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When trauma expert, Robert Scaer, (author of 8 Keys To Brain-Body Balance) was on YOUR LIFE AFTER TRAUMA earlier this year he spoke eloquently about trauma, dissociation and the freeze response (you can listen to the podcast here). He also fielded questions from callers, and from listeners who emailed me what they wanted to know. There was so much to cover we ran out of time.
But I wanted to know the answers to the others questions we didn’t get to, so I emailed Scaer and asked if he’d mind responding with the information. He’s such a genuinely compassionate trauma professional that he immediately sent the answers. I’m sharing the questions and Scaer’s insights with you today….
The answer to questions 1 and 3 are the same. The “adrenaline rushes”, and the “emotional triggers related to anxiety” are basically the same phenomenon. The arousal portion of PTSD is specifically related to being exposed to “cues” related to the traumatic event. These cues are imprinted procedural sensory memories from the trauma, still active because they were never extinguished through the “freeze discharge”. Because they’re unconscious, we’re not aware of being exposed to them until we get an unexpected adrenaline rush. In other words, the truama victim is repeatedly being blind-sided by unconscious messages from the environment that contain information linked to the trauma.
Because they’re unconscious, there’s no way to prepare for them. All one can do is gradually extinguish them through exposure to the cues while in a state of safety – the empathic, therapeutic “container”. In that state of grace, the amygdala is inhibited, and the emerging cue is extinguished in the absence of arousal/adrenaline rush. It’s like ringing the bell without feeding the dog. After a while, it stops salivating with the bell. That’s the basis for the efficacy of all body-based therapies. (I address all of this in the book).
I’m not a fan of psychopharmacology with trauma, primarily because you’re treating a bipolar (cyclical) condition with a static chemical – the side effects are greatly enhanced. I also don’t think you can heal trauma with words/talk therapy alone, because the somatic triggers in procedural memory are the source of recurring, inexplicable anxiety. I think you need to use the somatic therapies (SE, EMDR, Brainspotting, Energy Psychology (TFT) and Neurofeedback, or combinations of these in addition to talk. When anxiety is triggered with adrenaline rushes, I like self-administered EFT as a short fix. Also breath work is a useful tool here.Nobody really knows what the long-term effects of childhood pharmacology are, but when the child or adult is on meds, you’re only suppressing the discomfort. I do feel that meds interfere with ultimate healing, the extinction of body cues/memories that trigger the adrenaline rush. The use of anti-anxiety medication (primarily benzodiazepines) will dull the adrenaline/ anxiety response to cues, but at the risk of dependence. Benzodiazepines have been documented to ultimately make PTSD worse.
Robert Scaer, M.D. received his B.A. in Psychology, and his M.D. degree at the University of Rochester. He is Board Certified in Neurology, and has been in practice for 36 years, twenty of those as Medical Director of Rehabilitation Services at the Mapleton Center in Boulder, CO. His primary areas of interest and expertise have been in the fields of traumatic brain injury and chronic pain, and more recently in the study of traumatic stress and its role in physical and emotional symptoms, and in diseases.
He has lectured extensively on these topics, and has published several articles on posttraumatic stress disorder, dissociation, the whiplash syndrome and other somatic syndromes of traumatic stress. He has published three books, the first The Body Bears the Burden: Trauma, Dissociation and Disease, presenting a new theory of dissociation and its role in many diseases. A second edition of this book was released in October, 2007. A second book, The Trauma Spectrum: Hidden Wounds and Human Resiliency, addresses the broad and relatively unappreciated spectrum of cultural and societal trauma that shapes every aspect of our lives. A third book, Eight Keys to Brain/Body Balance, released in September, 2012, is a lay person’s guide to the workings of the brain, related to how the brain changes in stress and trauma, and may be healed. He is currently retired from clinical medical practice, and continues to pursue a career in writing and lecturing in the field of traumatology
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