The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

Author: Bessel Van Der Kolk
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by ohsobasic   2019-01-13

He will likely experience PTSD in one form or another - the seemingly strangest things can trigger it (a smell, a song that was on in the background, hell, locking a door could be a trigger since it sounds like it was one of the last things he did before finding his friend). This may be a helpful read for you, so you can be aware of what he might be going through, understand what to possibly expect, that sort of thing.

So sorry for your husband's loss, and good luck to you as you navigate helping him heal.

by BundleOfShae   2019-01-13
  1. Seroquel: Technically this is not an AED, but before we knew I had epilepsy, I needed anti-psychotics due to audible hallucinations. It turned me into a zombie that could barely function cognitively. The voices stopped with my next one. The first two months were terrible then and for months after.
  2. Keppra: It worked to stop seizures but I absolutely hated it. I gained weight, it made my hair fall out pretty much overnight, and made me depressed (also influenced by the hair loss. I wish doctors would listen to us about our feelings... Anyway, the first two months were also terrible, mostly due to the fact that at this point, I was upset about everything. Once I was on this, my capabilities to do math or follow directions (GPS needed for everything now), or speak well went out the door, so we took a chance with...
  3. Lamictal: OK. I have a love/hate relationship with lamotrigine. In my early days, I still kind of felt the way I did on Keppra. The first two months were the same as it. Mental fog, screwy speech, and a little stutter when I tried. I have been on this for six years now with no seizures except for one attempt to get off meds completely. I think after about a year I slowly got used to it and adapted. I was able to go on basically the lowest dose you can get ( 2.5 - 15.0 mcg/mL in your blood is the normal range. I was at 2.8. I stayed at this low dose up until a few months ago when I started hormone therapy, but that's a different story (I will note that estrogen/estradiol cancels out many seizures medications; be careful ladies).


>How did you deal with the initial drug side effects?

Cannabis, talk therapy, and my dog. Couldn't really do anything to address S/E except for trying a new drug.


>What strategies did you use to communicate to others that you are the same person

I had to pretty much sit people down and explain. Frankly, I think my poor speech during these conversations explained it pretty well on its own. For my parents/family, I gave them a book, "The Body Keeps the Score. " It was very hard to explain, but again the physical manifestations did most of it for me. I also explained to them that to me, the world was entirely different than the first 25 years of them knowing me. I explained it can be like I am bipolar at times.


>At a future point, did you determine yourself that the drug no longer worked and it was time to switch? Did someone else have to "convince you" that a change in drug regimen is needed?

I am lucky in that it only took two tries to get a drug I liked that stopped seizures and had tolerable S/E. But actually, I had to be the one to convince my medical team; it took a ton of moaning and arguing. Most doctors stop trying, IMO, once the main issue (seizures) is solved. I never kept a diary.

by slabbb-   2019-01-13

>I know I sound super desperate for help, sorry about that.

All good. Doesn't read like that to me, more someone encountering a difficult unprecedented situation in their experience and not knowing how to help or proceed :)

>is there any way for me to obtain a therapist's knowledge so I can even remotely help her?

Well you can probably gain some insight by reading and learning about how trauma influences and manifests psychologically and behaviourally, bringing that to the dynamic with your girlfriend, but short of training in psychotherapy, which is years long, it's not a straight forward process of gaining knowledge in this case. Read what you can (or watch vids if that is a preference. Though books on this subject will probably contain more information and details), really listen and be present to your girlfriend. If possible, cultivate patience and tolerance for the the more exasperating aspects of your gfs behaviour. Compassion helps; keep in mind there is pain somewhere even if your gf isn't consciously aware of it. Maybe take notes, make observations, build an operative framework to embed understanding in, specific tactics or methods etc. I dont know; those are suggestions, not prescriptive.

>study material

A couple of books come to mind: The Body Keeps the Score:Brain, Mind, and Body in the Healing of Trauma , and another, more symbolic and depth psychological oriented in its approach Trauma and the Soul: A psycho-spiritual approach to human development and its interruption . These may be helpful. There's a lot of research and books out there in this territory though, so well worth looking around online and seeing what you can find.

>standard operating procedure

Safety is paramount for those who live with trauma, safety in the environment and with others they're relating to, but more importantly, safety in relation to ones own feelings and embodied states.

Trauma takes up occupancy in ones body in an unconscious (emphasis on unconscious) energetic, emotive sense. It can seem like ones own feelings, thoughts, dreams and sensations are the enemy and attacking ones sense of self out of and through the very ground of that sense of self, acting out by themselves with little conscious control. A weird reversal of normalised associations with ones own experience can be present, as can various psychological defenses, such as dissociation and repression. Profound shame may be existent somewhere, exerting influence, alongside self-loathing and self-doubt. These qualities, as belief, as operative paradigms of psychological orientation, bind and entrap. Trauma and its psychology is complex, entangled.

It's perhaps significant to keep in mind that trauma of the kind your gf has experienced is a rupture in terms of a developing self; somewhere, somehow a break and splitting has taken place. Those split off parts of self still exist somewhere, and all of the original pain associated with them. The aim is integrating these extant parts towards a different kind of wholeness and integrity.

The process I've experienced through a therapeutic alliance has involved re-experiencing these 'splinter psyches' and the attendant affect qualities in a safe and trust based context. I've had to relearn how to be present to my own body and emotions in ways I wasn't familiar with. It was a very painful and confrontational process, long and slow, encountering and metabolising bits and pieces in small chunks, using dream, memory (or lack of), daily relational contexts as leverage, through questioning, into contact with feeling, image, re-embodiment. Learning how to just exist and be with myself in my body, learning acceptance. So lots of grounding and attention to breathing, posture, tension being held, etc.

Not sure if that's really all that helpful, and I'm not a professional.

Imo, trauma doesn't heal by itself and it never goes away until its worked with consciously.

Good luck! It's strenuous and problematic, what you're in.

by [deleted]   2018-11-10

Work on reading a book like the boy keeps the score to understand the impact of trauma trauma book

by lyinglikelarry   2018-11-10

I think trauma causes a lot of emotional imbalance instead of a true change of personality. The long term effects of trauma stem from being unable to mentally * process * what’s happened and accept it, your brain keeps running over it trying to process it, but keeps overwhelming itself in the process. It’s better in terms of recovery to be working through a lot of that emotional pain rather than dissociated from it.

You’re in a lot of turmoil and pain because of what happened, it’s just the truth and your family needs to get over it. There’s no such thing as to sensitive or emotional; people are primarily sensitive and emotional! Hypervigilience (sp?) is a totally normal reaction to trauma and you should absolutely not try to stop doing it, rather work on processing your emotions and regaining an authentic feeling of safety, it should go away on its own.

Maybe offering your family some books on the effects of trauma on the brain might help them be a little more understanding and sympathetic? If you haven’t experienced it yourself, finding out what it’s like to constantly experience emotional/sensational/visual flashbacks can be a shocker and suddenly all that « irrational » behavior makes more sense.

Everyone deals with trauma differently, the fact that you’re so sensitive right now means pure still connected to your emotions and honestly I think that’s a really positive sign in terms of recovery. Dissociation is a whole other layer that can complicate things.

Im naturally a super sensitive, upbeat personality, but after trauma I became really withdrawn, angry and cut off emotionally. Sudden changes in personality are a natural way people protect themselves. Maybe your family is reacting to how you’ve changed.

Are you in good trauma informed therapy? I’d suggest doing some reading and maybe trying EMDR if your therapist thinks you’re up for it.

Sources: I have a lot of sexual trauma and childhood trauma stemming from a whole mess of stuff. I’ve linked some stuff I’ve found particularly helpful, but I encourage you to do research and examine what you’re doing to recover.

by citiesoftheplain75   2018-11-10

OP, I hope you're doing well.

A bodyworker or somatic-oriented therapist will be able to help you navigate this tension. Practitioners of bodywork systems like Rolfing, Hakomi, somatic experiencing, and Feldenkrais could all be helpful to you.

You might contact one of the Meditation Instructors listed on the Dharma Ocean website. Dharma Ocean is a Tibetan Buddhist lineage whose approach to meditation works with the link between physical and mental tension. A Meditation Instructor will be able to provide direct advice and point you to other resources.

I've been practicing body-oriented meditation techniques and working through tension for 5+ years. The process is powerful, but there are ways to manage the volume and intensity of the unconscious material excavated by the practice. This type of meditation has vastly improved my quality of life. I believe it's definitely worth doing.

You may benefit from reading The Body Keeps the Score and The Body Deva .

Feel free to PM me if you'd like to discuss further.

by napjerks   2018-11-10

You have been through a lot and you deserve to get good help. If your current therapist isn't helping, pick a different one. Go on your insurance website and see others listed in your area. Or call your regular doctor (GP) and get a referral. You don't usually have to go in for a visit. Just say you want your doctor's recommendation for a therapist adn they will call you back with the new therapist's phone number. You are allowed to shop around. Just tell your current therapist, "The most recent session was my last. I am going to a different therapist now." That kind of thing is all you have to say. You're not going to hurt their feelings.

The next therapist you see, tell them from the first moment you walk in that you want to focus on anger management. Repeat this as many times as you need. Sometimes we have to keep the therapist on target. If you'd like to read a book you might like The Dance of Ager or The Body Keeps the Score .

On your own you can start writing things down that are happening so you can reflect on them. (I do this all the time and it's what's helped me the most over the past few years.) Get any kind of notebook or journal and keep a thought diary. And/or you can print out 10 copies of an anger worksheet like this. Cross out ptsd at the top and write anger, emotion, depression, whatever it is. The techniques for reflection are very similar. So you have copies ready and can just grab a pen and sit down when something flares up. This lets you learn about what is happening and be introspective. Evaluating the thoughts, feelings, emotions that unfold around certain events on a daily, weekly basis is extremely helpful for discovering what's going on within you. It's a way to pull out the useful information and find out how you can anticipate them and see them coming sooner. That way you can consciously intervene with yourself earlier and have a chance to respond differently - the way you would ideally want to respond - measured and cool and with calm control.

These tools help you review what is happening with you. They're kind of like self-incident reports. This is what happened, this is how I reacted. And then you take time to go over them and see if you can do it differently if the same thing happens again. You don't have to show them to anyone. They're just for you. Of course you can take them to your therapy appointments if you want to go over specific events. Especially if you had trouble deciphering what happened or what made you react a certain way and how to fix it. Focus on what. Not why. What happened. What were your thoughts, feelings. Why is a never ending circle. What is very specific. It's a forensic investigation. Not a philosophical or moral debate.

If you see similar things happening over and over again, it's important not to get mad at yourself or beat yourself up about it. Getting mad at yourself for getting mad just prolongs healing. It takes that much longer to cool off and let your emotions (chemical physiological body response) to run their course and get out of your system so your rational mind can start analyzing what happened. It takes about 20 minutes for adrenaline and the chemicals of the amygdala involved in the fight or flight response (in our case fight) to dissipate. If you get angry at yourself on top of whatever just happened, this just prolongs the process. So go easy on yourself if you can't fix it immediately. This is all part of the learning process. Take some breaths. Use typical anger management techniques to cool off. Sorry for writing a book! Hope some of this helps. Take what you need.

by napjerks   2018-11-10

I'm not sure if I completely understand but I'll try to respond. We definitely have this problem with anger in the sense that it's validating. The anger is validating. Because we feel like we are right. Like it's a crucial part of us and if we don't act on it we're not being true to ourselves. There is validation and justification in that feeling. But maybe that's not what you mean?

I'm really sorry for what happened to you. I hope some of this helps...

For example if we're getting mad at work we want to try to let go of being right. Being right is what gets us in this situation. The feeling is extremely validating and gives us a feeling of power. But it ruins our relationships. So we want to change the perspective from "holding back" to letting us both be right. We're all different people and there's more than one way to be right about something. See what if feels like to let that person be right.

They have their perspective, you have yours. What you want to do is find agreement. How can you both get what you want? You won't always have to acquiesce. Sometimes they will too. But more often than we like to admit, we can both get what we want most of the time.

Active Listening can help you more closely engage with people without becoming irate. And people really appreciate when you are clearly making an effort to hear what they are trying to say. Some won't! But the ones who matter will be appreciative.

In personal relationships like you describe, we can feel vindictive and want to get revenge. We start with feelings of betrayal, anxiety and fear but that left unchecked morphs into full on anger. The anger develops as a means of finding something to do about it. So we're not sad or disappointed any more, we're charged up and pissed off. And again, if left to fester it can turn into depression, misery, etc.

Maybe the best thing I can recommend is this book Getting Together and Staying Together . It deals with cheating and the emotions involved but it also just sets a strategy for working towards a relationship together and making it work.

To get back in shape, you want to let your emotions out but in a healthy way. Holding them in is what bottles them up and then everything becomes all murky and hard to decipher. So when you feel yourself pushing emotions down, pause and say "don't do that any more". Allow yourself to feel the real emotions. Be alert against the tendency to remain deadpan. And just listen to what the emotion is and what your mind is doing. If the emotions are worrisome, try techniques like using a thought diary or a cheap notebook, it doesn't matter. Anything you enjoy writing in and just pour it out.

Remember your hobbies. Find ways to be creative. Remember exercise. Physical things help your body sort stuff out naturally. Try reading The Body Keeps the Score to help you work it out.

And don't be afraid to seek a therapist. Your regular doctor can give you a referral (a name to call). With insurance it's a $20 - $50 copay. Usually they want to see you once a week for a month or so and then once a month until you feel you have what you need. If you don't like the first one, it's ok to shop around. Say thanks for the session and don't schedule another one. Then call someone else. Your insurance company's website usually has several therapists you can choose from. Most are CBT talk therapists. Be careful with alcohol and self-medicating. Be careful with intense music. Less is better, quitting is best when you're dealing with heavy issues. Don't punch things as a way to blow off steam. Listen to your thoughts and write down in a notebook or in a word doc what's bothering you. This will go a long way to helping you sort things out.

Hope some of this helps. Hang in there!

by napjerks   2018-11-10

I don't know what you've been through but maybe choosing clothing that helps you feel like you are wearing psychological armor could help. Symbols and colors help me a lot. Have a female trainer and just remind yourself you are in a safe place, working with a safe person. Maybe ask the trainer to go slowly, especially at the beginning of each workout.

It's better to pause a few times early on at the first sign of anything coming up and reflecting on it for a moment - how are you doing with this thought, feeling, emotion that has come up? Let's not wait and hold onto this thought through the rest of the workout, and we don't want to push it away unaddressed. Let's look at it right now. What's it saying? Is it realistic? Breathe a few times. Look around the gym. Are you safe? Is there any rational reason to believe you are not safe? What are my emotions telling me about what is happening right now.

Once you have a clear view of that the content of the thought is, apply your techniques, whatever they are right then and there to each thought/feeling/emotion one by one. Rather than try to just push through as negativity tries to pile up. Go very slowly the first 20 minutes. Don't time yourself, there's no need to, but you might be surprised to find that each pause usually only takes a minute or two. Don't worry about the time at all. Just ask them to only show you two or three things max each session and just focus on those so it's not overwhelming jumping from exercise to exercise.

Maybe it's sometimes just one big emotion. Do the same thing. Gently, gradually. Like asking a boulder questions. What is it saying back. Keep asking and applying until it gets smaller. Imagine the boulder kind of losing its strength. Like it's giving off steam and slowly losing its energy and continuing to get smaller until it's just a pebble. This kind of visualization is Buddhist in nature. I do this all the time and it helps me out. Keep going until the pebble gets tinier and tinier and eventually goes "poof" and doesn't even exist any more.

In preparation for the sessions with a trainer, you could sit at home with pen and paper and apply reflection techniques to your thoughts and emotions about the gym as a kind of test-run as well. What things have been coming up when you get triggered at the gym? Is it the trainer or the space? How can I soften these thoughts and create more room in my head for calm and peace so I can exercise which I know is good for me and makes me feel better.

And just keep reading things that help you maintain perspective and a focus on healing. The Body Keeps the Score is pretty popular. My Journey to Peace with PTSD is one of the few books I've seen that's more of a personal narrative account than a dry reading of tips and techniques. These are all just suggestions. Just some stuff that has helped me out. Hang in there!

by acdenh   2018-11-10

van der Kolk notably the author of The Body Keeps the Score , best selling book on CPTSD.

edit: more personal note; I dealt with abuse and emotional neglect in childhood, also some physical and sexual abuse from classmates. What is interesting is that I am transgender but at a certain point in childhood I somehow forgot and stopped understanding this about myself. I previously thought that I might have CPTSD, most specifically because I often deal with depersonalization and derealization, but it turns out that is extremely common in gender dysphoria. And more importantly, childhood trauma causes that splintering of the personality, or impairment in describing emotional states and their meanings. That is to say, for many years I could no longer recognize that gender dysphoria I was experiencing came from being internally female, rather than arising out of apparently nowhere.