Ok. Where do I start? I’ll try not to get too scientific and say things in plain English as much as possible. (the proof or scientific backup for what I’m about to say is available – and please feel free to correct me, if I’m wrong. Find Kimberly’s blog – or even better: download her absolutely brilliant, groundbreaking books from her page- and any links branching off from her posts, all the references in her books and whatever Google and Wikipedia dig up for you as well your standard reading list on PTSD and its outcomes).
I will say this in a stripped-down, somewhat simplified nutshell version: For any human being – and possibly other mammals, too – to develop a healthy concept of self including a sense of basic trust, there have to be certain developmental processes early in life, which need to see certain external stimuli at crucial times in order to evolve in a natural way and produce – well – a healthy individual. Any violation or disruption of these processes, like e.g. the bonding phase, prepare a predisposition for potential “aberrations” later on. Let’s e.g. say there is childhood (sexual) abuse, you’re being stripped of the experience of being safe in this world – in a very primordial, basic way. Let me be clear on this: Violating a child’s comfort zone in any pronounced way – be it sexual abuse, (excessive) beating, neglect, food deprivation or depriving them of any other of their vital needs – will leave them marked and with a sense of “apprehension” – and 24/7 so. Don’t take my words for it – bury yourself in aforementioned sources and links and find out for yourself (most of what I’m saying here is something I – again – learnt through Kimberly’s blog and the sources she links to, thanks KC!). That sense of being safe and sound – isn’t rooted anywhere in the “higher” processes of the brain – it’s rooted in our most ancient, primitive part of the brain. There is “circuitry” in those parts of the human brain that are even more simple and primitive and it’s those “brain” regions and ganglions that regulate the primary reflexes. My point being: Whatever therapies like CBT and DBT are telling you – IMO is coming from a skewed / inappropriate angle as it targets processes that occur long after the initial shock to the system has happened. In other words: Forget it! Doesn’t work in regards to (C-) PTSD! (Thanks to Jean for pointing it out to me, who went through this kind of therapy without – sustainable – results – as did I, needless to say).
However, here is something I never noticed until a few days ago, which I find quite interesting and which I’d like to share with you (being aware that it might totally contradict my above paragraph and conclusion…): I have been carefully observing and assessing my known triggers and their outcomes in situations like e.g. getting in line at the supermarket cash register – where I wasn’t able to do it a year ago, unless I went there at little frequented times, when I could almost be sure not to have other customers lining up behind me -, riding the public commuter train(s) at rush hour, being in highly frequented downtown areas, riding bumper to bumper in traffic… the list goes on and you might have found some overlap with your own triggers, I’d presume. Two days ago, I noticed that I lined up at the supermarket cash register at a mildly frequented time, not paying much attention to the time I went there or the situation per se, not having “planned” my errand at all. Behind me, two teenagers get in line, engaging in heavy and fairly passionate discussion about something, while moving within my “safe” zone. A year ago, I would have broken a sweat, my heart rate would have accelerated, breathing would have become a shallow panting etc. In other words: I would have been sure to manifest a full blown anxiety attack.
This time, when I left the store, all of a sudden I noticed that none of these symptoms had manifested. I didn’t know the guys – this would have been easy and would have devalued the significance of the situation (spell “habituation” for me – which *sigh* was suggested so many times by said CBT/DBT therapists – gah! So it wasn’t that.) But – it may have something to do with that – or not, I am not sure, yet. This is what I’d do: Everytime, I’d feel the physical manifestations of an anxiety attack, I’d sort of “soothe” myself, like a parent soothes a hurt or otherwise “worked up”, aggravated child. In my headline I coined it “mindful auto(self) feedback”. Upon looking for this expression, I found a number of finds, where this one sounds the most plausible and relevant to me. However, it’s not exactly tailored to your typical PTSD-induced anxiety attack situation, but rather a general way of conveying criticism in a workplace situation without having the criticized co-worker lose face or being humiliated (on second read I think, the processes and triggers mentioned in the article appear similar to the mechanisms governing C-PTSD and seem to work and play out in a very similar way, as a human being’s “reflex system” is potentially being triggered – which the article makes a strong point to avoid or at the very least take into consideration upon conveying potentially hurtful feedback to an individual).
It makes some sense to me, but feels way to weak in terms of working in similar ways for something as deeply rooted as (C-) PTSD. Yet – the basic idea of “self soothing” with compassion – much like a compassionate, considerate parent would do – seems to have worked for me, at least for this one type of triggering situations (it seems to have also worked to an extent when being in traffic, but with heavy limitations here…. in other words: Bumper to bumper on an innercity highway still freaks the living shit out of me!). So, tentatively speaking, this method of – sort of – “being my own parent” later in life and in situations that still trigger anxiety attacks, seems to get me to the point, where the outcomes begin to remain within a normal range of responses and most importantly: with the immediate physical responses indicating a “life threatening” situation slowly receding. At this point, I’m unable to say how sustainable these outcomes are, but they feel promising to say the least – all the more in the face of having felt helpless and out of control for such a long time (going on 50 years…)
The big humdinger I haven’t found a solution for just yet, however, is noises – or more accurately: vibrations happening at too close a range form comfort, like e.g. neighbours walking around, dropping things, etc. Depending on the immediate precursing experienced level of perceived survival stress from known triggers, I tend to respond to this particular set of triggers – the vibrations happening in or too close to my comfort zone (do I have one….?) with major, major physical discomfort. I kid you not: At times, being exposed to these triggers amounted to nothing short of full blown torture. (like e.g. in my previous abode, where I had a noisy, inconsiderate neighbour and thin walls and ceilings on top of that). I would experience so much stress that at some point, I had to be taken to hospital to rule out having suffered a heart attack (it turned out not to be one, but even paramedics including an emergency doctor weren’t so sure, when they responded to my call). What exactly is it that triggers such heavy responses in my body to seemingly “insignificant”, at best mildly annoying noises – or again: vibrations – in that way?
Today, I may have found a possible answer for the first time: From the records and personal accounts of my earliest time on the planet, of which I spent the first weeks and months in a pediatric “ward”, a (conditioned) connection between “rattling” and painful experiences following that soon after must have established itsself in my brain. What I do know is that my bed at the pediatric clinic had “safety rails” on each side, which the nurse had to remove to get me from my bed. When they did, it was usually early in the morning or late in the afternoon. (this is a “memory” that came back from self-induced trances, thus allowing unconciously stored images to come forward – a technique I learnt from a therapist specializing in clinical hypnosis). In other words: They’d “rip” me from my comfty bed and expose me to things like tube feeding [warning for some graphic, disturbing content], spinal taps or other very painful and majorly disturbing experiences. So, apparently, there is an immediate connection stored in my body that links “vibration” to ensuing (major) pain and physically intrusive experiences – makes sense?
If my above musings hold, I might have found an angle to (try and) desensitize these sensations or rather: Unlink them from each other. If vibrations – from taking the safe guards of my infant bed down – signalled ensuing pain then maybe – just maybe – I get to unlink the following experience of pain from the vibration, the idea being that such tiny vibrations lose their “trigger potential” along the lines of what I seem to have accomplished with lining up at the supermarket. Again – makes any sense?
Now is the perfect time to try this as Ms. landlady has her grandchildren over, who usually wake me at 6 a.m. from their running around – or their parents, who keep me awake until midnight for the same reason: Walking around, swinging doors shut etc. If this works… would you consider this something that’s boilerplate PTSD therapy (as in EMDR, e.g.)? Please note: I have not applied any bilateral tapping techniques or anything along those lines in the situation at hand (what would it look like, if I started tapping my temples in public? Could easily be taken for an insult from someone nearby, right?) The only thing I did was making myself aware of the impending physical manifestation, then send a silent, soothing message back to my consciousness, thinking of the words a compassionate parent might use in a situation that’s distressing to a child. B.t.w.: I am fully aware, how far out this may sound and appear to non-affected individuals, but after all – there is a lot of work to do on healing the inner child, isn’t there?
Is this a known technique from CBT/DBT and was it working then after all despite my previous doubts? As I haven’t had access to standard C-PTSD therapy, I wouldn’t know. Kindly help me out here, if so inclined! 🙂 Thanks in advance.