Strategies for alleviating fear and arousal
What is unique about humans is not only that we can examine our thoughts and emotions, but also that we can understand and change our responses to stress.
A Vietnam veteran, for instance, can tell himself at a Fourth of July fireworks parade that he is currently “safe in New York” and no longer in a combat situation.
He can further explain to himself that the firecrackers are functioning as “fear triggers” that reactivate traumatic recollections of being under attack. Such “flashbacks” are often accompanied by a sense of fright and horror.
When a victim uses strategies to prevent either internal or external cues from soliciting the fear cascade, seminal to the DSM IV-diagnosis of PTSD, he is applying one of several cognitive strategies that have been shown effective in trauma recovery.
While fear responses are common and occur in most individuals following a trauma, if your fear lingers, even in the absence of any external danger, you will most likely need to learn a variety of recovery techniques.
Many victims exposed to constant danger without adequate respite, such as victims of domestic abuse or veterans returning from excessive exposure to the horrors of combat, carry over into the present the same sense of threat and vigilance as they suffered while in the “war zone.”
This occurs because of the brain`s tendency to “over consolidate” anything associated with threat to survival. Trauma therapists refer to such fear-conditioned victims as “adrenaline junkies,” meaning they have become permanently conditioned to living in a fear mode.
Survivors stuck in the trauma of the past that are unable to engage the “present” in a spontaneous or gratifying way will need to “unlearn” their “fear complex.” Modern trauma therapists would regard establishing a safe haven for the victim as a necessity.
Ultimately the victim will need to revisit their recollections of the traumatic experience.
This form of “exposure” to the original trauma, used to be the cornerstone of C.B.T- Its rationale was to inoculate the victim. The trauma would be constantly revisited, resulting in “de-conditioning”
However, severely traumatized victims may be unable to do this without becoming “flooded” with emotional symptoms.
As a result, they would quit therapy and be deprived the opportunity to ever formulate or confront their trauma narratives.
Marylene Cloitre, an expert in trauma recovery, coined the term “STAIR” to describe the techniques required by some victims as another precondition to trauma exposure. She has found through clinical trials that without “Skills Training in Affective Regulation” many victims lack the capacity to tolerate trauma re-exposure.
With the support of a “coach” (usually a professional therapist) providing empathy, emotional support, and new (more adaptive) coping strategies, most victims can change their physiological and behavioral responses to trauma triggers within twelve sessions.
The therapeutic components involved in facing and finally overcoming fear encourage the victim to:
• Recognize the fear responses in one’s entire body
• View the symptoms as an opportunity to heal
• Identify the full spectrum of trauma triggers that elicit the fear response
• Check with those you trust whether you are accurate in your perceptions of danger
• Convince yourself that right now you are safely located in the present, and that the trauma is safely located in the past
• Learn how to anchor yourself in the present
One can practice a variety of exercises that develop “anchoring” skills. The goal is to feel comfortable in one`s skin no matter what is happening around you.
Some therapists pay attention to relaxation skills such as controlled breathing or meditating.
There is a myriad of psychological techniques that are useful in reducing the emotional distress evoked by the exposure to trauma-triggers.
Once the victim has learned techniques in “anchoring” that include engaging in soothing activities such as music, meditation, painting, and writing, the therapist should then guide the victim to “reclaim” life through increased social engagement.
• Give yourself credit each time you succeed in overcoming a fearful challenge.”