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It’s not the event that causes trauma it’s your physiological reaction. For example David and John witnessed a violent pub fight in which two people died, David froze in absolute terror, he felt disconnected from his body, he couldn’t move and he couldn’t respond. He was actually immobilized for more than three hours and he was eventually taken home by a kindly police officer. Once at home he sat alone staring at the wall until the early hours of the morning. Now John also witnessed the violent attack but his nervous system reacted in a very different way, he felt a sudden surge of adrenaline and his muscles tensed primed for action. He ran to the back of the pub and managed to escape via the fire exit, when at home he spent the evening talking to his wife about the event. David and John witnessed exactly the same event but their nervous systems reacted very differently, David developed PTSD and John didn’t. But why? There are constant movements within your inner landscape, salivation, breathing, heart rate, muscle tension, perspiration and so forth. Now they are a product of the harmony between the two branches of your autonomic nervous system the sympathetic which acts as a body’s accelerator and the parasympathetic which is your body’s brake. The sympathetic branch of your nervous system is responsible for the fight or flight response, it’s like the accelerator of a car. So when John ran out of the pub it was his fight or flight response that had primed him for action. His amygdala, his brain’s alarm bell, sent a distress signal to his hypothalamus which activated his sympathetic nervous system. His adrenal glands responded by pumping adrenaline into his bloodstream which caused his heart to beat faster pushing blood to his muscles and other vital organs. The parasympathetic branch of the autonomic nervous system is responsible for rest and digest, and social engagement, think of it like the brake pedal of a car. It puts a brake on arousal by slowing down your heart rate, relaxing muscles and returning your breathing to normal. There’s actually a very simple way you can experience these two systems for yourself, if you take a deep breath in you activate the sympathetic nervous system, when you exhale you activate your parasympathetic nervous system. Now John’s sympathetic nervous system enabled him to get away from the dangerous situation but it was the kind face, soothing tones and physical contact from his wife that brought him to a sense of calm and safety. John received the message ‘you’re safe with me’ which reset his physiology by activating his parasympathetic nervous system. Basically John’s a parasympathetic system opened and then stayed open because he felt safe in his wife’s presence, so the social engagement with his wife helped John’s nervous system reset after the trauma. Now David responded in a very different way, he froze, his nervous system shut down and expended as little energy as possible. This is called the freeze response and it’s the ultimate emergency system. Now during the freeze response the parasympathetic system comes in so strongly that it overwhelms a sympathetic arousal and sends a person into a state of freeze. This can be a full collapse, dissociation or partial freeze such as an inability to think clearly. The freeze response may be momentary such as a deer in the headlights but in humans the freeze response can continue indefinitely. Peter Levine trauma expert and the creator of somatic experiencing maintains that when in the freeze state your energy is tightly activated and doesn’t discharge so your nervous system concludes that you’re still in danger and the symptoms of trauma are born. Unfortunately unless you release the trauma from your body and nervous system you remain stuck in a traumatised state now. Peter Levine often uses a prop to demonstrate what’s going on in the body during trauma, this prop is a slinky, I have one with me today. So the slinky represents your energy and arousal level, if you’re walking around day to day this would demonstrate your energy and arousal level. If you’re running it’s more like this and if you’re in fight or flight mode then your energy is really aroused but when you’re overwhelmed your energy can become locked down in your nervous system and we have the freeze response. Now when this energy doesn’t get released it leads to a whole host of trauma symptoms such as flashbacks, nightmares, feelings of being unsafe, pain and PTSD. So by using this slinky we can see that John mobilised his energy by running away and this was then soothed by talking to his wife, the social engagement system. But David’s energy was locked down, stuck and frozen in time hence his PTSD diagnosis. According to Levine David experienced PTSD due to an incomplete biological process that got locked in his body and nervous system so when completing trauma work with David we need to discharge this energy gradually by the process of titration. So the key is to get a little bit of discharge at a time so a little bit of energy is released and again and again and so forth. So little by little his nervous system resets. How do you release trauma from the body? Levine suggests the bottom-up approach to trauma work which refers to the type of therapy which starts its work at the base of the brain the limbic system this is the part of the brain that’s responsible for the fight flight or freeze response. So the therapist would first facilitate a sense of safety and then use body-based interventions with the aim of releasing trauma’s impact on the body. Now to activate this bottom up process you can use a range of activities such as exercise, rhythmic movement, diaphragmatic breathing, yoga, EMDR and much more. Bottom-up approach is focus on body sensations, movement impulses and emotions, basically these interventions allow you to release the traumatic event from your body and nervous system so you can then relearn how to inhabit your body. By contrast the most prevalent approaches to psychotherapy today are top down approaches such as CBT, a top-down approach involves a therapist working directly with the thinking part of the brain, the prefrontal cortex, the aim of a top-down approach is to change thinking so interventions such as challenging thoughts, socratic questioning and thought records are all top-down interventions. But when someone is stuck in the freeze response they can’t process verbal communication well that’s because they’re prefrontal cortex, the logical, analytical, thinking part of the brain, is offline. Bessel Van Der Kolk the author of The Body Keeps The Score, says: “You cannot do Psychotherapy or psycho-education when people are frozen because when you’re frozen nothing can come into your brain until the frozenness is stopped”. This is why when helping someone come out of the freeze response relying on words alone often fall short. You better off treating freeze with somatic or bottom-up approaches.
00:08:06
Now I’ve already given examples of bottom-up approaches such as diaphragmatic breathing and yoga but equally important is the activation of the social engagement system. According to Polyvagal Theory we all communicate with each other via our social engagement system, facial expression, tone of voice and body language, so by communicating cues of safety we can enable someone to stabilise in our presence and eventually thaw. Remember talking to his wife was one of the key things that helped John move out of the fight or flight response. Sadly David had nobody to talk to which only served to embed the freeze response. Now to find out how the social engagement system can help regulate your nervous system and move you out of the freeze response please view my video on polyvagal Theory which is on the screen now and I look forward to seeing you soon.