November 1, 2023: Pre- and Post-Traumatic Stress

Healing doesn’t mean the pain never existedIt means the damage no longer controls our lives.  Karen Salmansohn

There are wounds that never show on the body that are deeper and more hurtful than anything that bleeds.  Laurell K. Hamilton

A true disclaimer:  I am neither a trauma expert nor a therapist. This is a conversation, not a prescription. If you’re reading this, remember to check me by looking up other sources (that’s a plural), especially if you like what’s here.

Some Terms:  Stress: a response; Stressors: things that cause stress: Distress: magnified stress response (including trauma); Eustress: good stress, but stress nonetheless; Trauma: resulting from horrible events like natural disasters, war, terrible accidents, molestation, etc.; Disorder: a maladaptation or impairment in social or personal interactions—“…involving abnormal behaviors or physiological conditions, persistent or intense distress, or a disruption of physiological functioning” (quote is from the American Psychological Association); Treatment: appropriate and effective attempts to either resolve or mitigate biological and psychological injuries.

To achieve great things, two things are needed: a plan and not quite enough time.  Leonard Bernstein

There is no living a stress-free life.  What changes is the degree of stress as well as our response to it.

Trauma is real.  Most often, trauma is a result of a subjective and objective interaction.  Treatments do not involve eradicating trauma like it never happened, but tend to focus more on mitigating the effects—learning to live as well as one can despite what happened or what could happen again.

A disorder is also real. And again, the point of treatment is not about erasing it, but about positive adaptations.

Stress, distress, trauma, and disorder are not a-priori signs of weakness (a data-free premise), but a-posteriori signs of problems (dependent upon empirical evidence).  Pretending otherwise is a disservice to others as well as to oneself.

A true story:  I was in a restaurant waiting for my meal.  A young man (late teen, early 20s?) became very upset because an item on the menu was not available, though the menu said the item was always available. So, he had a point.  But it was apparent he was not going to get what he wanted. The exchange escalated.  It was clear the customer cared and the server did not.  Finally, he ordered something else, but remained agitated.  He sat at a table near me, looked in my direction and exclaimed he’d never been so gaslighted in his entire life.  Though he wasn’t directly talking to me, I replied that was because he hadn’t lived very long. He suddenly stopped grousing.  It looked to me like his face went blank.

There has always been warring, sometimes not so much and other times, quite a bit.  Obviously, it’s again on the rise.  I suspect the latest round of the last 250 years or thereabouts, is nested in the rapid advance of technology when compared to the relatively slow adaption of biology.  The result from the rise and force of information, money, and stuff—all related to wealth accumulation—is those who gain power have a lot of it.  The trickle-up effect (crap rolls downhill, money attracts money) seems correlated with the wide divide between folks of means and folks who grow mean.

The prevalence of hyper-stress and trauma is not simply environs and social craziness, it is also individual as in what we can do to ourselves (as the example of the true story is meant to show). It’s easy to see why there seems to be little safe ground.

More terms: Pre-stress: anticipated; Post-stress: grounded in what actually occurred, whether from environmental, social, biological, or psychological forces. Both pre- and post-stress can occur whether it’s cued or uncued and despite the current absence of an actual traumatic event. Proxy Pre- or Post Traumatic stress: Occurring via a kind of introjection—distress of others taken on by an individual. How joyous can we be when friends, loves, family, or others around us are in distress though we were not?  For others, using proxy traumatic stress can be a way to justify behaviors.

Obviously, stress is ubiquitous and has always been thus.  And some stress is good for us (e.g., stimulating motivation).  Trauma is a different animal and not as prevalent as stress, but still part of the fabric of living.  But trauma appears to be on the rise again—this time, in part, because of the proximity afforded by overwhelming and often disparate information as well as the globalization of our world.  Okay, and war, hate crime, poverty, governing bodies that haven’t figured out what governing means, etc.  And, again, our biological adaptation is not as quick as tech advancement.

More terms:  Framing: how we look at or see events or others; Intervention: Getting ahead of a problem by improving and maintaining our signal detection abilities as well as our BS meters.  Intervention can be self-directed or socially available, but is not about self or social bullying.

There is no solution; seek it lovingly. Harlan Miller

Other possible help anyway: How we frame a problem matters in the pre- and post-trauma conditions and before it becomes a full-blown disorder—at which point it becomes much harder to intervene and reframe.  Therefore, personal or social intervention prior to a disorder makes it much easier to avoid having trauma and distress control us.  For example, when we look out a window, it frames what can be seen.  If the window is filthy and/or we are not attentive, our ability to see is diminished. If we want to see more, we must do something else. Clean the window.  Pay attention. Go outside. However, what captures our attention, captures us.  This may be one reason why some folk unconsciously don’t want to know some things. Nonetheless, what “captures” our attention can be shifted—not to avoid seeing what can get us, but to avoid getting reeled in.  For instance, check out figure/ground images that challenge our ability to shift attention (e.g., is the picture of an old woman or a young woman?).

An objective example: Effectively stopping a car in an emergency takes learning by both body and mind.  The need to slam on the brakes in the first place is distress—our nervous system can go a bit haywire.  Slamming on the brakes causes a car without an automatic braking system (ABS) to skid, further inflaming the nervous system.  The solution?  Pumping the brakes impairs skidding and helps to maintain control. To the untrained, the notion of taking their foot off the brake is crazy—what seems needed is more braking. Practicing retrains the nervous system to react differently. Biology has changed. Yes, one must practice the technique where it is safe to do so. And while today’s ABS pumps the brakes for us, relying on technology without learning the mechanics of driving is a pretty sure way to get into trouble.

One part of the nervous system is built to be reactive, but as noted above, can learn in some situations (good luck trying not to blink if something suddenly gets close to your eye).  However, life is not built to be only reactive.  Since biology is not completely wired in stone, what’s distressful today, with practice, may not be distressful later.  But the nervous system can also learn from thought experiments, not just from objective experiences (e.g., thinking of a scenario and how to solve it).

Thought experiment examples: Your boss, in a job you need, but don’t like, verbally assaults you, shouting about some work you did they do not like; “Are you an idiot?”  This is not a rock thrown at your head, so you can pause and go with a non-knee-jerk reaction. With training it will work.  You answer truthfully, “Sometimes. What are you specifically referring to?”  The boss comes in loaded for confrontation, meaning he knows the usual behavior is to become defensive.  You didn’t.  The boss may have a plan B, but the wind has gone out of the sail for plan A. For this to work, we have to learn to slow down reactions where possible.  Yes, much of society considers rapid correct responses as a good sign, but while that may be partially true (if the responses are correct), it is not enough to deem rapid responses as the epitome of intelligence.

Another example: Your spouse has an affair with your best friend and really liked it. They deliberately deceived you. Then you found out.  What now?  Time for someone to die?  Get beaten just short of death?  Maybe take everything you can get away with?  Time to take up wearing a horse-hair shirt or blouse of shame and blame?  They cheated.  They lied.  Not you.  Perhaps you and your body have learned something important that does not result in a disorder, merely a reorder?  A thought-experiment can be a method that is a much safer beginning, especially when it involves an accurate assessment of what will objectively occur (as opposed to just fantasies or hopes).

There are, of course, many other treatment methods.  Effective treatments are grounded in a patient’s outcome, not a practitioner’s preference.

That customer at the restaurant going semi-nuts has some learning to do.  Or, he has some trauma to carry.  Maybe some disorder to face down the line.  Of the three, learning, trauma, and disorder, learning is the least daunting.  Nonetheless, the body and mind can learn, unlearn, and relearn, trauma, disorder or not—neither takes over like rabies or parasites (the “zombie effect).  So, it is not stress or trauma or disorder themselves that ends us, but us thinking and feeling we’re ended.  I’m not being glib here, daunting has meaning and can be related to the onset of stress, trauma, or disorder.  It’s interesting that for the most part, humans help others if an objective disaster happens (the house is burning down), but if the mind breaks down, well, that’s a sign of weakness? And that’s assuming we can tell if the mind is broken or is the mind assessing reality in a different, but also effective way.  Recovery goes more slowly the older one is and/or the more severe one is hurt, but the ability to learn is still there. None of it is a sign of weakness, but a sign of trouble. Perhaps a little slowing down the rush to judgment will help us learn that the Helen Kellers of the world are abled differently.

We’re in one heck of a not-so-safe spot.  It seems beyond stress, more like distress and traumatic.  But if we remove just a couple of dominos from the domino effect of stress to distress to trauma to disorder, the linear effect is no more, though stress remains as part of life (that order is not sacrosanct—trauma can come on suddenly).  It helps to realize there is no guarantee, but honestly doing the best we can do, even if we fail, is one of the best treatments to avoid stress becoming something worse.  The “body” of us both collectively and individually can learn.

Next month: artificial intelligence—no doubt we need to take care of what we create, but are we afraid of creating an intelligence (if it is true intelligence) that works like us and will invoke its own version of manifest destiny—regulating us to the fields or reservation.  Or will some humans use AI to their own advantage, furthering the divide between the haves and the have nots?  Or, will we learn by and from our creation, to be smarter and more effective?

 

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