One day I was riding my bike on a back-country road where residents tend to let their dogs roam off leash. A yellow lab spotted me passing his property and came running toward me.Forgetting that picking up my pace was the best way to deal with guard dogs, I stopped to reason with him. Usually dogs can’t be reasoned with while protecting their property and will bark at you until you move on, but this dog took it a step further. He didn’t stop at the edge of his land like most dogs do, but instead jetted into the road and charged me.
The next thing I remember was lying flat on my back on the asphalt, my face and chest covered in muddy paw prints. Being clearly old and blind, the dog just trampled me, kept running, and took a very long, circular route back to his house.
It might have gone differently. He might not have stopped at just knocking me down; he might have gone for my throat.
At the time, my body had the normal stress response to being bulldozed by a large dog: shallow breathing, rapid heartbeat, clenching, throwing my hands up involuntarily.
The “fight-flight-freeze” response, that we all experience when confronted with potentially life-threatening events was triggered by an area in my brain called the amygdala, the center that registers danger and essentially takes over the body.
The next time I rode my bike and a dog approached me, I was better prepared. First, I kept riding and picked up my pace, but when the dog persisted and started pursuing me, I lifted my foot off the pedal and kicked him right in the forehead — a ninja move I’m still surprised I pulled off. Startled, he stopped the chase and resigned to going home.
This change in my behavior was a combination of the fight-flight-freeze experience I had, but also a follow-up state that fewer people learn about – “rest and digest,” the period after the assault when my body calmed down and I was able to piece together what happened and file it away for future use.
During fight-or-flight experiences, unnecessary functions in the brain and body shut down, including certain parts of the brain that are not needed when confronted with danger. “Rest and digest” is when those functions return, particularly the reengagement of the prefrontal cortex, a part of the brain that helps, among other things, organize emotional reactions.
Consider a different scenario. Imagine that I was severely bitten by one of these dogs. Imagine an ambulance had to come and paramedics fought to stop my bleeding just to get me to the hospital, where I endured surgery to keep me alive. Imagine me finally getting released from the hospital with mildly debilitating physical challenges that lasted for months.
Under such conditions, it is possible to experience a prolonged sense of irrational stress, to get stuck in fight-or-flight mode, and to be incapable of moving into rest and digest and the returned use of the parts of our brain that help us make sense of what happened. This is called Post Traumatic Stress Disorder, or PTSD.
In his book, The Body Keeps the Score, author Bessel van der Kolk writes, “Even years later, traumatized people often have enormous difficulty telling other people what has happened to them. Their bodies reexperience terror, rage, and helplessness, as well as the impulse to fight or flee, but these feelings are almost impossible to articulate. Trauma by nature drives us to the edge of comprehension, cutting us off from language based on common experience or an imaginable past.”
People with PTSD avoid memories or reminders that trigger an immediate physical stress response they can’t seem to control. This doesn’t mean they can’t talk about the experience at all, just that their body hasn’t processed the traumatic event so they can move on.
Bessel van der Kolk describes the “cover story” survivors often piece together in order to explain their severe symptoms and reactions to those around them. “These stories,” van der Kolk explains, “however, rarely capture the inner truth of the experience. It is enormously difficult to organize one’s traumatic experiences into a coherent account — a narrative with a beginning, a middle, and an end.”
The reason van der Kolk gives for this in his book, The Body Keeps the Score, is that unresolved trauma, in addition to shutting down the prefrontal cortex, dismantles the entire left side of the brain when a person is triggered.
The left side of the brain is collectively responsible for helping us put experiences into language, logically sequence them so we can better understand what happened, learn and put experiences to future use. Without the use of our left brains, we lack the ability to detect cause and effect, grasp long-term consequences, or plan.
Van der Kolk shares: “When something reminds traumatized people of the past, their right brain reacts as if the traumatic event were happening in the present. But because their left brain is not working very well, they may not be aware that they are re-experiencing and reenacting the past – they are just furious, terrified, enraged, ashamed, or frozen.” This is called an “emotional flashback.”
The hardest thing to grasp about loved ones suffering from PTSD is that, in the moment, they are reliving what happened to them. The left brain is not there to remind them they are no longer in danger or to work out a plan on how to respond in the future.
The cure for post-traumatic stress is for traumatic events to be re-experienced in a certain way and woven into the mind and body so that they are strengthened rather than compromised.
Traumatic events do not have to be truly life-threatening to cause PTSD. A person can come down with the disorder due to a perceived, or even symbolic, threat to safety. It can also result from an actual or perceived sense of threat to a loved one’s safety.
I once worked with a man named Cliff who suffered from debilitating panic attacks. During initial meetings, Cliff randomly and repeatedly told me he’d lived an exemplary life. Most importantly, he had perfect parents — that was important for me to know. He’d never suffered a day’s trauma because of them.
During assessment, his panic symptoms, he assured me, were hard-wired, begging the question: How was I to help? Cliff had already tried medication, and he’d come a long way to managing his symptoms, mostly with a hampering need to control his environment.
When I tried to help Cliff identify triggers, he became defensive, and an angry look would come over his face. Each time he’d steer the conversation away from that topic, undermining a major component of therapy.
When I confronted him about this, he reminded me again about the perfect childhood. When I pointed out that I’d never brought up his childhood, he looked at me suspiciously. Eventually we came to an impasse, and I told Cliff he was going to have to make a decision about whether he really wanted to continue therapy or not.
He assured me he did, he just wanted to make it very, very clear his parents never traumatized him. When he finally refused to explore any causes of his attacks that weren’t physical, I deferred him back to his doctor, who sent him back to me.
Cliff eventually faced the fact that while his parents were loving, they had unwittingly exposed him to their own distress. After a thorough inventory of his childhood, Cliff accepted he might have been traumatized by seeing his parents traumatized.
His parents had been forced to leave their home country and acclimate to America, a very different culture with a different language. His anxiety symptoms started during that time. Not knowing how to address their son’s irrational fears, his parents pursued costly medical treatment and some counseling for him, but nothing effective.
Recognizing Cliff had become an added burden to his parents, he began to suppress his anxiety, which boomeranged into full-fledged panic attacks that escalated into spells of vomiting.
Cliff and his parents had theorized that he was simply born anxious to alleviate feelings of powerlessness. His mother even cultivated stories about how sensitive he’d always been, even as a baby. This also relieved Cliff’s parents of the burden to figure out what was causing his symptoms; they were struggling enough as it was.
Cliff’s primary trauma was being a burden on his parents, and questions about possible causes for panic attacks that were not physical triggered him into fight-or-flight.
Since children are helplessly dependent on their parents, a profound vulnerability that theorists are only beginning to explore as a possible precursor for what is known as complicated PTSD, interactions with a parent’s distress can be a symbolic life-threatening event and ongoing trauma symptoms.
“Wing”, Courtesy of Social.cut, Unsplash.com, CC0 License; “Boxing Gloves”, Courtesy of Arisa Chattasa, Unsplash.com, CC0 License; “Grey Pigeon”, Courtesy of Tim Mossholder, Unsplash.com, CC0 License; “Icicles”, Courtesy of Emanuel Haas, Unsplash.com, CC0 License