Why some traumatised people feel near the tipping point during lockdown and what we can do to help… just one thing!

I wanted to write this short piece for people to gain a greater understanding of what the challenges may be for some people who have experienced developmental trauma or a traumatic episode.

Why would this be so?

One of the aims of therapy for the traumatised client is to try and live within a window of tolerance re emotions and sensations. This is a difficult thing for the client to master as they are frequently triggered by implicit and explicit memories that hijack the central nervous system. Early on in therapy clients either live in a state of hyperarousal or hypo-arousal. Early and middle stage work is helping the client to dampen down this highly dysregulated state.

Clients often feel a huge level of responsibility for things that are usually far out of their control, as well as the people-pleasing they output for personal aspects that are within their control. They live with a high level of hypervigilance and a continuous dread of terrible things that may be about to happen. Some clients live in fear of a knock on the door or an unknown number on their mobile. One client until recently still lived with the ironing board jammed against the backdoor at night.

These aspects cannot be worked on with cognitive behaviour, “change the way you think and you’ll change the way you feel” type therapy or time limited hypnotherapy because trauma is much more than a cognitive issue. It is felt in the body.

A client recently explained that a very short-lived trip to Asda threw her into panic where she was unable to cope. The one person from one household rule meant she wasn’t able to take her adult son in with her, that was the first stumbling block. For years she hasn’t done the weekly shop on her own as she doesn’t drive and she prefers to have someone with her to help.

The rules to this normally very straight forward task have changed beyond anything that we have known. Queues to get into the supermarket and a one-way system around the shop has meant you have to think on your feet, while consciously processing stuff that is usually processed automatically.

This is a paradox (to think quickly but also consciously with some effort is confusing) once this is accepted then comes the fact that you have to get this right and if you don’t then you are breaking some sort of code/rule that has been put in place to prevent very serious consequences. The client who is called Amanda and wants me to use her name, navigated the arrows but had forgotten a birthday card and didn’t know if she could double back on herself.

Feeling sudden panic, the effort to consciously process was not there and her body flooded with adrenaline for the flight or fight response. Feeling isolated she began to get upset. She wanted a way out but couldn’t immediately see one. 

On the face of it, it seems like it should be manageable, but all the automatic internal working models are activated in these panic stages. ‘I’m doing this wrong; it is my fault, this feels impossible. These kick in before the body is pushed into hypo-arousal, a cognitive collapsed empty state that feels very numb.

It is important to remember that in these moments the predominate feeling is fright.

People were not on hand to help… as people are barely smiling or saying hello with the eagerness to adhere to social distancing.

What this virus has brought us is the theme of disconnect.

• Stand apart

• Conflicting views

• Profession isolation – keyworker or not key worker (I’m not saying this shouldn’t happen, I’m just saying it has a consequence.
• Less touch

• Different sense of humour

• Bereaved or not bereaved

• Had the virus, not had the virus

• Working or furloughed

• Loving Boris, hating Boris

• Mask wearer, non-mask wearer

It has reinforced a detachment while maintaining all the online activity that has no heart.   

Amanda approached the self-serve lady that looks after that area, and checked if she could just walk through, she could. Amanda made it out into the entrance of the supermarket but one door was closed and a shutter was down making it dark. The security guards were wearing masks but indicated the way to exit. Out in the carpark, Amanda didn’t know where she was or where her son was in the car.

What had just happened to Amanda?

Her prefrontal cortex (the front part of the brain) had gone offline. She was operating on an automatic emotional processing part of the brain that assigns emotional memory, but because there is no blueprint for the ‘how to survive when the world if it is hit with corona virus) she was thrown into hyperarousal. It is a highly distressing thing to experience and can debilitate you for days.

So, what can you do to help?  If you see this anywhere at the moment, simply stand 2 metres apart and say “is there any way I can help you, do you want me to help you with whatever is wrong?

I have seen tearful people a few times out shopping and I have asked if they would like me to help. 

People are coping, until they are not coping and in traumatised people that can happen very quickly.

Asking people if they need help is a simple task by you that can bring connection without physical touch, WE NEED CONNECTION!!

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