I wanted to write this short piece for people to gain a
greater understanding of what the challenges may be for some people who have
experienced developmental trauma or a traumatic episode.
Why would this be so?
One of the aims of therapy for the traumatised client is to
try and live within a window of tolerance re emotions and sensations. This is a
difficult thing for the client to master as they are frequently triggered by
implicit and explicit memories that hijack the central nervous system. Early on
in therapy clients either live in a state of hyperarousal or hypo-arousal.
Early and middle stage work is helping the client to dampen down this highly dysregulated
state.
Clients often feel a huge level of responsibility for things
that are usually far out of their control, as well as the people-pleasing they output
for personal aspects that are within their control. They live with a high level
of hypervigilance and a continuous dread of terrible things that may be about
to happen. Some clients live in fear of a knock on the door or an unknown
number on their mobile. One client until recently still lived with the ironing
board jammed against the backdoor at night.
These aspects cannot be worked on with cognitive behaviour, “change
the way you think and you’ll change the way you feel” type therapy or time
limited hypnotherapy because trauma is much more than a cognitive issue. It is
felt in the body.
A client recently explained that a very short-lived trip to
Asda threw her into panic where she was unable to cope. The one person from one
household rule meant she wasn’t able to take her adult son in with her, that
was the first stumbling block. For years she hasn’t done the weekly shop on her
own as she doesn’t drive and she prefers to have someone with her to help.
The rules to this normally very straight forward task have
changed beyond anything that we have known. Queues to get into the supermarket
and a one-way system around the shop has meant you have to think on your feet,
while consciously processing stuff that is usually processed automatically.
This is a paradox (to think quickly but also consciously
with some effort is confusing) once this is accepted then comes the fact that
you have to get this right and if you don’t then you are breaking some sort of
code/rule that has been put in place to prevent very serious consequences. The
client who is called Amanda and wants me to use her name, navigated the arrows
but had forgotten a birthday card and didn’t know if she could double back on herself.
Feeling sudden panic, the effort to consciously process was
not there and her body flooded with adrenaline for the flight or fight response.
Feeling isolated she began to get upset. She wanted a way out but couldn’t immediately
see one.
On the face of it, it seems like it should be manageable, but all the
automatic internal working models are activated in these panic stages. ‘I’m
doing this wrong; it is my fault, this feels impossible. These kick in before
the body is pushed into hypo-arousal, a cognitive collapsed empty state that
feels very numb.
It is important to remember that in these moments the predominate
feeling is fright.
People were not on hand to help… as people are barely
smiling or saying hello with the eagerness to adhere to social distancing.
What this virus has brought us is the theme of disconnect.
- Stand apart
- Conflicting views
- Profession isolation – keyworker or not key worker (I’m not saying this shouldn’t happen, I’m just saying it has a consequence.
- Less touch
- Different sense of humour
- Bereaved or not bereaved
- Had the virus, not had the virus
- Working or furloughed
- Loving Boris, hating Boris
- Mask wearer, non-mask wearer
It has reinforced a detachment while maintaining all the
online activity that has no heart.
Amanda approached the self-serve lady that looks after that
area, and checked if she could just walk through, she could. Amanda made it out
into the entrance of the supermarket but one door was closed and a shutter was
down making it dark. The security guards were wearing masks but indicated the way
to exit. Out in the carpark, Amanda didn’t know where she was or where her son
was in the car.
What had just happened to Amanda?
Her prefrontal cortex (the front part of the brain) had gone
offline. She was operating on an automatic emotional processing part of the
brain that assigns emotional memory, but because there is no blueprint for the ‘how
to survive when the world if it is hit with corona virus) she was thrown into
hyperarousal. It is a highly distressing thing to experience and can debilitate
you for days.
So, what can you do to help?
If you see this anywhere at the moment, simply stand 2 metres apart and
say “is there any way I can help you, do you want me to help you with
whatever is wrong?
I have seen tearful people a few times out shopping and I have
asked if they would like me to help.
People are coping, until they are not
coping and in traumatised people that can happen very quickly.
Asking people if they need help is a simple task by you that
can bring connection without physical touch, WE NEED CONNECTION!!
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