Letting Go of the Grip of PTSD
Training the Brain to Respond rather than React
in recovery from PTSD
PTSD is a reaction based disorder. Survivors and people with untreated PTSD have anchors of horror that could come up with a familiar smell in the air, a tome of someones voice, something they see, hear taste or touch. During 4th of July fireworks combat veterans could have flashbacks as the sounds are similar to the battlefield. Just the sound of a firecracker could lead to a PTSD reaction. Core Mindfulness is just one way of many that can be used to retrain the brain to respond. Core mindfulness comes from Buddha’s Philosophy and means totally experiencing the moment, utilizing the body’s 5 sensory pathways. These sensory pathways are sight, smell, hearing, touch and taste. Utilizing these pathways to totally experience the moment the moment helps lower anxiety and helps one train the brain to respond rather than react. People go all out to exercise their bodies but how many really make it a point to exercise their minds?
For many years while treating people with schizophrenia I taught core mindfulness as part of my group therapy. Surprisingly, many who practiced learned to tune out the voices they were hearing. The first step is, What leads up to the reaction of hearing voices? One popular technique many began to practice was utilizing the self talk: “Stop!” “This isn’t me!” This is my illness.” For a few this began to really work. Then those who really applied it were ready to take it a step further. What I taught them next was how the brain receives its information through their five senses. What one saw, felt, heard, or smelled sometimes could trigger a reaction. Interestingly, this small group really got into this as they were realizing and experiencing how their positive self-talk seemed to help. I then would take them for a walk to get into the moment. By totally focusing on the experience of what the rose smelled like, what the trees looked like, what the chirping of the birds sounded like, and what the lemonade tasted like, people with schizophrenia began to experience the voices quieting down. By focusing on the experience of the moment they were also slowly training their minds to new habits which could lead to tuning down the volume of the voices. They continued to practice focusing on the wind against their chin and hearing the birds. Then they slowly began to experience how, when they would even talk to another person, the voices they heard in their heads would become softer and not as noticeable. By learning to turn down the voices, by practicing in the moment techniques, many began to stay out of the inpatient unit.
I had one case of a person who was on the list to go to the state hospital because of multiple inpatient episodes in one year. After time spent building a relationship, establishing trust and teaching the person to experience what happens to the voices while practicing positive self-talk and experiencing the moment, the person began to realize the voices weren’t as loud. Today this person is no longer at risk for more intensive treatment. In fact, they have gone years now without an inpatient episode.
Practicing core mindfulness works! If practicing core mindfulness can work with the voices of schizophrenia, it can certainly work with the reactions of PTSD. In fact, often the intrusive thoughts and intrusive images related to trauma are often misdiagnosed as psychosis. The difference is that the intrusive thoughts of PTSD are more focused and related to trauma. Psychotic voices are part of a disorganized thought process and are more outside of the body like one would hear sounds through a set of headphones. Intrusive thoughts are inside one’s head.
PTSD is a reactive disorder. The brain uses the same senses to send and receive information as in core mindfulness training. In the transmission of information to the perception part of the brain, traumatic thoughts and memories emerge from the amygdala, the part of the brain where they are permanently stored. This process is also connected to one’s fight or flight response and one’s sense of perception. When a dog sees fire, the dog runs away. The dog smelled the smoke long before it saw or felt the heat of the fire. The same is true with humans. The transmission of information from the sensory system is about self protection. That self protection is heightened in a person with PTSD.
One of the things I may do with a client is go for a walk in a safe secure place While walking I request the client to focus on the feeling of one’s feet while taking each step. Total focus was in the moment, being aware of where one was walking, and emphasizing safety. I then asked the client, while walking, to inhale counting up to four steps, then hold their breath for four steps, then exhale slowly for the next 8 steps and do this for a cycle of ten. I would then ask the client to sit and feel the warm sun, feel the breeze flow against their face, or hear any noises as there are often birds. I would I then ask them to focus on the moment by experiencing what the wooden bench felt like, to smell the smell of the air, and to look at the trees. I asked them to focus on the experience of the moment and to maintain this for 3 minutes. Even three minutes for a person with PTSD could be very difficult to accomplish. The goal would be to find a starting point. If one could completely focus for 2 or 3 minutes then with practice the next week the person may be able to focus for 4-5 minutes. By practicing core mindfulness skills, one is exercising the mind’s ability to focus and training the mind to respond. Often with PTSD one habitually reacts to similar events. By practicing, the reactions decrease and the ability to respond increases.
Teaching people to practice a combination of breathing exercises and core mindfulness helps people practice a new behavior of being more in control of the way their brain habitually reacts to similar events. The more core mindfulness is practiced, the more the brain will be trained to cope with what was once a debilitating reaction. Core mindfulness helps teache the brain how to respond to information received by the sensory system of touch, vision, hearing, taste and smell.
Some describe PTSD as a time bomb encased with bricks! A similar smell or similar sound can set it off. People with PTSD often don’t understand the “Why” behind the time bomb! By practicing breathing exercises, self hypnosis and core mindfulness behaviors, the brain is learning more positive habits to deal with stressors. A person can actually teach himself or herself to form a new habits of responding to familiar stressors. The more these new behaviors are practiced the more reprogrammed the brain becomes to respond rather than to react.
Copyright 1/28/10
