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It Didn’t Start With You:

 How Inherited Family Trauma Shapes Who We Are

Traumas Lost and Found

The past is never dead. It’s not even past.
— William Faulkner, Requiem for a Nun

It didn't start with youA well-documented feature of trauma, one familiar to many, is our inability to articulate what happens to us. We not only lose our words, but something happens with our memory as well. During a traumatic incident, our thought processes become scattered and disorganized in such a way that we no longer recognize the memories as belonging to the original event. Instead, fragments of memory, dispersed as images, body sensations, and words, are stored in our unconscious and can become activated later by anything even remotely reminiscent of the original experience. Once they are triggered, it is as if an invisible rewind button has been pressed, causing us to reenact aspects of the original trauma in our dayto-day lives. Unconsciously, we could find ourselves reacting to certain people, events, or situations in old, familiar ways that echo the past.

Sigmund Freud identified this pattern more than one hundred years ago. Traumatic reenactment, or “repetition compulsion,” as Freud coined it, is an attempt of the unconscious to replay what’s unresolved,so we can “get it right.” This unconscious drive to relive past events could be one of the mechanisms at work when families repeat unresolved traumas in future generations.

Freud’s contemporary Carl Jung also believed that what remains unconscious does not dissolve, but rather resurfaces in our lives as fate or fortune. “Whatever does not emerge as Consciousness,” he said, “returns as Destiny.” In other words, we’re likely to keep repeating our unconscious patterns until we bring them into the light of awareness. Both Jung and Freud noted that whatever is too difficult to process does not fade away on its own, but rather is stored in our unconscious.

Freud and Jung each observed how fragments of previously blocked, suppressed, or repressed life experience would show up in the words, gestures, and behaviors of their patients. For decades to follow, therapists would see clues such as slips of the tongue, accident patterns, or dream images as messengers shining a light into the unspeakable and unthinkable regions of their clients’ lives.

Recent advances in imaging technology have allowed researchers to unravel the brain and bodily functions that “misfire” or break down during overwhelming episodes. Bessel van der Kolk is a Dutch psychiatrist known for his research on posttraumatic stress. He explains that during a trauma, the speech center shuts down, as does the medial prefrontal cortex, the part of the brain responsible for experiencing the present moment. He describes the “speechless terror” of trauma as the experience of being at a “loss for words”, a common occurrence when brain pathways of remembering are hindered during periods of threat or danger. “When people relive their traumatic experiences,” he says, “the frontal lobes become impaired and, as result, they have trouble thinking and speaking. They are no longer capable of communicating to either themselves or to others precisely what’s going on.”

Still, all is not silent: words, images, and impulses that fragment following a traumatic event reemerge to form a secret language of our suffering we carry with us. Nothing is lost. The pieces have just been rerouted.

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Emerging trends in psychotherapy are now beginning to point beyond the traumas of the individual to include traumatic events in the family and social history as a part of the whole picture. Tragedies varying in type and intensity—such as abandonment, suicide and war, or the early death of a child, parent, or sibling—can send shock waves of distress cascading from one generation to the next. Recent developments in the fields of cellular biology, neurobiology, epigenetics, and developmental psychology underscore the importance of exploring at least three generations of family history in order to understand the mechanism behind patterns of trauma and suffering that repeat.

The following story offers a vivid example. When I first met Jesse, he hadn’t had a full night’s sleep in more than a year. His insomnia was evident in the dark shadows around his eyes, but the blankness of his stare suggested a deeper story. Though only twenty, Jesse looked at least ten years older. He sank onto my sofa as if his legs could no longer bear his weight.

Jesse explained that he had been a star athlete and a straight-A student, but that his persistent insomnia had initiated a downward spiral of depression and despair. As a result, he dropped out of college and had to forfeit the baseball scholarship he’d worked so hard to win. He desperately sought help to get his life back on track. Over the past year, he’d been to three doctors, two psychologists, a sleep clinic, and a naturopathic physician. Not one of them, he related in a monotone, was able to offer any real insight or help. Jesse, gazing mostly at the floor as he shared his story, told me he was at the end of his rope.

When I asked whether he had any ideas about what might have triggered his insomnia, he shook his head. Sleep had always come easily for Jesse. Then, one night just after his nineteenth birthday, he woke suddenly at 3:30 a.m. He was freezing, shivering, unable to get warm no matter what he tried. Three hours and several blankets later, Jesse was still wide awake. Not only was he cold and tired, he was seized by a strange fear he had never experienced before, a fear that something awful could happen if he let himself fall back to sleep. If I go to sleep, I’ll never wake up. Every time he felt himself drifting off, the fear would jolt him back into wakefulness. The pattern repeated itself the next night, and the night after that. Soon insomnia became a nightly ordeal. Jesse knew his fear was irrational, yet he felt helpless to put an end to it.

I listened closely as Jesse spoke. What stood out for me was one unusual detail—he’d been extremely cold, “freezing” he said, just prior to the first episode. I began to explore this with Jesse, and asked him if anyone on either side of the family suffered a trauma that involved being “cold,” or being “asleep,” or being “nineteen.”

Jesse revealed that his mother had only recently told him about the tragic death of his father’s older brother—an uncle he never knew he had. Uncle Colin was only nineteen when he froze to death checking power lines in a storm just north of Yellowknife in the Northwest Territories of Canada. Tracks in the snow revealed that he had been struggling to hang on. Eventually, he was found facedown in a blizzard, having lost consciousness from hypothermia. His death was such a tragic loss that the family never spoke his name again. Now, three decades later, Jesse was unconsciously reliving aspects of Colin’s death—specifically, the terror of letting go into unconsciousness. For Colin, letting go meant death. For Jesse, falling asleep must have felt the same.

Making the connection was a turning point for Jesse. Once he grasped that his insomnia had its origin in an event that occurred thirty years earlier, he finally had an explanation for his fear of falling asleep. The process of healing could now begin. With tools Jesse learned in our work together, which will be detailed later in this book, he was able to disentangle himself from the trauma endured by an uncle he’d never met, but whose terror he had unconsciously taken on as his own. Not only did Jesse feel freed from the heavy fog of insomnia, he gained a deeper sense of connection to his family, present and past.

In an attempt to explain stories such as Jesse’s, scientists are now able to identify biological markers— evidence that traumas can and do pass down from one generation to the next. Rachel Yehuda, professor of psychiatry and neuroscience at Mount Sinai School of Medicine in New York, is one of the world’s leading experts in posttraumatic stress, a true pioneer in this field. In numerous studies, Yehuda has examined the neurobiology of PTSD in Holocaust survivors and their children. Her research on cortisol in particular (the stress hormone that helps our body return to normal after we experience a trauma) and its effects on brain function has revolutionized the understanding and treatment of PTSD worldwide. (People with PTSD relive feelings and sensations associated with a trauma despite the fact that the trauma occurred in the past. Symptoms include depression, anxiety, numbness, insomnia, nightmares, frightening thoughts, and being easily startled or “on edge.”)

Yehuda and her team found that children of Holocaust survivors who had PTSD were born with low cortisol levels similar to their parents, predisposing them to relive the PTSD symptoms of the previous generation. Her discovery of low cortisol levels in people who experience an acute traumatic event has been controversial, going against the long-held notion that stress is associated with high cortisol levels. Specifically, in cases of chronic PTSD, cortisol production can become suppressed, contributing to the low levels measured in both survivors and their children.

Yehuda discovered similar low cortisol levels in war veterans, as well as in pregnant mothers who developed PTSD after being exposed to the World Trade Center attacks, and in their children. Not only did she find that the survivors in her study produced less cortisol, a characteristic they can pass on to their children, she notes that several stress-related psychiatric disorders, including PTSD, chronic pain syndrome, and chronic fatigue syndrome, are associated with low blood levels of cortisol. Interestingly, 50 to 70 percent of PTSD patients also meet the diagnostic criteria for major depression or another mood or anxiety disorder.

Yehuda’s research demonstrates that you and I are three times more likely to experience symptoms of PTSD if one of our parents had PTSD, and as a result, we’re likely to suffer from depression or anxiety. She believes that this type of generational PTSD is inherited rather than occurring from our being exposed to our parents’ stories of their ordeals. Yehuda was one of the first researchers to show how descendants of trauma survivors carry the physical and emotional symptoms of traumas they do not directly experience.

That was the case with Gretchen. After years of taking antidepressants, attending talk and group therapy sessions, and trying various cognitive approaches for mitigating the effects of stress, her symptoms of depression and anxiety remained unchanged.

Gretchen told me she no longer wanted to live. For as long as she could remember, she had struggled with emotions so intense she could barely contain the surges in her body. Gretchen had been admitted several times to a psychiatric hospital where she was diagnosed as bipolar with a severe anxiety disorder. Medication brought her slight relief, but never touched the powerful suicidal urges that lived inside her. As a teenager, she would self-injure by burning herself with the lit end of a cigarette. Now, at thirty-nine, Gretchen had had enough. Her depression and anxiety, she said, had prevented her from ever marrying and having children. In a surprisingly matter-of-fact tone of voice, she told me that she was planning to commit suicide before her next birthday.

Listening to Gretchen, I had the strong sense that there must be significant trauma in her family history. In such cases, I find it’s essential to pay close attention to the words being spoken for clues to the traumatic event underlying a client’s symptoms.

When I asked her how she planned to kill herself, Gretchen said that she was going to vaporize herself. As incomprehensible as it might sound to most of us, her plan was literally to leap into a vat of molten steel at the mill where her brother worked. “My body will incinerate in seconds,” she said, staring directly into my eyes, “even before it reaches the bottom.”

I was struck by her lack of emotion as she spoke. Whatever feeling lay beneath appeared to have been vaulted deep inside. At the same time, the words vaporize and incinerate rattled inside me. Having worked with many children and grandchildren whose families were affected by the Holocaust, I’ve learned to let their words lead me. I wanted Gretchen to tell me more.

I asked if anyone in her family was Jewish or had been involved in the Holocaust. Gretchen started to say no, but then stopped herself and recalled a story about her grandmother. She had been born into a Jewish family in Poland, but converted to Catholicism when she came to the United States in 1946 and married Gretchen’s grandfather. Two years earlier, her grandmother’s entire family had perished in the ovens at Auschwitz. They had literally been gassed—engulfed in poisonous vapors—and incinerated. No one in Gretchen’s immediate family ever spoke to her grandmother about the war, or about the fate of her siblings or her parents. Instead, as is often the case with such extreme trauma, they avoided the subject entirely.

Gretchen knew the basic facts of her family history, but had never connected it to her own anxiety and depression. It was clear to me that the words she used and the feelings she described didn’t originate with her, but had in fact originated with her grandmother and the family members who lost their lives.

As I explained the connection, Gretchen listened intently. Her eyes widened and color rose in her cheeks. I could tell that what I said was resonating. For the first time, Gretchen had an explanation for her suffering that made sense to her.

To help her deepen her new understanding, I invited her to imagine standing in her grandmother’s shoes, represented by a pair of foam rubber footprints that I placed on the carpet in the center of my office. I asked her to imagine feeling what her grandmother might have felt after having lost all her loved ones. Taking it even a step further, I asked her if she could literally stand on the footprints as her grandmother, and feel her grandmother’s feelings in her own body. Gretchen reported sensations of overwhelming loss and grief, aloneness and isolation. She also experienced the profound sense of guilt that many survivors feel, the sense of remaining alive while loved ones have been killed.

In order to process trauma, it’s often helpful for clients to have a direct experience of the feelings and sensations that have been submerged in the body. When Gretchen was able to access these sensations, she realized that her wish to annihilate herself was deeply entwined with her lost family members. She also realized that she had taken on some element of her grandmother’s desire to die. As Gretchen absorbed this understanding, seeing the family story in a new light, her body began to soften, as if something inside her that had long been coiled up could now relax.

As with Jesse, Gretchen’s recognition that her trauma lay buried in her family’s unspoken history was merely the first step in her healing process. An intellectual understanding by itself is rarely enough for a lasting shift to occur. Often, the awareness needs to be accompanied by a deeply felt visceral experience. We’ll explore further the ways in which healing becomes fully integrated so that the wounds of previous generations can finally be released.

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An Unexpected Family Inheritance

A boy may have his grandpa’s long legs and a girl may have her mother’s nose, but Jesse had inherited his uncle’s fear of never waking, and Gretchen carried the family’s Holocaust history in her depression. Sleeping inside each of them were fragments of traumas too great to be resolved in one generation.

When those in our family have experienced unbearable traumas or have suffered with immense guilt or grief, the feelings can be overwhelming and can escalate beyond what they can manage or resolve. It’s human nature; when pain is too great, people tend to avoid it. Yet when we block the feelings, we unknowingly stunt the necessary healing process that can lead us to a natural release.

Sometimes pain submerges until it can find a pathway for expression or resolution. That expression is often found in the generations that follow and can resurface as symptoms that are difficult to explain. For Jesse, the unrelenting cold and shivering did not appear until he reached the age that his Uncle Colin was when he froze to death. For Gretchen, her grandmother’s anxious despair and suicidal urges had been with her for as long as she could remember. These feelings became so much a part of her life that no one ever thought to consider that the feelings didn’t originate with her.

Currently, our society does not provide many options to help people like Jesse and Gretchen who carry remnants of inherited family trauma. Typically they might consult a doctor, psychologist, or psychiatrist and receive medications, therapy, or some combination of both. But although these avenues might bring some relief, generally they don’t provide a complete solution.

Not all of us have traumas as dramatic as Gretchen’s or Jesse’s in our family history. However, events such as the death of an infant, a child given away, the loss of one’s home, or even the withdrawal of a mother’s attention can all have the effect of collapsing the walls of support and restricting the flow of love in our family. With the origin of these traumas in view, long-standing family patterns can finally be laid to rest. It’s important to note that not all effects of trauma are negative. In the next chapter we’ll learn about epigenetic changes—the chemical modifications that occur in our cells as a result of a traumatic event.

According to Rachel Yehuda, the purpose of an epigenetic change is to expand the range of ways we respond in stressful situations, which she says is a positive thing. “Who would you rather be in a war zone with?” she asks. “Somebody that’s had previous adversity [and] knows how to defend themselves? Or somebody that has never had to fight for anything?” Once we understand what biologic changes from stress and trauma are meant to do, she says, “We can develop a better way of explaining to ourselves what our true capabilities and potentials are.”

Viewed in this way, the traumas we inherit or experience firsthand not only can create a legacy of distress, but also can forge a legacy of strength and resilience that can be felt for generations to come.

You can order the book here: www.amazon.com/dp/1101980362/ .

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PTG – Post Traumatic Growth

Can we rise above into a new place of strength?

Looking at our capacity for expansion after overcoming adversity

“Trauma never goes away completely,” I responded. “It changes perhaps, softens some with time, but never completely goes away. What makes you think you should be completely over it? I don’t think it works that way.”  The Trauma of Being Alive - The New York Times / Good article on dealing with grief.:

Post Traumatic Growth refers to positive psychological change experienced as a result of adversity and other challenges in order to rise to a higher level of functioning. (Wikipedia)

Many scientific studies have shown the negative impact that stress and trauma have on our physical, mental and emotional health. Experiencing suffering or trauma does not necessarily mean that what comes after the event is a damaged or dysfunctional life. While coping with traumatic events, some people discover their ability to grow in ways they hadn’t before.

Psychologists Richard Tedeschi and Lawrence Calhoun at the University of North Carolina pioneered the concept and they were the first to coin the term post-traumatic growth in 1996. The Posttraumatic growth (PTG) theory’s research shows that significant development occurs within the context of loss and pain.

Alt text hereImagining a pathway that leads from trauma to personal strength

The most consistent benefits shown are increased personal strength, self-confidence and determination. Closer relationships and compassion towards others is another positive change that signals PTG, as well as a greater appreciation of life in general. An individual’s priorities and philosophies can change for the better, and they can experience a deeper spiritual connection. Another PTG benefit is that people perceive new opportunities that are available to them after trauma.

This does not imply that an expectation should be placed on an individual to live a radically “improved” life after trauma. The opportunity for expansion is possible, but there are many factors that can influence how a person manages through crises.

The Importance of Engaging with the Trauma

According to Tedeschi and Calhoun, “certain kinds of personal qualities – extraversion, openness to experience, and perhaps optimism – may make growth a bit more likely. The degree to which the person is engaged cognitively by the crisis appears to be a central element in the process of posttraumatic growth.

Alt text hereOvercoming trauma can lead to radical growth

The individual’s social system may also play an important role in the general process of growth, particularly through the provision of new schemas related to growth, and the empathetic acceptance of disclosures about the traumatic event and about growth-related themes. Posttraumatic growth seems closely connected to the development of general wisdom about life, and the development and modification of the individual’s life narrative.”

Spiritual teacher and author of the seminal book Be Here Now, Ram Dass, suffered a massive stroke at age 65. The grace and wisdom he gained from this experience is a poignant example of posttraumatic growth. Author Sarah Davidson recounts listening to the first time Ram Dass spoke publicly about his loss of faith after his stroke: “Everyone saw me as a victim of a terrible illness. But what happened to my body was far less frightening than what happened to my soul. The stroke wiped out my faith.

In the following months he began to look at the effects of the stroke in a different way. He had been deeply humbled by the compassion of others, and he had learned what it was to be dependent instead of being the one who helps.

The stroke was giving me lessons, advanced lessons. It brought me into my soul, and that’s grace. Fierce grace. – Ram Dass

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Make A Therapy Style Weighted Pillow For Grounding

This is a great idea to use at home if you feel triggered, stressed or fearful. It reduces the out of body feeling (floating/ dissociation) and helps you remain present in the body and focused in the moment. My therapist had a large weighted toy dog that you could hold on your lap during a session. It really helped.

SG x

therapy pillow

Grounding is the practice of consciously and deliberately connecting to the earth and to one’s own body for self-regulation of states of activation. Extreme trauma and stress can throw the nervous system into states of, on one extreme, hyperaraousal and on the other, numbness and immobility. Grounding helps train the nervous system to calm down, re-balance and re-learn how to function normally. Grounding is a healing tool that is often used within the context of a therapeutic session (self-therapy or with a therapist). It helps you to focus and reduces the out of body feeling or floating.

Having some objects on hand that apply pressure and weight to the body can really help enhance the felt sense of grounding. A heavy pillow is nice because it conforms to the body, which can feel comforting. Also, it offers a lot of sensory stimulation – you can pick it up and feel the texture of the contents, and hear the sounds the contents make when moved around. Patting and handling the pillow make it change shapes. All of this can help bring the attention into the body and into the moment.

Since I made my therapy pillow, I have used it when really activated – in other words, when triggered and feeling panicked and terrified. It has worked well to calm me in those moments. I have also brought it with me to therapy. Holding it on my lap during a therapy session really adds a helpful calming effect which is especially nice to have when bringing up really difficult issues and memories.

Instructions:

1. Obtain a Small Pillow Case.

I went to a thrift store and found a couple of nice place mats (pictured above) measuring 14 x 20 inches. These place mats with a lining are nice because they are the right size to fit on my lap and not too labor intensive (you only have to sew one inch or so of the seam where you opened it to put the contents in). You can also use a standard pillow case (20×26 inches) but it can be pricey to buy enough stuff to fill a standard pillow case – although it’s not really a big deal if the contents are all on one end – it still works. If you have a travel pillow or decorative pillow, you can empty it and fill it with your contents. If you don’t have anything on hand you could buy a travel pillow case. Also, if you’re OK with some sewing, you may want to just get some cloth and create a pillow out of it – then you can customize the size, making it so it fits on your lap nicely and applies pressure to both of your thighs.

2. Ideas for fillings.

  • lentils
  • beans – pinto beans, mung beans, kidney beans, soy beans, black beans etc.
  • split peas
  • buckwheat hulls
  • rice
  • dried corn
  • couscous
  • grains like buckwheat, millet, barley
  • small smooth pebbles
  • sand – sand can seep out the pillow seams though so you may want a plastic bag directly around the sand

corn, beans, lentils

For my therapy pillow I bought 8 pounds of green lentils. In terms of price, probably the cheapest filling is sand, but any kind of fine sand might escape the pillow. There are cheap landscaping pebbles out there, like “pea gravel” and perusing the landscape rocks and decorative rocks option is a pretty inexpensive.

3. Prepare your Pillow Case

– sewing machine or needle and thread

– scissors or seam ripper

If using a pillowcase, sew together the open end until you have a one inch opening – or whatever size opening will fit your funnel. If using a place mat, use a small scissors or seam ripper to open up a hole for the funnel.

Cut a hole along the seam for the funnel

4. Fill Your Pillow.

– funnel

– something to pour lentils with – cup, bowl, large liquid measuring cup

pouring lentils into a therapy pillow

5. Test It.

Feel the weight and make sure you like how it feels on your lap.

I found that 8 pounds works on my lap but not on my feet. It works on one foot. I’m pretty sure 16 pounds would be enough to apply pressure to both of my feet.

For now, I’m content to just use it on my lap.

It would be great to have another, 16 pound, pillow for my feet at some point.

6. Sew it Up

If you are happy with the weight, sew up your pillow and then…

7. Remember to Use It!

Article by Heidi Hanson

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Domestic Violence Victims Mistakenly Judged Unstable After Abuse

Trauma continues after someone leaves an abusive relationship, professor of general practice tells Victoria’s royal commission into family violence (Australia).

As a young girl, Alana Levinson struggled with the shame of her father's substance abuse.

The trauma suffered by domestic violence victims after leaving an abusive relationship meant family law court staff sometimes mistakenly judged them as psychologically unstable, a professor of general practice has told Victoria’s royal commission into family violence.

Kelsey Hegarty, a general practitioner who leads an abuse and violence research program at the University of Melbourne, told commissioners that psychological trauma continued long after someone left an abusive relationship.

It meant that when they appeared before a court to seek custody for any children involved, the fear and post-traumatic stress felt by victims could make them seem erratic, she said, while perpetrators appeared calm and rational by comparison.
“I think they have great difficulty telling a coherent story [to the court],” Hegarty said.

“They’ve taken a long time to name what has happened to them as family violence, so sometimes they appear chaotic or difficult or don’t give a linear story. It’s part of my job as a GP to help them to name that violence and give much more of a coherent story.

“But the problem is … they can look mentally unwell and sometimes those diagnoses by court-appointed psychiatrists and psychologists can be used against them in child custody disputes.”

Getting letters in the mail from a perpetrator’s solicitor could be enough to trigger flashbacks, nightmares and anxiety, Hegarty said. Often unable to access legal aid because they did not qualify or because such services were too stretched to help them, many victims had to navigate the legal system alone while still recovering from the violence, she said.

As the third week of public hearings drew to a close on Friday, the commission heard from legal experts about various ways in which court systems sometimes failed victims.

The counsel assisting, Luke Moshinsky, said the commission had heard from witnesses about how a combination of the state child protection system and the federal family law courts left some victims lost.

“One of the issues raised in a number of submissions is each system places different expectations on women on what it means to be a good or protective parent,” Moshinsky said.

“Child protection may expect her to prevent all contact with the abusive father, whereas the family court expects her to facilitate access to children, with the mother criticised for opposing this.”

Leanne Miller, the director of the west division of the Department of Child Protection, told the commission the department received 92,000 reports in one year, of which 25,000 were followed up. Of those, just over 4,000 went to court.

“Certainly we are involved with women and in all instances, we seek to preserve children within their family,” she said. “That’s the fundamental principle of the [Child Protection] Act.”

A lay witness who also gave evidence to the commission on Friday described how she was made to feel she was a “difficult ex-wife” when she phoned a Melbourne court to ask how to get an intervention order.

A court staff member asked the woman, who cannot be identified, if her lawyer had put her up to it, she said.

“I remember nearly hanging up,” she said. “The implication was there that I was being a difficult ex-wife.”

The woman said her case was not taken seriously until she explained her ex-husband had a gun and had made threats to kill her and her child.
The commission heard she was in an ongoing family court battle with the man, who lives interstate, over access to their child.

Legal fees have wiped out any savings she had on leaving the abusive relationship, and she does not feel it is safe to leave their child alone with him.

“I think there are enough test cases now,” she told the commission. “Rosie Batty is the most prominent, but there are many people in the same predicament.

“When people make a threat to kill a child, that doesn’t go away – it doesn’t go away because someone has done a six-week anger management course.

“In my opinion, supervised contact centres are needed from that point in time.”

The woman also said courts need a standard and supportive response for women who reach out for help, as she had done.|

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Self Care When You Have PTSD

This is a good article by (PTSD expert). Devote time to self care, do things that bring you joy each day, be gentle on yourself and create an environment that is supportive to your recovery.
Love & baby steps,
SG x
Always prioritize yourself. | 25 Things To Do When You're Feeling Down
It can be very stressful to experience and have to manage the symptoms of PTSD. They can take quite a toll on many aspects of your daily life. Considering the amount of time that may be regularly devoted to managing your symptoms of PTSD, other areas of your life may get less attention. One such area is self-care. Poor self-care can have a major impact on your mental and physical health. Given this, it is important to take time to devote to self-care. This article provides some coping skills that may help you improve your self-care.

Increasing Self-Compassion

A lack of self-compassion can have a huge impact on self-care and recovery from PTSD. A lack of self-compassion may decrease motivation to continue through those difficult moments in treatment. It may increase feelings of helplessness and hopelessness. A lack of self-compassion can also bring about strong feelings of shame, which may lead you to not adequately care for yourself. In fact, low self-compassion may increase the likelihood that you engage in self-destructive or punishing behaviors, such as self-injury. Self-compassion can be difficult to increase; however, it is very important to do so and is a major part of good self-care. This article provides some strategies for fostering a stronger sense of self-compassion.More »

Increasing Your Contact with Positive Activities

When people are not taking adequate care of themselves, they may be more likely to isolate or avoid activities that they used to enjoy. Not surprisingly, this can have a major impact on a person’s mood, further increasing the desire to avoid and isolate. Part of taking good care of yourself is making sure you stay active and in touch with activities and relationships that you enjoy and find rewarding. One way to do this is through behavioral activation. This article takes you through a series of steps that will help you increase the number of positive activities that you engage in on a daily basis. More »

Improving Your Self-Esteem Through Self-Supportive Statements

Many people with PTSD may suffer from low self-esteem. The symptoms of PTSD can be very difficult to cope with. In addition, many people with PTSD also experience other difficulties, such as depression. Due to these difficulties, people with PTSD may experience negative thoughts about themselves, resulting in low self-esteem and feelings of worthlessness. Therefore, it is very important to learn how to catch these thoughts and combat them with positive thoughts. In doing so, you can serve as your own source of social support. More »

Coping with Sleep Problems

Getting enough sleep is a major part of increasing your self-care. Getting adequate sleep can have a major effect on your mood, energy, ability to problem-solve and think clearly, and physical health. Unfortunately, many people with PTSD experience significant problems with sleeping. This article presents some basic coping strategies that may help improve your sleep. More »

Self-Care and Your Emotional Health

Although we may not think much about it, exercise, our diet, and the amount of sleep we get are all very important aspects of self-care, and self-care is incredibly important to our emotional health. A major effect of poor self-care is that it can “muddy” or “cloud” our emotions. When we are tired, hungry, overly stressed out, or in bad physical shape, we may be more reactive or have stronger emotions. There are a number of ways to improve self-care and reduce the occurrence of cloudy emotions. Some activities that can help you improve your self-care (and your emotional health) are described in this article. More »

Self-Soothing Coping Strategies

Uncomfortable and stressful emotions are common among people with PTSD. Many of these emotions (shame, anger, guilt) can be particularly difficult to sit with. Self-soothing coping strategies can be particularly helpful for these emotions, as they are focused on caring for yourself and treating yourself in a compassionate manner. Effective self-soothing coping strategies may be those that involve one or more of the five senses (touch, taste, smell, sight, and sound). Learn some examples of self-soothing strategies for each sense. This article presents some common self-soothing coping strategies that may be particularly helpful for someone with PTSD. More »

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Increasing Self-Compassion in PTSD

Countering Negative Beliefs and Thoughts about the Self

A lack of self-compassion can have a huge impact on recovery from PTSD. A lack of self-compassion may decrease motivation to continue through those difficult moments in treatment.

 It may increase feelings of helplessness and hopelessness. For example, a person might think, “I am a failure, so what is the point with continuing with treatment?” A lack of self-compassion can also bring about strong feelings of shame and guilt, which can make emotions even more difficult to manage. Finally, low self-compassion may lead to self-destructive behaviors. For example, a person might begin to engage in deliberate self-harmas a form of self-punishment.

Self-compassion can be difficult to increase; however, it is very important to do so. Below are some strategies for fostering a stronger sense of self-compassion.

Recognize That You Are Human

First, remember that you are human. Oftentimes people will set very high expectations that cannot be met. For example, a person with PTSD may have in their mind a timeline for when their symptoms should be eliminated through treatment. Different people progress through treatment at different paces. Some people notice immediate gains, whereas others may take a little more time to notice benefits from treatment.

Setting very high standards or expectations increases the likelihood that you are not going to meet those expectations, which can increase feelings of worthlessness, helpless, hopelessness, and failure. Recognize that you are human and that there are going to be times when you struggle or slip. This is normal and actually a positive part of the process of recovery. Those moments of struggle can help you identify areas you need to continue to work on, as well as help you identify additional coping strategies to prevent similar struggles in the future.

Be Mindful of Negative Self-Focused Thoughts

Just because you have a negative self-focused thought does not mean it is true. Our thoughts are largely the result of habit. We cannot always trust our thoughts, and this is especially the case for negative thoughts about the self. Such thoughts generally only result in more shame and guilt.

Mindfulness can be a very useful strategy for managing negative thoughts. Being mindful of thoughts helps you take a step back from your thoughts, not connecting with them or buying into them as truth. This will decrease their intensity and eventually decrease the frequency with which they occur.

Practice Self-Care

When people feel low self-compassion, they are at greater risk for engaging in self-destructive behaviors or isolating. When you are experiencing low self-compassion, it is very important to act in a way that is counter to that low self-compassion. Remember, even if we cannot always control our thoughts or feelings, one thing that we can always have some level of control over is our behavior and the choices we make. Therefore, when you are feeling worthless, act in a way that is opposite to that feeling. Basically, engage in some kind of self-care activity. Do something nice for yourself and your body.

Self-care may be a difficult thing to do if you are having very strong negative thoughts or feelings; however, even a small self-care activity can prevent these thoughts and feelings from taking hold. Acting as though you care about yourself can eventually bring about actual feelings and thoughts of self-compassion.

Validate Your Emotions

Another way to increase self-compassion is to validate your emotions. We don’t experience emotions randomly. They are there for a reason. Emotions are our body’s way of communicating with us. When we beat ourselves up for having certain emotions, all we do isincrease our emotional distress. Therefore, recognize that your emotions are important and reasonable. Try to listen to what your emotions are telling you and realize that it is okay to have those emotions.

Reduce Self-Destructive Behaviors

A lack of self-compassion can lead to self-destructive behaviors, such as deliberate self-harm, eating disordered behaviors (for example, binging and restricting), or substance use. These behaviors may be used as a form of self-punishment. In addition, although they may initially reduce feelings of distress, in the long-term they only reinforce a sense of shame, worthlessness, or helplessness. Therefore, it is important to take steps to reduce these behaviors. Strategies focused on impulse control may be particularly useful in this regard.

Practice Acts of Altruism

If you are feeling like there is nothing you can do to help yourself, then make the choice to help others. Acting with compassion towards others can improve your own self-compassion. In addition, there is some evidence that helping others can facilitate recovery from a traumatic event. Helping others (for example, volunteering) can improve your mood, provide a sense of accomplishment and agency, and bring about a sense of worth.

Recognize Your Accomplishments

Finally, recognize what you have accomplished. It is especially important to recognize accomplishments you have made despite the experience of PTSD symptoms. Make note of difficult tasks you have accomplished or challenging situations you have successfully navigated. Recognize accomplishments both big and small. We often brush aside small accomplishments; however, no accomplishment is too small when you have PTSD. Give yourself credit for showing strength and perseverance despite dealing with a PTSD diagnosis.

Self-compassion is very important in recovering from PTSD. However, it is also a very difficult thing to foster. Try out all of the strategies above and discover which combination of activities and behaviors work best for you. Progress may be slow, but even a small amount of self-compassion can have a tremendous impact on your mental and emotional health.

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Beginning Treatment of PTSD and Related Anxiety Disorders

Good article on healing from PTSD/ C-PTSD.

Love & baby steps,

SG x

(Source: #solar_sisters)

by Tom Cloyd, MS, MA – Counselor / Psychotherapist

Posttraumatic stress management

Posttraumatic Stress Disorder, or PTSD (described below), is a serious, disabling psychological condition whose successful treatment takes time, care, and experience. Latest research on treatment effectiveness indicates that, while a single treatment session can produce excellent results, complete treatment may take a number of weeks. With complex PTSD cases, involving chronic trauma or multiple traumatic events, the disorder can take significantly longer to resolve, and complete resolution may be difficult.

While you are waiting for your treatment to finish, what can you do to help yourself return to a normal life as quickly as possible? Suggested here are several answers to this important question, answers that have been found to be helpful to many people. It is likely that you will get the same results that they have, if you apply these ideas and procedures thoughtfully and diligently.

Why does PTSD happen?

When something traumatic happens to us, we are, by definition, overwhelmed by the amount of negative feeling that the event provokes. Our normal capacity to function is lost, for a time. We are traumatized.

Immediately after the event is over, all that remains is a memory. Our brains have the capacity to heal naturally from the effects of traumatic events, by converting traumatic memory into ordinary memory. The result is that the memory no longer functionally disturbs us, although we may always be uncomfortable about what happened to us.

However, if our brain has not been able to recover from an extremely distressing, painful, fearful, or shameful experience that occurred in the past, posttraumatic stress symptoms (described in the next section) will result. Whether or not these symptoms constitute formal PTSD, they will still produce a serious anxiety disorder, with complex and disabling consequences.

Failure to heal from a psychological trauma will result in continuing hypersensitivity to certain stimuli, resulting in one form or another of emotional over-stimulation of the brain. Memory of the trauma will simply continue to overwhelm the brain, with the result that one is stuck with the traumatic memory and its effects.

What does PTSD do to us?

The person with enduring posttraumatic stress experiences symptoms that seriously disrupt their peace of mind, their relationships, their work, or their recreational activities. This situation can easily continue for years. With active PTSD, there are four results of an unhealed psychological trauma. Described as psychological symptoms, they are these:

Memories of the trauma keep coming back to us, repeatedly;

We try hard, over and over, to avoid anything (including memories) associated with the trauma;

We experience a general loss of ability to respond positively to the important things and people in our life;

We experience chronic increased responsiveness to stimulating things in life, so that we may be inappropriately irritable, suffer from insomnia, have trouble with anxiety and lack of concentration, be “jumpy”, and so on.

Recovery from PTSD

Recovery from PTSD initially involves teaching your brain new ways of dealing with your distressing and disruptive memories and symptoms. Do not mistake this learning of symptom management methods for treatment. Symptom management is similar to first aid. Its purpose is to assist you in achieving some comfort, and adequate function, while you are transitioning to full treatment.

This learning of new ways of managing symptoms will often occur automatically if you will simply allow your brain to notice the effects of certain new behaviors. In the beginning of your treatment, practicing some rather simple things will get you started with the essential learning you will need to accomplish promote you healing:

Check in with yourself from time to time. Notice where your main attention is focused at the moment. Practice distinguishing between “inside stuff” and “outside stuff” – internal versus external stimuli, and memories and the imaginary world inside your head as contrasted with the real world physically around you. Work at learning to become good at choosing to attend to the outside stuff as a way of stopping unpleasant internal experiences. You can do this by spending a little time carefully noting the details of your present environment – objects, shapes, colors, textures, and so on. Allow your attention to shift and to become absorbed in what is real, immediate, and safe.

Practice choosing to calm yourself. Let go of muscle tension, slow your breathing and bodily movements, become quiet outside and inside. Practice allowing your mind to become blank, then keep it blank and calm for a little while. Practice allowing yourself to come to a resting place from time to time. If this is hard for you (and it can be particularly difficult before your PTSD has received much treatment), then practice calming yourself using slow walking, noticing carefully every little movement you make. Pretend you are stalking an animal that is very close to you, and you are seeking to move up to it and just touch it, unseen. Walk very, very slowly, noticing every little movement you make. This will require a great deal of concentration. Do this exercise for several minutes – the longer the better. This active calming exercise is often very helpful for individuals with PTSD.

Practice correcting your time perspective. Bring your attention to present reality here and now. Notice the day of the week, and how old you are, and remind yourself that right now you are not being confronted by an emergency. It may be helpful when doing this to say these things out loud to yourself (if you’re alone!).

Practice correcting your thinking errors. Remind yourself frequently (and particularly when you are upset or anxious), that with PTSD you will tend to have a distorted view of the world. Work at correcting this view by reminding yourself that:

Problems are much more common than crises. Only the latter requires a rapid response.

Feelings will often mislead you. Most of the time your house is NOT on fire, the world is not in crisis, and you are safe right where you are.

Over-reaction (excess feelings), and its opposite (numbness), can bemanaged, while your treatment is focusing on resolving their causes. Let excess negative feeling be a signal for you to choose to use active calming and relaxation skills, such as the slow walking exercise described above. Practice this choice often, for practice will much improve your ability to respond effectively.

Practice caring for yourself. Self-care activities of the most basic sort ARE very important for victims of psychological trauma. Give particular attention to: sleep (or resting, if sleep isn’t possible), exercise (a very good idea!), proper nutrition and medical care, and engaging supportive social contacts. These are all critical aspects of your personal self-support program.

Recovery from PTSD requires action

Help yourself to recover and to grow into a positive relationship to your life by noting and using that which is naturally healing for you. This may well include contact with special people, places, activities, thoughts, feelings, or objects. All of these will be things which in the past have tended to calm you, to help you feel whole and comfortable and at peace, and have led you to feel wonder and gratitude for being alive.

Seek out these things often, to anchor yourself in the real world as an antidote to the experience you have when encountering active posttraumatic stress. Invite yourself to return as often as you can to this healing, real world.

Remember the healing wonder of laughter, and how it tends to put everything into correct and comfortable perspective. Laughter truly is the language of the gods. Speak it often!

FINALLY, do remember that just as the body, if healthy and properly supported, will naturally heal from wounds, so will the mind heal from psychological trauma, under the right conditions. Flowers know how to grow, and our mind knows how to heal. We only need to give it the right kind of support, and the healing will occur. Many, many other people have done accomplished this healing. You surely can as well.

2

Ways To Beat Your Stress Hormone

The Need For Peace

I have more suggestions, eat an alkaline diet, practice simple relaxation techniques, accept and avoid toxic people, add healthy people. Find joy daily, walk in nature, dance, create, have fun.

SG x

Now , listen to the sounds inside your body ¿ your breath and heartbeat. This is where your attention should be, within yourself. Don¿t think, just focus on your breath.

 Poor cortisol: It means well but just doesn’t know when to quit. Produced by your adrenal glands, this “stress hormone” helps regulate blood pressure and the immune system during a sudden crisis, whether a physical attack or an emotional setback. This helps you to tap into your energy reserves and increases your ability to fight off infection.

Trouble is, relentless stress can keep this survival mechanism churning in high gear, subverting the hormone’s good intentions. Chronically high cortisol levels can cause sleep problems, a depressed immune response, blood sugar abnormalities, and even abdominal weight gain. “When cortisol spikes, it tells the body to eat something with a lot of calories—a great survival tactic if you need energy to flee a predator but not if you’re fretting over how to pay bills,” says nutritional biochemist Shawn Talbott, PhD, author of The Cortisol Connection.

Fortunately, an antidote to the body’s fight-or-flight mode has evolved: the relaxation response. Here are eight surprising ways to invoke stress management—and in some cases, cut your cortisol levels almost in half.

To Cut Cortisol 20%…Say “Om”
People who practiced Buddhist meditation significantly decreased both cortisol and blood pressure in a 6-week Thai study. Similarly, participants who meditated daily for four months decreased the hormone by an average of 20% in a study at Maharishi University, while levels in the non-meditating control group actually went up slightly. (Try these 8 simple meditations that can change your life.)

To Cut Cortisol Elevation 66%…Make a great iPod mix
Music can have a calming effect on the brain, especially while you’re facing down a major stressor. When doctors at Japan’s Osaka Medical Center played tunes for a group of patients undergoing colonoscopies, the patients’ cortisol levels rose less than those of others who underwent the same procedure in a quiet room. Even if an invasive gastrointestinal exam isn’t in your immediate future, you can forestall cortisol spikes in other stressful situations—when hosting dinner for your in-laws, for instance—by queueing up background music. And to wind down faster at bedtime, listen to something soothing instead of watching TV.

To Cut Cortisol 50%…Hit the sack early—or take a nap
What’s the difference between getting six hours of sleep instead of the suggested eight? “Fifty percent more cortisol in the bloodstream,” Talbott says. When a group of pilots slept six hours or less for seven nights while on duty, their cortisol levels increased significantly and stayed elevated for two days, found a study at Germany’s Institute for Aerospace Medicine. The recommended 8 hours of nightly shut-eye allows your body enough time to recover from the day’s stresses, Talbott says. When you fall short of the mark, take a nap the next day—Pennsylvania State University researchers found that a midday snooze cut cortisol levels in subjects who’d lost sleep the previous night.

To Cut Cortisol 47%…Sip some black tea
The “cup that cheers” has deep associations with comfort and calm—just think of how the English revere their late-afternoon teatime. As it turns out, science confirms the connection: When volunteers at University College London were given a stressful task, the cortisol levels of those who were regular black-tea drinkers fell by 47% within an hour of completing the assignment, while others who drank fake tea experienced only a 27% drop. Study author Andrew Steptoe, PhD, suspects that naturally occurring chemicals such as polyphenols and flavonoids may be responsible for tea’s calming effects.

To Cut Cortisol 39%…Hang out with a funny friend
The pal who keeps you in stitches can do more than distract you from your problems—her very presence may help temper your hormonal stress response. Simply anticipating laughter is enough to reduce cortisol levels by nearly half, according to researchers at Loma Linda University. (If your favorite Tina Fey clone can’t meet for coffee, you may be able to achieve the same stress-melting effect by popping in a DVD of The Office.)

To Cut Cortisol 31%…Schedule a massage
A little pampering can rub your stress levels the right way. After several weeks of massage therapy, subjects’ cortisol levels decreased by nearly one-third, on average, according to studies at the University of Miami School of Medicine and elsewhere. In addition to keeping cortisol under control, massage sessions reduce stress by promoting production of dopamine and serotonin, the same “feel good” hormones released when we socialize with pals or do something fun.

To Cut Cortisol 25%…Do Something Spiritual
Religious ritual fortifies many people against everyday pressures, and it can also lower cortisol secretion, report University of Mississippi researchers. Churchgoing study subjects had lower levels of the stress hormone, on average, than those who did not attend services at all. If organized religion isn’t of interest to you, try developing your spiritual side by taking a walk in nature’s “cathedral”—in the woods or along a beach—or volunteering for a charity.

4

Getting Triggered

Suddenly In Defense or Survival Mode

When triggers hit, they’re usually unexpected and beyond your control.

And what usually happens next, right after the trigger: You react with old ‘defenses’ or ‘survival strategies’ that are no longer helpful or healthy (if they ever were), and that only make things worse.

Some simple examples of triggers and the ‘conditioned responses’ they unleash:

  • Someone criticizes something you’ve said or done, and you instantly get defensive and angry, then verbally go on the attack.
  • Someone criticizes something you’ve said or done, and you instantly feel crushed and defeated, then go silent and try to ‘disappear.’
  • Walking into your childhood home, your body suddenly tenses up and your eyes scan for threats.

The Nature of Triggers

Triggers can be totally obvious, like someone touching you sexually when you don’t want or expect it, or someone threatening you or clearly trying to take advantage of you.

Triggers can be obvious or subtle, in our awareness or not.

Or they can be subtle, like someone making a mildly sarcastic comment that reminds you of mean and shaming things a parent used to say, or someone giving you a look that seems to have some contempt in it.

Triggers aren’t always about other people and what they say or do. They can be something like a faint smell of alcohol (that used to be on the breath of an abuser). They could be the shape of a man’s moustache, a style of clothing, a wallpaper pattern, or the sound of a slamming door. They can be an ‘anniversary’ date of a traumatic event like an abuse experience or someone’s death.

What are triggers for a particular man depends on his unique experiences of being vulnerable and hurt in his life, and the unique details of the situations in which those experiences occurred.

The trigger is always real. By definition, a trigger is something that reminds you of something bad or hurtful from your past. It ‘triggers’ an association or memory in your brain.

But sometimes you are imagining that what’s happening now is actually like what happened back then, when in reality it’s hardly similar at all, or it just reminds you because you’re feeling vulnerable in a way you did when that bad thing happened in the past.

Just as triggers range from obvious to subtle, sometimes we’re aware of them and sometimes we’re not. Your body may suddenly freak out with a racing heart and feeling of panic, but you have no idea what set off that reaction. You may suddenly feel enraged in a slightly tense conversation, but be unable to point to anything in particular that made you angry. Sometimes you can figure it out later (for example in therapy), and sometimes not.

Also, though we may not realize that we just got triggered, or why, it can be obvious to someone who knows us well, like a partner, friend, or therapist. When you feel comfortable doing so, with someone you really trust, it can be very helpful to talk over situations where you seemed to over-react.

Triggers that involve other people’s behavior are often connected to ways that we repeat unhealthy relationship patterns learned in childhood. Things that other people do – especially people close to us and especially in situations of conflict – remind us of hurtful things done to us in the past. Then we respond as if we’re defending ourselves against those old vulnerabilities, hurts, or traumas.

But our responses usually just trigger vulnerable feelings in the other person, as well as their own old self-defense patterns, and we both end up repeating the unhealthy relationship patterns we that fear and don’t want in our lives.

As noted above, other common triggers include ‘anniversaries,’ that is, dates or holidays that remind you, at some level, of traumatic experiences, of how your family wasn’t and isn’t so happy and loving, etc.

Triggers’ Power and Effects

The power of a trigger depends on how closely it resembles a past situation or relationship, how painful or traumatic that situation or relationships was, and the state of your body and brain when the triggering happens.

Reactions can be big and fast, or creep up on you slowly.

If you’re feeling very calm and safe, the reaction will be much less than if you’re feeling anxious and afraid. If you’re feeling little support or trust in a relationship, your reactions to triggering behaviors by the other person will be much greater.

A trigger can bring out feelings, memories, thoughts, and behaviors.

Other people might have no idea that you’ve been triggered, but you could be struggling with terrible memories in your head. Or you could suddenly have all kinds of negative thoughts and beliefs about the other person and/or yourself, like, ‘I never should have trusted her,’ ‘Every woman will stab you in the heart,’ ‘What a loser I am,’ etc.

Reactions to triggers can be very dramatic and rapid, like lashing out at someone who says the wrong thing or looks at you the wrong way. In these cases, your brain has entered a ‘fight or flight’ state and the part of your brain that you need to think clearly, to remember your values and what’s important to you, and to reflect on your own behavior, is effectively shut down.

But responses to triggers can also creep up on you, playing out over hours and days, and get worse over time.

You may find yourself depressed and retreating from any contact with friends, or drinking a lot more every night, or smoking way more cigarettes than usual. You may find youself getting lost in TV, videogames, or pornography. Days later you may wonder, ‘Woah, how did I get back into this?’

Awareness and Learning = Freedom and Control

Basically, if you’re reacting to someone or something much more intensely than seems to make sense, then the situation has triggered something deeper and older in your brain. You’re not reacting to what’s actually happening in the here and now, and you’re certainly not acting freely.

You can change how you respond to triggers.

Instead, you’re feeling and acting, however consciously or unconsciously, as if you’re ‘back there’ in that old painful or traumatic experience, on autopilot and enslaved by old conditioning.

Fortunately, it’s entirely possible to greatly increase your awareness of your own unique triggers, and of what happens in your mind and body when particular things trigger you. With that foundation of awareness and understanding in place, you can learn how to avoid simply responding as you always did in the past, and instead respond in new and much more healthy ways.

In this way, you can free yourself from deeply ingrained conditioning, actually rewiring your brain to respond in new and much healthier ways to the inevitable triggers we all encounter in our lives and relationships.

For many men, understanding and reconditioning their responses to triggers will require, or be greatly speeded up, by help from a therapist or counselor. There are also self-help resources available, including those mentioned under Additional Resources below.

Expert Views

Aphrodite Matsakis

Due to the way traumatic memories are stored, when something arises in the present that reminds you of a past event, you may feel the feelings associated with the past event…. We call the present-day events triggers, because they trigger the emotions associated with the trauma….

You may be unaware of certain triggers, because you have amnesia about the traumatic events and so can not relate present-day sights, smells, actions, feelings, and people to those involved in your trauma. Often trauma survivors do not know why they react so negatively or intensely to certain situations. It may seem that the situation does not warrant such an extreme reaction, yet there may be a perfectly logical reason for such a reaction if the situation is in some way similar to the trauma…

Having triggers, or reacting to them, does not mean you are crazy or defective. However, when you are blind to what you are feeling and why you are feeling it, you may be driven to act in ways that do not serve you well. The purpose of this chapter is to help you become more aware of your triggers and to help you to manage your reactions to them

Elizabeth Vermilyea

A stress response can trigger avoidance in the form of denial, dissociation, bingeing, substance abuse, self-harm, and other behaviors in an effort to get rid of feelings. These avoidance behaviors, in turn, can trigger stress responses inside because they are reminders of old efforts to deal with painful feelings. The stronger the response, the stronger the impulses to avoid. The effort spent avoiding leaves little energy to manage day-to-day life, and the result is increased stress responses that increase impulses to avoid. What a mess!

Fortunately, self-regulation skills can help you to tolerate (sit with) and control intense feeling states that have led to avoidance or dissociation in the past. You can learn to feel and control the intensity of your emotions to reduce avoidance.