post-traumatic stress

Releasing Your Body from Trauma's Grip: A Review of The Body Keeps the Score by Bessel van der Kolk

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If you’ve experienced a traumatic event, you know the symptoms that follow.  It could be physical or emotional pain directly related to the trauma, but also symptoms in response to reminders of the event once you’re physically healed.  You might be dealing with panic or out-of-control flashbacks that pull you into re-experiencing the trauma.  You may have trouble putting words to what happened to you, with gaps in your memory or difficulty placing a beginning, middle, and end to your experience. 

Bessel van der Kolk, in his book The Body Keeps the Score, describes the experience of holding trauma in our bodies both through changes to the structures of our brain and effects of trauma on daily living for those who have experienced traumatic events. 

In his 40+ years of clinical experience as a psychiatrist, van der Kolk has done extensive research on the effects of trauma on brains and bodies of children and adults.  His focus on neuroscience and attachment form the basis of his points in his book.  

How This Book is Organized

How Trauma Affects the Brain and Body

Van der Kolk begins the book giving background information about trauma and how it impacts both the structures of the brain and interpersonal relationships.  He discusses how trauma activates your fight-or-flight response in the amygdala, or emotional center of your brain.  This affects not only how you remember and tell the story (typically more images than biographical details), and it also changes how that information is stored in your brain.

He normalizes traumatized individuals’ difficulty improving, not because they don’t want to, but because of the impact of the symptoms and the weight of self-blame they carry in response.  This can cause physical symptoms and reactions in the body that echo long after the traumatic event has ended.  It can affect their lives as they lose their ability to focus or concentrate, they dissociate or disconnect emotionally, and they have difficulty feeling safe with other people.

When the subject of blame arises, the central issue that needs to be addressed is usually self-blame – accepting that the trauma was not their fault, that it was not caused by some defect in themselves, and that no one could ever have deserved what happened to them.
— Bessel van der Kolk

The Impact of Trauma in Childhood

Next he moves on to discuss the impact of childhood trauma and insecure attachment on adults.  He highlights insights from research with children and teens to highlight the detrimental effects of trauma and how it can be reversed.

One insight he shares is that how we cope with trauma as children usually translates into how we cope as adults.  We learn to survive amidst chaos using certain strategies, some of which can include addiction, destructive relationships, or other unhealthy patterns.  Recognizing where these patterns originated can release some of the self-blame you carry. 

Many traumatized children and adults simply cannot describe what they are feeling because they cannot identify what their physical sensations mean…trauma victims cannot recover until they become familiar with and befriend the sensations in their bodies.
— Bessel van der Kolk

How to Treat Trauma

Luckily, trauma is not a death sentence, because our brains are designed with healing mechanisms in place.  During this section, van der Kolk highlights several different methods of psychotherapy that can help heal the effects of trauma, such as EMDR (eye movement desensitization and reprocessing), yoga, internal family systems therapy, writing, theater, psychomotor therapy, group therapy, and others. 

He speaks about using an approach to trauma treatment that focuses both on top-down interventions (strengthening the control center of the brain with activities such as mindfulness and yoga) and bottom-up interventions (regulating the emotional brain through breathing, touch, and movement).  He emphasizes that revisiting the trauma is an essential part of this process, but it needs to be done when you are feeling safe and grounded in the present moment.  Ultimately, he believes (and I agree) that experiential knowledge is much more powerful than intellectual knowledge, and therapy should incorporate these aspects.

More than anything else, being able to feel safe with other people defines mental health; safe connections are fundamental to meaningful and satisfying lives.
— Bessel van der Kolk

How to Use This Book

If you are someone who has experienced trauma or helps others who have been traumatized, The Body Keeps the Score will be a helpful resource to put words and explanations to what you feel and experience.  You might discover a completely new perspective on your story of trauma as a result.

Begin with the first section of the book if you are curious to understand how trauma affects the brain.  His anecdotes about individuals who have experienced trauma coupled with images of brain scans illustrate the connection between trauma and the brain.  My guess is that you’ll find your story to be more common than you realized.

In particular, I think the first section of the book is helpful for women who have experienced sexual assault or other violent crimes.  He speaks at length about the freeze response of the brain that shuts down and inhibits the victim’s ability to fight back against their attacker.  This survival response often becomes a source of self-blame after the traumatic event.  Knowing it is a natural biological reality to shut down can lift some of that blame.

If you’re interested in the concept of attachment and how trauma during childhood can affect development, read the middle section of the book, where van der Kolk shares research insights into the impact of attachment on children.  He speaks about the impact of a caregiver’s ability to emotionally attune to their children and respond to their needs so that children can learn to self-regulate.  Children who don’t receive that attunement can grow up to be anxious (feeling too much) or avoidant (not feeling at all).

If you want to learn more about a particular type of therapy to treat your trauma, jump ahead to Section Five of the book, where van der Kolk outlines the different methods of therapy that have been helpful in his experience of treating trauma.  As an EMDR practitioner, I enjoyed how he described the way a typical EMDR session works, as that can give you an idea of what to expect.

Overall, I think the combination of personal anecdotes, research, and hope this book offers make it an invaluable resource for therapists who work with traumatized clients, but also for those who are seeking to heal from their personal stories of trauma.

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Have you been dealing with the aftereffects of trauma?  Are you having trouble focusing or getting distracted by your symptoms?  Do you want to heal from the effects these events have had on your brain and body?  At Restored Hope, I offer counseling services, including the use of EMDR, to help process and heal from traumatic events and begin to live a full life again.  Give me a call at 734.656.8191 or email me today to schedule your first appointment and hear how I can help.

How to Cope with Trauma-Related Anger

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The experience of sexual abuse or sexual assault as a child, teen, or young adult can have traumatic effects throughout your life. In a similar vein, betrayal by a spouse who is a sex addict can shatter your sense of normalcy and leave you reeling from the traumatic backlash.  It is normal to experience anger in response to traumatic events.

Yet we often fear or avoid anger because of its perceived destructive effects.  We throw around statements like, “hurt people hurt people,” as though it’s a given that anger stemming from hurt will harm those around us.  If you watched parents express anger with violence or abuse, you’re more likely to be primed to believe that anger is unacceptable.  However, anger is not inherently bad nor is it harmful.

Reactions to Anger

There are various different ways in which we naturally react to anger caused by trauma.

Uncontrollable outbursts of anger

Anger may feel like it is constantly simmering under the surface, waiting to burst out at the slightest provocation.  You could be more irritable and likely to lash out at others around you.  You may feel out of control of the intensity of your anger response.  You might also experience shame, especially if your anger is directed toward your loved ones, or it is similar to unhealthy expressions of anger you experienced as a child.

This type of reaction to anger can involve violence, either with physical action or with words.  If you are becoming violent with those around you, please seek help.

Suppressing your anger.

If anger isn’t acceptable to you, you may take your anger and turn it inward as self-contempt or self-loathing.  This is a common response for women.  At its most extreme, this suppression of anger can turn into self-harm behaviors, drug and alcohol abuse, overeating, or suicidal thinking as ways to express the anger that has no other outlet.  Sometimes suppressing anger can be encouraged by religious backgrounds that place an overemphasis on forgiveness and equate anger with sin.   

If you are actively having suicidal thoughts and considering taking your own life, please care for yourself by calling the Suicide Prevention Hotline at 1-800-273-TALK.

Numbing out.

A third way might be ignoring anger through distraction or numbing, until you are no longer able to access the anger itself.  You may know it’s there or see it come out from time to time, but you just can’t get and stay angry.  This can come after prolonged suppression of anger when the body adapts to the response of the mind.  It can also be a way of dissociation or detaching from reality when the trauma has significantly affected your sense of self.

Healthy Response to Anger

Anger is a natural response to perceived injustice or wrong being committed against you.  In many cases of trauma, the anger is justified by the wrongful actions of an abuser or betrayer.  You can recognize the emotion of anger as acceptable because feelings alone do not harm anyone.  In fact, anger can, at times, indicate love or care for other people, like your children or fellow survivors of abuse.  You can learn to use your anger to serve you and help you move forward, rather than destroy your life.  The more aware you become of your experience of anger, the more able you are to manage it effectively.

How to Deal with Anger

Get into therapy.

First and foremost: if you are a survivor of trauma, whether it is from your childhood or from more recent experiences, the most effective way you can work through it is through therapyEMDR-Certified therapists and trauma-informed therapists do specialized work in treating trauma.  Find a therapist who you click with and trust them to be your support as you walk through the anger and other corresponding emotions that arise from your trauma.

Identify your go-to response to anger.

From the list above, identify yourself: are you someone who stuffs their anger down, only to turn it inward on yourself?  Do you find yourself lashing out at others and feeling angry all the time?  Or do you numb out and find it difficult to experience or express anger at all?  Examine the origin of this automatic response: did your family or parents handle anger in this way?  In the opposite way?  Where did you learn to express your anger in this way?  Acknowledging that anger is learned helps you to feel empowered to learn new ways to deal with anger.

Identify other emotions that are intensifying the anger or getting in the way.

Your anger may be directed at your abuser in the case of sexual abuse, or your spouse in the case of spousal betrayal and addiction.  However, you might find outbursts of anger in the present moment have nothing to do with the individual who wronged you: instead, they may be directed at individuals you interact with in everyday life.  It may be connected to stress, feelings of overwhelm, hurt, disappointment, or sadness.  Explore how any of the emotions behind the anger might be difficult for you based on past experiences.

Conversely, if you struggle to access your anger, examine what might be getting in the way.  Perhaps fear of how you will react or how others will perceive you prevents you from feeling comfortable experiencing your anger.  Follow the narrative through with these questions: if I really allowed myself to get angry, what do I believe would happen?  How true do I believe this is?

Slow down and notice your body.

When you feel anger coming up, hit the pause button.  Slow yourself down for long enough to check in with your thoughts and experience.  Notice your body’s physical response to the anger.  Describe or draw the anger: what color is it?  What shape, size, and texture?  Is it moving or standing still?  Where is it located in your body?

Write a letter to your abuser or betrayer.

For those who are pointing the finger of self-blame at themselves, it can be helpful to write out a list of the reality of how the other person harmed you. This can assist you in feeling justified anger at the abuser for their actions, rather than directing that anger at yourself.  I’d recommend you write this letter as a personal exercise rather than a letter to give to the abuser or betrayer: this will help you feel more freedom to express the full weight of your anger and be as honest as you’d like.  If you find yourself wanting to share that letter, talk with your therapist and support individuals before making that decision.

Reframe your anger as a “dashboard light” telling you there’s something wrong.

Use your anger as a tool to indicate something’s off.  It could be that you need to step up your self-care through contacting a supportive friend, attending an extra therapy session, or practicing a breathing exercise.  If you learn to accept the anger as it arises and examine what your anger is telling you, it will help the angry feelings to dissipate.  This increased awareness of the messages of anger can help you channel that anger into assertiveness and setting boundaries in relationships that trigger your anger.

Speak out on behalf of others currently experiencing trauma.

Channel your anger and frustration over past trauma into service for those who are experiencing similar situations.  Write letters to government officials about fighting back against human trafficking or legislation related to sexual abuse.  Attend events or rallies to support causes that empower women.  Volunteer at a domestic violence shelter.  Get involved in survivor’s groups where you can find others who have been through similar experiences.

Release anger through physical activity.

Often anger can feel like restlessness or pent up energy.  When anger threatens to overwhelm, channel that energy into physical activity that will increase your endorphins and help you release your anger.  Take a kickboxing or self-defense class to help you to feel empowered and able to defend yourself.  Go for a long run and imagine the anger releasing into the ground with each footfall.

Write a statement affirming how you will deal with anger.

Negative beliefs about yourself or the world around you can perpetuate feelings of anger.  Once you’ve identified the sources of your anger and your influences on how you experience or express anger, identify faulty thinking patternsthat make it difficult for you to feel in control or safe.  Write a statement reminding yourself of what is true about your anger that gives you support and grounding during intense experiences of anger.

Do you struggle with outbursts of anger that seem to come out of nowhere?  Or do you have difficulty even accessing anger?  Are you afraid of what will happen when you feel anger?  Do you have a history of trauma?  At Restored Hope, I offer personalized, trauma-informed counseling to help you understand the effects of trauma on your daily life, as well as release the triggers and anger that continue to arise.  Give me a call at 734.656.8191 or email me today to schedule your first appointment.