A young mother brought a seven year old boy to my office. The young man, an intelligent boy, had suddenly started to throw up on being taken to the school. He pleaded and begged his mother not to send him to school. On investigation I learnt that he had developed a fear of school that came from his fear of a particular male teacher. This teacher’s fault was that he spoke loudly, which frightened the boy. If this fear would not have been addressed, the young man could have developed fear of authority figures, school, academics in general and even cars, in which he was being driven to school. Later he may have developed generalised anxiety and even agoraphobia, which would have prevented him to go out of the house.
Trauma and stress, though different words, are linked together. Trauma-physical, psychological or emotional- produces stress. We can define trauma as an event that is usually sudden and unexpected (but can also be expected as in abuse) that disturbs the body and the mind for a short or long period of time. As such, the disturbance that body and the mind experience is termed ‘Stress’ or ‘Bad Stress’. Such stress can be experienced for a short period or can be prolonged, when it can become chronic. At such times, the body gets used to the tensions and the person carrying this tension believes they are relaxed. Traumatic stress or ‘Bad Stress’ is a term that is unrecognised in medical diagnostic terminology.
However, Post Traumatic Stress Disorder (also known as PTSD) is a recognised medical condition. As the name suggests, it develops due to stress that follows a traumatic event. Any threatening experience that a person goes through or witnesses can trigger symptoms of Post-Traumatic Stress Disorder. This syndrome consists of cluster of symptoms that include nightmares, flashbacks of the traumatic event, increased irritability, sensitiveness to slight noise, sleep disturbances, avoidance of any image or memory that reminds the sufferer of the trauma. If these symptoms do not occur at the same time, the person is not medically suffering with Post-Traumatic Stress Disorder. These symptoms are commonly seen in people following a road traffic accident, natural catastrophes like earthquakes and hurricanes, fires, torture, physical and sexual abuse and in wars.
From the perspective of human body and mind, any experience that is interpreted as threatening by the unconscious mind is considered traumatic and so becomes stressful. Say if a parent, for example, screams at a child the child’s mind can register it as stressful, depending on the child’s temperament. This experience can be perceived as traumatic though it is not a life-threatening event. Even if the experience of screaming is short-lived, it could remain alive in the child’s mind for a long time. This could continue to affect the thinking and behaviour of the child till the issue is addressed. Bullying, neglect, rejection, corporal punishment and humiliation are examples of events that the mind perceives as threatening-not life threatening but threatening the sense of freedom. Though single events have powerful impact, repetitive perceived threats could become traumatic for the person. Any experiences that create fear or anger that are suppressed are equated with traumatic events by the mind.
A middle-aged lady once came to see me for issues that had arisen because of five deaths in her immediate family within a short space of time. Her childhood had been uneventful and happy which was reflected in how she related with her husband and her children. Though she did not have any life threatening issues, these losses had become distressing for her. The body had to follow the mind and so she became sad, unable to focus on day-to-day life.
When a child is brought up in an environment of extreme strictness, there is a loss of freedom that is experienced by the mind of the child. It occurs unconsciously. If there is no positive approval in the child’s life, the strictness becomes a trauma. If there is lack of opportunities for emotional expression, traumatic stress is experienced.
Hormones and chemicals called neurotransmitters govern our body’s physiological activities. Bad Stress is experienced when a hormone called cortisol is secreted in excess in the body. The role of this hormone is to stir up the body to enable it to escape or fight any threat that the senses (sight, smell, touch, hearing and taste) come across. It is a different matter if the threat is real or imaginary. The mind treats the image of the threatening object as real. If someone was bullied many years ago, the images keep the incidents alive in the memory of the person. So if the person comes across any situation or person that unconsciously reminds them of the bullying incidents, then the person tends to feel the same way they felt during first experience. The net effect of many similar unpleasant experiences affects the current perception, thinking and behaviour of the individual.
The mind-body connection of traumatic stress is not known to us in our awareness or consciously. A person can present with complaints of physical or psychological nature totally unaware that the unconscious part of our mind is responsible for them. In my practice, I have seen adult cases of bed-wetting, social phobia, high blood pressure, low testosterone levels, diabetes, blood disorders, depression, anxiety, eating-disorders and addictions among other conditions that resulted from traumatic stress. Forgetting an unpleasant experience because it happened many years ago is not an excuse for the unconscious mind to be not affected by it.
Research shows that relaxation helps in all conditions of stress. Regular relaxation practices are helpful because they have the same basis of effect as the effect of unpleasant experiences. It has an accumulative impact on the body and the mind. Like a bank balance, ‘relaxation balance’ creates a cushion against future stresses. Addressing individual traumatic events with imagery work or counselling neutralises the emotional impact of the experiences.A state of relaxation is then created in the body. When many such unpleasant experiences are neutralised, there is a change in the individual’s perception, thinking and behaviour.
During natural catastrophes like earthquakes, about 40% to 50% of the people tend to develop symptoms of Post-Traumatic Stress Disorder. The rest of the population that have gone through the same experience will not have the symptoms but may continue to harbour the emotional distress for an indefinite period of time. Psychiatrists say that 30% of people suffering with depressive conditions have no previous stress events in their lives. It is the population that does not have symptoms immediately following a trauma that comprises this 30%. According to psychiatric research, stressful life events are seen in 70% of sufferers of depression.
PTSD affects about 0.4% to 1% of the population at any given moment in time. According to some experts, it is a common undiagnosed condition in mental health .A research done in Australia by Henderson, Andrews and Hall was published in 2000 in the Australian and New Zealand Journal of Psychiatry. It concluded that as compared to the general population, sufferers of PTSD were 26 times more likely to suffer with mood disorders like depression, 37 times more likely to develop generalized anxiety disorder, 28.6 times more likely to develop panic disorder and 6.5 times more likely to develop alcohol abuse. PTSD if untreated also makes a person more vulnerable to develop symptoms when exposed to subsequent minor traumatic events. Research also shows that a relaxed person will experience less emotional distress than others when experiencing trauma.
What you experience as ‘job stress’ or ‘family stress’ or ‘road rage’ are situational stresses that have roots elsewhere. If you would be adequately relaxed, these experiences have little stress value. So when you are practising some form of relaxation on a regular basis, you are unconsciously accumulating the effects of relaxation. At demanding times, this accumulated relaxation acts as an emotional buffer. So you are less likely to experience traumatic stress or job stress or road rage. Many PTSD cases go to courts for compensation claims. Till recently in Ireland, such cases were being awarded disproportionately large sums of money. The not well-known fact is that the background and the personality of the involved person are of primary importance in how the incident affects them. A person brought up in a deprived, dysfunctional background will be in a state of chronic stress. As such a trauma can trigger symptoms of PTSD more intensely than in someone who comes from a secure, safe and loving upbringing.
Dr. Herbert Benson is a well-known researcher in relaxation. His researches suggest that 20 minutes of meditation done everyday will keep a person mentally healthy. In order to steer away from the politics of religion, he uses the term Relaxation Response for any meditation like activity. Dealing with traumatic stress is a skill that requires practice.