*That is an article from the Spring 2024 challenge of Contentment Journal.
By Josh Briley, PhD, BCMAS, FAIS
All through my profession as a psychologist, whatever the setting (VA clinic, non-public apply, telehealth, or jail), I’ve struggled towards the overwhelmingly widespread false impression that after somebody begins to expertise post-traumatic stress, they may at all times have it. That they’re now one way or the other “damaged” or “broken” and can’t be “fastened.”
This false impression is fueled by plenty of elements. One issue is the medical career’s major method to psychological points: prescribing drugs. Now, whereas I’m not anti-medication, my scientific expertise has satisfied me they need to not essentially be the first-line method to overcoming post-traumatic stress. Many of the sufferers with post-traumatic stress that I’ve labored with over time have been on psychotropic drugs for sleep, anxiousness, despair, and ache, with no vital enchancment of their signs. Not solely do these drugs not resolve the problems contributing to the signs of post-traumatic stress, however they embrace negative effects that usually negatively affect the affected person’s high quality of life; negative effects which the prescriber could handle with one more remedy, and thus, the cycle perpetuates.
Nonetheless, the largest issue that retains individuals “caught” and believing they may by no means overcome their post-traumatic stress and that they’re, subsequently, one way or the other “damaged” is a misunderstanding of what it means to “get higher.” Most individuals I’ve labored with outline “getting higher” as forgetting in regards to the occasion(s) and “going again to who I used to be earlier than.” Admittedly, that is an unattainable objective. We can not return to who we’re following any vital life-changing occasion. For instance, when you turn out to be a guardian, you can not return to considering and performing as you probably did earlier than your first youngster was born. As soon as puberty begins, you can not return to who you had been pre-puberty. Each examples ceaselessly alter the way you suppose, really feel, and behave. Equally, upon getting skilled a traumatic occasion or a collection of traumatic occasions, you’ll not neglect it, nor will you be capable of revert to considering, performing, or feeling the best way you probably did earlier than the trauma(s).
Due to this fact, if “getting higher” doesn’t imply forgetting in regards to the expertise and going again to who you had been earlier than the trauma, then what does it imply? “Getting higher” is greatest outlined as post-traumatic development, which includes incorporating the traumatic expertise into the narrative of who you’re, shifting past the trauma reactions, and creating a brand new regular in your life in which you’ll obtain a full, glad, and wholesome life with out the fixed emotional and bodily difficulties that usually maintain us caught following a trauma. Step one to attaining post-traumatic development is to know the reactions that happen throughout and following a trauma so you don’t really feel so uncontrolled of your self. When you perceive these reactions, it’s important to discover ways to overcome these reactions so you possibly can start to expertise post-traumatic development. This text will briefly clarify the explanations we react as we do following a trauma and focus on a examined however novel expertise that may be utilized to assist alleviate the reactions and easy the transition to post-traumatic development.
Physiological and Evolutionary Features of Put up-traumatic Stress
Throughout a traumatic expertise, a facet of the sympathetic nervous system, referred to as the “combat or flight” response, kicks in. A number of bodily and psychological modifications happen from this with the only goal of permitting us to outlive a harmful encounter. Bodily, our coronary heart charge will increase, muscle stress in our legs and arms will increase, respiratory turns into shallower and extra speedy, and blood movement is concentrated from our torso to our extremities. Mentally, we develop tunnel imaginative and prescient to concentrate on the menace and anybody within the quick space whose security we could really feel chargeable for. Greater order, logical reasoning is lowered, and our most elementary experiential, emotional determination making is amplified. These modifications are all designed to get us out of hazard as shortly and safely as attainable.
The way in which our nervous system is designed, as soon as the quick menace is over, then the parasympathetic nervous system, often known as the “relaxation and digest” response, is meant to be activated to counter all the modifications from the sympathetic nervous system activation and restore us to regular functioning. In different mammals, that is exactly what occurs. They encounter a menace, reply to it, after which return to regular functioning. They keep on this parasympathetic state till they encounter one other hazard or a reminder of the menace. At this level, they’re briefly in sympathetic arousal till the brand new menace, or the reminder is gone.
Nonetheless, in contrast to different mammals, people are in a position to anticipate threats the place there could also be none and don’t want a bodily or situational reminder to recall the worry and heightened arousal of the trauma. Due to this fact, we’re extra susceptible to remain in combat or flight long-term with out permitting our nervous system to return to regular.
The longer we’re in a combat or flight response, the extra of an impact it has on our brains and our bodies. The mind is extremely adept at turning into environment friendly at repetitive behaviors and feelings. Due to this fact, after we keep in a state of heightened arousal and search for hazard in every single place, the pathways that course of these threats turn out to be extra energetic and, over time, turn out to be the default pathways for the exercise in our brains. Thus, a cycle is created during which we constantly really feel threats the place there could also be none, so our brains adapt and keep in a state of combat or flight, reinforcing the sensation of being at risk always. We could start to really feel as if we at all times need to be on alert, we could also be simply startled, and our startle response could also be larger than normal. We could also be liable to emotional outbursts, particularly of anger, worry, or disappointment, we could have problem enjoyable and bother falling or staying asleep. As well as, we could discover ourselves reliving the trauma by means of both intrusive recollections, nightmares, or totally re-experiencing it within the type of a flashback. Because of this, we could isolate ourselves from others, have problem with reminiscence or with concentrating on duties to the extent that work and faculty efficiency undergo, and should really feel simply overwhelmed.
The longer we expertise these reactions to the trauma, the extra entrenched {the electrical} pathways related to these reactions turn out to be. Lately, now we have realized that such pathological electrical exercise within the mind is related not solely with the overall signs of tension, insomnia, and different difficulties typically skilled as a part of post-traumatic stress however the particular patterns {of electrical} exercise may be tied to the precise difficulties an individual is experiencing.
Conventional Technique of Managing Put up-Traumatic Stress
Due to the disruption these difficulties have on our lives, most of us go to our major physicians and get a prescription. These drugs are supposed to cut back the severity of the anxiousness and insomnia that happen from post-traumatic stress, and they can accomplish that for a quick interval. The issue with these drugs is they don’t handle the underlying trigger for the sympathetic activation contributing to the hyperawareness and re-experiencing signs of post-traumatic stress. Because of this, regardless of compliance with drugs and struggling by means of the negative effects of those drugs, we don’t expertise vital enchancment in our each day functioning. 
Many individuals additionally search out remedy to assist with the signs of post-traumatic stress. Till very lately, probably the most regularly utilized strategies in psychotherapy to assist with post-traumatic stress had been therapy approaches that emphasize immediately confronting the recollections and triggers head-on. These are very intense therapy approaches that escalate the overwhelming and unsightly feelings evoked by the recollections of the trauma. The underlying principle of those therapy approaches is that, by intentionally recalling the averted recollections and telling the tales of what occurred, we are going to transfer the reminiscence from the extraordinary and emotional experiential reminiscence to the narrative reminiscence and thus scale back the depth of the emotional response. Due to this fact, sympathetic nervous activation won’t be as intense, and we will transfer on from the trauma. When achieved accurately, these therapy approaches are efficient, but tough for each affected person and therapist to undergo. When achieved incorrectly, the affected person can turn out to be retraumatized, and their signs really turn out to be extra debilitating, resulting in much more extreme anxiousness and insomnia.
Put up-Traumatic Progress
If conventional remedy approaches and drugs are sometimes tough or unsuccessful, then what hope does somebody caught in a post-traumatic stress cycle have? Thankfully, there may be hope. It’s attainable, and much more accessible than many consider, for even somebody with extreme post-traumatic stress to maneuver past these struggles. As soon as they be taught to take action, they’re now not “caught” within the trauma and might take pleasure in their life once more. 
Attaining post-traumatic development shouldn’t be as unattainable as it might sound. The first element is studying to intentionally activate the parasympathetic nervous system within the face of a perceived menace or when experiencing the reminiscence or a reminder of the trauma. There are a lot of methods to attain this parasympathetic activation, though a complete dialogue of them is past the scope of this text. The first element in all of those approaches includes studying to loosen up the muscular tissues within the physique and studying to reframe what we inform ourselves in regards to the trauma.
There are a lot of methods to loosen up the physique: progressive muscle rest, guided imagery, and meditation are only a few. These strategies contain bodily enjoyable our our bodies, altering our respiratory patterns to a slower and deeper rhythm, and studying to focus our minds. Specializing in these bodily modifications can flip off sympathetic activation and activate the parasympathetic nervous system. For individuals who can grasp these expertise, the outcomes are wonderful. Nonetheless, many individuals don’t have the endurance, the dedication, or the time to decide to studying and training these expertise each time they understand hazard or encounter a reminder of their trauma. Thankfully, there are applied sciences obtainable that may robotically activate the parasympathetic nervous system. Essentially the most examined of those applied sciences is Cranial Electrotherapy Stimulation (CES).
Cranial Electrotherapy Stimulation: A Trendy Strategy
Cranial Electrotherapy Stimulation (CES) is a non-invasive expertise that’s FDA-cleared to deal with anxiousness and insomnia. CES, in its trendy type, has been utilized in america for the reason that early Nineteen Eighties, although the roots of the expertise are a long time older. CES makes use of tiny quantities {of electrical} present to normalize {the electrical} exercise within the mind. As this exercise is normalized, the nervous system is basically “reset” to function how it’s designed. The parasympathetic nervous system is robotically engaged, and reduction from the anxiousness that’s prevalent in post-traumatic stress is usually quick and drastic. Many individuals describe feeling their anxiousness “soften away” inside a single therapy. Moreover, as a result of the nervous system is basically “reset” by CES, sleep high quality and amount are considerably improved. Not like different insomnia remedies, which artificially sedate you and disrupt wholesome sleep cycles, CES normalizes {the electrical} exercise within the nervous system and improves sleep naturally. When the nervous system is working as designed, a wholesome sleep cycle is a part of that operation. The outcomes are cumulative, so the extra consecutive days CES is utilized, the higher the outcomes will probably be and the longer they may final. Whereas a number of CES units are in the marketplace, the worldwide chief in analysis and scientific utility is Alpha-Stim® (www.alpha-stim.com). CES is obtainable in america solely by a written order from a licensed healthcare supplier however is obtainable over-the-counter in different nations, which permits CES units to be distributed. In Europe, Asia and a lot of the remainder of the world, CES is authorised to deal with despair additionally, and is mostly thought-about secure sufficient to not require a physician’s order.
I’ve used Alpha-Stim, each as the only technique of therapy and along side remedy, to deal with individuals fighting continual and sometimes debilitating anxiousness and insomnia related to post-traumatic stress. Lots of my sufferers had been on drugs for many years, had participated in each outpatient and residential therapy, and had given up hope of getting a traditional life. I’ve labored with individuals who had been unable to go away their homes as a result of anxiousness that accompanies feeling as if one is at risk in every single place they go. They remoted themselves as a lot as attainable and, in consequence, missed vital household occasions and had few, if any, associates. They believed they had been “damaged” as a result of they didn’t reply to conditions the best way “regular” individuals did. Years of medicines and unsuccessful makes an attempt at remedy had satisfied them they’d at all times be that approach.
Nonetheless, as soon as I launched Alpha-Stim as a therapy modality, the variations had been nothing wanting exceptional. Throughout remedies in my workplace, I might see them visibly loosen up within the chair, and lots of of them reported feeling higher on the finish of the primary therapy than they’d felt in years if not a long time. As they obtained their very own units, they reported sleeping by means of the evening, with the ability to go to the shop with their spouses, attending kids’s and grandchildren’s college occasions, and having fun with holidays with households for the primary time in years. Their relations would cease me within the clinic and inform me tales of the modifications they noticed in my sufferers, typically with tears of their eyes.
Contained in the clinic, I additionally witnessed unbelievable transformations. Lots of my sufferers would now not sit alongside the sting of the ready room, gazing everybody warily whereas ready for an appointment. As a substitute, they’d work together with the opposite sufferers, laughing and smiling, with no signal of tension. Throughout remedy periods, the modifications had been additionally exceptional. My sufferers would begin their CES therapy both within the ready room or as quickly as they entered my workplace and had been relaxed inside minutes. Thus, we had been in a position to get to the meat of the session extra shortly and simply than we had earlier than introducing Alpha-Stim, spend longer in processing the feelings and ideas that stored them caught in post-traumatic stress, and overcome their struggles. We might course of completely different traumas extra shortly and effectively. Because of the mixture of CES and remedy, sufferers had been in a position to overcome the difficulties that had stored them caught and enter right into a interval of post-traumatic development. Related, although maybe not fairly as drastically, enhancements had been reported in sufferers who utilized Alpha-Stim as a sole technique of therapy and didn’t take part within the obtainable particular person or group remedy providers I supplied within the clinic. Moreover, a lot of the sufferers who used Alpha-Stim frequently had been in a position to come off of, or not less than drastically scale back the dosage of, their anxiousness, despair and sleep drugs.
Put up-traumatic development shouldn’t be solely attainable; it’s important if we wish to dwell a cheerful, wholesome, fulfilled life. Each problem we encounter is a chance to be taught extra about ourselves, others, and the world. Nonetheless, being caught in a state of post-traumatic stress prevents us from shifting previous survival mode. Activating the parasympathetic nervous system is the simplest and environment friendly approach of calming our minds and our bodies and permitting ourselves to place the trauma into perspective and start to rebuild our lives. CES is a really efficient software to help on this transition and is the simplest technique of facilitating the development from post-traumatic stress to post-traumatic development that I’ve utilized in over 20 years as a psychologist.