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On the last track 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.
On this track 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
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
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
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
--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.
On this track, we discussed three major physiological aspects
of grief. They are the mind-body connection, acute
stress reactions, and emotional triggers.
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