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Living with Uncertainty *

written by Odelya Gertel Kraybill, PhD., LCPC, ACS
on Sunday, 22nd March ,2020

As I write this, I am about to end the third week of isolation. I work from home, and currently see clients online.

This is a time of great uncertainty.  It's not easy for anyone.  But for trauma survivors, myself included, times like this are especially difficult.  I want to explain why and review the actions I am taking to manage moments of frozenness that lie at the core of traumatic experience and rise to the surface in hard times. 

It starts with emergency management 

Biologically we all react the same way to stress. When we sense danger (real or perceived) our nervous system is quick to take charge.  This sets off a series of reactions to make sure we survive.

Stress triggers our past stress reactions

Everybody struggles with stress. But some are more vulnerable to high stress: Trauma survivors, people with chronic conditions, people who live in uncertain conditions (immigrants, refugees, kids in foster care and so forth). 

Why are some especially vulnerable? Stress triggers the same biological mechanisms as trauma. Our nervous system is triggered when it detects a cue familiar from past experiences of stress and trauma.  The neural networks created by our body to cope with those past experiences get re-activated.

Along with reactivation of those networks comes re-awakening of the fears and anxieties we experienced on those occasions. If the cues triggering us persist, we get more anxious and fearful over time as more and more of our attention and energy is controlled by our trauma response system.  Without even quite noticing it, we begin to feel threatened and jumpy.   Our ability to absorb information and focus and do rational decisionmaking is reduced.

Stress Is Cumulative. Each episode of high stress or trauma 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, those of us with a history of trauma have to be even more prepared for it than others. We have to be ready to do major trauma response management every time stress levels rise, no matter how “ordinary” they may seem.

Stuck in Withdrawal. When we become overwhelmed with stress, we reach a point where we experience an intense instinct to withdraw.  It happens after and sometimes during emergency experiences, but it can also happen as a result of an accumulation of “normal” stress.

For example, you might be driving in a rush to an appointment, because you are late.  Another car cuts you off in an intersection. You glare at the driver and they make a rude gesture.   In the end, you have to cancel the appointment.    

When you get home, your children are running around the house and making a lot of noise.  The TV is blaring. Everyone is hungry so you rush around to make dinner.

But what you really want to do is get away from it all.  You long to step away to a quiet room, withdraw and get some time to regroup.

In this example, withdrawal is a healthy, normal, useful, and life-preserving response to stress.  It guides us to get to a safe place and to renew the reserves of energy we called up to cope with stress.   

Withdrawal (Stage #3 in the ETI roadmap) is a secondary response to fight/flight/freeze reactions.  Whenever the fight/flight/freeze instinct has been triggered, almost immediately afterward we experience a powerful urge to withdraw to safety and rest. 

Though it serves an essential protective function or certain individuals, this life-preserving response can morph into a cycle of misery.   Rather than ensure a temporary place of renewal and recuperation, withdrawal can become a more or less permanent location of living.  When this happens, individuals cycle through intense emotions of shock, fear, anger, denial, and rumination, and feel unable to get out of the swamp of emotions.  

In response to withdrawal, take action to regain a sense of control.

1. Gather information. The simple action of gathering information is itself a big step towards regaining an inner sense of control. But, make a special effort to ensure that your sources of info are reliable
 since incorrect info is a huge problem in many crises. Once you have figured out reliable sources, limit your exposure to other sources since it is easy to get flooded by the volume and emotional intensity of many info sources.  

2.  To keep your stress down, try to limit online news exposure to not more than once or twice daily. Adjust your news notifications to reflect your choices of news sources.   

3.  Maintaining routines is your first source of grounding in times of high stress. The pull to withdraw and rest is powerful for many of us and should be honored.  But maintaining a sense of action helps us feel more in control over the uncertainties that surround us. Create a daily schedule and do your best to maintain it as a matter of highest priority.

4.  Try moving more and talking less. This may seem counterintuitive. The urge to sit still and try to shield or nest ourselves is strong, especially for those who are exposed to chronic stress.  But endlessly discussing the stress we feel or the causes of it can keep us focused on it and signal our nervous system to maintain high alert. Seek out any possible way to gently move. Walk, climb steps, stand up and stretch, listen to calming or uplifting music, dance. Create a reminder to stand up and move, at least every two hours of your waking hours.

5. Social support. Isolation is difficult and can feel debilitating. We all need social engagement and support to feel connected. The right kind of connection helps us feel grounded and safe, and our nervous system calmer. Use this as a time to connect to others around your interests. 

6. Connect to others and create online networking, whether about drawing, singing, dancing, a book club, etc.  Anything that we do face-to-face in small numbers we can do online. If you don’t have adequate support systems, call a support hotline, find a support group, reach out to a spiritual community, ask your family to help you find a therapist.

7. Regarding social distancing. Until there is an official call for it, read this link
and make your best judgment. Remember that this call is to protect vulnerable members of communities. 

8. Journal. There are many ways to journal:

•Create a visual journal
.  You don’t need to be an artist. Take a few magazines, markers, and glue, and create a daily collage
on what’s on your mind. Scribble, draw color templates
.

•Write a poem, haiku
, or a detailed description of your feelings. Share your writing with someone, use social media, share with your loved ones, or your therapist. (I have a journal with each of my clients).

•Sing or dance your journal. Choose songs that describe your feelings or the feelings you wish to connect with at this moment, and sing, move/dance and see how you feel.

9. Strengthen your Vagal Tone

. The Vagus nerve is the longest of the cranial nerves and controls your nervous systems (stress and calming ones). The vagus nerve connects the calming parts of our nervous system (parasympathetic). Through slow rhythmic breathing, mindful movement, singing/humming, you can strengthen your vagal tone. 

THE BASICS

What Causes Stress?

Find a therapist to overcome stress

10. Create music playlists (10 min each), one that is calming and one that is uplifting.

Make a point to listen to it at least once a day. When you listen, look at the lyrics and sing. This will strengthen your vagal tone, calm you, and help you connect to life resources.

11. Rest and get enough sleep. Rest and sleep are Make sure you get enough rest from activities and engagement. Give priority to sleep, ideally between the hours of 10 pm-7 am.

12. Eat clean. In times of stress, most of us crave comfort foods, many of which contribute to inflammation in the body. The more we suffer from inflammation, the more our immune system is compromised. Take steps to help your body reduce inflammation. Movement, and a good diet are the first steps in that direction (read blog about inflammation and mental-health).

Eat
whole foods as much as possible, especially vegetables. Minimize sugar consumption.

•Avoid fruit and seed-based oils
, use avocado oil and olive oil instead.

•Read what experts say
about supplements to support the immune system at this time.

•Drink warm water in lemon or calming teas.

•Read New Zealand's study
demonstrating the effectiveness of multi-vitamins in mitigating stress symptoms in crisis response.

12. Stay tuned to the here and now when you are ruminating or feeling flooded: 

•Scents like orange blossom essential oil, chamomile or lavender have a relaxing effect on some people. Mint helps some people come out of high-stress moments.  

•Try this relaxing meditation
 I recorded to help get grounded in your body.

13. Self-Compassion.  When we scold ourselves for thinking or feeling a certain way, we send a signal to our nervous system that we are not enough, and we tighten within.

Remember, you are ALWAYS doing the best that you can at any given moment. Given a choice, you may have responded differently to events at the time of high stress/trauma. But you couldn't.  Survival mechanisms took over and helped you do whatever it took to stay alive.

 When we allow ourselves to be what we are, warts and all, our brain pathways “expand”. When we criticize ourselves they “tighten”.  Since you did the best that you could, you are now also doing the best that you can (read more in this blog).

Try this ETI Simplified Self-Compassion Exercise:

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ETI Simplified Self-Compassion

Source: Dr. Odelya Gertel Kraybill Expressive Trauma Integration™

This too will pass. For now, we are all in this together, trying our best to face one of the greatest uncertainties of our time. To say we are uncomfortable is an understatement.  Yet, we are still here, doing our best to manage our stress response, anxieties, fears. Stay informed, create and expand a set of activities that are within your control, stay safe and healthy.

 

Join COVID19 challenge #1 and share it with others. 

 

 *Kindly shared by Dr. Odelya Gertel Kraybill, originally published in Psychology Today

 

 

 

 

 

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