
How To Escape the Mind Prison: A Guide
A guide to freeing yourself from your thoughts. Learn about mindfulness, radical acceptance, commitment to change, and the cycle of suffering.
Trauma is a person’s emotional response to a distressing experience. Few people can go through life without encountering some kind of trauma. Unlike ordinary hardships, traumatic events tend to be sudden and unpredictable, involve a serious threat to life—like bodily injury or death—and feel beyond a person’s control. Events are traumatic to the degree that they undermine a person’s sense of safety in the world and create a sense that catastrophe could strike at any time. Parental loss in childhood, auto accidents, physical violence, sexual assault, military combat experiences, the unexpected loss of a loved one are commonly traumatic events.
Trauma describes a type of injury, which can be physical, sexual, or emotional/psychological. Alterations in arousal, reactivity, mood, anxiety, thoughts, and behaviors can occur following traumatic experiences.
Acute trauma reflects intense distress in the immediate aftermath of a one-time event and the reaction is of short duration. Some examples include a car crash, physical or sexual assault, or the sudden death of a loved one.
Chronic trauma can arise from harmful events that are repeated or prolonged. It can develop in response to persistent bullying, neglect, abuse (emotional, physical, or sexual), and domestic violence.
Complex trauma can arise from experiencing repeated or multiple traumatic events from which there is no possibility of escape. The sense of being trapped is a feature of the experience. Like other types of trauma, it can undermine a sense of safety in the world and beget constant, and exhausting, monitoring of the environment for the possibility of threat. Click here for more information about Complex Trauma.
Vicarious trauma arises from exposure to other people’s suffering and most commonly occurs in professions that are called on to respond to injury and mayhem (e.g., physicians, nurses, first responders, firefighters, and law enforcement).
Adverse Childhood Experiences (ACE) cover a wide range of difficult situations that children either directly face or witness while growing up, before they have developed effective coping skills. ACEs can disrupt the normal course of development and the emotional injury can last long into adulthood. The loss of a parent; neglect; emotional, physical, or sexual abuse; and divorce are among the most common types of Adverse Childhood Experiences.
Distressing events activate an area of our brain called the amygdala. The amygdala is responsible for detecting threats and responds by sending out an alarm signal to multiple body systems–this results in our “fight or flight” response. The sympathetic nervous system stimulates the release of adrenaline (epinephrine), noradrenaline (norepinephrine), and stress hormones (e.g., cortisol) that prepare the body to fight, run, or freeze. Short-term fear, anxiety, shock, and anger/aggression are all normal responses to trauma. Such negative feelings dissipate as the crisis abates and the experience fades from memory, but for some people, the distressing feelings can linger, interfering with day-to-day life.
Sufferers of long-term trauma may develop emotional disturbances, such as extreme anxiety, anger, sadness, survivor’s guilt, disassociation, the inability to feel pleasure (anhedonia), or PTSD (post-traumatic stress disorder). The amygdala become hyperactive, its over-reaction to minor perturbations leading to an outpouring of stress hormones. Living in defense mode, and vigilant to the possibility of threat, people may experience ongoing problems with sleep or physical pain, encounter turbulence in their personal and professional relationships, and feel a diminished sense of self-worth.
Positive psychological changes after trauma are also possible when people acknowledge their difficulties and see themselves as survivors rather than victims of unfortunate experience. These can include building resilience, the development of effective coping skills, and development of a sense of self-efficacy. Some people may undergo post-traumatic growth, forging stronger relationships, redefining their relationship with new meaning and/or spiritual purpose, and gaining a deeper appreciation for life. It may sound contradictory, but post-traumatic growth can exist alongside PTSD.
Those who’ve experienced trauma throughout their lives often have a “disorder” called “survival mode.” Clinically, we call this Post Traumatic Stress Disorder (or Complex Post Traumatic Stress Disorder). Unfortunately, the symptoms of post-traumatic stress can disguise itself and lead to misdiagnosis.
Disorders such as Borderline Personality Disorder, Obsessive compulsive disorder, Eating Disorders, Body Dysmorphia, Attention Deficit Hyperactivity Disorder, Depression, Generalized Anxiety Disorder, Dysthymia, and panic disorder may be manifestations of post-traumatic stress. This highlights the importance of recognizing symptoms and signs of Post-Traumatic Stress Disorder (PTSD) and Complex Post Traumatic Stress Disorder (C-PTSD).
What are common signs and symptoms of Post Traumatic Stress Disorder (PTSD)?
NOTE: PTSD is more likely to occur in individuals who are single, divorced, widowed, socially withdrawn, or in lower socioeconomic statuses
Selective Serotonin Reuptake Inhibitors (e.g., Sertraline, Paroxetine, Citalopram, Escitalopram, Fluoxetine) and Serotonin Norepinephrine Reuptake Inhibitors (e.g., Venlafaxine, Duloxetine) are first line medications for post-traumatic stress disorder. Prazosin is often used for trauma-related nightmares. Propranolol (Inderal), Clonidine, Valproic Acid (Depakote), Buspirone (Buspar), Mirtazapine (Remeron), Trazodone (Desyrel), Amitriptyline (Elavil), and Nortriptyline (Pamelor) may also be prescribed. Medications primarily target intrusive thinking, ruminations, negative thoughts, mood reactivity, hypervigilance, aggression, irritability, impulsivity, insomnia, muscle tension, and panic attacks.
The algorithm below is from the Psychopharmacology Algorithms Project at the Harvard South Shore Psychiatry Residency Training Program
Project Leader: David Osser, MD
While medication can be very important in the treatment of post-traumatic stress disorder, psychotherapy is equally (if not more) important and strongly recommended. Exposure therapy, mindfulness-based therapies, cognitive behavioral therapy, psychodynamic psychotherapy, psychedelic assisted psychotherapy, eye movement desensitization reprocessing (EMDR), family therapy, and group therapy are used to varying degrees.
Modalities such as neurofeedback, Transcranial Magnetic Stimulation (TMS), and ketamine infusion therapy are recommended if medication and traditional therapy are not beneficial (or only partially beneficial).
As young children, we develop a sense of “self” through the interactions we have with the important trusting figures in our lives. Our sense of self evolves by exploring a variety of ideas, personalities, sexualities, genders, etc. By “trying on” different identities, we formulate a coherent sense of who we are. We learn about our bodies and how they relate to our feelings. We learn what trust means and who we can and can’t trust. As children, we are like sponges of information. And we don’t know any different.
Normally, our sense of self develops within a safe environment. But when there is no safety or security and our innocence is turned against us and our curiosity is made out to be a burden, we do what any normal, innocent child would do–we hide. We dissociate into pieces and parts. We learn to be who we need to be to remain safe. We become chameleons. We learn that our worth is dependent upon our productivity, on our external appearance, on how much money we have, how popular we are, and how much our friends and significant others love us.
It’s no wonder medicine is often ineffective. That’s because there is NOTHING inherently wrong with us at all. That doesn’t mean we aren’t feeling pain, depression, anxiety, fear, etc. And it doesn’t mean medicine wouldn’t be helpful. But it is important we remind ourselves that nothing is inherently wrong with us. When we are hurt by those who are supposed to protect us, we not only hide who we are, but we hide within our thoughts. And we hide from ourselves.
By doing so we regain some of the control we lost at an early age. We live in our heads because it’s the only safe place to live. Our own bodies aren’t even safe. We hide from ourselves and neglect ourselves because we were taught to fear ourselves–that being ourselves is dangerous. So, we try to control everything. EVERYTHING.
Our obsessiveness and neuroticism aren’t a problem or a disorder. They are normal responses to learning that being ourselves is dangerous. Countless times we hear ourselves saying “I don’t know how I feel.” That’s because we are exhausted. We are burned out. We’ve been made to believe that being ourselves and showing love for ourselves is selfish and BAD.
We “fight” (i.e., overreact with anger and aggression), we “flight” (i.e., run away or avoid), and/or we “freeze” (i.e., dissociate) when confronted with anything that might threaten our safety and security that we work so hard to maintain. Part of healing from trauma is recognizing these reactions and using coping skills to rewire our brains.
A guide to freeing yourself from your thoughts. Learn about mindfulness, radical acceptance, commitment to change, and the cycle of suffering.
Category: Anxiety Disorders, Dialectical Behavioral Therapy, Education, Mental Disorders, Mindfulness, Trauma and PTSD
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