Something I experience as both a gift and challenge of being a therapist is that I get to practice, every day, the tools of my trade. On myself.
If practice makes perfect, I should be brilliant at transitions and stress management now. Almost two years ago, when I moved from Asia to the US, the stress triggered painful recalls from the past that had nothing to do with the move.
This was my sixth move from one country to another in over ten years. You might think, as I did, that I’d be getting pretty good at this transition business.
Wrong! That move ended up to be one of the hardest experiences of my life, and it dragged me, for a while, straight back to my darkest, most fearful memories and feelings.
Why stress and trauma are similar So what was happening? Stress, lots of it, for a long time.
I expected stress, of course. What I hadn’t expect was that I’d lose control of so many huge pieces of my life for so long.
There was something else I hadn’t reckoned with. For much longer than I expected, I lost access to many of my most important mechanisms for sustaining myself: close friends and social support, routines, self-care, familiarity and predictability, ability to maintain healthy diet - all things that I count on to help me stay strong..
For survivors, stress feels like trauma.
Everybody struggles with stress. But for those with trauma in their life history, stress is especially difficult. Why? The natural human response to stress is very similar to our response to traumas. So when survivors go through stress we will be reminded, big time, of trauma. In those moments it’s easy to feel that the traumas days are here again.
Stress triggers the same biological mechanisms as trauma, only in a less intense or systematic way. We may not be in full fight or flight mode like in trauma, but the same mechanisms of the nervous system are on high alert. Adrenalin and cortisol are flowing. Sensory integration is harder (ie: our ability to give attention to the sensory inputs of sight, hearings, smelling, feeling that we want to focus on and ignore the sensory inputs we don’t want). Anxious or fearful thoughts and feelings are increased. Without even quite noticing it, we begin to feel threatened and jumpy. Our ability to absorb information and focus is reduced.
Stress is Accumulative. At a biological level, stress activates responses that are familiar to us from previous stress experiences in the past. When we experience this, we may feel that we have returned to realities of long ago, even when the circumstances are far different. Each episode of stress reactivates the same response mechanism and deepens the neural pathways through which we experience stress.
So although everyone has to work on stress management from day to day, trauma survivors have to be prepared for more. We have to be ready to do major trauma response management every time stress levels rise, no matter how modest the stressors may seem by “ordinary” standards.
Stuck in Withdrawal
A response I personally experienced right after trauma and witness in others is “withdrawal”. (ETI framework). This is an instinctive, life-preserving (secondary to fight and flight) response to trauma that reduces vulnerability to further injury.
However, many survivors have a hard time moving beyond it. Almost all survivors experience that the pull to “withdraw” lingers. Whenever alerts, triggers or stress rise, most survivors feel to some extent an urge to withdraw. What to do about this?
ISP as foundation for trauma integration
You might think that as a therapist I have a certain advantage in dealing with the challenges of my own life. The truth is that it took me quite a while to put two and two together in understanding what I was experiencing during my move.
Psychoeducation is one of the first steps to take when responding to stress and trauma. My knowledge did help me to recognize that what I was feeling was mostly a stress response sending me back to the past. It also helped me recognize my triggers, alerts and secondary alerts (read this post for more on how our past responses to trauma become associated with difficult memories). Like everyone else, when I could name (and re-name - it’s a task that never really ends!) for what they are, they became easier to deal with.
I started working hard to get back to the things I know help me. For me that is things like therapy, finding one friend to really talk with, practicing self-compassion, maintaining routines (diet and exercise), finding things that give me a sense of meaning and purpose (eg: figuring out arrangements for work, writing, developing new materials, etc.).
Most of those play a key role in what I call an Individualized Sustainability Plan (ISP).
If you are a trauma survivor you should work on your ISP. As a clinician, this is one of the three pillar of my work with clients on trauma integration. Thoughtfully designed and regularly updated, an ISP can assist you to get through stressful times even many years after the trauma took place.
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