| |
Healthcare Training Institute - Quality Education since 1979CE for Psychologist, Social Worker, Counselor, & MFT!!
Section
7
Physiological Aspects of Trauma and Grief
|
|
Read content below or listen to audio.
Left click audio track to Listen, Right click to "Save..." mp3
In the last section, we discussed Healing Self-Statements. In
my version of this technique, I use three steps in helping
clients to create healing self-statements. They are considering
grief neutrally, identifying needs, and identifying strengths.
In this section, we will discuss the physiology of grief as
it relates to clients suffering from post-traumatic stress syndrome. I
have found that there are three major physiological aspects
of grief. They are the mind-body connection, acute
stress reactions, and emotional triggers. As
I describe the physiological aspects of grief, evaluate the ways in which I
communicate the information to various clients. You may want to compare
these case studies to clients you are currently treated.
Three Major Physiological Aspects
of Grief
♦ #1 The Mind-Body Connection
Sam, age 52, was a former boxer and an ex-Marine. Sam was robbed in his
home when he experienced an odd mind-body connection that he couldn’t
explain. The thief demanded Sam open his safe. Sam stated, "My
mind froze. It was like I was dumbstruck. When I could think again,
I remembered the gun hidden in my pocket. When I went for it, my hand
froze. Now, I’ve lived my whole life around violence and I know
how to kick some ass. Why would I just freeze up like that?"
I
explained to Sam that there is no single definitive theory as to how trauma
affects the body. I stated, "Your autonomic nervous system may
have been destabilized or perhaps your body chemistry was changed. When
we experience danger, our bodies try to react in a self-preserving manner. Your
body was trying to save itself, Sam." Do you have a client who
has experienced a mind-body connection?
♦ #2 Acute Stress Reactions
As you know, there is a critical moment in stressful interactions when clients
can feel anxiety start to increase. In my experience, clients tend
to have two types of acute stress reactions. The two types
of acute stress reactions are hyper-arousal and hypo-arousal.
Lori,
age 49, experienced hyper-arousal. Lori
stated, "I always thought that if I were to be mugged, I’d just
do whatever the mugger told me. You know, hand him my purse, write
him a check, whatever he wanted so I wouldn’t get hurt. But when
I actually got mugged, boy did I fight back! I punched the mugger,
pulled his hair, and tried to tear his clothes off of him. Now he was
probably twice my size, but something came over me. I’m normally
shy and timid, but I was a wild woman that day!" I explained
to Lori that she was experiencing hyper-arousal. I
stated, "Hyper-arousal is when the body secretes adrenaline
in higher amounts than normal to enable an efficient ‘fight or flight’ response."
In
addition to hyper-arousal, the other acute
stress reaction clients may experience is hypo-arousal, in
which the client enters a state of numbness. As you are aware, clients
who experience hypo-arousal can react to stressful situations
through dissociating. Hypo-aroused clients may even
enter an altered state of consciousness.
For example, Mark was a combat
medic in Iraq. Mark stated, "I was living on adrenaline for days
on end. Then, one day, there was a car bomb. We had to triage
seven patients. On my way to pull the last victim from the scene, I
froze. I couldn’t move even though I wanted to. Then I
just sort of blacked out. I woke up three days later in a sick bay. I
can’t remember anything between the time I froze and the time I woke
up." As you know, Mark had experienced hypo-arousal. I
explained to Mark that his body had secreted non-adrenaline in
an effort to effect a numbing reaction , much the same as when animals play
dead.
♦ #3 Emotional Triggers
In addition to mind-body connection and acute stress
reactions, the third physiological aspect of grief I have found is emotional
triggers. As you are obviously aware, the two types
of emotional triggers are external and internal. Clearly,
external triggers are located within the environment.
For
example, Mary, age 29, responds fearfully to anger in other people’s
voices. Mary stated, "My girlfriend, Cindy, and I were driving
to the mall when a carjacker caught us at a stoplight. He seemed so mad. He
was yelling and screaming. I was so scared and then he dragged us out
of the car. When he took off, he tried to run us over. To this
day, whenever I hear someone get mad, I get so scared." Mary
was so traumatized that she perceived any type of hostility
as a threat to her existence. Mary stated, "It’s so bad that
if someone gets annoyed and speaks out, I start crying."
I stated, "Logically
you know that the person is simply irritated and that you are safe from an
attack, but on an emotional and physiological level you are on guard waiting
for an attack. How does this make you feel?" Mary stated, "I
feel like I have no control." Are you treating a client like Mary
who suffers from an emotional trigger? You might try the Managing Triggers
technique I will now describe.
♦ 4-Step "Managing Triggers" Technique
To help Mary manage her triggers and overcome the physiological aspects of
grief she was experiencing, I decided to try the Managing Triggers technique. The
Managing Triggers technique combines stress reduction techniques with visualization. I
implement the Managing Triggers technique using four steps. They
are deep breathing, visualizing the trigger, stopping
the visualization when the client gets upset, and repeating
the exercise. Evaluate my method of the Managing Triggers technique
to see how it compares with yours.
--First, Mary did a deep breathing exercise. Do
you currently use a deep breathing exercise with your grief clients? Mary
found a comfortable position in which to sit and closed her eyes. Next,
she relaxed her neck and shoulders. Mary then took a deep breath from
her stomach and held it for two seconds. After exhaling with a sigh
and visualizing stress and tension leaving her body, Mary repeated the exercise
until she felt relaxed.
--Once Mary felt relaxed, we continued with the second step
of the Managing Triggers technique. The second step
is to visualize the trigger. I
asked Mary to visualize someone other than her attacker yelling at her. Mary
stated, "I’m imagining my mom yelling at me and I don’t
feel relaxed anymore."
--The third step is to stop visualization when
the client gets upset. Mary stopped the visualization in order to calm
down, if the focus is calming, or you might have the client vent the feeling
before stopping.
-- In addition to deep breathing, visualizing the trigger, and stopping
the visualization when the client gets upset, the fourth step
in the Managing Triggers technique is to repeat the
exercise. With Mary I had to repeat the exercise several times
before she could visualize an angry situation without fear.
Mary could
eventually visualize her mother yelling at her without felling afraid. Next,
Mary repeated the exercise using more hostile visualizations. In a later
session, Mary stated, "It feels good to be able to imagine a pissed off
carjacker and not start crying uncontrollably. I feel like I’m
in control again." Are you treating a Mary who has very deep seated
triggers and may need to practice visualization and stress reduction?
In this section, we discussed three major physiological aspects
of grief. They are the mind-body connection, acute
stress reactions, and emotional triggers.
In the next section, we will discuss Mind Sets of Grief. In my practice,
I have found that there are three basic mind sets of grief. They are absolutist
thinking, intolerance of mistakes, and denial of personal difficulties.
Reviewed 2023
Peer-Reviewed Journal Article References:
D'Andrea, W., & Pole, N. (2012). A naturalistic study of the relation of psychotherapy process to changes in symptoms, information processing, and physiological activity in complex trauma. Psychological Trauma: Theory, Research, Practice, and Policy, 4(4), 438–446.
Diminich, E. D., & Bonanno, G. A. (2014). Faces, feelings, words: Divergence across channels of emotional responding in complicated grief. Journal of Abnormal Psychology, 123(2), 350–361.
Katz, A. C., Norr, A. M., Buck, B., Fantelli, E., Edwards-Stewart, A., Koenen-Woods, P., Zetocha, K., Smolenski, D. J., Holloway, K., Rothbaum, B. O., Difede, J., Rizzo, A., Skopp, N., Mishkind, M., Gahm, G., Reger, G. M., & Andrasik, F. (2020). Changes in physiological reactivity in response to the trauma memory during prolonged exposure and virtual reality exposure therapy for posttraumatic stress disorder. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication.
Peer-Reviewed Journal Article References:
D'Andrea, W., & Pole, N. (2012). A naturalistic study of the relation of psychotherapy process to changes in symptoms, information processing, and physiological activity in complex trauma. Psychological Trauma: Theory, Research, Practice, and Policy, 4(4), 438–446.
Diminich, E. D., & Bonanno, G. A. (2014). Faces, feelings, words: Divergence across channels of emotional responding in complicated grief. Journal of Abnormal Psychology, 123(2), 350–361.
Katz, A. C., Norr, A. M., Buck, B., Fantelli, E., Edwards-Stewart, A., Koenen-Woods, P., Zetocha, K., Smolenski, D. J., Holloway, K., Rothbaum, B. O., Difede, J., Rizzo, A., Skopp, N., Mishkind, M., Gahm, G., Reger, G. M., & Andrasik, F. (2020). Changes in physiological reactivity in response to the trauma memory during prolonged exposure and virtual reality exposure therapy for posttraumatic stress disorder.Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication.
Smith, K. V., & Ehlers, A. (2020). Cognitive predictors of grief trajectories in the first months of loss: A latent growth mixture model. Journal of Consulting and Clinical Psychology, 88(2), 93–105.
Taylor, S. (2020). Transformation through loss and grief: A study of personal transformation following bereavement. The Humanistic Psychologist.
QUESTION
7
What are three major physiological aspects of grief?
To select and enter your answer go to .
|