Tackling Trauma - More Lessons from "The Body Keeps the Score"

Posted by tonyoverbay

"If you feel safe and loved, your brain becomes specialized in exploration, play, and cooperation; if you are frightened and unwanted, it specializes in managing feelings of fear and abandonment," says Bessel van der Kolk, author of The Body Keeps the Score (https://amzn.to/3QtMBPG). In today's episode, Tony explores what unresolved trauma can look like in adult relationships and what steps can be taken to overcome trauma and rewire the brain for connection. Tony completes the long-awaited part 2 of his review of "The Body Keeps the Score." You can find part 1 at https://www.tonyoverbay.com/how-trauma-impacts-us-all-the-body-keeps-the-score-review-pt1/ 

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Transcript

Tony: So let me take you back to the summer of 1988. Yes. The year that I graduated high school. The top movies, and I had to look these up, “Who framed Roger Rabbit?”, “Coming to America”, “Crocodile Dundee”. Not part one, no, we're talking part two. “Big”, “Willow”, “Diehard”. And music, George Michael topped the charts with “Faith”, INXS with “Need You Tonight” and Rick Astley was never gonna give you up.

So I was a high school senior. I was growing up in Sandy, Utah, and we had a very late winter and the high school baseball season was gonna consist of probably about a dozen games. So much different than where I live now in California where the baseball season can last all year long. So I was actually looking forward to summer leagues and I had been talking to a couple of college scouts and I was really hoping to be able to play somewhere in college.

And then we head out on a senior trip to St. George where I ended up getting run over by a 20 foot dual prop ski boat and cut up both of my legs and that in essence put a little bit of an end to my baseball hopes and dreams. And then on July 31st, 1988, one of my very best friends, Trent Curl, along with his brother Toby, and Trent's girlfriend, Lisa Warren, who actually had been my eighth grade crush and Toby's best friend Jeremy were killed tragically when their car drifted into oncoming traffic on the way back home from a trip to Jackson Hole. Then a couple of years later, I remember vividly receiving a call from my dad that my brother had passed away. I had just turned 21, so that would've made him 24. And now fast forward to just two or three years ago, my daughter, McKinley, my wife, Wendy, and I were preparing to run a half marathon and we were listening to music and I was playing some Jackson Five. Now don't judge, but this is when little Michael is going all in on who's loving you, which reminded me of another version of that song by Terrence Trent D'arby. Now, Trent, my aforementioned best friend who unfortunately had passed away and my best friend Grant and I wore out this CD of Terrence Trent D'arby, I think it was called, “Introducing the Hard Line” and Terrence's version of “Who's Loving You” came on, and I just started bawling. I couldn't stop and it was out of nowhere. And here we are preparing to run this race and I feel like I'm gonna get dehydrated from the amount of tears that are flowing from my eyes. And it was visceral. It was this gut reaction, and again, it just hit me so hard and out of nowhere. And I pictured my friend Trent, the only one of us with rhythm, singing and dancing to that song.

And then just a few weeks ago, my son, his girlfriend, my wife and I were driving back from Vallejo, California. Where my son's college basketball team had played a game and we passed a sign for Mayor Island. Now it's a naval base and it's where my brother died over 30 years ago. And at the time of his passing, I didn't even know where Mayor Island was. But in 1993 when we moved to California, I didn't even realize that I would be an hour and change from where he died. And so each and every time that we drive to the Bay Area, to San Francisco, to the beach, every time we drive through that area and I pass that sign that says Mayor Island, I'm just hit with these memories of my brother. Or even more recently, just a week ago with my family in town for Christmas, we drove up to the scene of an accident. And I immediately just panic and terror just overcame me. And I had my daughter McKinley with me, and I immediately just asked her if she could pull up find my phone and make sure where all the kids were, because that just brought such a horrific feeling and thought of my daughter Alex, and the ordeal that she went through almost a year ago, and the accident that she is going to be recovering from for the rest of her life.

So today we're gonna talk about trauma. And we're gonna be using Bessel van der Kolk's book, The Body Keeps the Score as our guide because as you can see in each one of these situations, the body really does keep the score and it holds on to certain feelings, thoughts, memories, and emotions, and they can come up out of nowhere. So today in keeping The Body Keeps the Score as our guide, I wanna share some information that I think will help you start to recognize how trauma shows up in your life, and maybe more importantly, as well as what to do. So we're gonna talk about that and so much more coming up on today's episode of the Virtual Couch.

Hey everybody. Welcome to episode 356 of the Virtual Couch. I'm your host, Tony Overbay. I'm a licensed marriage and family therapist and host of the Waking Up to Narcissism podcast as well, which I would encourage you to go listen to this week. You're probably gonna get this Virtual Couch episode on a Wednesday, and my plan on Friday is to release an episode with an amazing woman named Ashley Boyson and she has a very popular Instagram account called The Moments We Stand and I feel like for some reason, I want to say spoiler alert, but I feel like in this day and age, a quick search, a Google search on anybody can find out what the story would be, but she tells a pretty harrowing story of feeling like everything in her life was going perfectly. Five kids, a dream home, her husband's an attorney, and just things had seemed off, but she had been overlooking a lot of red flags. And in the episode we talk about turning red flags yellow. But eventually she learns to find out that he was murdered. And I will leave it there, but it's just not even what you would probably think there and it's one of the first guests, I think when I was doing a little bit of digging before the episode where I could have watched the Dateline NBC of her, or I think maybe the true crime report or the forensic files. But she's an amazing woman with an amazing story and is really doing some great work and helping others go through tragedy and go through trauma.

And that leads a little bit into what we're talking about today. We are talking about trauma and before we jump to the episode, then please just sign up for my newsletter. I think I'm just going down that path. Just go to tonyoverbay.com and sign up for the newsletter and you will not get inundated with information. As a matter of fact, I just haven't put one out for a little while. There's a goal to be more consistent with that, but there's just a lot coming here in 2023. There are a few new podcasts. There's still the magnetic marriage subscription based podcast where you're gonna hear real coaching. There's a revamp, an upgrade to the magnetic marriage course that is coming. And now the course is different from the workshop. If you go to tonyoverbay.com/workshop, there's a $19, everything you didn't know, you didn't know about your marriage and how we show up in marriages and relationships. And that is still available. Again, that's $19 money back guarantee. And that's at tonyoverbay.com/workshop. And I still have the Path Back Pornography Recovery Program and there's actually a discount going for the month of January on that, but act fast. And my social media team, the Amazing Yeah Yeah agency has put some things together there and you can find that on my Instagram account, which is Tonyoverbay, underscore LMFT. And you can also go to Tony Overbay Licensed Marriage and Family Therapist on Facebook. And I'm there on LinkedIn and other places like that as well. So just go find those things and you'll see a lot more content and information about the things that are coming. The most exciting thing though, is a True Crime podcast that I've done with one of my daughters, and it's one of my daughters that has not been on the show. And she's amazing. She's hilarious, and she is a true crime fan. And so she has brought in a very big case from the past. There's a Netflix documentary made of it, and we're gonna talk about that for a few episodes. We've already got those filmed where she's gonna bring the facts of the crime, and I'm gonna talk as much therapy and psychology as I can, and we plan on doing this on a regular basis. So if you go to tonyoverbay.com and sign up for the newsletter, you're gonna find out a lot more about that when those things come out.

So today I want to get to trauma and I'm going to refer to a document and now I look back on this and I did an episode a part one episode on The Body Keeps the Score and it was back in episode, oh, I had the notes, but it was in the 200 and twenties I think. So we're at 356 now. So we're talking a couple of years ago is when I did this and I did something that I do on occasion where I finished that episode, I got through a little bit of the notes that I had on The Body Keeps the Score, and then I looked back at the transcript and I said, okay, we're gonna do a part two, probably a part three, maybe even a part four. Stay tuned. So here we are two years later. Let's get to part two.

But, I also want to share that the notes that I'm referring to, and I believe I shared this back two years ago. I found an amazing, just an amazing book review of The Body Keeps the Score. So I listened to the audio book and it really is, it's a game changer. I know that gets used an awful lot, but the book, The Body Keeps the Score by Bessel van der Kolk is, I feel like a little bit of the bible of trauma in a sense. And this is someone's notes, 10 pages worth of single space notes. And they have just made this available on the internet, but I could not find who created this 10 page document of notes and so I'm gonna refer to that and all credit goes to this unnamed person, but I wanna read the summary that they did and then we're gonna jump down into more of where we left off in that part one.

So I'm gonna jump down into just really getting into more of the, what do we do about trauma? But here's what the person said about their book club notes on The Body Keeps the Score. They said, “My top takeaways from The Body Keeps the Score is that there are many different types of trauma that a person can and most likely will experience during their life, from childhood abuse and or emotional neglect, to an auto accident, war, a terrorist attack, or sudden death of a loved one. Much of trauma is a normal, albeit, uncomfortable neurological response to a dangerous situation, and so once a person experiences a trauma on a subconscious level, their brain, again, on a subconscious level, begins to not only organize their worldview, but also create actions around their response to those traumas in an attempt to keep them safe. So this can lead to a lot of problematic behaviors if the person is trying to numb out or escape from remembering what happened. Or it can lead them to feeling crazy because we are unable to numb out and feel stuck in a state of being hyper aroused, such as feeling chronically anxious or on edge or chronically hyper-vigilant about people and places and things.”

And that might not even seem like it's related to our trauma. So if you are someone that just runs more anxious in general, or somebody that is more depressed than normal or usual. These are things that I feel like, especially as a therapist, that it can be really good to go in and talk through, because a lot of times these things can just be responses to trauma. And trauma, and I love how this person lays that out, that it can be everything from the things that we often think of, childhood abuse, but it can also be emotional neglect. It can also be accidents, car accidents. But that part about emotional neglect, and this is something that I talk so much about on this podcast, is I really feel like we can bless all of our parents' hearts, but I just feel like it's almost impossible to get that right, meaning parenting, because, and I overuse this very simplistic example, but if a seven year old kid asked for a pony for their birthday and they don't get the pony, they don't say, yeah, that was a pretty big stretch because we live in an apartment and there's no room for a pony. The seven year old said, I would like a pony, please. And so in their mind, they have concocted some version of a reality where who knows, maybe they're gonna keep the pony in the bathroom, or maybe they'll just take it out for walks. I mean, people have dogs. Why not a pony? But they've created some sort of narrative that is gonna make sense. So then when they're not given that pony, then they don't just say, yeah, I understand that didn't make a lot of sense. Maybe we don't have the financial means for a pony. And where will we put a pony? In their mind they think, oh, my parents don't like me because I asked for a pony and I didn't get it. Now that's again, oversimplified, but when we really look at the concepts around what abandonment feels like as a kid, it's that we come out of the womb and we utter a small whimper and everyone jumps to attention and takes care of us. And so that's our factory setting. And that's the way that we survive, is that we express our needs and then when we're young, people meet our needs. And as we get older and we start to just go through life, everybody isn't jumping up and down to meet our needs. So then we make these pretty big demands or requests and people don't respond.

Then we can start to feel like what's wrong with me? And we have this default programming of shame because it must be because people don't love me, that I didn't get the pony for my seventh birthday, or that I don't get to eat candy corn for every meal. I mean, it is corn. The word corn is there, so what's the big deal? And so trying to make sense of things when we're a kid, when we don't even know what is going on, in essence, can lead to those deeper feelings of abandonment, which then leads on into that world of attachment. And attachment is what do I have to do to get my needs met? Do I have to be incredibly hilarious and funny? Do I have to be the athlete that gets everyone to notice me? Do I need to be the one who just keeps the peace in the home, or do I need to be the one that always gets bad grades and so everybody puts their attention on me? So there's so many different roles that we almost slide into in order to get our needs met, and we wanna get those needs met because we feel like if we don't get those needs met, we're gonna die.

And so emotional neglect can also feel like trauma. So now all of a sudden we come into our adult years, and if we were that person that was in charge of managing everybody else's emotions, and that was the way that we got our needs met, or that's the way we were noticed or seen, or the way that we felt validated, then we can bring that into our adult relationships. And all of a sudden when everybody is just doing their own thing comes the feeling of trauma or what it can feel like to be, you can be, nobody cares about me, or I'm unlovable. And I feel like if you go back through these Virtual Couch archives in a sense, there's so much that I feel like we've discussed over the last year or two about different things from everything from attachment styles, I mean, look at that concept around an anxious attachment. Here's somebody that, as a kid said, oh, I want love. I really desperately want love. But if their parent, and again, this is a, bless their parent's heart. If their parent is saying, hey, not right now, champ, I got a lot going on. Or, you know, this TV show's about to start, or, I'll get to you later tomorrow. Or, hey, actually you're fine. Don't worry about it. If things aren't really as big of a deal as you think they are, then when the kid is saying, hey, I need connection. I need to know that I matter. And then, again, even when they're doing their best is saying, hey, not right now. But then if the parent all of a sudden is feeling down, sad, and says, man, I really want to feel like I'm a good parent, and they go to their kid and say, hey, come give mom or dad a hug, or, you know, I love you. Right? Or do you see all these things that we're doing for you? So then when the kid maybe isn't necessarily looking for somebody to be there for them, but the parents saying, I'm ready. Come over here, gimme a hug. So we almost have this mixed view of attachment. So now all of a sudden we get into our adult relationships and we say, the only thing I want in life is to be loved. And then someone focuses that bright spotlight of love or attention onto us, and all of a sudden, we feel like, I don't really know how to do this. I mean, this is what I want. And so now we're looking for that external validation and we're telling the person that we've desperately wanted to love us. Well, not that way, maybe do it a different way. 

So we bring all of these traumas, and that may sound like a big word, but for today we're gonna use trauma a lot. But we bring those traumas into our adult relationship. And that's why I feel like this book, The Body Keeps the Score, just hits on so many different levels because then, again, we're talking about everything from childhood abuse, and we can have sexual abuse, physical abuse, but we're also getting into that emotional neglect. And I feel like that is more probably common of a form of trauma that I see in my office than the physical or the sexual abuse. So the author of this paper again says, “We begin to organize on a subconscious level, things into our worldview, and we create actions around our responses to these traumas and in an attempt to keep us safe, but it can lead to a lot of problematic behaviors if we're trying to numb out or not remember what happened. We can feel crazy because we're unable to numb out and we feel stuck in the state of being hyper aroused, feeling chronically anxious, on edge, hyper-vigilant. And we may not even recognize that these are things that are related to trauma,” and they say, “while there is a lot of emotional and physical pain associated with trauma, we can overcome it.”

There's the big takeaway that we're gonna get to today, and this is why this book is so incredible because it gives solutions on how to overcome it. And I feel like as so many things with mental health, the exact opposite of what we're probably doing the most of right now, such as running away from our feelings, thoughts, and, emotions and dealing with them later are feeling like they aren't as big of a deal as we think they are, not the greatest idea for dealing with or processing trauma. So I'm gonna give you some tips on how to deal with that today. So they go on to say that, yeah, “So while there's a lot of emotional and physical pain associated with trauma, we can overcome it. This is done by understanding that what we are experiencing is largely neurological and that we aren't crazy or somehow beyond help. That once we bring awareness to our feelings and our actions and we see them as more of a defense mechanism than something that makes logical sense, then we can start to regain control of our brain, our body, and our life.” So when you start to just look at this, and I love it, it's an acceptance and commitment therapy model of check this out, look at how I'm behaving, that's interesting. So based on these situations, these circumstances that I'm going through at this very moment in time, here's how I react. Because when you can take yourself out of that moment, see yourself in the context of that moment, then we can start to look at, what is the trauma maybe that has led to that response in that moment?

So, the person said, “The big gift in trauma is self-awareness, but it's a gift that we have to work hard at unwrapping,” but then they say, “but boy, is it worth it.” So they go on to say that they hope you enjoy this book as much as I did, and my notes are below. So thank you person who created all of these notes, and if you want a quick recap on the first part of the book, then I do, I highly recommend that you go check out episode 220 something or 200 and something. I'll put a note, I'll put a link to the episode in the show notes. But that's the first part of this episode on trauma. 

So where I'm gonna jump in is we left off on the other episode talking about trauma being misdiagnosed and mistreated and talking about the diagnostic criteria for trauma, so I'm gonna jump into this person's notes right after that trauma is largely neurological, so that's what we talked about a little bit in the opening. So when people are really upset, they often feel like they are losing their mind. Now in technical terms, they're experiencing the loss of their executive functioning. You might hear this from time to time, this loss of executive functioning, because that's a big part of other things such as Asperger's or some of these disorders. And the loss of executive functioning is, in essence the loss of being able to, that executive functioning area is the area where we make sense of things. It's often called our rational brain, our logical brain. So, the brain on trauma. The limbic brain and the visual cortex show increased activation and the speech center shows markedly decreased activation. So the more intense that our emotions are, it activates that amygdala, our fight or flight part of our brain. And so then our rational, our cognitive brain, and I love how Bessel van der Kolk says that our rational cognitive part of the brain is the youngest part of our brain, and it only occupies about 30% of your skull. And its primary concerns with the world outside of us are understanding how things and people work and figuring out how to accomplish goals, manage our time, and then sequence our actions. And I love how he says that's the youngest part of our brain, so intense emotion and this, hyperactivated amygdala, the fight or flight response, now that's the old guard, the OG, that's been there forever, that's there to protect us. So it's this newer part of the brain is the one that says, okay, I think we're safe now, what do you wanna do? And so Bessel van der Kolk says, “The brain is built from the bottom up. So the most primitive part, also known as the reptilian brain, is located in the brainstem just above the place where our spinal cord enters the skull.” And that reptilian part of the brain is responsible for hunger and thirst, pain, breathing, pretty important, ridding the body of toxins, meaning urinating, defecating, poo poo, pee pee jokes. Uh, anybody as a dad that's getting older. The brainstem, the hypothalamus, which sits directly above it, controls the energy levels of the body. 

So again, we've got this very base version of the brain that is eat, drink, pain, react, emote, breathe, poop, pee. And from there we get right above that, the hypothalamus that controls the energy level of the body and it coordinates the endocrine and immune systems and keeps the internal balance that we know as homeostasis. So we go right up from the reptilian brain and we've got the limbic system, or they call it the mammal brain. This is the seed of emotions. This is the monitor of danger, the judge of what is pleasurable or scary, the arbiter of what is or is not important for survival purposes. So the limbic system is shaped in response to experience. So the more that you do, the more that you think and feel, that shapes the limbic system. Again, this mammal brain, so that in partnership with the, you know, as an infant, your own genetic makeup and your inborn temperament, those are what starts to shape what it feels like to be you. So, this limbic system, so that's when I talk about nature and nurture, birth order, DNA abandonment, rejection. Now we're talking limbic system. And so whatever happens to a baby contributes to the emotional and perceptual map of the world that it's developing and that its brain creates. This is where he says, “Neurons that fire together, wire together.” Also known as neuroplasticity. And that's not something that's just set in concrete at birth or at age three, or five, or 12, or 19 or 25.

We've got more and more data that say that the neurons that fire together, wire together, throughout your life. So now if you feel safe, you feel loved, then your brain becomes specialized in exploration, play, cooperation. But if you're frightened, if you feel unwanted, then it specializes in managing feelings of fear and abandonment. So in the book, The Body Keeps the Score, Bessel van der Kolk says, “The emotional brain equals the reptilian brain and limbic system.” So the emotional brain is at the heart of the central nervous system, and its key task is the lookout for your welfare. If it detects danger or there's any special opportunity that you need to be aware of, it alerts you by releasing a little dose of hormones, and the result is a visceral gut sensation, ranging from feeling a little bit queasy to the grip of panic in your chest, and it will interfere with whatever your mind is currently focused on, and it'll get you moving physically and mentally in a different direction. So now, well-functioning frontal lobes are crucial for a harmonious relationship with our fellow human beings. So without flexible, active frontal lobes, people become creatures of habit and their relationships start to become superficial and routine. And then he talks about invention, innovation, discovery, and wonder. They're all lacking when you are just trying to survive. And I see this so often. If I go into the people that are in emotionally abusive relationships and I talk about it, I like to call it, it's a waste of emotional calories and emotional energy when somebody is continually just trying to manage their feelings and emotions and regulate their safety when they're in a relationship with a significant other. Where when people feel safe, then they are free to explore, to play, to be cooperative, and when that is the what it feels like to be you on the inside, then you're more open to invention, innovation, discovery, and wonder. But when you are in this, I have to protect myself, then we never get to those things and it never becomes a, you are the best version of you. So, those frontal lobes, let me go over that quickly. Bessel van der Kolk says, “Our frontal lobes can also, but not always, stop us from doing things that will embarrass us or hurt others. We don't have to eat every time we're hungry or blow up every time we're angry or kiss anybody who arouses our desires,” but he says that, “it is exactly on that edge between impulse and acceptable behavior where most of our troubles begin.” So the more intense that visceral or sensory input from the emotional brain, the less capacity that the rational brain has to put a damper on it. So if you think about that, if you are one who falls prey to impulse on a regular basis, if you can start to see where I'm going here, you can start to relate that to trauma.

And I'm not saying, okay, now, you know, oh my gosh, we gotta dig in there and rewire your entire brain. But sometimes just being aware that, oh, I am a bit impulsive and I get right between that edge of impulse and acceptable behavior. And that is where my trouble begins. And so that visceral or emotional brain, if it is very impulsive, that most likely that's there to protect me for some reason. All of a sudden I feel like I have to impulsively act on something, or maybe I'll never get another chance to do that again, or that's the only time that I feel this sense of adrenaline or rush. So just being aware of that often is part of this road to recovery. So he says, “Past trauma and the ongoing threat perception system of the brain, it affects people's current reactions.”

So this amygdala, the fight or flight part of the brain makes no distinction between past and present, once it's triggered, even if the trigger isn't the same as the original trauma, then your brain is still gonna say, oh, I'm triggered. And it's not trying to say, yeah, but this one doesn't seem as real. So in the book he talks about the challenges, not so much learning to accept the terrible things that have happened, but learning how to gain mastery over one's internal sensations and emotions. Sensing the feelings and the emotions, naming the feelings and the emotions, and identifying what's going on inside of you is really the first step to recovery. And let me talk a little bit about the amygdala and then I'll get away from the brain here and we'll talk more about, I wanna hit a little bit on this concept of mirror neurons, but the amygdala's really important. It's important that our amygdala is working correctly. Bessel van der Kolk says “It's like a smoke detector for danger, we don't want to get caught unaware by a raging fire, but we also don't want to get into a frenzy every time we smell smoke.” So we need to be able to detect whether somebody is getting upset with us. But if the amygdala goes into overdrive, then we may become chronically scared that people hate us or that we feel like they are out to get us.

So our amygdala means well, but if that panic button is stuck on, then that can be something that we're gonna need to work through. And so therapy, and I love that Bessel van der Kolk talks about this, “Therapy only works if a person is grounded in the present moment,” you know he says, can feel their butt on the chair, see the light coming through the window and feel calm and safe. So, “being anchored in the present while revisiting the trauma, that's what opens up the possibility of deeply knowing that the terrible events belong to the past.” And this is one of the most powerful things about talk therapy. And I know that this is so powerful. I see it on a daily basis that when somebody can sit there and they are grounded and they are able to talk and express these feelings and emotions and tell these stories from the past or even things that are going on in the present, or their fears of the future and they can talk about those and express those in a way that is safe and have somebody there that is not trying to tell them, well, why didn't you do this? Or you should do this instead. But when somebody is really there and saying, and then what happened? And tell me what that was like, and how did you feel? That all of a sudden we're grounded, we're anchored in that moment, and we're able to express something scary and we feel safe. And that's starting to rewire or change the neuropathways of the brain. So again, therapy works when somebody's grounded, they're in that present moment. So being anchored while revisiting trauma opens that possibility of deeply knowing that the terrible events belong to the past. If a person's in a flashback or they don't feel calm or safe, if they start to feel defensive or aggressive, and feel unsafe or not believed, then therapy doesn't work and at best it can make a person almost re-traumatized. And that's the part where if, and I'm not trying to say that as a knock on therapist, but I'm trying to say that as a bless the heart of your friends, that if we start to open up about trauma to those and you do not feel believed and you do not feel safe, then again, not only does it not work as a way to help heal, but it can make you almost feel re-traumatized because there's somebody that doesn't believe you.

So I said I would move away from the brain after the amygdala, but Bessel van der Kolk has a great way to talk about the thalamus. “So our thalamus is like a cook. It takes information from all the senses, and then it blends it with our autobiographical memory. So breakdown of the thalamus explains why traumas are primarily remembered not as a story with a beginning, middle, or end, but as isolated sensory imprints, images, sounds, physical sensations that are accompanied by intense emotion, usually terror and helplessness.” And so in the book, the Buddha Brain, the author talks about the mechanisms of memory. And the way that memory works is such an interesting thing where we conjure up an image and then we fill in all the gaps. And it's a more productive use of neural real estate, I believe, the author Rick Hansen said. But that's where we start getting into this concept of confabulated memory, where every time that we recall a memory, then we're gonna fill in the gaps with different details. And then when we put that memory away, now that's the new confabulated memory. So in normal circumstances, Bessel van der Kolk says the thalamus also acts as a filter or a gatekeeper. So he says, “This makes it the central component of attention, concentration, and new learning, all of which are compromised by trauma.” So people that have PTSD have their floodgates wide open, they lack a filter, and they're on constant sensory overload. So in order to cope, they try to shut themselves down and they develop tunnel vision and hyperfocus. And if they can't shut down naturally, they may enlist drugs or alcohol to block out the world. And the tragedy is that the price of closing down includes filtering out sources of pleasure and joy as well. It's as if the brain has to do all or nothing thing, because it's so fearful or afraid of trauma. And Bessel van der Kolk talks about mirror neurons. This is a really interesting concept that there's a belief that these mirror neurons could be the key to all kinds of things in the future. Mirror neurons explain empathy, imitation synchrony in the development of language. “Mirror neurons,” he says, “are like neural wifi. We pick up not only another person's movement, but their emotional state and intentions as well.” So when people are in sync with each other, they tend to stand or sit in similar ways. Their voices take on the same rhythms, but mirror neurons also make us more vulnerable to others' negativity, so that we respond to their anger with fury or we're dragged down by their depression. And because trauma almost invariably involves not being seen or not being mirrored and not being taken into account, then treatment for trauma needs to reactivate the capacity to safely mirror and be mirrored by others, but also to resist being hijacked by others' negative emotions. And he talks about two ways to implement change.

So now we're talking top down or bottom up. “So structures in the emotional brain decide what we perceive as dangerous or safe. There are two ways of changing the threat detection system from the top down,” which he says, “is through modulating messages from the medial prefrontal cortex.” What does that mean? Mindfulness, meditation, yoga. So from the top down, being able to just have that pause and bring in information in a much more calm way. Or he says, “From the bottom up through the reptilian brain, through breathing, through movement, and through touch, which helps recalibrate your autonomic nervous system.” And he goes into a lot of detail about the autonomic nervous system as well as the sympathetic nervous system, the parasympathetic, I'll talk about those two because people have really clever things that they remember with the sympathetic nervous system and the parasympathetic nervous system.

So the sympathetic nervous system acts as the body's accelerator. It includes the fight or flight or what Darwin referred to as the escape or avoidant behavior. Functions with the use of emotions. The parasympathetic or PNS works against emotions and it promotes self-preservation. So functions like digestion, wound healing, exhaling, that helps to calm us down. So, you know, inhaling helps to activate adrenaline. Exhaling helps us to calm down. So you can access your whole, you know, the sympathetic and parasympathetic are part of this autonomic nervous system, and you can access those through breathing, movement, touch. I mean, breathing is one of the few body functions under, it's underneath both conscious and autonomic control. There's a neuroscientist named Paul McClain. He compares the relationship between the rational brain and the emotional brain to that between more or less of a competent rider and his unruly horse. “So as long as the weather is calm and the path is smooth, the rider can feel like they are in excellent control. But then unexpected sounds or threats from other animals can make the horse bolt. So then forcing the writer to hold on for dear life.” So likewise, when people feel like their survival is at stake, or they're seized by rages, longings, fear, sexual desires, they stop listening to the voice of reason. And it makes little sense to argue with them.

 Sometimes this is that, I think I did an episode long ago on the passenger and the rider, and so it's that same thing. So the rider can be in excellent control. You know, the rider is that rational brain. And then the emotional brain is the animal that is being ridden. And then if that animal is spooked, so to speak, that emotional brain, then it can just take off. And that rational brain is literally hanging on there for dear life. So a person who has been in anger management classes, for example, maybe seven or eight times, might extol the virtue of the technique by saying they are great, they work terrific, but then they find out, as long as you're not really angry.

When our emotional and rational brains are in conflict, for example, when we're enraged with somebody that we love or frightened by somebody that we depend on, or we lust after somebody who is off limits, then a tug of war ensues and it gives us a visceral experience. Our gut, our heart, our lungs, they will lead to both physical discomfort and psychological misery. And then the next component that he talks about is adrenaline. So insults and injuries are remembered, the best because the adrenaline that we secrete to defend against potential threats helps us to engrave those incidents into our minds. So how crazy is that? So even if the content of the remark fades, our dislike for the person who made it usually persists. So that adrenaline is a pretty neat thing except for when it's not. So when, when that adrenaline is flowing, you know, and it's there to defend us against potential threats, it's saying, hey, don't forget this guy. And so now you all of a sudden almost have this anchored memory that I don't know if I'd like that person very much. So then when something reminds traumatized people of the past, their right brain reacts as if the traumatic event were happening in the present. But because their left brain isn't really working well at that moment, they may not be aware that they are re-experiencing and reenacting the past.

Because to them, they're furious, they're terrified, they're enraged, they're ashamed, they're frozen. And after that emotional storm passes, then they might look for something or somebody to blame it on. Well, look at what you made me do, and if we're honest, I think most of us have blamed others for our behavior from time to time. But hopefully once we cool down, hopefully we can admit mistakes. But trauma absolutely interferes with this kind of awareness, and that's what I talk often about over in the world of emotional immaturity or narcissism, that it really is, it's a response to childhood trauma where somebody is left without a real sense of self needing external validation and lowered empathy because that trauma interferes with our awareness, people don't experience trauma in the same way. So not everybody experiences trauma in the same way. Some are on hyper alert, some go numb and have decreased activation, blank stares, absent minds. Those are the outward manifestation of the freeze function and so much of how we react to trauma, which survival mode we go into as adults, is how we learn to react to trauma as children. If we numb out as kids, we might numb out as adults, and if we went into fix it mode as kids, or if we had to get our needs met, we had to go juggle or clean the house, we might do that stuff when we're older as well. But after trauma, then many people are either hypervigilant or they're numb. So if they're hypervigilant, then they can't enjoy the ordinary pleasures that life has to offer. And if they're numb, then they have trouble absorbing new experiences, or they may not be alert to signs of real danger. And what Bessel van der Kolk talks about is when that amygdala, what he calls malfunctions, “People no longer run when they should be trying to escape, or they no longer fight back when they should be defending themselves.”

So it can be really challenging to help people deactivate these defense mechanisms that once ensured their survival. So the key about working with trauma is it's not about stopping a behavior like yelling, it's about deactivating a defense mechanism that leads to that yelling. So, to sum this up really quick, it says four main points to know about trauma. “People are patients, but their participants and their healing, and they need to restore their autonomy. Victims of trauma continue to be there instead of here.” So when somebody is in their trauma response, they're there, not here and we need to get them back to here. And you can only be fully in charge of your life if you acknowledge the reality of your body and you're aware of all of its visceral dimensions. And then he also says that “People who suffer from flashbacks,” and I think the vast majority of us do in some form or fashion, maybe that sounds like a dramatic concept, but it's not, “often consciously or unconsciously organize their lives around trying to protect against them.” And this is where I feel like the concepts around we're trying to manage our own anxiety and we do that often through the control of others or trying to control our own environment where in reality when all we're trying to do is control ourselves or others, the truth is there's a lot of disorder or there's a lack of control in the world, and that's where acceptance can come in.

And acceptance can be scary, especially when our body is trying to protect itself by gaining control. So again, they organize their lives, trying to protect themselves. They might work out trying to be strong enough to fend off an attacker or numb themselves with drugs to try to cultivate an illusionary sense of control in highly dangerous situations like bungee jumping and skydiving. Fighting unseen dangers is exhausting and it leaves people fatigued and depressed and weary. And so if the elements of trauma are replayed over and over, then the accompanying stress hormones engrave those memories even more deeply. Again, the neurons that fire together wire together, and all of a sudden then ordinary day-to-day events become less and less compelling. Not being able to deeply take in what's going on around you, it can make it impossible to feel alive. And it becomes really difficult to feel the joy as well as the aggravation of ordinary life. It can be harder to concentrate on the tasks that are in front of you if you're not feeling fully alive in the present. You know? And when you're not, Vessel van der Kolk says, “Not being fully alive in the present, it keeps you more firmly imprisoned in your past.” So there's a lot of different responses to trauma. It can be everything from frantic to collapse. It can be focused, it can depend on your level of danger, but he says that angry people live in angry bodies. That the body of trauma victims are tense and defensive until they find a way to relax and feel safe. And one of the best ways to do that really is to begin by describing physical sensations that are beneath those emotions. The pressure, the heat, the muscular tension, the tingling, the caving in, the feeling hollow. And then work on identifying sensations that are associated with relaxing or pleasure. You know, part of the job as a therapist is to help people become more aware of literally their breathing, their gestures, their movements, paying attention to subtle shifts in your body, such as tightness in your chest or gnawing in your belly, or especially when you talk about negative events that sometimes people claim, well, no, that those things aren't a big deal. The most natural way for human beings to calm themselves when they're upset is by clinging to another person. But this is hard if the person was physically or sexually violated, because they often then are terrified of bodily conduct.

He talks about the power of hitting rock bottom. I think about this often that rock bottom truly is this principle of hindsight. But he says, “Therapy often starts due to some inexplicable or problematic behavior. Not sleeping or eating, fear of others, partner cheating, jumping into the fix of the problem is not the solution. It takes time and patience to allow the reality behind these symptoms to reveal themselves.” So you can't just jump in there and fix something in a session or two, but starting to be aware and knowing that I think I want to get some help is a huge step. And he says, “Many traumatized people find themselves chronically out of sync with the people around them and many find comfort in groups where they can talk about what happened to them with others who have gone through things that are similar.” This often helps alleviate this sense of isolation, but usually at the price of having to deny their individual difference or isolating oneself into a narrowly defined victim group can promote a view of others as irrelevant or at best dangerous.

Which eventually only leads to further alienation. So a lot of times people then stay away from these groups or people that have had similar experiences because their brain tells them stories like, well, I just don't wanna get in there and just complain all the time. And I feel like that's an adorable story that your brain is telling you to keep you away from the unknown, when in reality that unknown is what can heal you. If relationships with people don't help, relationships with other mammals can, animal therapy, it's very real. But talking through things is really important. Sigmund Freud saw or thought that the lack of verbal memory is central and trauma, and that if a person does not remember that he is likely to act it out. I thought that was such a deep thought. Freud said he reproduces it, not as a memory, but as an action. He repeats it without knowing, of course, that he's repeating it. And in the end we understand that this is his way of remembering. As early as 1893, there was a study called The Talking Cure, Freud's and Brewer, the individual hysterical symptoms immediately and permanently disappeared when we had succeeded in bringing clearly to light the memory of the event by which it was provoked. So when the patient had described what that event was in the greatest possible detail and had put that affect into words. So there needs to be, this was a quote from that study. “There needs to be an energetic reaction to traumatic events. And if there isn't, the affect remains attached to the memory and cannot be discharged.” Tears and acts of revenge are how most people discharge their trauma. So if people don't consciously remember, they react. So if you've been hurt, you need to acknowledge and learn how to name what happened to you. 

I'm gonna wrap this up with a couple more things real quick here. In 2002, Dr. Spencer Eth interviewed 225 people who had escaped the Twin Towers. And when asked what had helped them recover the most, the survivors credited acupuncture, massage, yoga, and EMDR, in that order. And massage was particularly helpful among rescue workers. So the survey suggested that most helpful interventions focused on relieving the physical burdens generated by trauma. So trauma makes people feel like either somebody else or like nobody. And people often lose their ability to speak. And in order to overcome trauma, you need to help get back in touch with your body and with yourself because our sense of ourselves is anchored in a vital connection with our bodies. We do not truly know ourselves until we can feel and interpret our physical sensations. And we need to be able to register and act on these sensations to navigate safely throughout life. So if you are unaware of what your body needs, you can't take care of it. If you don't feel hunger, you can't nourish yourself. If you mistake anxiety for hunger, you may eat too much. And if you can't feel when you are full, you'll keep eating. So this is why cultivating this sensory awareness is such a critical aspect of trauma recovery. Traumatized people need to learn that they can tolerate their sensations, that they can befriend these inner experiences and they can cultivate new action patterns. And that's done through everything from talk therapy to yoga, to, as you mentioned, everything from massage and emdr.

But moving forward into healing, no one can treat away abuse or rape, molestation, or any other horrendous event and what has happened can't be undone, and that's not said in a negative way, but what can be dealt with are the imprints of the trauma on the body, the mind, and the soul, so that crushing sensation in your chest that you may label as anxiety or depression, the fear of losing control, always being on alert for danger or rejection, the self-loathing, the nightmares, the flashbacks, maybe the fog that keeps you from staying on task or fully engaging in what you’re doing. Or being unable to fully open your heart to another human being. Trauma robs you of the feeling that you are in charge of yourself. So the challenge of recovery is to reestablish ownership of your body and your mind, and to feel what you feel without becoming overwhelmed or enraged or ashamed or collapsed. So for most people, there's four things. Finding a way to become calm and focused. Learning to maintain that calm in response to images or thoughts, sounds or physical sensations that remind you of your past, or finding a way to be fully alive in the present and engage with the people around you and not having to keep secrets from yourself, including secrets about the ways that you've managed to survive.

And one of the key things of doing this is finding yourself around safe people and also finding out things that matter to you. It goes back to are you acting in accordance, in alignment with your values or are you living a life full of socially compliant goals or doing things that you feel like you're supposed to do or you'll let other people down? Because that feeling that I may let someone else down can absolutely be tied back to some childhood trauma because you're responsible for you and the best way to find out who you are is to start to take action on things that matter to you and see where that takes you. So, welcome to the world of trauma recovery.

If you have questions, thoughts, or any other things that maybe we can address in future episodes, then send me a note contact@tonyoverbay.com or through my website or comment on the post that will go up about this on my social media feeds on Instagram. I would love to get your opinions because trauma can absolutely be overcome, but the exact thing that we often are afraid of, of talking about it and I hope you heard that part where needing to be able to talk about it with people that do feel safe, can absolutely help you move through and pass trauma, and be able to invite it to come along with you while you start to take action on things that matter. And then you really start to find yourself and live this more purposeful, intentional, value-based life. And that's an amazing place to be, rather than wasting all of your time in emotional calories and energy trying to manage your emotions, manage your anxiety, or control your environment. All right, send me your questions and we'll see you next time and taking us out per usual, the wonderful, the talented Aurora Florence with her song, “It's Wonderful”. We'll see you next week and have an amazing time. See you next week on the virtual Couch.

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