Tuesday, June 7, 2011

How a Lesson Learned in Childhood Can Help Us Manage Stress and Trauma

I just finished a psychotherapy session with one of my clients who is recovering (well I might add) from an injury. Along with the physical symptoms, she has been plagued by worry and that is what she wanted to address today.


As we dove into the issue, her belief system surfaced and she began defending her worrying. It went something like this, “If I don’t worry, how am I going to be able to protect and care for my loved ones?” and “Sometimes when I lay here and worry about my health issues, I get an insight as to how to get the help I need.”


Coming from a Jewish background, all the emphasis on worrying seemed so very familiar and I know she isn’t Jewish so I said, “Sounds so much like the Jewish mother worry I grew up with but I know you aren’t Jewish.” She quipped back one word which made us both laugh, “Catholic.”


As we went back to the issue of her belief system, it occurred to me that:

A) Intense worry is an expression of hypervigilance, which is a trauma response akin to “flight.” It is based in fear and our thoughts race out of control to try and find safety. It sells itself as “I am taking care of myself and my loved ones.” The reality is that we are full of adrenaline and if we are sending energy to protect others, and ourselves it is frenetic and only adds static and confusion into the picture. To make matters worse, the static blocks our being in a place of peace where we might be more prone to tap into our insight to help creatively address the issue about which we are worried.


That led me to apply the same logic to “fight” and “freeze” and how they may appear for her in her situation as well and, as it turns out we uncovered them in the mix too.


B) There are times when she has intense anger and frustration, which is an expression of “fight.” I have always made a distinction between being “mad” and being “angry.” If I am mad, the intense feelings are controlling me and if I am angry, I can effectively use the feelings as an advocate. In her situation, she has temporarily lost the ability to drive as well as a lot of other normal activities and feels vulnerable, so as a protection, anger and frustration surface regularly.


C) “Freeze” comes up for her in two forms – she literally can get frozen into overwhelm and inaction through analysis paralysis and alternately she goes into denial.


As we explored this further, there is a healthy way to address these core drives, which we summarized as follows:


A) Replacing intense worry with healthy concern. Rather than spamming herself and others with adrenaline laced worry, to recognize that her intention is to broadcast love and protection. Loving concern emanating from her balance point can help her tap into her insight which can assist her in forging a direction to meet the concerns.


B) Replacing intense anger and frustration with advocacy. One definition of an advocate is, “One that supports or promotes the interests of another.” When done from your balance point, it shifts one from being vulnerable as a victim to being empowered as a support and protector of oneself and others.


C) Replacing denial with a healthy assessment of the situation and to incrementally improve it. In her case, she temporarily is unable to drive. Denial helps her manage the despair but it blocks her from taking action. Another approach is to accept the temporary condition and continue to heal incrementally so she can eventually regain that ability and other abilities as well. If over time, some of those abilities do not come back online, then we will need to work on acceptance. At this moment in time, the jury is not out yet as to how she will eventually recover.


As she asked me to summarize the session for her I said, “It is like we learned as kids, ‘Stop, Look and Listen before you Cross the street.” What this means to me is when she notices for instance that she is in intense and ineffective worry that is akin to “Look” and “Listen.” She can then “Stop” and take action to change her behavior which in the old childhood adage is “Cross the street.” It’s fun to see how we can apply that principle at any age.

Saturday, January 1, 2011

Return on the Investment

My wife and I spent a wonderful New Year's at a party thrown by dear friends. It was supposed to be a wedding that I was to officiate, but about a week before the wedding, the bride and groom decided to call it off. I laud them for that as some of the saddest words that have been spoken in my psychotherapy office are from those who have said, "I knew I was making a mistake when I walked down the aisle."

Here's the twist, the groom's family had booked flights to be here from Europe, and the bride's family had bookings to be in town from all over the country. The father of the bride converted the wedding into a New Year's party and both families followed through with their plans. Everyone was in attendance, including the couple that was to have married and their immediate families. And it was a lovely time. When people can forgive and understand and be sensible, magic can happen and it did tonight.

I woke up at 2:00 and it is now 6:30 on January 1st. I awoke to thoughts of the wedding and the amazing job that both families did to convert what could have been a scar into a healing. Somehow that led me to thoughts of my own family and the amazing job that they did to allow me to have the life that I enjoy.

Like many Americans, I am part of the second generation of an immigrant family. Knowing the family history as I do, if my grandparents on both sides hadn't had the courage and made the sacrifices to leave eastern Europe before the war, my branch of the family tree would have burned in the Holocaust with other branches that weren't as fortunate. I am able to write this because of who they were and what they did.

My resolve for the New Year is that my life and the way I live it be deemed to be a worthy return on the investment that my parents and grandparents, and those before them provided so that I may have the privileged life that I enjoy. Along with that resolve, my wish for the New Year is that people can forgive and understand and be sensible so that magic can happen in the world as it did in microcosm at a New Year's party that was initially planned as a wedding.