It's Not Surprising That You Are Still Not Done with the Accident

Richard, not his real name, was anxious to photograph the deer that he had been tracking all morning. The boulder nearby looked like the perfect place where he could scan the field. That thought was the last he remembered. With one misstep, he felt himself tumbling over the rock and dropping eight feet onto the ground. For a few minutes he was too shocked to realize what had happened; then the excruciating pain in his shoulder caused him to scream. For months, he repeatedly reviewed the events that led up to his fall. He believed that if he understood how it had happened, the pain that should have gone away by now, would finally subside.

CHOOSING AN EFFECTIVE TREATMENT

Recovering from a traumatic event can seem like a long path to health. Often what we want most is to “move past” it, to be done with it, and to not think about it ever again. To these ends, we want to choose a path of recovery that will cost the least in heartache and misery. Knowing how the brain is affected by traumatic events can help us feel more confident that we are choosing a path of recovery that will help us feel better faster.

HOW DOES TRAUMA HAPPEN?

Trauma happens when the body does not get to complete one or more of the biological survival steps that happen when we face a threat. Regardless of the nature of the threat, the nervous system is designed to go through five basic biological steps. These are:
1. Stop and startle
2. Scan the environment to locate the threat
3. Evaluate the situation to determine if it is dangerous or life threatening
4. Fight or flee if the situation is dangerous; freeze if the threat is life threatening
5. Release any residual energy and rest

HOW DO THESE BIOLOGICAL STEPS CONNECT TO THE BRAIN?

Incomplete Biological Steps

When one or more of the biological steps does not get to complete, the body functions, which happen automatically and outside of our conscious control, can shut down or become impaired. This means that the autonomic nervous system may not be able to generate energy when we need it or calm us down when our systems get too revved. We may no longer think clearly or interact in a cooperative manner with others. Some symptoms that result are poor sleep, digestion and libido; impaired oxygen delivery to the brain; numbness; depression; anxiety; increased heart rate; extreme cautiousness; and physical or emotional defensiveness.

The Role of the Brain in Trauma

3 Sections of the Brain

The autonomic nervous system is controlled by three sections of the brain. By understanding what each section does, we can find ways to “talk” to each and thereby give the body a chance to complete the biological steps so that trauma symptoms significantly ease or disappear.

Reptilian: The oldest part of the brain located above the spinal cord is the reptilian brain. If we perceive the threat as life threatening, this part of the brain makes us freeze; this helps us to hide, avoid bleeding to death or look as though we are dead so we don’t stimulate another’s aggression. Our energy gets saved for later when we feel safer to move.

Limbic: Sitting above the reptilian brain, the limbic brain organizes our body to fight the threat or to run from it. While the reptilian brain is like the foot on the brake of a car, the limbic brain acts as the accelerator. This section allows us to take action for defense.

Neo Cortex: The last part of the brain to develop is the neo cortex. Situated above and surrounding the other two sections, this section fine-tunes our ability to be in relationship with others. When we face a threat, the body’s first line of defense, when possible, is to communicate verbally; we try to talk ourselves out of the threatening situation. If this is not feasible because we don’t have enough support or too much is happening too fast, the other sections of the brain take over.

3 Ways to Talk To the Brain to Shorten Recovery Time

Step 1. Shifting Your Attention From the Story to the Sensations

Engaging the neo-cortex is great when we need to figure things out, but it can get in our way when are trying to complete the biological steps. Specifically, it tends to override our natural ability to shake off the tension that builds when we face a threat. If the neo-cortex has its way, it will want all of our attention given to the story’s details: what and how did the threat occur and what were the consequences. As a result, we can get stuck on any of the first four steps listed above and we never get to the rest stage. To resolve trauma symptoms, it is important to recognize the pull the neo-cortex will exert toward staying with the story and how we must repeatedly and gently shift our attention toward sensation.

Step 2. Paying Attention to Impulses

Paying attention to impulses that come from the limbic brain can help us complete each of the steps. In particular, we need to track any desire or impulse to move the body in certain ways. These impulses can be subtle such as a minor turn in the head to orient toward the threat or a big movement of the arm or leg to assist with fighting or running. These kinds of restorative movements happen spontaneously without us analyzing and planning that a certain movement will work.

Step 3. Coming Out of Shut Down Slowly

Finally, if we are caught in freeze so that we feel immobilized physically or emotionally, we need to pay attention to the reptilian brain. We can think of freeze as having our feet on both the gas and brake of a car. The engine is revving, but we are going nowhere. To avoid having the car go out of control, we would slowly release the brake. To resolve the shut down,

a. Pay attention to just small portions of the threatening experience. This means instead of talking about the entire accident, we look at what happened one step at a time.
b. Pay attention to our natural desire to release pent up energy. This can be barely noticeable as ripples or more dramatic as hot and cold flashes. Because the reptilian brain works very slowly when it comes to recovering from trauma, it’s important to allow a lot of time for this release. In addition, we want to make sure that the energy is moving out of the body and not just buzzing around under the skin.
c. Look for opportunities to engage verbally and socially with others who help us relax and feel alive. It’s important to come out of isolation in order to “thaw” our emotionally frozen state.

BUT WAIT…

In the past I saw a therapist after I fell while rock climbing. We talked about how my relationship changed with my son because I was too scared to go climbing with my son again. Even with the therapy, I got depressed after awhile. We didn’t pay attention to any of the biological steps you mention.

Coming to an understanding of how you are affected emotionally by a traumatic experience can be very helpful. Your therapist may not have known how to recognize that your body really was in a state of freeze. Over time, this frozen state could manifest as depression. By focusing on the biology of what your body would have wanted to do during the fall, if there had been time and space, your body can come out of freeze and the depression.

After the fall, I shook violently. I forced myself to stop because everyone was watching me.

It’s common to feel embarrassed when your body feels out of control. By understanding that the shaking was the brain’s way of having the body release extra energy, you may have been able to tell your neo cortex that the shaking was helpful and to let it happen.

After the accident, I told everyone I knew about what happened. It seemed to help.

It is natural to want to tell others everything that happened. Doing this, however, can cause the body to feel as though the accident never ended. This in turn perpetuates the trauma symptoms. By telling just a little bit of the story at a time then letting the body release the pent up energy associated with that part of the story increases the likelihood that you will be able to finally rest and put the accident behind you.

WHAT HAPPENED TO RICHARD?

When Richard came to me several years after the fall, he was still afraid of falling, and even at home, he noticed he walked into things. He had become depressed because he did longer took walks into the woods and had lost his interest in photography. Richard thought if he could just “figure out” what had happened and what he had done wrong he finally could relax.

We began our work by looking at what happened prior and after the fall before moving through the actual fall. It was important to first complete the step of orienting to the boulder and the ground below. This allowed his system to locate and evaluate the boulder as dangerous. Because Richard did not go unconscious, he was able to describe what the ground looked and felt like after the fall. Next, I invited him to take time to pay attention to how his body felt when he discussed how other hikers appeared to rescue him. This helped his nervous system to begin to sense that the fall was over.

Working with the actual fall was done very very slowly and with Richard sitting on the floor surrounded by many soft pillows. By working slowly, the moves that his body would have wanted to do, if there had been enough time and space, came forth spontaneously. At one point, we both watched as an arm went down to brace his fall while his body turned to protect his head. He told me it felt as though his arm was moving itself. In later sessions, he practiced righting himself over and over by rocking side to side and backwards as he sat on the floor. This helped his body to restore its sense of equilibrium. When he was ready, he finally let himself fall back into the cushions. The first thing he said was, “I survived!” and he wept. Two months after we had begun our work, Richard resumed his treks into the mountains with his camera in his backpack.

IN SUMMARY

1. When we encounter threat, different sections of the brain control how we respond.
2. This response follows a specific series of biological steps that happen automatically.
3. To avoid trauma, each step must be completed.
4. If a step does not get to complete we can elicit the help of the neocortex, limbic and reptilian brains to help with the process.

NEXT STEP

If you are struggling with trauma symptoms, remember that your brain knows exactly how to guide your body to complete each step of the threat response. If you need additional support in paying attention to sensation and re engaging with others, find a professional who understands how the brain functions during threat.