Fight or Flight? , PTSD & Biofeedback
The following article brings up some interesting points.
I think it's a “starter” article to lead to different avenues of introspection. One is the idea of - which fight or flight response did we choose as we faced different threats presented to us in our time in pain? Could we have chosen differently and if so, how- and what would be the outcome?
Another good point is, just like an inner-city gang member or a soldier in a war zone, we are in a constant state of alert. What has this done to us, our personality, our choices, or our perceived threats? A life in constant pain, especially a hidden illness where disbelief is a constant, or an undiagnosed “rare” condition where you never know what to expect has to be severely detrimental to our physical, mental, emotional and eventually our spiritual response.
Being happy and productive requires a huge amount of attention and care, a balance of care, a balance of nurture versus spartan living. One thing that has changed me a lot is the idea that death can happen at any time now. There are phases to this feeling from total fear and paranoia to the attitude of “I just don't care. Take me whenever, I'm ready.” On the Walk I had no fear after a while, mainly because, I was just too tired to fear. I learned a lot from that.
The next article brings up the possible inevitability of PTSD and how a chronic pain patient may be a perfect target for this disorder. -ed.
Fight or Flight?
Adapted from Psychology, Third Edition, by Philip G. Zimbardo,
Ann L. Weber and Robert Lee Johnson.
Consider this stressful situation: At a meeting for which you have thoroughly prepared, the chair criticizes you and accuses you of failing to attend to tasks that were, in reality, someone else’s responsibility. As all eyes turn on you, you feel your face getting hot, your jaw tightening, and your fist clenching. You would not shout or hit anyone—doing so would only make things worse. But you feel like shouting or striking out.
Now consider another stressful situation: You walk into class a few moments late, only to find everyone putting books and notes away—apparently preparing for a test you did not realize had been scheduled for today. Your heart seems to stop, your mouth is dry, your knees feel weak and you momentarily consider hurrying back out the door. Your life is not really in danger, and running away will not solve your problem—so why should you feel a physical urge to escape?
These two scenarios illustrate the two poles of the fight-or-flight response, a sequence of internal processes that prepares the aroused organism for struggle or escape. It is triggered when we interpret a situation as threatening. The resulting response depends on how the organism has learned to deal with threat, as well as on aninnate fight-or-flight “program” built into the brain.
The learned fight response
Evidence that the fight response can be learned is seen, for example, in studies showing that reactions to a perceived insult are strongly dependent on culture. In the United States the learned fight response has been nurtured in the “culture of honor” that developed in the South—which some experts believe may account for the southern states’ much higher murder rate in comparison to the northern states.(1) Learning can also affect our internal responses to stress. For example, in a study of patients with high blood pressure (which can be a stress response), those who took placebos along with their medication for high blood pressure maintained a healthy blood pressure after the medication was removed, as long as they continued taking the placebo.(1)(2)
This suggests that their expectation that the placebos would control their blood pressure was enough to reduce the emergency response of the blood vessels.
While the fight or flight response clearly can be learned, it also involves an innate reaction that operates largely outside consciousness. This was first recognized in the 1920s by physiologist Walter Canon, whose research showed that a threat stimulates a sequence of activities in an organism’s nerves and glands. We now know that the hypothalamus controls this response by initiating a cascade of events in the autonomic nervous system (ANS), in the endocrine system and in the immune system.(4)
As you will recall, the autonomic nervous system regulates the activities of our internal organs. When we perceive a situation as threatening, this judgment causes the hypothalamus to send an emergency message to the ANS, which sets in motion several bodily reactions to stress. This response is helpful when you need to escape a hungry bear or confront a hostile rival.
It served our ancestors well, but it has a cost. Staying physiologically on guard against a threat eventually wears down the body’s natural defenses. In this way, suffering from frequent stress —or frequently interpreting experiences as stressful —can create a serious health risk: an essentially healthy stress response can become distress.
How can you not want to read more? If so, look these up. -ed
References:
1. Nisbett, R. E. (1993). “Violence and U.S. regional
culture.” American Psychologist, 48, 441 -449.
2. Ader, R., & Chohen, N. (1975). “Behaviorally conditioned
immuno-supression.” Psychosomatic Medicine, 37, 333 -340.
3. Suchman, A. L. and Ader, R. (1989). “Placebo response
in humans can be shaped by prior pharmocologic experience.” Psychosomatic
Medicine, 51, 251.
4. Jansen, A. S. P., Nguyen, X. V., Karpitskiy, V., Mettenleiter,
T. C., & Loewy, A. D. (1995, October 27). “Central command neurons of
the sympathetic nervous system: Basis of the fight-or-flight response.”
Science,270, 644 -646.
Adapted from Psychology, Third Edition, by Philip G. Zimbardo, Ann L. Weber and Robert Lee Johnson.
I think it's a “starter” article to lead to different avenues of introspection. One is the idea of - which fight or flight response did we choose as we faced different threats presented to us in our time in pain? Could we have chosen differently and if so, how- and what would be the outcome?
Another good point is, just like an inner-city gang member or a soldier in a war zone, we are in a constant state of alert. What has this done to us, our personality, our choices, or our perceived threats? A life in constant pain, especially a hidden illness where disbelief is a constant, or an undiagnosed “rare” condition where you never know what to expect has to be severely detrimental to our physical, mental, emotional and eventually our spiritual response.
Being happy and productive requires a huge amount of attention and care, a balance of care, a balance of nurture versus spartan living. One thing that has changed me a lot is the idea that death can happen at any time now. There are phases to this feeling from total fear and paranoia to the attitude of “I just don't care. Take me whenever, I'm ready.” On the Walk I had no fear after a while, mainly because, I was just too tired to fear. I learned a lot from that.
The next article brings up the possible inevitability of PTSD and how a chronic pain patient may be a perfect target for this disorder. -ed.
Fight or Flight?
Adapted from Psychology, Third Edition, by Philip G. Zimbardo,
Ann L. Weber and Robert Lee Johnson.
Consider this stressful situation: At a meeting for which you have thoroughly prepared, the chair criticizes you and accuses you of failing to attend to tasks that were, in reality, someone else’s responsibility. As all eyes turn on you, you feel your face getting hot, your jaw tightening, and your fist clenching. You would not shout or hit anyone—doing so would only make things worse. But you feel like shouting or striking out.
Now consider another stressful situation: You walk into class a few moments late, only to find everyone putting books and notes away—apparently preparing for a test you did not realize had been scheduled for today. Your heart seems to stop, your mouth is dry, your knees feel weak and you momentarily consider hurrying back out the door. Your life is not really in danger, and running away will not solve your problem—so why should you feel a physical urge to escape?
These two scenarios illustrate the two poles of the fight-or-flight response, a sequence of internal processes that prepares the aroused organism for struggle or escape. It is triggered when we interpret a situation as threatening. The resulting response depends on how the organism has learned to deal with threat, as well as on aninnate fight-or-flight “program” built into the brain.
The learned fight response
Evidence that the fight response can be learned is seen, for example, in studies showing that reactions to a perceived insult are strongly dependent on culture. In the United States the learned fight response has been nurtured in the “culture of honor” that developed in the South—which some experts believe may account for the southern states’ much higher murder rate in comparison to the northern states.(1) Learning can also affect our internal responses to stress. For example, in a study of patients with high blood pressure (which can be a stress response), those who took placebos along with their medication for high blood pressure maintained a healthy blood pressure after the medication was removed, as long as they continued taking the placebo.(1)(2)
This suggests that their expectation that the placebos would control their blood pressure was enough to reduce the emergency response of the blood vessels.
While the fight or flight response clearly can be learned, it also involves an innate reaction that operates largely outside consciousness. This was first recognized in the 1920s by physiologist Walter Canon, whose research showed that a threat stimulates a sequence of activities in an organism’s nerves and glands. We now know that the hypothalamus controls this response by initiating a cascade of events in the autonomic nervous system (ANS), in the endocrine system and in the immune system.(4)
As you will recall, the autonomic nervous system regulates the activities of our internal organs. When we perceive a situation as threatening, this judgment causes the hypothalamus to send an emergency message to the ANS, which sets in motion several bodily reactions to stress. This response is helpful when you need to escape a hungry bear or confront a hostile rival.
It served our ancestors well, but it has a cost. Staying physiologically on guard against a threat eventually wears down the body’s natural defenses. In this way, suffering from frequent stress —or frequently interpreting experiences as stressful —can create a serious health risk: an essentially healthy stress response can become distress.
How can you not want to read more? If so, look these up. -ed
References:
1. Nisbett, R. E. (1993). “Violence and U.S. regional
culture.” American Psychologist, 48, 441 -449.
2. Ader, R., & Chohen, N. (1975). “Behaviorally conditioned
immuno-supression.” Psychosomatic Medicine, 37, 333 -340.
3. Suchman, A. L. and Ader, R. (1989). “Placebo response
in humans can be shaped by prior pharmocologic experience.” Psychosomatic
Medicine, 51, 251.
4. Jansen, A. S. P., Nguyen, X. V., Karpitskiy, V., Mettenleiter,
T. C., & Loewy, A. D. (1995, October 27). “Central command neurons of
the sympathetic nervous system: Basis of the fight-or-flight response.”
Science,270, 644 -646.
Adapted from Psychology, Third Edition, by Philip G. Zimbardo, Ann L. Weber and Robert Lee Johnson.
Post Traumatic Stress Disorder
By SARA STAGGS, LICSW, MSW, MPH
By SARA STAGGS, LICSW, MSW, MPH
Following is an example of how post-traumatic stress disorder (PTSD) can develop after a single traumatic incident.
Tony had a somewhat stable childhood. Though his parents divorced when he was 8, he, his mother and siblings stayed in the same house and he regularly saw his father, who remained in the same town. He had some difficulty with learning in school, and as a result often felt discouraged. His grades reflected this. However, he found success and acceptance in athletics, and always had a lot of friends.
Tony joined the Army when he was 18, looking to see some different parts of the world, serve his country, and perhaps one day go to college. For the most part, he enjoyed being in the Army — he found camaraderie with his “brothers,” stable pay, and he enjoyed training in communications.
While deployed in Afghanistan, he was riding in a convoy when his vehicle drove over an improvised explosive device. The others riding with him were killed and he was grievously wounded. He recuperated in Bethesda, mostly recovered but for the loss of one eye.
Tony is on partial disability and misses his former career, friends and the future he’d imagined. It has been two years, and he is working as a tattoo artist and finds his trauma symptoms are interfering with his life. He and his girlfriend have been fighting a lot, and recently, during an argument, he threw a glass at her. It missed, but it scared him that he could lose control like that.
While some of Tony’s symptoms present as classic PTSD material — he is having flashbacks, is very jumpy, and avoids thinking and talking about events surrounding his trauma whenever possible — there are others that make it more difficult for him to get support. Hypervigilance results in an overall elevation of the system, making the survivor extremely reactive to his surroundings.
Tony finds that he has rages that come out of nowhere and finds it impossible to predict what will set him off. He wants to be alone a lot more than he used to and even when he is around other people, he feels an isolation that is new to him. He is constantly distracted and worries about his memory, since he seems to be forgetting things that just happened to him.
Tony was initially worried about telling anyone what was going on, so he found an online chatroom for other veterans. He found a lot of participants not only didn’t think he was crazy, but they had a lot of the same feelings and symptoms. A couple of guys had worked with therapists and found it helpful, so Tony reached out to the VA. He was able to work with a therapist who used CBT with exposure. His therapist provided him with psychoeducation about trauma and how it affects someone’s body and brain. He learned to recognize triggers that upset him and how to tolerate discomfort with his symptoms.
Because Tony remembered that he used to really connect with drawing, his therapist had him draw frames from his traumatic event, from some times prior to the event, to the explosion and immediate aftermath, to afterward. Tony told his therapist the story several times until he found that the memories did not come on their own anymore, and when he thought about them they weren’t nearly as upsetting or vivid.
Tony found almost immediate relief in his trauma symptoms. He also found that he liked feeling more in control of his moods. He continued to see a therapist for a few months to continue to work on his anger and relationship issues. He and his girlfriend broke up, but he found that he was able to get through it better than he’d imagined. He also didn’t want other veterans to feel ashamed of their symptoms the way that he did and decided to volunteer to be a mentor to returning veterans.
Notice how Tony, with the help of a well trained and understanding therapist, was able to overcome some of the harsher symptoms to allow him, not only to function again, but to go beyond the call of duty! Remember, there are still people who don't believe PTSD exists. -ed.
Tony had a somewhat stable childhood. Though his parents divorced when he was 8, he, his mother and siblings stayed in the same house and he regularly saw his father, who remained in the same town. He had some difficulty with learning in school, and as a result often felt discouraged. His grades reflected this. However, he found success and acceptance in athletics, and always had a lot of friends.
Tony joined the Army when he was 18, looking to see some different parts of the world, serve his country, and perhaps one day go to college. For the most part, he enjoyed being in the Army — he found camaraderie with his “brothers,” stable pay, and he enjoyed training in communications.
While deployed in Afghanistan, he was riding in a convoy when his vehicle drove over an improvised explosive device. The others riding with him were killed and he was grievously wounded. He recuperated in Bethesda, mostly recovered but for the loss of one eye.
Tony is on partial disability and misses his former career, friends and the future he’d imagined. It has been two years, and he is working as a tattoo artist and finds his trauma symptoms are interfering with his life. He and his girlfriend have been fighting a lot, and recently, during an argument, he threw a glass at her. It missed, but it scared him that he could lose control like that.
While some of Tony’s symptoms present as classic PTSD material — he is having flashbacks, is very jumpy, and avoids thinking and talking about events surrounding his trauma whenever possible — there are others that make it more difficult for him to get support. Hypervigilance results in an overall elevation of the system, making the survivor extremely reactive to his surroundings.
Tony finds that he has rages that come out of nowhere and finds it impossible to predict what will set him off. He wants to be alone a lot more than he used to and even when he is around other people, he feels an isolation that is new to him. He is constantly distracted and worries about his memory, since he seems to be forgetting things that just happened to him.
Tony was initially worried about telling anyone what was going on, so he found an online chatroom for other veterans. He found a lot of participants not only didn’t think he was crazy, but they had a lot of the same feelings and symptoms. A couple of guys had worked with therapists and found it helpful, so Tony reached out to the VA. He was able to work with a therapist who used CBT with exposure. His therapist provided him with psychoeducation about trauma and how it affects someone’s body and brain. He learned to recognize triggers that upset him and how to tolerate discomfort with his symptoms.
Because Tony remembered that he used to really connect with drawing, his therapist had him draw frames from his traumatic event, from some times prior to the event, to the explosion and immediate aftermath, to afterward. Tony told his therapist the story several times until he found that the memories did not come on their own anymore, and when he thought about them they weren’t nearly as upsetting or vivid.
Tony found almost immediate relief in his trauma symptoms. He also found that he liked feeling more in control of his moods. He continued to see a therapist for a few months to continue to work on his anger and relationship issues. He and his girlfriend broke up, but he found that he was able to get through it better than he’d imagined. He also didn’t want other veterans to feel ashamed of their symptoms the way that he did and decided to volunteer to be a mentor to returning veterans.
Notice how Tony, with the help of a well trained and understanding therapist, was able to overcome some of the harsher symptoms to allow him, not only to function again, but to go beyond the call of duty! Remember, there are still people who don't believe PTSD exists. -ed.
Let's Discuss PTSD
by Dennis Kinch – JTP, WfH
“Like comedy, this discussion can be used as a measurement of
how free you are from the fear of non-validation.”
Read on: -ed
The reason I am posting this article should be apparent to anyone who suffers from chronic pain. If you received a diagnosis of a mostly permanent, painful disease and especially to those who suffer the non-diagnosis, non-believing, misunderstood glare of a doctor or loved one, you have undergone a stressful traumatic experience. We always think of war as causing PTSD and there is no doubt that it does, but any trauma can be a catalyst for the many, scary symptoms of this disabling stress disorder. If I said list the 5 most harrowing experiences in your life, no matter what you list, they can cause PTSD. I also understand that any mention of a “mental” disorder brings up the glare again, in your mind. Further proof that PTSD exists for many pain patients.
There are, however, many “disorders” or impairments that are in the mind when you have chronic pain, but most are physically in the brain and directly caused by constant pain. So the next time you hear anyone bring up the idea of a “mental” disorder, instead of thinking “They're telling me it's I my head!”, rather think, “It's caused by pain!” and then repeat, “It's caused by pain!” You see, the doctors who accuse us of everything from being drug addicts to hypochondriacs always seem to forget, it's caused by pain. If there was no pain there would be no anxiety, somatization, PTSD, initial filtering problems, fragility, sadness, depression, being too wrapped up in a minor amount of pain (yes, I heard all of these, even after I took hours of psyche tests which showed I only had filtering problems, nothing else.); the list goes on and on.
Think to yourself, would you still feel these emotions if pain had never entered your life? Doesn't this mean the doctors, and your loved ones, should be looking for what caused the pain in the first place, since we all admit there is pain. I always thought it was strange that all of the doctors who were my accusers never referred me to a counselor, or psychiatrist! Strange, huh? The 2 times I went to one it was automatic protocol in the pain clinics I was in. Think about it, pain counseling. Both of my PhD counselors said, “We are testing for disorders your pain is causing you and perhaps by knowing they exist, you can work on it or at least be aware of their existence.” How true this was.
In the 1st case they tested for 8 hours and only found physical things wrong, like spine and leg muscles and nerve problems. In the 2nd one, 8 hours of testing again, but this time all mental, they could only find the filtering problem. That's it! Nothing else mentally. But it was good they pointed this disorder out. They believe it to be a permanent, physical impairment in a certain sector of my brain, but I can do exercises to improve my intake of information. I have to imagine the chaos and confusion of a constant pain signal, which cause the received information to become somewhat scrambled, to move out of the way. I do this when I am reading, or listening to someone talking. It took a little practice but it's mostly handled. The other funny thing is I was happy to go to a counselor. I would have done anything to help calm the pain, anything. I believe most of us are the same way.
So I recommend seeing a counselor, but make sure they are a pain counselor. Then they know to look for disorders caused by the pain. PTSD is one of these; and there are things you can do about it. I consider it an important part of my physical therapy. Another one is occupational therapy, which teaches you how to do things you normally do in life, but how to work with your limitations. This used to have a stigma also with pain patients until everyone saw how it worked with brain or spine injuries. Like the story of Fybromyalgia, it will take time for society to catch up with what we already know...the pain is very real!
by Dennis Kinch – JTP, WfH
“Like comedy, this discussion can be used as a measurement of
how free you are from the fear of non-validation.”
Read on: -ed
The reason I am posting this article should be apparent to anyone who suffers from chronic pain. If you received a diagnosis of a mostly permanent, painful disease and especially to those who suffer the non-diagnosis, non-believing, misunderstood glare of a doctor or loved one, you have undergone a stressful traumatic experience. We always think of war as causing PTSD and there is no doubt that it does, but any trauma can be a catalyst for the many, scary symptoms of this disabling stress disorder. If I said list the 5 most harrowing experiences in your life, no matter what you list, they can cause PTSD. I also understand that any mention of a “mental” disorder brings up the glare again, in your mind. Further proof that PTSD exists for many pain patients.
There are, however, many “disorders” or impairments that are in the mind when you have chronic pain, but most are physically in the brain and directly caused by constant pain. So the next time you hear anyone bring up the idea of a “mental” disorder, instead of thinking “They're telling me it's I my head!”, rather think, “It's caused by pain!” and then repeat, “It's caused by pain!” You see, the doctors who accuse us of everything from being drug addicts to hypochondriacs always seem to forget, it's caused by pain. If there was no pain there would be no anxiety, somatization, PTSD, initial filtering problems, fragility, sadness, depression, being too wrapped up in a minor amount of pain (yes, I heard all of these, even after I took hours of psyche tests which showed I only had filtering problems, nothing else.); the list goes on and on.
Think to yourself, would you still feel these emotions if pain had never entered your life? Doesn't this mean the doctors, and your loved ones, should be looking for what caused the pain in the first place, since we all admit there is pain. I always thought it was strange that all of the doctors who were my accusers never referred me to a counselor, or psychiatrist! Strange, huh? The 2 times I went to one it was automatic protocol in the pain clinics I was in. Think about it, pain counseling. Both of my PhD counselors said, “We are testing for disorders your pain is causing you and perhaps by knowing they exist, you can work on it or at least be aware of their existence.” How true this was.
In the 1st case they tested for 8 hours and only found physical things wrong, like spine and leg muscles and nerve problems. In the 2nd one, 8 hours of testing again, but this time all mental, they could only find the filtering problem. That's it! Nothing else mentally. But it was good they pointed this disorder out. They believe it to be a permanent, physical impairment in a certain sector of my brain, but I can do exercises to improve my intake of information. I have to imagine the chaos and confusion of a constant pain signal, which cause the received information to become somewhat scrambled, to move out of the way. I do this when I am reading, or listening to someone talking. It took a little practice but it's mostly handled. The other funny thing is I was happy to go to a counselor. I would have done anything to help calm the pain, anything. I believe most of us are the same way.
So I recommend seeing a counselor, but make sure they are a pain counselor. Then they know to look for disorders caused by the pain. PTSD is one of these; and there are things you can do about it. I consider it an important part of my physical therapy. Another one is occupational therapy, which teaches you how to do things you normally do in life, but how to work with your limitations. This used to have a stigma also with pain patients until everyone saw how it worked with brain or spine injuries. Like the story of Fybromyalgia, it will take time for society to catch up with what we already know...the pain is very real!