Negative thoughts

[Ukrose]

Hi, I'm suffering thats it in a nutshell. My ptsd anxiety panic attacks has reared its ugly head again. I can't stop thinking of tge past awful things that have happened to me, and then my body starts to shake, my hands get pins and needles and I just can't function. Please if anyone has any suggestions on how I can stop this, I'd so appreciate it. I feel I am the only one going through this, which of course I know I'm  not, but it feels so lonely. I see people out shopping, laughing and I try to put on a brave face but I'm dying inside. 😔

[Eagle Ray]

Dear Ukrose,

I've had similar issues in my body related to trauma at various times. What helped me a few years ago was learning about the body's physiological responses to trauma and I came to understand that the shaking is actually the body trying to enact a recovery. So although it feels awful, especially because it can be uncontrollable at times, I learned to understand and accept that my body was trying to rebalance itself and work with it. I found just being aware of this in itself could help my body settle.

There's a few modalities for trauma that work through the body and even with the shaking response itself. One is called TRE (Trauma Releasing Exercises) developed by a guy named David Berceli. I did a few sessions with a TRE therapist in 2021 and found it very helpful. The approach teaches exercises that help the body to release stored trauma through the shaking response via central pattern generators in the spine. It's used quite a lot for PTSD. You could look it up if interested. There is a TRE Australia website that includes a directory of practitioners. I'm not allowed to post direct links here but it should be easy to find.

The other modality I have done is Somatic Experiencing. This also starts from the body and it is about gently allowing responses in the body to complete that did not get to complete at the time a trauma occurred. It was developed by Peter Levine who has been working in the field for over 50 years now and originally developed the idea from seeing how animals naturally recover from trauma in the wild. Us humans tend to get stuck more easily. His books may be helpful, especially in terms of understanding the physical symptoms in your body you are getting. I've read In An Unspoken Voice and Trauma & Memory, but he has an earlier one called Waking the Tiger as well. I eventually found a therapist who practises it where it worked well for me, but I did have to try a few others first who weren't the right fit. I did find a list of practitioners in Australia on the Somatic Experiencing International website, but that list is quite small now compared to what it used to be. But even just reading about the approach may be a good starting point, or listening to podcasts with Peter Levine (there's quite a few). He has some containment strategies I found helpful recently when I was really trauma activated due to a bad experience with EMDR. Those exercises can be found in the YouTube video: Treating Trauma: 2 Ways to Help Clients Feel Safe, with Peter Levine. But even if you just look up something like "Peter Levine self-soothing techniques" you will find a few ideas.

I don't know how it works for you, but for me there is like something that triggers a physiological reaction linked to trauma, then that can trigger thoughts, then that feeds back into the trauma response. So I find for me it's initially more an instinctive reaction rather than thoughts causing the trauma response, but once that response is activated then my mind can react with thoughts and then the trauma response can spiral. So for me, working through the body in the first instance has been really helpful. You may also want to google things like "Window of Tolerance" and "Polyvagal Theory" which also help explain what the body does in a trauma response.

Those are just some thoughts. I used to shake a lot. I remember as a teenager I would shake all the time. So I really get the horrible anxiety and overwhelm that goes with that. But my system has gradually learned to regulate itself more. So it is possible to greatly improve and feel goodness in your body again and live more of the life you want to.

The other generally helpful thing is grounding - noticing your surroundings through your senses, feeling the ground beneath your feet and coming back into the present moment. It might be just taking 5 minutes and looking around the room, noticing the colours, forms, objects etc around you, seeing if you can hear any sounds etc. Finding a good trauma-informed therapist can also be helpful as co-regulation with another is so important in trauma recovery. Have you sought any support at all? I can also recommend the Blue Knot Foundation if the trauma links with Complex PTSD as that is their speciality, and they can be great to talk to for finding some safety and stabilisation. There number is 1300 657 380 (9-5 every day, eastern states time).

Take care and listening if you want to chat more,

ER

[Ukrose]

Thank you so much for all the information. Very greatly appreciated l. I am seeing a psychologist who has been fantastic so far. She has suggested EMDR, but I noticed you said you had a bad experience with it. That worries me. I don't want any worse troubling feelings than I already have. Thank you once again. I wish you well 

[Eagle Ray]

Hi Ukrose,

There were a number of factors contributing to my bad EMDR experience, so it might help if I briefly outline what those are. Basically, it was not done as it should have been. My psych introduced it suddenly in the middle of a session when I wasn't expecting it without any prior preparation. I'll explain the steps that were missed and I would check that your psych is following all of these steps...

8 Phase Protocol - I would look this up online and ensure your psych follows it. It's there to help the EMDR work as well as possible while minimising risk of harm to the client. My psych went straight into Phase 4. I had no preparation or resourcing and no careful working out of a target memory beforehand. We went straight into processing a memory in session which had it been looked into more carefully, it would have become apparent that memory could trigger life-threatening fear for me (based on prior trauma), which is exactly what happened. So I had severe flooding and retraumatisiation for many weeks afterwards. It's important the EMDR processing itself does not start with the worst memories, but gradually builds up the client's understanding of the process as well as installing safe, positive memories as resources and containment strategies for any difficult feelings that arise. All steps are important.

Modifications for Complex PTSD - I'm not sure if your diagnosis is PTSD or Complex PTSD, but EMDR was originally developed for single-incident PTSD. In the case of Complex PTSD it is more complicated because there are usually many layers of memories and traumatic experiences that occurred over a period of time, often years. So beginning to work on one memory can trigger others and people with Complex PTSD are especially easily pushed outside their Window of Tolerance (e.g. into fight/flight/freeze). So if you have Complex PTSD, your psych should be making adjustments and taking things slowly with great care. To find out more, I suggest googling "Dr Arielle Schwartz EMDR Therapy for Complex PTSD" which is quite a good summary of how it should be modified.

Dissociation and Dissociative Disorders - All EMDR practitioners are supposed to screen for dissociation and dissociative disorders prior to undertaking EMDR. There are screening tools for this. My psych didn't do this but knew I had recently scored 37.5 on the DES-II screening tool and you are not meant to proceed with EMDR if a person's score is above 30, and more recent recommendations say 20. The consequences for me were massive as I have likely OSDD/partial DID and the EMDR triggered new alters/parts breaking through and severe dissociation. I was basically polar swinging between terror and severe dissociation for weeks. I am very dissociative so I was high risk. I would ask your psych about screening for dissociation beforehand as a basic safety measure. If you do score above a certain level, it doesn't necessarily preclude EMDR, it just means doing a whole lot more work first to prepare and see if you can get to a level where it's safe to proceed.

Neurodiversity - I fall into this category as well with likely undiagnosed ADHD and autism. My brain is hyperconnected and I have very high levels of sensory sensitivity. So this also made me much more susceptible to side effects from the EMDR, including intense neurological effects and the internal dissociative barriers in my brain coming down too much and too fast. I've read of other people with neurodiverse brains also being really impacted by EMDR in this way, so just another thing to consider if this is relevant for you.

I don't want to put you off, because some people do get great results from EMDR. But it's really important the practitioner is experienced, accredited and they know what they're doing. Nothing should be rushed and all steps should be done with care. From what I have read, many people describe a hangover-like effect in the days afterwards. Others experience not being able to feel positive emotions for a while. I certainly had that one. Some people become more tearful. Many describe feeling worse for a while before feeling better. For me, the side effects were extreme, but I was not a good candidate for it and the right safety precautions were not taken. Many do report that after going through some rough patches with the EMDR, they do have major improvements where they find previously traumatic memories no longer affect them much and they feel much better generally in life. So there is potential for success, but I would just go through all the necessary preparation first and don't hesitate to ask your psych lots of questions and ensure you feel ready to do it. It's so important it's done at your pace and to always communicate if anything in the process doesn't feel right for you...

[Eagle Ray]

Sorry, ran over word count... just finally... 

I hope that helps a bit. I would read up on it and learn as much as possible beforehand and that should help you have a better sense of it and how you feel about it going forward. Remember, you always get to choose what you want to do or not do in therapy, so trust your gut and do some research to help guide you as well.

All the best and take care,

ER