system does not activate).

• Adults who are secure or earned secure are able to cope with stress and interpersonal problems with self-regulation.

• Adults coming from the insecure attachment patterns use external forms of self-regulation: fleeing/distancing/addictive or compulsive behavior; or fighting/clinging/confronting/demanding.

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Brains “synch up”

• Children model their brain use on how their parents are using their brains.

• If you are living in your right hemisphere (emotional chaos, dysregulation, temper flare-ups, intrusive memories, the ever-present past) your child is living in his/her right hemisphere.

• If you are living in your left hemisphere (disconnected, unemotional, removed from your own life story, rational/logical) your child is living in his/her left hemisphere.

• Children depend on the adults around them to learn how to integrate their hemispheres.

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Circle of Attachment Secure (Earned)

Hippocampus rules

Ambivalent, Right

Hemisphere,

amygdala takes

over

Avoidant, Left

Hemisphere,

little info from

amygdala

Disorganized/Traumatic

Amygdala rules

More ChaoticMore Rigid

More IntegrationMore Integration

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Secure Attachment (SA) = Functional

Pre-frontal Cortex (PFC)

Functions of SA Functions of SA Functions of SA Functions of SA

Regulation of body systems

Attuning to others

Balancing emotions

Modulating fear

Responding flexibly

Exhibiting mindsight and

empathy

Paying attention to body’s

wisdom

Functions of PFCFunctions of PFCFunctions of PFCFunctions of PFC

Regulation of body systems

Attuned communication

Emotional balance

Calming the amygdala

(modulating fear)

Response flexibility

Empathy

Intuition

Morality

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The Mind’s Domains of Integration

1. Integration of Consciousness: Presence2.Vertical Integration: The Embodied Mind3. Bilateral Integration: Hemispheres, brain parts4.Memory Integration: Implicit and Explicit5.Narrative Integration: Who are we in the world?6. State Integration: Can our inner community connect?7. Temporal Integration: Who are we in time?8. Interpersonal Integration: Connection with others9. "Transpirational" Integration: Connection beyond breath

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Appendix

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Early Stress/Trauma Symptoms

• Hypervigilance (being “on guard” at all times

• Intrusive imagery or flashbacks

• Extreme sensitivity to light and sound

• Hyperactivity

• Exaggerated emotional and startle responses

• Nightmares and night terrors

• Abrupt mood swings

• Shame and lack of self-worth

• Reduced ability to deal with stress

• Difficulty sleeping

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The Next Symptoms that may appear

• Panic attacks, anxiety, and phobias

• Mental “blankness” or spaced-out feelings

• Avoidance behavior

• Attraction to dangerous situations

• Addictive behaviors

• Exaggerated or diminished sexual activity

• Amnesia and forgetfulness

• Inability to love, nurture, or bond with others

• Fear of dying or having a shortened life

• Self-mutilation

• Loss of sustaining beliefs

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Final Group of Symptoms• Excessive shyness

• Diminished emotional responses

• Inability to make commitments

• Chronic fatigue or very low physical energy

• Immune system problems and certain endocrine problems such as

thyroid malfunction and environmental sensitivities

• Psychosomatic illnesses, particularly headaches, migraines, neck and back

problems

• Chronic pain

• Fibromyalgia

• Asthma

• Skin disorders

• Digestive problems

• Severe premenstrual syndrome

• Depression and feelings of impending doom

• Feelings of detachment, alienation, and isolation

• Reduced ability to formulate plans 55

Implicit Memory and PTSDImplicit Memory and PTSDImplicit Memory and PTSDImplicit Memory and PTSD

•Body memories of proprioceptive experience stored by amygdala and can be irradiated (generalized more and more widely)

• Intrusive memories – lack of sense of time – show amygdala activity, lack of activity in hippocampus, result in effective ADHD

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Suffering vs. MourningHealing from PTSD

• Verbal:o NVC processes (Empathy)o EMDR (Eye Movement Desensitization and Reprocessing)

o Narrative therapies

• Preverbal:o Somatic Experiencingo Energy Therapy

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SUFFERING: IMPLICIT SUFFERING: IMPLICIT SUFFERING: IMPLICIT SUFFERING: IMPLICIT EXPERIENCEEXPERIENCEEXPERIENCEEXPERIENCE

· Amygdala-based· Looping (“Why did that happen? How could I have done that? How could they have done that?), Intrusive memories· No resolution· Hurts as much today as it ever did (timeless)· Shame· Sadness· Grief· Anger

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Mourning: Transforming Implicit into

Explicit Experience

An NVC view: Holding the pain of the experience, sadness that it happened, and the beauty of the need simultaneously.Results in compassion and understanding (contextualization and appropriate storage)

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EXPLICIT EXPERIENCEEXPLICIT EXPERIENCEEXPLICIT EXPERIENCEEXPLICIT EXPERIENCE

· Movement to hippocampus-based· Understanding (Placing in context, Seeing the whole, Mindsight into others’ behavior)· Resolution (Self-compassion)· Tied into autobiography

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One’s posture and facial muscles signal emotional states, not

only to others, but to oneself as well. These micro-expressions

are what Paul Ekman studied in his pioneering research

spanning over four decades. With practice and patience, one

can develop the skills necessary to observe these very brief

changes of muscle tension (often in a fraction of a second)

throughout parts of the face. The specific patterns of these

muscle contractions communicate the full range of emotional

nuances to oneself and to others. As social creatures, it is

through empathy that we make our deepest communications.

To do this we must be able to “resonate” with the sensations

and emotions of others; we must, in other words, be able to

feel the same things as those around us feel. The way we

indicate this is primarily nonverbal.

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10% 90%

Amazingly, as much as 90% of the vagus nerve

that connects our guts and brains is sensory! In

other words, for every one motor nerve fiber

that relays commands from the brain to the

gut, nine sensory nerves send information

about the state of the viscera (organs) to the

brain so as to restore balance.

Quote by Porges, “The afferent feedback from

the viscera provides a major mediator of the

accessibility of prosocial circuits associated with

social engagement behaviors.”

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Bibliography

•Bessel A. van deer Kolk, M.D.The Body Keeps The Score, Viking, 2014

•Peter A. Levine, Ph.D. Healing Trauma, Sounds True, 2008

•Daniel J. Siegel, M.D. The Mindful Therapist, Norton, 2010

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