Questions and Answers Regarding PTSD and CPTSD

Keywords: PTSD and CPTSD.

I get a steady amount of questions through emails and social networks. Hereunder are some recent ones that I answered and that can apply, and be helpful to you.

You can find more questions and answers here in one of the ebooks of The Trauma Essential Series.

Could you tell me in a basic way what happens in your brain when you have PTSD? What are the cognitive processes that are involved?

That is a big question with many variables. How it affects the brain depends on the state of mind you were in when you went into the experience or period that was traumatic, how long the trauma lasted, and the support you received afterwards. Furthermore, there is a big difference in how it impacts the brain if the trauma happened when you were a child, or if it occurred when you were an adult. When you are a child, trauma might prevent full development of "higher" parts of the brain as your energy is invested in survival; that is, it is most present in the brain stem and the RAS (reticular alerting system).

The cognitive processes are often impaired due to dissociation acting as a survival mechanism; amnesia, numbness, feeling walled off from what happened to you. All of these things need to come back online very carefully—and within sufficient containment—by addressing both the cognitive and somatic parts.

Didn't the trauma cause the emotion?

The trauma is the overwhelming emotion. The event/person is the context in which it happened.

Is it possible to also find nonduality when we are taking action?

I think the action flows out of seeing something very clearly. So, when I don't instantly react to my anger through blame or through self-reproach, I am actually in touch with my anger. Being directly "in touch" is the action. It is that connection—when you have enough resilience and containment—that helps process your emotional residue and that potentially dissolves dissociation. Nonduality is action, whereas dissociation is reaction.

I have had PTSD from developmental trauma and have IBS and Fibromyalgia. The current thinking is that they are—at least in part—an immune system response to being in fight/flight mode for many years. Do you think this is a reasonable theory and if so—if I manage to heal from my trauma—do you think that these conditions will resolve?

They might certainly lessen, though when physiological symptoms have been in place for a long time, those symptoms "set" the body in a certain way. In addition to working through the trauma, you might need some other support to optimize the function of your nervous system, endocrine system, and immune system.

When trauma is leaving one’s body, when the nervous system is starting to relax and find a healthy balance, can your body go into a shock?

What I often see is when the releasing goes to quick and without sufficient presence, your body will try to protect you (i.e. dissociates) by starting to show physical pain. That can be sudden headache, getting nausea, dizziness or fainting, or physical pain. It is important to recognize these signs and slow down the process. Release is not always resolution. The key is containment while release is unfolding.

By "cognitive", are you referring to the mind and senses? And by "somatic", are you saying that the healing of past injuries are stored in the body as well? In which case, perhaps massage work would help, in addition to whatever positive effects can be garnered by the help of neuro-plasticity (for the mind and senses).

You need the cognitive part (our thought capacity) to create a healthy framework to address trauma and not fall back into old patterns, and one needs the somatic part to really work through the emotional residue that is stored within the body/nervous system. Massage can be a help for some, but can also be a triggering for others. In itself it is not enough to resolve deep seated trauma, but it is a good addition to one's effort towards healing.

By nonduality do you mean not having to choose between taking action from our (trauma) feelings, but to do both, feel the feelings but not handle them like they are real because you realize these are from the past?

I think that generally we act in reaction based on our past experiences. When awareness replaces choice, which is based on our past, then that creates other variables—possibility and opportunity. When I work with clients, I often hold them on that crossroad of either going with their reactive default patterns or, through gained awareness, moving into another direction altogether.