[CN: This article might bring up memories of retraumatization. Some people might feel guilt or shame for not ‘having done it right’. The article only offers ideas. There is no way to really do it right. We always do the best we can and positive results are never guaranteed, even if we know all the right things. It was not your fault.]
It is not rare for new overwhelming stress to happen before we are done figuring out the old trauma. People who have been victims of abuse are at greater risk of being victimized again. We might not have the skills to navigate dangerous situations yet, abusers specifically look for vulnerable people, and our nervous system is hurt from the trauma we experienced in the past and cannot take much more stress on top of what it is already handling.
Signs of an acute stress response
We know that life events have been too much when we show signs of an acute stress response even though we have been stabilized before. Our symptoms suddenly increase again. We notice more:
- nightmares or flashbacks
- vulnerability to triggers
- anxiety
- negative thinking
- difficult feelings
- dissociation
- amnesia
- unpredictable switching
- constant hypervigilance
- constant flight/fight/freeze/shutdown
- sleeping problems
- cognitive problems like inability to concentrate
- issues with maladaptive coping
- ….
This is very uncomfortable and it can feel disheartening. We spent so much time reducing all these symptoms and now they are back. Our effort is not wasted or destroyed. We have learned that we can get regulated and we will return to it again because we have experienced it before. And this acute stress does not have to stay with us. There is a window of opportunity to recover our sense of safety and regulation and integrate the stressful event so that it does not get stuck in the form of new trauma. The process is very similar to what First Responders do with survivors of disaster to prevent PTSD. We can treat ourselves as if we have just survived an earthquake. We need a bit of special attention because we have been traumatized before.
Stop the harm
The first step is always to make sure that the overwhelming distress or violence against us is not happening anymore. It might include leaving a bad partner or removing ourselves from a work situation that has been overwhelming our capacity to regulate ourselves. It needs clear choices here. It has to stop. Once it does, we can make proper plans and take care of ourselves.
(If we cannot make it stop, it needs more help, and if that is not available it is natural to fall back on survival strategies. Humans are not made for constant overwhelm and there is no trick to make it ok. Military training for these situations includes learning how to dissociate. If there is no way out, that is an appropriate solution. It is not the right time to try and integrate any of it. We do have to be careful to differentiate between feeling stuck and being stuck. A lot of situations are not impossible to change, it just feels that way.)
Optional: Secure evidence
[CN This paragraph implies sexual abuse in a way that could trigger memories]
In some cases we don’t just experience an overwhelm of our capacity to process events. Something illegal happened to us. It is our right to bring that to justice. To keep that choice open for Future-Us to decide, we might want to secure evidence of what happened. Hospitals usually offer free treatment for that and hold on to the evidence until we decide what to do with it. It is best to do that immediately because it is uncomfortable, even when we tell them that we have been traumatized before and that they need to be extra careful. The very least they can do is to take care of possible injuries professionally. This adds distress. It might not be worth it. But we don’t know that yet. I like the approach of ‘always choose what creates more choices and not less’. There is no law that you have to press charges but it is helpful to keep that choice available. There is also no law that you have to secure evidence. If this would push you over the edge it is a fair choice not to do it.
Safety
Next we create a safe space (in the real world, not as imagery) for ourselves. It will not feel safe at first because we need to recover our trust in relative safety before we will really feel relatively safe again. If our trauma recovery never got to a place where we felt a bit of safety, this will be a bigger struggle and might become a main focus for a while. Safety acts as a counterbalance to the potentially traumatizing stress we just went through. We use our orientation tools to overcome the dissociation that prevents us from noticing that we are not in the difficult situation anymore and make sure to take in how safe we are right now. Nothing bad is happening here.
We make the place safer by reducing all stressors. That can include not reading any job-related mail and limiting news exposure. Something bad is always happening out there but we don’t have to be aware of it all the time and certainly not when we are trying to prevent long-term effects of stress.
Then we add control and choices. We are in charge now, we decide what happens. And we notice how we can choose something and be in control of the situation as a ‘felt sense’. Possible helpers have to make sure that we get as much control as possible.
The pillars of stability
Once a safe space is created, we turn towards the most basic things we need to gain strength and integrative capacity. Our goal is to bring ourselves into a good physical condition so that the body can process the stress and release it. To gain strength, we need sleep and food and hydration. Good hygiene distances us from dark feelings. We can take medication to support ourselves if it is too difficult to take care of ourselves without help. When we listen to our bodies we might notice a need to move around, which is one of the most natural ways to process stress in the body. So we make sure that we move. If going outside is not a great idea (see safety) we can find ways to move at home. There is a dissociative tendency to forget about these very basic functions and if we forget to take care of ourselves we will feel weaker and it might confirm the feeling of not being well. Lower capacity diminishes our chances to process and integrate the stress right now. The experience of being so disconnected from our body can sometimes make it feel really weird that we rely on sleep and food so much but we really do.
Warmth
The next essential element is physical and emotional warmth. This is why First Responders wrap survivors in blankets. Our body experienced a shock and we treat it for shock and that includes keeping it warm. A blanket and hot sweet tea can feel like a surprising relief. It helps not to get stuck in the freeze response. More options might be a hot bath, hot comfort food, cuddling with a furry pet. Someone else might want to check our bathwater if our body awareness is low to avoid it getting too hot or too cold. Some people can profit from hugs or cuddling with a loved one but that might be far from what we can cope with as well.
Warmth also includes an emotional aspect. We get it from soft surfaces, stuffed animals, quiet conversations with gentle people. Depending on where in our healing journey we are, comfort through other people might work well or feel overwhelming and that is ok. There are a lot of ways to add warmth and warm people are just one of them. You probably have go-to comforters that you can use.
Normalcy and Resources
At first, we might need all our energy to simply eat and sleep and be. Once we have a bit more energy, we slowly return to our normal life while staying in the safe space, isolated from stressors. We pick up mundane tasks with our hands like washing our dishes or folding laundry. It doesn’t have to be much. Just an indicator that normal life is happening and we are doing normal things and the world is working like it normally does. We do the routines we always do because this is just like every other normal day where nothing bad happens to us. This normality will help us to find our felt sense of safety again.
Because we exist in an artificial bubble of our private crisis intervention, there are no rules of what has to be done and we are free to engage with things that make us feel better. It might be creative work like painting or crafting, diving into a fantasy world in a book or TV series, playing a game or learning something new. Maybe we have a special interest that we can engage in where we feel capable. Resources and distractions move our attention and physiological responses away from the trauma responses and help us to regulate ourselves again. They work best when we are present while using them. Partners and helpers can support us by giving us the space to take an actual break from everything to recover. While it looks like we are just doing ‘fun’ things, it is actually not easy to do them at all and doing it anyway to reconnect with normality does increase our chances of recovering from our shock event.
Therapy
Therapists can help us with specific techniques to help us process the events. The release tool in SE is especially helpful. I never recommend TRE for people with prior trauma and dissociation because it is unspecific and risky, even though it is popular with First Responders. This kind of help will not always be available because it might be hard to find a crisis counselor who has time for us. There is usually a local crisis team that makes time for us when there has been an illegal action against us. Other overwhelming situations might not qualify for this support.
Time
We do the things that feel right and are available without engaging in toxic coping that would cost us capacity and then we mostly need time for things to settle. Our nervous system needs a couple of days where it engages with safety in the environment, and no new stress is added. It has a natural tendency to release stress when danger has passed. We try to integrate the event as something that happened in the past and is not happening anymore. More integrative capacity increases the chance that it will not get stuck as new trauma. Our current symptoms might fade over the next few days and weeks. We have not lost all our progress.
You might have noticed that I have not mentioned parts throught this whole process. In most cases other parts vanish during high stress events and won’t show up for a donsiderable amount of time. If they do, we use our regular tools for co-regulating other parts. Having them hide is the best option for everyone and we don’t have to artificially search for them. A system has its own wisdom when it comes to high stress and we can trust the process.
When there is no integration
All our effort might not be enough when the event was way too big to integrate it. That is normal and happens to good people. We know that it happened when symptoms stabilize on the increased level or when they suddenly vanish and leave us with no distress at all. Dissociative people will experience the latter more often. We are used to structurally dissociating the distress and putting it somewhere outside our awareness. One of the signs that this happened is when we seem to have a sudden tremendous improvement but we cannot follow our own development that led to the improvement. We did not walk through any steps. It just suddenly vanished. Without any experience of release there has probably not been a release. We are going on with normal life and witnessed the mystery of dissociation at work. It wraps things up for later when we are better able to take care of them. They won’t necessarily come back in the form of flashbacks. Not everything does. This is not a failure. The body-mind system did exactly what it is supposed to do when things are overwhelming on this level. When it happens, we pick up our life and do what we can to be safe and we are gentle on ourselves.
New overwhelming stress does not automatically have to lead to new trauma. If we slow down and take our time we might be able to process some of it in the following days. It is at least worth trying. If the high stress event was very similar to your past trauma, always seek professional help to guide you through this. It hits differently than ordinary overwhelm.
Managing impossible situations
[CN explains survival techniques that you might be very familiar with because you used them intuitively during TraumaTime.]
Traumatized people can face impossible situations that are constantly overwhelming and there is no way to stop it. It is just their normal life right now. It can objectively not be changed. The goal cannot be to process or integrate anything. The goal is survival. And with it comes the goal of the smallest possible injury when injury is inevitable.
There are ‘tricks’ to endure impossible situations. You need to make very sure that you are in an impossible situation before you use them. Some are not ‘healthy’ and can become the foundation for maladaptive coping later.
Breaks
One of them is based on pendulation. Whenever possible, we look for small moments that we can make a little bit better than the general situation. Having small breaks from pure survival helps us not to get stuck in deep freeze/shutdown. We keep a bit of flexibility in our nervous system by keeping it in motion and sometimes giving it a break to regulate. It helps if we can leave the overwhelming situations for a few minutes. Every break from it where we can relax our body a little bit is helpful. The key is to notice and pay attention to the break from trauma consciously.
Micro goals
We can set ourselves very small goals within the impossible situation. Even if that just means managing to endure the next hour or the next round of overwhelm and arrive at the break from it again. This will highly depend on the situation. They come with their own opportunities for logical micro goals. It creates a small sense of control.
Hyperfocus
Dissociative people are good at limiting their awareness. For hyperfocus, we narrow it down to one small sensation, movement, a resource or an activity. You might already know activities or topics that draw you in that way. Hyperfocus leads into a hypnotic state that blocks out overwhelming stimulation from outside. Our world has become tiny and calm.
Storytelling
To create distance from the stressful experience, some people report about it as if they are a narrator who tells the story of someone who experiences the situation. They give the character in the scene a name and talk about it like this is someone else. It is the extreme version of the observer exercise. This is where ‘my body’ becomes ‘the body’ in our narrative.
Externalizing
A similar tool to create distance from a painful inner experience is to imagine it as a shape with a color and consistency and to place it outside our body. Maybe it hangs in the far corner of the room and we only pass it occasionally. Some people personify or name this externalized object to make engagement easier but for our purpose we just place it somewhere where it doesn’t bother us and add to it if new suffering comes up. These last 3 are dissociative techniques that might come easy for us but might come at the cost of more chronic dissociation later on.
Repetition and Rhythm
There is some relief in a mantra, tapping a certain rhythm, repeating a movement or reciting a text or lyrics over and over again. I find it weirdly helpful to count the beats of a piece of music like dance teachers do to help with dance steps. It combines counting with a certain rhythm/emphasis. Repeating one verse of a song under our breath is also a great option. A rhythm like that can help to keep us going when we push ourselves through activities during impossible times.
Escapism
If reality is not a place that fosters survival we are allowed to hide in fantasies. A lot of survivors report that this is a main strategy that got them through TraumaTime. We can hide in stories. Dissociative people classically score high in absorption. That is the trait that helps us to vanish in inner pictures or outside stories and limit our focus to exclude outside stimulation.
Resistance
By finding small ways to resist the situation we can keep up a small sense of rebellion and therefore control. Sometimes it is possible to make life harder for those who make life hard for us. We never do that to the point where it causes us more trouble but we can do it in small ways and even just thinking about it and imagining it can help our mood.
Meaning-making and thoughts about the future
People find relief when they remind themselves of a greater purpose of their situation or how things will be better when it is over. That includes fantasies about a future life where none of this matters anymore. Sometimes protecting others or taking care of them creates a bubble of meaning within the suffering
These are survival strategies. They are strictly meant for impossible situations we cannot escape from. They are not recovery strategies at all. They exist to help people endure until help arrives or the impossible situation ends. You probably know them from TraumaTime. They are sometimes the root of the symptoms that we experience today (depersonalization, derealization, trauma-based OCD, maladaptive daydreaming, you name it.) As long as we can’t be grounded because it is psychologically unsafe to be more present, resources like they are taught in trauma therapy will not have the intended effect.
I feel conflicted and sad about sharing survival skills with you at all because this is a space that is usually focused on recovery. The reality of life is that sometimes people need these skills because impossible situations are a reality and society does not feel responsible to create change. It is absurd to demand recovery from people are are barely surviving. These are literally strategies taught in the military to endure torture. You shouldn’t be in the position to need them and I am sorry.
For helpers:
While writing this article it stood out to me how morbid and absurd it is to teach people recovery skills when they are not in recovery and still surviving impossible situations. That includes living below the poverty line and being bullied by the government. We are used to telling people all about our standard tools. It asks people to deny their greater reality and pretend that they are safe. How tone-deaf do we have to be to approach active victims like that and tell them that this would make a difference. ‘If you just ground yourself and use your skills, you will be better’. Really? Some changes have to be systemic changes to create the chance for recovery. We put an impossible pressure on people who are surviving real harm if we demand that they start their recovery in the middle of it. They will be ‘resistant’ and they will be right. It is an impossible demand.