Post Traumatic Growth | Post Traumatic Thriving | Recovering from Trauma

Hey there everybody, and welcome to this presentation on post traumatic recovering from traumatic injuries. I'm your host, Dr. Donnellice Snipes. In this video we're going to define big T and little T traumas. We'll explore the impact of trauma regardless of size and finish by exploring some strategies for post traumatic threat, thriving or recovering from traumatic injury. Big T traumas and little T traumas are terms that have been thrown around a lot recently. But what do they really mean? A big T trauma represents often a singular event in which there was a threat of serious injury or death and a sense of helplessness and horror. This could have been a car accident, a heart attack, a robbery, a tornado, a something that was super duper intense and there was a threat of serious injury or loss of life. But just because there is not a threat of serious injury or loss of life or a sense of hopelessness and helplessness and horror doesn't mean that it's not traumatic, doesn't mean that it's not going to have a impact on the individual. So people started using the term language, little T trauma. These are highly stresses, highly distressing events that don't fall into the big T category. So non life threatening injuries, being bullied, neglect, emotional abuse, the death of a pet or even the death of a loved one to cancer, that can be extremely traumatic. And a lot of times little T traumas aren't short in nature. They can go on for a long time. For example, a loved one who has cancer may struggle with that cancer and chemotherapy for months or even years. Emotional abuse and bullying can go on for months or even years. And it's important to recognize that little T traumas do do damage. And I really struggle with the term little T traumas or what some other people call micro traumas because I think it minimizes the impact of these traumas on people's psyche, on people's lives. Think about a stone or a rock that's in a river. Now if you take a rock and you hit it with a hammer hard enough, you're going to break it, you're going to change its shape. That's true. Just like a big T trauma, you know, that's that one big hit and it is going to significantly alter the individual's perception of things. But if you take that same rock and you put it in a river where the water washes over it day in and day out, it changes that rock, it erodes that rock, but it's a lot slower in what happens. So does the little stressor of the river. Is that less impactful? Does that make less of a change on the rock? No, but it may take more time. So it's important to recognize that we should not minimize the impact of little t traumas steps in post traumatic thriving. Now, I'm going through these in this video, which is an hour or less depending on how long I talk. But it's important to recognize that recovering from trauma takes time. So I'm just kind of giving you a really high level overview. So the first step is to create safety. After a trauma, a person is stripped of their sense of personal empowerment and safety. That's what trauma does to people. And if a person receives adequate support right after that trauma, it may not develop into traumatic injury. But if they don't, then, or if they don't process what happened, then it can develop into what we call traumatic injury. So the person, there's a part of that person that still feels disempowered or unsafe. In order to move forward, it's important to first create safety. We all need to feel safe. Then acknowledge the reality of the traumas. This happened, it is what it is not. It shouldn't have happened. Or maybe I'm misremembering or it wasn't as bad as I remember. It is what it is. Acknowledge the reality of what happened. And this again comes after you create safety. You don't want to do this if you don't have resources, if you don't have support when you are addressing this trauma again because then you're going to feel more vulnerable and potentially re traumatize yourself. So create safety. Acknowledge the reality of the traumas. Assess the impact the trauma is having on you. What are your symptoms? Not everybody responds to trauma in the same way. Not everybody responds to a particular trauma in the same way. So you may respond to a tornado in one way and to a robbery in another way. Well, one is a natural disaster. One is a event that is perpetrated by another human being. So it makes sense that in the first one you may not lose your faith in humanity, but in the second one, you may question the goodness of humanity. So your reaction to different traumas may differ, and that's okay. But it's important to assess the impact that the trauma or the traumas you've experienced experienced are having on you. Take an inventory. Then accept where you are. Stop shoulding yourself. I should be over this by now, or I shouldn't feel this way about this. You feel how you feel and getting to that point of acceptance is really important. Getting to that point of saying, okay, this is what we're dealing with now. How do I address it? This, the next step is defining a rich and meaningful life. This is where I am. These are my symptoms. Where do I want to be? What is a rich and meaningful life to me? Increase your motivation for change. Then identify ways to address the symptoms that you have that help you move toward that rich and meaningful life. And this may mean experimenting. You may not know exactly what's going to help you address a particular symptom, but you may have some inklings, you may have some ideas, and now's the time to start experimenting to see what works. Once you've identified some strategies that you might want to use, take the first step. So let's look at these a little bit more in detail. Post traumatic thriving. And I have on this, you are here, symptoms and all that. Is that mindful acceptance, acceptance of the trauma and how it's impacting you. This is, these are your symptoms. This is what happened. It is what it is now. How are you going to address it? How are you going to use your energy? Are you going to use your energy to struggle with your symptoms in a way that moves you away from your rich and meaningful life? Are you simply going to struggle with your symptoms and not move forward or backward, you just kind of stay stuck? Or are you going to evaluate how you're using your energy in response to your symptoms and identify strategies that help you move closer to your rich and meaningful life, that help you feel happier, that help you nurture important relationships? As I mentioned, once you define your rich and meaningful life, that's all well and good. So you have this vision, you have this light at the end of the tunnel, so to speak, where you want to go. That's wonderful, but it takes more than that. Now you've got to increase your motivation. Ask yourself, if I were better able to manage the symptoms that I have, it would help me move toward my rich and meaningful life by physically. How is it going to help you move toward the physical aspects of your rich and meaningful life? Is it going to help you improve your health? Well, probably if you're stressed, then that is taking its toll on your blood pressure, on your blood sugar, on your health. It's keeping your cortisol levels high, it's making you age faster. Is it going to improve your energy? Probably. If you're not stressed and if you start sleeping better and are in less pain, then you're probably going to have more. And that energy can be used to move towards your rich and meaningful life. Likewise, if you start freeing up some energy from resentments and anger and other stuff that you may be having, tying your energy up in right now, then you're going to have all this extra energy that suddenly is there that you can put toward your rich and meaningful life. So how awesome is that? Affectively, if you were better able to manage your symptoms, how would it impact your mood? Hopefully it would help you feel better, more motivated, more curious, more enthusiastic. Cognitively, if you were better able to manage your symptoms, if you were able to get better sleep, have more energy, be in a better mood, how would it improve your attitude? Would you still be as negative and pessimistic or would you be more optimistic? How would it help your concentration if you weren't hyper vigilant or exhausted all the time? Would you be able to concentrate better, make better decisions, or even tap into that long lost creativity? Environmentally, if you got your symptoms under control, so you weren't feeling hyper vigilant, so you were, so you were feeling safer and you were feeling more empowered, how would that impact the stress level in your environment? And I know that's sort of intangible, but we've all walked into environments, rooms, places where the energy has been very good, and we've all walked into places where the energy has been oppressive, it's been very stressful. So how will it improve your environment if you address all of this stress? Will you feel more liberated and more positive in your environment? Will you feel safer and your relationships? If you get your symptoms under control, you have more energy, you're in a better mood, you can concentrate more, you're not as hypervigilant, how is that going to impact the quality of your relationships? Your energy that you have to invest in relationships, probably going to have more of that. And how are you going to enjoy your relationships more if you're able to actually tap into feelings like enjoyment and engage in activities that bring you happiness and joy and contentment? Once you've increased your motivation, you've figured out where you want to go, what your rich and meaningful life looks at, you've increased your motivation, you've said, okay, these are all the reasons that I really want to do the hard work to get over there. All right, now it's time to figure out how do we get from point A, which is where you are, it is what it is to your rich and meaningful life. Point B, I mentioned earlier, you're going to take an inventory of each of your symptoms and for each symptom, ask yourself, what is Causing it. Because it may not be your trauma. It could be, but it may not be. Is it related to my trauma? And if so, how? So that goes to understanding. If you're hyper vigilant, is it related to your trauma? Yes. You're on edge because you don't feel safe. So that helps, helps you understand where that feeling is coming from, how it's related to the trauma. And then you can start identifying strategies to help you feel safer. So what strategies can I use to address it then? Keep a log of how often, how intense, or how long the symptoms last. Hypervigilance, panic, whatever symptom we're talking about, it's good to try to focus on one symptom at a time, or maybe two. If you feel really froggy and keep a log. That way you can see incremental progress. You're not going to go from having flashbacks every single day to no flashbacks at all. You want to have fewer flashbacks or flashbacks that don't last as long, or flashbacks that are less intense, or all of the above. Regardless, even if you are still having one every day, if they are less intense, that's progress. Then if they are shorter in duration, they become less intense, then become shorter in duration. That's even better. Exploring with one strategy at a time how you're going to address these issues. Now, normally I start out with physical interventions, but with trauma, it is so important to create safety that I feel like it's important to start there. So environmentally, when you experience trauma, whether it is ongoing trauma from abuse or neglect or bullying, there can be a lack of a sense of safety. Even a loved one who had cancer, you may develop a lack of a sense of safety, a fear that every time you have, you get sick or you have a pain that you've got cancer. So that lack of a sense of control and safety is paramount. Triggers for your sense of unsafeness in your environment abound. So things that are related to your trauma may serve as triggers. Things, people, places, smells and sounds. So you want to take an inventory of those things and figure out, all right, what things are triggering my stress response, what things are keeping me feeling unsafe and disempowered. Once you've identified your trauma triggers in your environment, and this includes your home, your car, your work, ideally restaurants in general, and places you like to recreate, whatever that looks like, whether you like to go hiking or roller skating, the environments that you frequent, try to figure out, how can I feel safe in these environments? And develop a plan to eliminate or mitigate any of Your trauma triggers in those environments. Now eliminate means get rid of them. If there is something in your home environment that triggers your trauma that you can get rid of, like a picture or a particular smell, or maybe you want to add another deadbolt to your door, whatever it is, do that. That way you feel safer. But sometimes you can't completely eliminate something. For example, being in a restaurant where there's a lot of activity, you can't tell everybody to be quiet and don't move and only go to the restaurant when there's nobody else there. Likely the restaurant's not open, then what can you do? And a lot of people who feel unsafe in restaurants sit with their back towards a wall so they can see all the entrances and exits. That mitigates the situation, so they feel safer in in that environment. If there's a particular smell in that particular environment, bring with you either personal air purifiers or another smell to counter it. And you can even rub something like Vicks VapoRub right underneath your nose so you smell that instead of the triggering smell. Identify triggers, sites, smells, sounds and sensations for safety as well. Triggers are not only things for bad stuff. Triggers can also promote a feeling of relaxation and happiness and safety. And identify ways to add those to each of your environments. On your mobile device, maybe you have the lock screen as a picture of your significant other, or your kids, or your dog, or something that makes you feel safe, happy and content. What else can you do? What other sights, smells, sounds or sensations can you add? And then create a rescue pack to have with you. You're not always going to be in an environment that you can control, and it would be overwhelming to try to plan for every single environment. But if you have a rescue pack, then you have tools that you can use in the event that you start feeling triggered. Create a thought list that has distress tolerant mantras on them. Things that you tell yourself like, I can get through this. This will end pretty soon. This too shall pass. I'm strong enough, I'm safe. In this context, develop four or five distress tolerant mantras. These are things that you tell yourself that remind yourself that you are safe and you are empowered. Activities. Breathing is one way to stimulate your vagus nerve, your relaxation response. So you can just engage in slow diaphragmatic breathing. Breathe through your belly, inhale for four, hold for four, exhale for four, then hold for four and repeat. That is the easiest way to do it. You can do that when you're driving. You can do that when you're in line at the dmv, wherever. You don't need any particular tools. If you have bubbles, you can go to the store and get those little tiny containers of bubble stuff that they use at weddings and parties. And you can keep those in your backpack or in your rescue pack. Because again, when you take a deep breath and then you blow out slowly in order to either make a big bubble or make as many bubbles as possible, that does a similar thing to the breathing exercise that I just talked about. Balloons are the same way. If you've ever tried to blow up a balloon, you take a big breath in, you hold it, and then you exhale as long as you can to try to blow up that balloon. That too will start triggering that vagus nerve. Bubble gum is another technique to stimulate that relaxation breathing. Because you're chewing it, you're also noticing the texture and the taste, which is a bonus. But then when you get ready to blow the bubble, you take in that big breath, you hold it for a second, and then you blow until you can slowly so you don't pop the bubble. You want to see how big that bubble gets. All of those are breathing oriented activities. Have a phone with you. Most of us always have our phone with us, so that's not a big deal. But having a phone with you, then you can call a friend, you can call somebody and talk to them. Most of us have somebody that we can call and talk to. If you have nobody that you can call and talk to, then make sure that you have programmed in the crisis hotline for your local area because there's going to be somebody that can answer the phone and talk with you, help you get grounded. And narration is a final activity that I encourage people to have in their rescue pack. And this isn't something that you're actually going to have in your package, but narration is an activity that you can do when you start feeling triggered. Just start talking to yourself and you can do it in your head. You don't have to actually talk out loud, but narrating everything you're doing. I'm walking into. I'm walking down the hall. I'm looking for the bathroom. I'm turning right and going into the bathroom. I'm looking for a stall that's empty. Whatever it is that you're doing that helps you stay grounded and in the present moment so you're not as likely to dissociate or be overcome by flashbacks and sensations. Essential oils are great. You can put a couple drops of essential oils on a cotton ball and put it in a little tiny baggie and keep it with you. Or you can get some of the little tiny bottles of essential oils and just keep that with you. They even have little roll on things that you can use diluted essential oils and keep those with you. So there are a lot of ways that you can have essential oils if you want to use those, but you don't have to get that fancy. You can also just use wax tarts. I keep wax tarts in a little baggie in my purse. I keep one of those. I also keep a wax tart in a little cup in my car, so when it gets hot during the day, it melts the wax tart and makes my car smell really good. But that smell is a smell that triggers feelings of happiness and contentment. So I am not being triggered by other smells. An anchoring object can be helpful grabbing something. And ideally it's an object like a worry stone or prayer beads or even a little stuffed animal or something that helps you feel safe and content. But holding it and then describing it to yourself, what does it feel like? Is it cold? Is it warm? Is it smooth? Is it rough? That can help you stay anchored in the moment. An instant ice pack is one that I really encourage people to keep with them because holding ice cubes can really distract you from whatever else is going on. If you're starting to ruminate or if you're feeling like you're starting to emotionally dysregulate. Holding ice cubes because it's unpleasant, because it doesn't feel great, it distracts your body's attention. It distracts your attention to that cold sensation. Not everywhere you go are you going to be able to get your hands on really cold water or ice. But if you have an instant ice pack with you, then if you really need to, you can open that thing up and as it gets cold, you can put it on your wrist. Or some people will put it on the back of your neck. But be careful doing that so you don't trigger a migraine or something. But that ice cold sensation is going to draw your attention to it and away from anything else that you might be thinking about. Music. Some people have playlists, songs that they like to listen to that help them feel safe and empowered. And on the other end of the spectrum, noise canceling headphones. If the noise is overwhelming or if there are sounds that are triggering to you, for example, the sounds of sirens can be triggering to some people, then noise canceling headphones can be helpful. So those are things that you can include in your rescue path. That you want to keep with you pretty much wherever you go. Additionally, when creating safety, so we've talked about mitigating or eliminating any trauma triggers. We've talked about adding triggers that remind you that you're safe and empowered. We've talked about creating a rescue pack so you can deal with triggers in less controlled environments. And finally develop mindfulness. It's really important to be aware of how you're feeling so those sensations don't overcome you and feel like they come from out of the blue. If you become more mindful, then you're going to notice when you start getting that feeling or start that thought starts to creep into your conscious awareness and you can address it before it becomes a full out anxiety provoking situation. As you become more mindful, you'll also become more aware of triggers in your environment and potentially able to decouple them. You'll be able to say, okay, I'm noticing that this smell is triggering a trauma reaction in me and in this context, at this time, I'm safe. That smell reminds me of something from the past that was unsafe, but in the present, that smell does not mean that I'm unsafe physically. Trauma affects us in a lot of different ways. When people experience traumatic injury, their HPA axis or their stress response is always on. Now, it may only be on a little bit or it may be wide open, but it's almost always on. They may feel like they want to fight. They may feel angry and irritable. They may feel like they want to flee. They feel worried or anxious or stressed out. They may feel like they're just gonna freeze, like they don't know what to do. And they feel hopeless, helpless, powerless. They may feel like they need to fawn. They need to try to find whatever's causing that perception of threat, whatever's triggering that threat, and try to figure out how to make it better. They're gonna try to fawn over it to make make it go away or reduce the threat from it. Or number five is the forget about it. And when people are stressed out for too long, the HPA axis turns down its sensitivity. Instead of getting excited about things that would normally get excited about, it only gets excited about the most intense things. So forget about it. Is that feeling of being flat or even depressed noticing this? Once you are aware of this, then you can start addressing your HPA axis. You can start figuring out, okay, I'm feeling like I want to fight, I'm feeling angry. What steps can I take to address that sleep disturbance? Remember I said we're going to ask, is this symptom caused by my trauma or something else? Sleep disturbance can be caused by a not good sleep environment. It may be too hot, too noisy, too crowded, and that may not have anything to do with your trauma. But a sleep disturbance is going to throw your neurotransmitters out of whack and make your trauma reaction worse. Hypervigilance and nightmares are both often associated with trauma. Okay, so that makes it harder to sleep because it's harder to relax, to get good sleep. And you may be afraid to go to sleep because you're afraid you're going to have nightmares. And when you do go to sleep, you wake up with nightmares. Okay, so those are two symptoms that are related to your trauma, that it will be important to figure out strategies that are helpful for you to address those particular symptoms. Alcohol may or may not be directly related to your trauma. Some people drink in order to help them feel like they can get to sleep easier because they're hypervigilant, because they're stressed out all the time. So it's kind of tangentially related to the trauma. But alcohol also disrupts sleep quality. Circadian rhythm disruption and poor sleep hygiene also can contribute to sleep disturbance. And this again could be tangentially related to the trauma because you don't want to go to sleep. Or maybe you're tired all the time because you're not getting good sleep so you nap a lot. But ultimately, poor sleep is associated with poor mood and is associated with increased anxiety, is associated with increased stress and increased activation of the HPA axis or the stress response. So it's something that needs to be addressed. Hypervigilance or always scanning, always feeling unsafe, always being hyper alert to anything that's going on is exhausting. And if that's a symptom you have, then recognizing, okay, this is here because my brain's trying to protect me from future threats. Now how can I feel safer so I don't feel like I have to be on guard all the time. Restlessness is your body's way of staying primed. Just like in tennis, if you are standing on the baseline and you're standing flat footed, it takes more time to get to that ball than it does if you're bouncing on your toes. If you're bouncing on your toes, you're already primed and you're ready to go. If you are in a car, you know, getting that engine revved ahead of time gets you prepared to get off that starting line. So with restlessness, recognizing that's your body's way. Again, it's a response. Your HPA axis, your stress response is active, saying, hey, we need to be ready to jump at a moment's notice. How can you handle this? What can you do to cope with your restlessness? Maybe you can't make it completely go away right now. That's okay. How can you cope with it? Can you get some sort of fidget item that you can use? Can you stand up instead of sitting down? What is it that might help you cope in that particular situation? You know, sitting through a staff meeting, I find, you know, I have difficulty sitting through long meetings and I find that if I have paper with me that I can just sketch or color and I'm not an artist by any means, but if I can be doing something with my hands and it helps channel that energy a little bit. Exhaustion. Now again, this could be caused by poor nutrition, it could be caused by thyroid dysfunction, it could be caused by poor sleep. So a lot of things, hyper vigilance, restlessness, theoretically, if you start feeling safer and you start getting better sleep, you'll be less hyper vigilant, less restless and less exhausted. So you see how these things are going to start folding in on themselves and an improvement in one area is likely going to improve others. If you improve your restlessness, then you might feel less exhausted. Eating or weight changes are also common effects of trauma. Some people eat to self soothe, some people lose their appetite, some people are stressed out, so they're eating, but it's going straight through them and their body can't even use the nutrients because it slides through so fast. Being aware of that and working with a nutritionist, working with your doctor to modify your diet to make sure that you're getting adequate nutrients so your body can make the neurotransmitters it needs to help you feel more relaxed. Pain and inflammation also increase because of muscle tension, because of sleep disturbances, because of neurotransmitter changes. So it's important to look at that. People can also experience increased pain after a trauma, especially a trauma that involved actual physical injury. They may continue to have ongoing pain that is caused by memories of that trauma. Recognizing where the pain is coming from and identifying strategies to address it is what we need to do in order to promote post traumatic thriving. Instead of saying, I shouldn't have this or this doesn't make any sense, get curious, say how does it make sense? And okay, what can I do about it? How can I make it a little bit better? Maybe I can't get rid of it completely. But how can I make it a little bit better? And then after that, how can I make it a little bit more better? Sensations are another effect of trauma. Big T or little T. A lot of times our traumatic memories are encoded or stored in our body as sensations. Maybe not even memories with words attached to them. And when we experience those sensations, when those sensations are triggered, it can trigger a cascade of stress reactions. Becoming aware of those sensations, noticing those, recognizing what causes those sensations, and then either desensitizing that or avoiding that particular sensation can help you thrive in the post trauma world. And dissociation. I already mentioned that on another slide, but dissociation is feeling like you are checking out of your body. Feeling like you are like a fly on the wall observing yourself or maybe just kind of blanking out and then coming to some point later. Not necessarily dissociative fugue where you go anywhere but you lose time. You're sitting there cooking eggs and the next thing you know, the eggs are burned to a crisp and you don't remember them even starting to burn. That would be dissociation. Recognizing the early warning signs of dissociation and triggers for dissociation and then using some of those grounding techniques like narrating or getting safe or calling a friend can help you stay grounded and anchored so you don't dissociate. When people start feeling more empowered to control some of these reactions, or they at least start understanding where these reactions are coming from and feel more capable of managing them, then anxiety starts to go down. That stress response, that HPA axis, starts to relax a little bit. Affectively, unhooking from your feelings is a tool that can be really helpful. Instead of saying, I am depressed, I am terrified. Saying, I am having the feeling that I'm terrified. Okay, I'm having this feeling. I'm holding it in my hand. What am I going to do with it? What's it telling me to do? What's its purpose? And how can I best respond? It's not me, it's this feeling. How am I responding to this feeling? Purposeful action is looking at what's going on. I'm having the feeling that I'm terrified. Okay, so I'm unhooked from it. Now purposeful action is saying, all right, how can I use my energy to address this situation in a way that is going to move me toward my rich and meaningful life? I could just sit on it and dwell on it. Is that a good use of my energy to move me toward my rich and meaningful life? I could use my energy to call a friend. Is that going to help me address this feeling of being terrified in a way that can help me move toward my rich and meaningful life? Well, possibly if I call a friend, it might help me de escalate and get a different perspective so I can address it differently. Forgiveness is also an important aspect of post traumatic thriving. Not only forgiving others, but forgiving yourself. Remember, forgiveness doesn't mean saying it's okay, no problem. Forgiveness is saying it's over. I've learned from it, but I am not going to continue to steal energy from my present and tie it up in my past. It's not worth my energy to continue to dwell on this. I've learned from it, so I've used my energy to learn and I'm going to move forward now and I'm going to leave that in the past. Hardiness is the concept of commitment, control and challenge. And that kind of goes along with that whole rich and meaningful life. In your rich and meaningful life, you've identified the people, places, things and experiences that are important to you. With hardiness, those are the things to which you're committed. So you have all of those things out here. Looking at all of those things to which you're committed to, which ones are going well and then which ones over here not going so well. For most of us, there's always something over here in the not going so great category, and that's okay. But hardiness encourages us to broaden our perspective. Instead of focusing on the one thing that's going crappy, notice everything and the one thing that's going crappy. So notice what you're committed to and which of those things are going well and that you already have control of the situations that are going on. What aspects do you have control over? In what way do you have control over the things that are going well? In what way do you have control over the things that aren't going so well right now? And challenge. Once you've identified something like a traumatic injury, seeing that instead of as a barrier or an obstacle to keep, that's going to keep you from living your rich and meaningful life, looking at it, at it as a challenge and saying, okay, well, how can I solve this? This is a challenge. How can I get over it, get around it, get under it in order to get, continue to move forward towards my rich and meaningful life. Affectively, when we experience trauma, a lot of times we may experience what's called emotional dysregulation. And that is the result in part of the HPA axis, the stress response system becoming dysregulated Once it turns down its sensitivity, then you may feel flat a lot of the time, but when it finally does get triggered, it just has a tsunami of stress hormones. So you feel furious and it could be, you know, anxious furious or angry furious, but you go from flat to furious. And it's important to recognize that this is not just all in your head. It's not you just being, quote, overly emotional. This is a neurological neurochemical reaction to ongoing unremitting stress and recognizing that as your HPA axis gets back in balance, as you start feeling safer and more empowered so you're not feeling like you are always in danger, the tsunami of chemicals, the emotional dysregulation may start to improve because you're not going to, because that HPA axis is going to be getting re regulated. Basically, when people experience trauma, big or little, there's anger and anxiety. Both of these are emotions that are designed to protect you. Fight or flee. Your body is dumping energy that says, hey, there might be a threat. Just like a smoke alarm, there might be a threat. So I'm going to give you a whole bunch of energy so you can get up off the couch and look, figure out if there is a threat and if there is, deal with it. If there's not, then give me the energy back. You know, no problem, no harm, no foul. Anger and anxiety are not designed to keep you stewing on that. They're not designed to influence your perception of the entire world. They are neurochemical emotional reactions in the moment that are designed to give you energy to figure out if you're safe and help you stay safe. The end. Depression exists when you feel hopeless and helpless to change a situation to get safe. A lot of people after trauma start feeling depressed because their HPA axis is dysregulated. They're feeling flat, unmotivated a lot of the time and they don't know how to feel any better. So they start feeling resigned to depression. Identifying what's motivating your depression, what's causing it? What things can you do to address your depression? Guilt and shame also need to be processed. Guilt and shame are variations of anger, but they're anger at yourself. I feel guilty or I feel ashamed that I did this or I didn't do this or that this happened. And it's important to evaluate those things by unhooking, you know, I'm having this feeling of guilt now. Can I forgive myself for it? Do I even need to forgive myself for it. Grief is another effect of trauma because when we lose our sense of safety, when we feel disempowered, it often alters our perception of the world. It changes what we think about people. We may lose some dreams or have to change some of our dreams and expectations. And if it involved loss, then we may also have to grieve that loss. Whether it was a pet or a relationship or a traumatic death of some sort, grief is still important. And until you move through that grieving process, it's going to be hard to completely come to terms with that trauma and feel safe and empowered again. And low motivation kind of goes along with depression, kind of goes along with HPA axis dysregulation. When your energy is low, when you're not sleeping, when your dopamine is low, when. When your norepinephrine is low, then motivation is likely going to be low. If you feel hopeless and helpless, if you feel disempowered, then motivation is likely to be low. So it's important to explore what is causing me to feel unmotivated at this time and what are some strategies I might be able to use to improve my motivation, even if just for five minutes. You know, don't look to feel motivated to clean the whole house. Figure out how can I get motivated to take a shower? How can I get motivated to call a friend? You know, motivated to do a specific task Cognitively, there's an old story about two wolves. There are two wolves living inside us. One is anger and anxiety and grief and stress and all those dysphoric emotions. And one is happiness and optimism and empowerment. Which one survives? They're going to battle to the death. Which one survives? And ultimately, it's the one that you feed. And so I use the mnemonic you feed to remember cognitive strategies to address trauma. Again, unhooking. Unhooking from your thoughts. I'm having the thought that people are untrustworthy. Okay, what am I going to do with this thought? FCP in context. So I have this thought that people are untrustworthy. What are the facts for and against that belief in context? Not all the time, because in certain situations, people are untrustworthy. But in this particular context, at this particular point in time, what are the facts for and against my belief? What control do I have in this particular situation? So maybe at this point in time, are people trustworthy? I'm not really sure. So maybe I can trust them a little bit, but not trust them with my bank account and a key to my house and what is the probability based on the facts in the current situation? And if I take steps within my control, what is the probability that I'm going to get hurt or there is going to be a catastrophic result? This can help us update our schema. Many times after a trauma, our schema becomes generalized and we may feel like everybody is untrustworthy. By using facts, control and probability in the current context, we can update our schema and start seeing that, okay, sometimes people are untrustworthy, but other times people are trustworthy and we can start seeing the variations instead of glumping everybody into one category. Explanations. Alternate explanations is another tool that we can use. A lot of times when we have experienced trauma, we may project the past, what people did in the past, onto people in the present, or what happened in the past, to our expectations of the present by looking for alternate explanations. Why did this happen? What are three alternate explanations for why I didn't get this job? What are three alternate explanations for why my friend didn't call me back? What are three alternate explanations besides the one that is making me feel disempowered and unsafe? You know, it could have absolutely nothing to do with you. It could have something to do with them or something completely different. Exceptions is another cognitive tool for post trauma thriving. Looking for exceptions to beliefs like it is never safe to do this or this always happens. Every time there's a thunderstorm, there's a tornado. Well, no, you know, there are exceptions to that. And it's important to identify the exceptions to your trauma based cognitions, to your thoughts, to your beliefs that you are unsafe. What are the exceptions in this situation that you've been safe. And dialectics means embracing the good with the bad. Instead of viewing people or things or situations or places as all good or all bad, embracing the dialectics and recognizing that okay, in certain situations, at certain times, things are not good, things are, things are dangerous, things are whatever. But there are also times when people, places things are good, are helpful, are empowering and embracing those dialectics can help us feel safer when we start to recognize that we can differentiate. When we start to learn to differentiate, we start between the unsafe and the safe. So trauma can lead to pessimism and negativity, suspiciousness, feelings of disempowerment, difficulty concentrating, or flashbacks. And it's important to figure out for each of those what triggers that symptom for you, what strategies might help you address it in a way that helps you feel, guess what? Safer and more empowered relationally after a trauma. A lot of times we Have a reduced sense of self awareness, we kind of go numb because our body and our brain and everything else is just sort of in chaos. A lot of times after trauma, we lose a particular sense of self awareness. And it's important to regain that, to become more mindful of how you're feeling, what you're thinking in the moment in order to re establish a relationship with yourself. Why is that? Because in order to keep yourself safe, in order to take steps to empower yourself to stay safe, you have to be aware of when you feel unsafe. So becoming aware of your particular triggers, becoming aware of your early warning signs can help you learn to manage your symptoms. So you feel safer in the present environment. Sometimes because of the environment that it happened in or because of the trauma, you may develop an obnoxious inner critic that wants to criticize how you handle the trauma, that wants to criticize you for not being over the trauma yet or for being over the trauma too soon. And it's important to address that obnoxious inner critic. Evaluate, okay, the inner critic say, inner critic in me is saying, I got over this trauma too soon. We'll just take that one. What are the facts for and against that? Is this something I believe? I don't care what my inner critic believes. What is it that I believe? And talk back to the inner critic. You can even tell him to be quiet, you know, I'm not going to listen to that. I believe that I will process this in my own time. After a trauma, some people can develop overly rigid or overly weak boundaries. Sometimes they people will shut others out as a reaction to trauma because they don't want to get hurt again. Or on the other side, they just let down all of their boundaries because they're so afraid of abandonment that they feel like they need to connect with other people. They feel a need for dependent connections. Neither one of them in their extreme is healthy. So it's important to evaluate if you notice that you're either pushing people away or letting people walk all over you, that may be an effect of the trauma. And what is the function of that? Why is it that you're letting people walk all over you, for example, and is it actually helping you feel safer and more empowered? People may experience changes in activities as a result of trauma. Maybe they used to like to go to the mall, and they used to like to go hiking, and they used to like to do all these things out in public, and now they don't feel safe out in public. That can be certainly be an effect of the trauma. And working through those fears, recognizing, okay, what is it about going to the mall that makes me feel unsafe and is there a way I can mitigate that? So maybe not going on a Saturday afternoon where it's packed to the brim, but going first thing on a Monday morning when there's not many people there. So you're still being able to do something you enjoy, but it's in a much less threatening environment at that point in time. So you can start reclaiming and regaining some of the activities that you enjoy doing, although you may at least temporarily have to do them at different times. Similarly, if, for example, you got into a car crash on the interstate, maybe you're terrified. Now, whenever you get on the interstate, you have all kinds of trauma triggers. Okay, well, getting from point A to point B, you may not want to take the interstate for a while until you've processed that trauma and worked through those triggers. But in the interim, how can you get from point A to point B without being on the interstate? Yeah, back roads take longer, but it is a opportunity or it is a strategy to use until you can fully process the, the trauma triggers. So the trauma is not controlling your life, you're controlling your life and you're still doing what you want to do and in your rich and meaningful life and hopefully processing some of the trauma stuff so you can take back the totality. Sometimes after a trauma, people shut others out for fear of overwhelming them or thinking, you know, if I told them what I was thinking or feeling, they just wouldn't understand. And that's totally normal. When you went through the trauma, it was overwhelming to you. And yeah, it may be a lot for people to hear or for people to empathize with, but you're making a lot of assumptions that they wouldn't understand or that it would overwhelm them. Now obviously you've got to be careful in who you reach out to. You're not going to reach out to your 11 year old niece or somebody you don't know, or somebody that you already know doesn't have a lot of capacity for empathy. But reaching out to a significant other that wants to be there for you and beginning to share. You don't have to dump everything once you can. If you don't feel like they would understand or if you're afraid that you're going to overwhelm them, you can give them a high level overview, you know, crack the door open a little bit so they can kind of get a peek inside. And then if that's not overwhelming, you can invite them completely in, so to speak. And finally, emotional unavailability. When people experience trauma, it is freaking overwhelming. It's exhausting. We've already talked about this. It can make you not trust other people. It can make you pessimistic, can make you suspicious. It can make it feel like, you know, your insides are kind of spinning out of control, which makes it hard to be empathetic with others, to respond to other people's feelings and sense stuff, because you're barely keeping a lid on your own stuff. Recognizing when you are overwhelmed, when you are burnt out, when you are emotionally unavailable is important. It's not a bad thing. I mean, you don't want to stay emotionally unavailable forever, but everybody gets to that point sometimes where they're like, I just can't take any more input. I cannot take one more thing. Recognizing that is huge, because then you are empowered to take steps to figure out, okay, how do I deal with this? I'm feeling like my pressure cooker is completely pressurized. What can I do in order to let off some of the steam so I can be emotionally available for others? That goes back to that purposeful action. I'm having the feeling that I'm overwhelmed, and I can't take one more thing. What can I do? How can I use my energy in order to deal with that so I can be emotionally available to those people who are important in my rich and meaningful life? Trauma impacts every aspect of your being. If you didn't receive adequate support to help you feel safe and empowered after the trauma, then it likely caused traumatic injury. If you were able to process what happened and process the trauma and feel safe and empowered, then, yeah, it was a trauma, it was exhausting, it sucked, and you probably integrated it. But if you didn't, then it was probably ended up hanging out there in your amygdala, not being filed, not knowing what to do, bouncing around and causing traumatic injury. Traumatic injuries can increase your feelings of hopelessness, helplessness, and being stuck or trapped. Because a lot of times, you know, those symptoms we talked about. A lot of times people don't understand how they connect to the trauma. Once they start understanding how they connect to the trauma and how it makes sense, then they start feeling more empowered. Once they can put a name to it, once they understand why it's happening, then they can start figuring out ways to address it. Recovering from traumatic injury takes time, but most positive steps you take will often decrease the intensity and or frequency of most of your other symptoms. So, for example, we talked about sleep if you start getting better quality sleep, then it's likely going to help your HPA axis, your stress response system start to rebalance, which will help rebalance your hormones and your neurotransmitters, which will help you have more energy and feel less fatigued and be better able to concentrate. You know, so there's just addressing one thing is going to help other things. Is it going to improve all of those other things completely? No. You know, you're still going to have to work on your trauma related cognitions, but it's certainly going to improve the landscape in which you're working.