Stress and Anxiety

Stress and anxiety are natural responses generated by the nervous system. An increase in heart rate and heightened nervous energy are both telltale signs that the body is mobilising to deal with an external stimulus.

However, sometimes the sensations induced by stress and anxiety can become all-consuming and will begin to encroach on health and well-being. Furthermore, the body may respond to past stresses despite no immediate danger in the present. Below are five practical techniques that aid in the management of stress and anxiety.

Identifying Sources of Stress and Anxiety

Is there anything in particular that is known to be causing stress and anxiety? It might be a specific event, deadline or a variety of more minor stressors.

One great way to identify and document stressors is through journaling. A journal can act as a physical manifestation of the stresses and anxieties that reside in the body. The act of writing these feelings down can act to discharge some of the inhibited emotions that cause dysregulation in the nervous system. Furthermore, it can be equally helpful for people to find that there is no obvious cause of stress or anxiety. If this is the case, it might be a sign to seek professional help 1.

Developing Healthy Boundaries

If key sources of stressors can be identified, this is a great chance to start taking action. For example, someone struggling with a stressful work life can think about what boundaries might improve this situation. It could be through taking time for themselves and ensuring they only work within working hours. It might also be through communicating their stress and anxiety with a colleague or someone who can support them.

Looking After the Body

Stress and anxiety start within the body. These feelings can therefore be tackled with approaches that focus on the health of the body. Ways to ensure health and well-being include:

• Getting enough sleep
• Exercising regularly
• Having a nutritious diet

These approaches to healthy living may seem simple; however, at times of stress and anxiety, it is common for people to stop looking after themselves.

Furthermore, many coping strategies that people use to relieve themselves of stress and anxiety can facilitate further mental health struggles in the long run. Substances such as alcohol, caffeine or self-enforced isolation can all be temporary distractions. However, although these mechanisms achieve instant gratification, they tend to heighten levels of stress and anxiety 2.

Breathing Techniques

In times of stress, it is common for people to struggle with breathing. For example, it is common for people to hold their breath subconsciously or to breathe in quick, shallow breaths. Improper breathing patterns can lead to anxiety, panic attacks, fatigue and more 3. However, with the correct breathing techniques, reducing the impact of stress and anxiety is possible.

Countless breathing exercises can help manage stress and anxiety. One of the most common breathing techniques for stress and anxiety relief is the 4-7-8, which calms the nervous system.

• Begin by breathing in for four counts; remember to think about the breath as it comes in. You can even close your eyes if this helps.
• Hold your breath for seven counts.
• Exhale for eight counts, remaining mindful of your breath.
• Continue to repeat the counts of 4-7-8 until you start to feel calmer.

The process of inhaling, pausing and exhaling allows for the correct flow of oxygen and will tranquillise feelings of stress and anxiety 4.

Compassionate Self-Talk

Although there are a huge number of physiological techniques to overcome stress and anxiety, it is also important to think about how internal monologues influence wellbeing. When people speak to themselves negatively or overly critically, it can exacerbate the effects of stress and anxiety.

As a result, it is essential to look at reframing stressful situations and to work towards more compassionate forms of self-talk.

Instead of saying:

“I am stressed about my relationship. It must mean I’m a terrible partner.”

It is far more helpful to say:

“I am stressed about my relationship. This shows that I am someone who cares about my significant other”.

While the former is an example of catastrophising and overly critical self-talk, the latter is an example of gentle compassion. When people speak to themselves with thought and understanding, they can far more easily alleviate stress and anxiety 5.

Recap

Stress and anxiety don’t have to be a constant struggle. Instead, there are practical approaches that allow people to improve their health and well-being and live beyond the emotional and physical impacts of these sensations:

• Identifying and documenting stressors
• Developing healthy boundaries
• Looking after the body
• Breathing techniques
• Compassionate Self-talk

All of these practical approaches to relieving stress and anxiety intersect with one another. Looking after the body can involve implementing regular breathing exercises. Equally, compassionate self-talk can allow people to develop healthy boundaries. These techniques are crucial approaches that can drastically improve well-being and general health.

Endnotes

1. Frye, D. (2021). Retrieved from https://www.psychologytoday.com/gb/blog/hope-relationships/202107/6-strategies-managing-stress#:~:text=One%20of%20the%20best%20things,body%2C%20brain%2C%20and%20emotions.
2. Frye, D. (2021). Retrieved from https://www.psychologytoday.com/gb/blog/hope-relationships/202107/6-strategies-managing-stress#:~:text=One%20of%20the%20best%20things,body%2C%20brain%2C%20and%20emotions.
3. Ankrom, S. (2023). Retrieved from https://www.verywellmind.com/abdominal-breathing-2584115
4. Gotter, A. (2018). Retrieved from https://www.healthline.com/health/4-7-8-breathing
5. Wells, L. (2023). Retrieved from https://positivepsychology.com/anxiety-tools/

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However, for those with social anxiety disorder, also known as social phobia, routine interactions can cause considerable stress. As a result, social anxiety disorder leads to an avoidance of social situations that disrupt everyday life and significantly impact a person’s well-being.

In this article, we explore social anxiety disorder and how trauma, particularly childhood trauma, plays a role in developing the condition in later life.

What Is Social Anxiety?

Common, everyday experiences pose a significant challenge to those suffering from a social anxiety disorder. These individuals fear being negatively perceived, judged, and scrutinised. This fear is primarily associated with unfamiliar people or strangers. However, some sufferers find social interaction immensely challenging, even with close friends and family members.

Although social anxiety typically begins in adolescence, it can sometimes arise in early childhood or develop in adults. With up to a 12% lifetime prevalence, it is one of the most prevalent anxiety disorders. This is notably high compared to 7% for post-traumatic stress disorder, 6% for generalised anxiety disorder, 5% for panic disorder, and 2% for obsessive-compulsive disorder.^[1]

The types of experiences that sufferers may find hard to endure include, but are not limited to, the following:

• Attending social gatherings and parties
• Initiating or engaging in conversations
• Going to school or work
• Interacting with strangers
• Making eye contact
• Going on dates
• Meeting friends of friends
• Entering a room in which people are already seated or in conversation
• Returning items to a store
• Eating in front of others
• Using a public restroom
• Using public transport

The severe stress these social interactions cause impacts daily routines, employment, school, relationships, and hobbies. Whilst avoiding anxiety-inducing situations will ease a person’s discomfort in the short-term, long-term avoidance only exacerbates the issue.

Social anxiety disorder can become a chronic and debilitating mental health issue. Recognising the signs and symptoms of the condition and seeking early treatment is paramount for allowing the individual to find confidence and develop skills to allow for stress-free social interaction.

Symptoms of Social Anxiety

Comfort levels in social situations vary significantly from person to person. Feelings of unease, discomfort, or shyness are not necessarily signs of social anxiety. Neither is a lack of interest or enthusiasm for unfamiliar social situations or large groups of people.

Instead, our responses to situations largely depend on our personality traits, life experiences, and upbringing. Some people are naturally more reserved or introverted, whilst others are more extroverted and outgoing.

In contrast to understandable nervousness, social anxiety disorder provokes strong feelings of fear, intense anxiety, and avoidance that interfere with all aspects of a person’s life and render them powerless.

Signs and symptoms of social anxiety disorder may include:^[2]

• Fear of situations in which you may embarrass yourself or be negatively judged.
• Extreme fear when talking with strangers.
• Intense anxiety surrounding social or public situations.
• Avoidance of social or public situations.
• Excessive anxiety in anticipation of an activity or event
• Catastrophising or expecting the worst possible outcome at the event
• Physical symptoms, such as trembling, shaking, blushing, sweating, upset stomach, racing heart, muscle tension, and a shaky voice.
• Poor verbal communication skills when faced with a stressful situation.
• An inability to think clearly.
• Over-analysis of performance and perceived flaws and judgements post-event.
• Reduced self-esteem, self-worth, and a lack of self-confidence.

Among children, symptoms could be displayed through extreme clinginess to their caregiver, crying, temper tantrums, or refusing to speak.

Social anxiety disorder symptoms often present differently at specific periods. They may even alter over time. If a person is experiencing stress or going through challenging life changes, the symptoms will likely flare up and escalate.

The Implications of Trauma

Research has evidenced that the development of social anxiety disorder is more prevalent among those who have experienced trauma and chronic stress. Some of the traumatic events understood to have predictive value for the onset of social anxiety include:^[3]

• Childhood abandonment or neglect
• Physical, sexual, or emotional abuse
• Bullying
• Family or relational conflicts, such as divorce, custody cases, and domestic violence
• Loss of a loved one
• Postnatal depression or stress during pregnancy or infancy

Studies have demonstrated a direct correlation between childhood traumatic experiences and the onset of severe social anxiety, general anxiety, depression, and low self-esteem among individuals who struggle with social anxiety disorder.^[4]

Social Anxiety and the Brain

As noted above, social anxiety emerges from a convergence of factors, including childhood experiences, genetic predisposition, trauma, and unusual brain functioning.

Studies on the brain of social anxiety disorder sufferers have shown hyperactivity in the region of the brain called the amygdala. The amygdala is responsible for the activation of our threat response system triggering fight or flight.

This automatic survival response activates an avalanche of symptoms, including increased respiratory action, rapid heart rate, muscle tension, digestive discomfort, a surge in blood sugar, and an overwhelming sense of stress and anxiety as your body prepares itself to flee or fight. ^[5]

Individuals with social anxiety perceive social interactions as legitimate threats triggering this evolutionary danger detection system resulting in a state of hyper-vigilance and stress.^[6]

Fortunately, the brain is remarkably adaptive and can form new connections and neural pathways at any stage of life through effective treatment. ^[7] With effective treatment, those with social anxiety disorder can reorientate their brains to react in a calmer, more rational state during social encounters that pose no real threat.

If you have a client or know of someone struggling to heal from psychological trauma, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and outpatient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long-lasting recovery. For more information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

[1] Unlocking-Potential.Co.Uk, 2021, https://www.unlocking-potential.co.uk/wp-content/uploads/2019/06/Statistics-relating-to-Social-An

[2] Purdon, Christine et al. “Social Anxiety In College Students”. Journal Of Anxiety Disorders, vol 15, no. 3, 2001, pp. 203-215. Elsevier BV, doi:10.1016/s0887-6185(01)00059-7. Accessed 3 Nov 2021.

[3] Schmidt, Louis. “Social Anxiety Disorder: A Review Of Environmental Risk Factors”. Neuropsychiatric Disease And Treatment, 2008, p. 123. Informa UK Limited, doi:10.2147/ndt.s1799. Accessed 3 Nov 2021.

[4] Kuo, Janice R. et al. “Childhood Trauma And Current Psychological Functioning In Adults With Social Anxiety Disorder”. Journal Of Anxiety Disorders, vol 25, no. 4, 2011, pp. 467-473. Elsevier BV, doi:10.1016/j.janxdis.2010.11.011. Accessed 3 Nov 2021.

[5] “What Is ‘Fight, Flight Or Freeze’?”. North West Boroughs Healthcare, 2021, https://www.nwbh.nhs.uk/healthandwellbeing/Pages/Fight-or-Flight.aspx.

[6] Sladky, Ronald et al. “Disrupted Effective Connectivity Between The Amygdala And Orbitofrontal Cortex In Social Anxiety Disorder During Emotion Discrimination Revealed By Dynamic Causal Modeling For Fmri”. Cerebral Cortex, vol 25, no. 4, 2013, pp. 895-903. Oxford University Press (OUP), doi:10.1093/cercor/bht279. Accessed 3 Nov 2021.

[7] Månsson, K N T et al. “Neuroplasticity In Response To Cognitive Behavior Therapy For Social Anxiety Disorder”. Translational Psychiatry, vol 6, no. 2, 2016, pp. e727-e727. Springer Science And Business Media LLC, doi:10.1038/tp.2015.218. Accessed 3 Nov 2021.

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In non-traumatised individuals, this happens throughout their lives and causes no ill effects. Their nervous systems respond appropriately to all levels of danger – they see it when it’s there and when it’s not, and they don’t feel the need to scan for it consciously.

However, the nervous systems of traumatised individuals are very different – they’re much more likely to be constantly on guard, scanning for the next threat. This state is called hypervigilance.

In this blog, we’ll explain what hypervigilance is and some healthy coping strategies you can employ to manage it.

What Is Hypervigilance?

Stephen Porges uses the metaphor of a ladder for our threat response. Before the most well-known responses, such as fight, flight, or freeze, comes hypervigilance – an extremely alert state where we’re actively looking out for danger. Our heart rate rises, adrenaline is released, our breathing becomes more shallow, and our muscles tense up.

Hypervigilance is one of the most common symptoms of post-traumatic stress disorder (PTSD). Constantly checking for danger is exhausting. On a physical level, our bodies weren’t designed to be under stress for long periods, and mentally it can be highly confusing and can distract us from our day-to-day activities. Completing work assignments or being emotionally present for our loved ones is difficult when our body is telling us to watch out for an attack!

As such, hypervigilance has a hugely detrimental effect on our personal lives. It can hold us back in our careers, prevent us from developing meaningful relationships, and stop us from sleeping properly.^[1] Symptoms present slightly differently in everyone, however some of the most common signs include:

• Anxiety
• Fear
• Sweating
• Feelings of paranoia
• Dilated pupils
• Agoraphobia
• Increased startle reflex

What To Do About Hypervigilance?

If you’re suffering from PTSD or suspect you are, a professional diagnosis and treatment is always advised. While it would be fantastic to be able to heal our trauma by simply following certain steps and practices, it’s often far more complex than that.

However, there are certain activities you can do to bring yourself back into a resting state if you’re noticing symptoms of hypervigilance. Please note that the list below is not exhaustive – it’s important to find what works for you.

Sleep Hygiene

Sleeping properly is essential to every aspect of our health. However, hypervigilance makes this difficult – it’s hard to drift off when your body is telling you to watch out for danger.

This sets off a horrible cycle of feeling worn out due to lack of rest, exacerbating our existing problems. While there isn’t a guaranteed way of falling asleep on command, there are certain practices you can follow to make getting some better quality rest more likely:

• Avoid screens for an hour before bed, especially video games.
• Have a set time you wake up and go to bed – your circadian biological clock likes routine.
• Exercise regularly, but not just before bed.
• Don’t nap after the early afternoon.
• Use your bed for sleeping – don’t bring your work laptop or phone with you!
• Avoid heavy meals, alcohol, and caffeine before bed.

Exercise

Exercise is one of the best things we can do for hypervigilance. It’s not just about keeping our body supple, stretching out the muscles that tense up during hypervigilance, and working off the adrenaline energy. Exercise also releases feel-good endorphins that can boost our mood and overall sense of well-being.

Certain exercises, such as yoga stimulate the parasympathetic nervous system.^[2] This part is responsible for our rest and digest state and helps calm us down.

Remember To Breathe

When our bodies are getting ready for threat, our breathing becomes sharp and shallow as we attempt to take in as much oxygen as possible in case we have to fight or run away. We might not be able to control our heart rate or perspiration consciously, but we can control our breathing.

Studies have shown that deep, paced breathing correlates with activation in our insula, the region of the brain linked to bodily awareness, interoception, and pain processing. By breathing deeply and calmly, we can send a message back to our brain that we’re in a safe place.^[3]

Conclusion

It’s very easy to think of our nervous system as a one-way road. It sends the message we’re in danger or that we’re safe, and we respond accordingly. However, our nerves are actually information superhighways, with signals travelling both ways. By sending signals back to our brain that we’re safe, we can stop it from firing so many signals.

Although none of these activities are suggested as helping to heal trauma and PTSD, they are brilliant coping strategies for the symptoms that can blight our lives. They complement each other, are very accessible, and cost nothing – you’ve got nothing to lose by trying.

If you have a client or know of someone struggling to heal from psychological trauma, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and outpatient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long-lasting recovery. For more information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

[1] Wyk, M. V.. “The relationship between PTSD, hypervigilance and disordered sleep.” (2013).

[2] Khattab, Kerstin et al. “Iyengar yoga increases cardiac parasympathetic nervous modulation among healthy yoga practitioners.” Evidence-based complementary and alternative medicine : eCAM vol. 4,4 (2007): 511-7. doi:10.1093/ecam/nem087

[3] Haase, Lori et al. “Mindfulness-based training attenuates insula response to an aversive interoceptive challenge.” Social cognitive and affective neuroscience vol. 11,1 (2016): 182-90. doi:10.1093/scan/nsu042

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Post-traumatic stress disorder, or PTSD, is a condition surrounded by many myths and misconceptions. Many people often link PTSD purely to war veterans. As the condition was only added to the DSM-III in 1980 – before this, it was known as shell-shock, soldier’s heart, and war neurosis – this could explain why.^[1]

Thankfully, medical science and public knowledge have developed significantly since the 1980s, and the words trauma and PTSD are now deeply embedded in the popular lexicon. Dr Bessel van der Kolk’s book The Body Keeps The Score is a bestseller year on year, and we’ve seen celebrities such as Paris Hilton talking about their own trauma recovery journey.

However, despite the growing awareness of PTSD’s existence as a condition, there is still much misinformation about its symptoms. People assume that PTSD means you must be haunted by nightmares and wake up screaming in the night. While these are both valid symptoms, PTSD is much more complex.

All humans react differently to trauma, and misunderstanding this is dangerous as it can be a barrier to reaching out for help. In this blog, we explore three of the lesser-known PTSD symptoms.

Body Dysmorphia

Obsessive thoughts about one’s appearance characterise body dysmorphia or body dysmorphic disorder (BDD). These usually centre on small, sometimes imagined flaws such as acne, body weight, body hair.

Whether the flaw exists or not is largely irrelevant – either way, it causes intrusive thoughts, which are highly distressing. Attempting to hide these perceived flaws can often impact people’s social, romantic, and professional lives.

BDD should not be confused with eating disorders such as anorexia or bulimia, although they can co-occur. The same can be said for obsessive-compulsive disorder (OCD).

Body Dysmorphia and Trauma

As with many mental health conditions, it’s hard to draw a distinct causative line between trauma and BDD. However, one study found that a considerable majority (75%) of people with a BDD diagnosis had also experienced some form of trauma in their childhood.^[2] It seems that the most significant risk factor for BDD is emotional neglect – although physical and sexual abuse also ranks highly.

This is shocking but not surprising – as children, we tend to internalise things and assume they’re our fault. If we’re subjected to abuse by a caregiver – someone we’re meant to be able to trust – we think that somehow we’re at fault. It follows logically that if we grow up with the mistaken belief we’re inherently bad, our perception of our body could be affected.

It is also thought that BDD could function as a maladaptive coping disorder for the symptoms of PTSD, such as anxiety and depression. When we’re fixated on our perceived flaws, we’re distracted from our past.^[3]

Physical Pain and PTSD

PTSD shouldn’t just be thought of as another mental health condition. Brain scans can observe physical, structural changes in trauma survivors’ hippocampus and ventromedial prefrontal cortex (vmPFC).^[4] These parts of the brain are responsible for episodic memory and value-based decision making, which means trauma survivors often have trouble distinguishing between the past and the present.^[5]

This can lead to our bodies feeling like they are under threat, even when they aren’t. When under threat, our body sends out vast amounts of adrenaline, our muscles tense up, and we feel alert. However, we are only designed to be in threat response for a short time, so this puts a massive amount of stress on our bodies. Our muscles being tense all the time can lead to musculoskeletal problems, and poor sleep prevents us from healing and regenerating.

When we’re in threat response, our sensitivity to pain increases. This evolved initially to help us detect danger as soon as possible, but in the body of the trauma survivor, it can make existing and new conditions seem both unending and even more intense.

Withdrawing Socially and PTSD

Our whole evolution is designed to keep us away from danger – most people know about fight, flight, and freeze. However, it’s not common knowledge that socialising also helps us avoid threats – Prof. Stephen Porges’ Polyvagal Theory states that this is our first response to danger. After all, if the people around us like us, they won’t want to hurt us.

PTSD can cause us to cycle through this threat response faster than we should – trauma survivors often find themselves highly anxious or withdrawn in situations with people. This can be baffling for the trauma survivor, so it’s not uncommon for people to withdraw socially as a response.

Humans are not meant to be solitary creatures – being lonely puts a heavy burden on us emotionally, physically, and behaviourally.^[6] We naturally strive to connect with others, so it’s common to find people using maladaptive coping strategies, such as substance use when we feel unable to.

To Conclude

To foster a society where healing from trauma is normalised, it first needs to be understood. By dispelling some of the myths surrounding PTSD, you can also be a part of this much-needed change.

By increasing awareness of the myriad of symptoms that PTSD can cause, rather than the more dramatic effects displayed in popular media, hopefully, more people will reach out to get the help they deserve.

If you have a client or know of someone struggling to heal from psychological trauma, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and outpatient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long-lasting recovery. For more information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

^[1] Crocq, M A, and L Crocq. “From shell shock and war neurosis to posttraumatic stress disorder: a history of psychotraumatology.” Dialogues in clinical neuroscience vol. 2,1 (2000): 47-55. doi:10.31887/DCNS.2000.2.1/macrocq

^[2] Didie, Elizabeth R et al. “Childhood abuse and neglect in body dysmorphic disorder.” Child abuse & neglect vol. 30,10 (2006): 1105-15. doi:10.1016/j.chiabu.2006.03.007

^[3] Grant, Jon E, and Katharine A Phillips. “Recognizing and treating body dysmorphic disorder.” Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists vol. 17,4 (2005): 205-10. doi:10.1080/10401230500295313

^[4]  Bremner, J Douglas. “Neuroimaging in posttraumatic stress disorder and other stress-related disorders.” Neuroimaging clinics of North America vol. 17,4 (2007): 523-38, ix. doi:10.1016/j.nic.2007.07.003

^[5] Weilbächer, Regina A, and Sebastian Gluth. “The Interplay of Hippocampus and Ventromedial Prefrontal Cortex in Memory-Based Decision Making.” Brain sciences vol. 7,1 4. 29 Dec. 2016, doi:10.3390/brainsci7010004

^[6] Hämmig, Oliver. “Health risks associated with social isolation in general and in young, middle and old age.” PloS one vol. 14,7 e0219663. 18 Jul. 2019, doi:10.1371/journal.pone.0219663

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Levine began to develop Somatic Experiencing following his observations of animals in the wild. He noticed that, when facing threat, animals display a range of threat responses similar to humans – fight, flight, and freeze. Unlike humans, however, Levine noticed that animals were adept at releasing the physical energy charged up by the threat response, able to recover quickly and return to a state of internal homeostasis. Humans, unfortunately, have a much harder time releasing this energy.

Even though we may be safe now, our nervous system can become ‘stuck’ in its threat response. When we live our day to day lives with a frozen threat response, we continue to sense danger in the environment, are on high alert and in a state of high reactivity. Alternatively, we become numb and apathetic, unable to live fully in the present.

Somatic Experiencing helps to restore clients to health by assisting them in releasing their frozen energy and gaining a visceral understanding of safety.

Trauma and the Brain

Let’s simplify the brain into two basic primary modes; ‘safe’ and ‘survival’. Safe mode allows us to relax, engage with others, and learn new information. When we are safe, we are healthy, open, and sociable.

In safe mode, the branch of the Autonomic Nervous System^[1] (responsible for regulation of physiologic processes) activated is the Parasympathetic Nervous System, responsible for rest and digestion.

In survival mode, we are on high alert, constantly surveying our environment for threat, and highly reactive to stimuli. Or we are emotionally shut down, numb and apathetic to our surroundings. Decisions in survival mode are often fear-based. In survival mode, it is the Sympathetic Nervous System (responsible for the fight/flight response) that is activated.

In the face of threat, we enter survival mode, which ensures our safety. When the threat has passed, we may still be in survival mode, because the threat was overwhelming that we froze. While our threat responses aim to ensure our survival, they can be detrimental to our health if they are prolonged. Prolonged activation of our threat response leads to a range of physical and psychological health issues^[2], including anxiety, depression, poor concentration, strained interpersonal relationships, flashbacks, and other mood and personality disorders.

How does Somatic Experiencing work in Practice?

 To release the grip of our frozen threat responses on our well-being and functionality, the accumulated energy from the response must be discharged. A trained SE therapist guides the client in becoming aware of their physical sensations when talking about their past experiences. The client’s narrative of the experience is not the centre of focus in therapy, Instead, focus is placed on the physical, inner sensations that arise when the experience is revisited.

Unlike traditional talk therapies, which take a ‘top-down’ approach, focusing on cognitive processing, Somatic Experiencing uses a ‘bottom-up’ approach, where focus is given the bodily sensations linked to traumatic memories.

In the early stages of SE therapy, clients are educated on the nervous system and how it is affected by a traumatic event. This serves to dispel any confusion as to why a person is experiencing difficult trauma-related symptoms.

Before visiting the traumatic memories, therapists help clients to resource their own innate strength, peace and resilience by discussing positive aspects of the client’s life, perhaps people or places that bring them a sense of peace and calm.

Once the resources for strength and resilience have been identified, a gradual revisiting of the traumatic memories can take place. This stage of the process, known as titration, allows clients to slowly accept the memory and the associated feelings. The process is gradual to prevent overwhelm and retraumatization.

As the memories are revisited, the trained SE therapist will witness and track the clients sensations and physicality, such as a change in breathing, postural shifts, or a change in tone of voice. The client collaborates with the therapist by informing them about invisible sensations, like a change in body temperature or a dizzy feeling.^[3]

When sensations arise, clients may respond by shaking, trembling, or crying. There may be muscular tightening, clenching of hands, clenching of the jaw. These phenomena are considered to be a release of the frozen energy, and are encouraged. At the same time, the therapist will help the client come to a calmer state by encouraging the use of the cultivated resources at the beginning of therapy^[4]. Over time, the movement from activation to calm becomes a lot smoother, and further exploration can take place.

What are the Benefits of Somatic Experiencing?

 Somatic Experiencing offers a range of benefits to clients who have experienced trauma, such as child abuse, neglect, sexual abuse, violence, natural disasters, or motor vehicle accidents.

Following a course of SE therapy, clients may experience^[5]:

• A greater sense of self
• Increased confidence
• Reduction in PTSD symptoms
• Improved concentration
• Improved relationship with one’s body

Unresolved trauma permeates into all aspects of our lives. It can lead to a host of disruptive and inhibitive physical and psychological symptoms that get in the way of us being able to fully live our lives. With Somatic Experiencing, clients can find that healthy functioning is restored, and maladaptive behaviours, or survival strategies, can be reduced. Ultimately, Somatic Experiencing helps clients find balance and regulation in their nervous system, which is integral to leading a healthy life.

If you have a client, or know of someone who is struggling and could benefit from participating in treatment modalities such as somatic experiencing, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and out-patient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

^[1] McCorry, Laurie Kelly. “Physiology of the autonomic nervous system.” American journal of pharmaceutical education vol. 71,4 (2007): 78. doi:10.5688/aj710478

^[2] Selye H. The Stress of Life. New York: McGraw-Hill; 1956.

^[3] Healthline. n.d. Somatic Experiencing: How It Can Help You. [online] Available at: <https://www.healthline.com/health/somatic-experiencing#considerations> [Accessed 25 June 2020].

^[4] Healthline. n.d. Somatic Experiencing: How It Can Help You. [online] Available at: <https://www.healthline.com/health/somatic-experiencing#considerations> [Accessed 25 June 2020].

^[5] Khan, K., 2018. How Somatic Therapy Can Help Patients Suffering From Psychological Trauma. [online] World of Psychology. Available at: <https://psychcentral.com/blog/how-somatic-therapy-can-help-patients-suffering-from-psychological-trauma/#:~:text=Somatic%20therapy%20offers%20a%20variety,a%20heightened%20ability%20to%20concentrate.> [Accessed 5 August 2020].

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It struck Selye that more research was needed into the relationship between inflammatory diseases and “just being sick”, to explore what symptoms predate the diagnosis of disease, or even hospital admission. If more attention could be focused on generalised symptoms, Selye reasoned, it could be possible to prevent such diseases and improve the way they are treated.

However, it is not just doctors that had not engaged fully with the relationship between stress and serious illness; people who suffer from continued stress often continue to endure it until they fall ill and are then forced to rest to heal the consequential illness, and neglect the fact that it could have been prevented.

While Selye was tasked with identifying a new sex hormone, he discovered that despite whatever type of toxic substance he injected his lab rats with, the autopsies displayed the same findings; enlarged adrenal glands, weakened lymphatic systems, including the thymus, peptic ulcers on the stomach and duodenum. Experimenting further, Selye placed his rats in uncomfortable and ‘stressful’ situations, such as on cold surfaces in the laboratory, or on a continuous treadmill which forced the rats to stay in the same position for extended time. The results were the same as when they were injected with noxious substances. It was a result of these studies that Selye connected the hypothalamic-pituitary-adrenal axis to the way the body handles stress^[2].

This connection is involved with how the body responds, to fight against stressors. The hypothalamus, which is the bridge between the brain and endocrine system, communicates with the pituitary gland, which is gland which produces hormones and is rooted in the base of the skull. The hypothalamus then releases adrenocorticotrophic hormones (ACTH) into the bloodstream, prompting the adrenal cortex, above the kidneys, to create stress hormones, corticoids. These corticoids are sent to the required parts of the body to combat the stressor^[3].

Selye found that the nervous and hormonal responses to stressful situations, or “stressors” help a person cope with the impact it has on the body, what he described as General Adaptive Syndrome (GAS). However adaptive the body may try to be to withstand stressors, there are limits to how much the body can process and defend the body from; when chronic stressors begin to break weaken resistance in the body, diseases of adaption can occur, such as high blood pressure, cardiovascular disease, psychological conditions, sexual dysfunction, metabolic diseases, cancer, weakened immune systems and digestive diseases^[4].

More contemporary research by Christine Bryla, a nurse researcher, examined literature that focused on the relationship between stress and the advancement of breast cancer and the intermediary effects of the immune system. The studies that she used to support her research showed a positive relationship existed between stress and the development of breast cancer, however the exact process was not determined.

The majority of researchers Bryla used in her studies suggested that women of certain characteristics developed the cancer or experienced the more advanced stages; these traits were largely being over-reactive to emotional stress^[5]. Furthermore, research has found that those who are either unable to cope with stress, or endure chronic stressors, or both, tend to display more high-risk behaviours, such as smoking, using drugs, driving dangerously or disregarding a healthy diet. While these hypotheses are not able to be generalised due to question of methodological validity, they all strongly indicate that managing stress is hugely beneficial for not only our wellbeing, but our ability to live a disease free life.

If you have a client, or know of someone who is struggling to find the right help for any form of mental health issue, including stress, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and out-patient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources

[1] https://brainconnection.brainhq.com/2013/04/05/hans-selye-the-discovery-of-stress/ – accessed 12/01/2020

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5915631/ – accessed 13/01/2020

[3] https://brainconnection.brainhq.com/2013/04/05/hans-selye-the-discovery-of-stress/ – accessed 12/01/2020

[4] https://pdfs.semanticscholar.org/8bdd/71f8ffa51174d160fd67ef99139b243f6dce.pdf – accessed 12/01/2020

[5] Bryla, Christine M. “The relationship between stress and the development of breast cancer: a literature review.” In Oncology nursing forum, vol. 23, no. 3, pp. 441-448. 1996. – accessed 12/01/2020

The post Stress, Illness And Disease appeared first on Khiron Clinics.

Given that stress is an unavoidable part of life, it is vital that a person develops a way to deal with stressors. One way to begin to manage stress is to adopt a more accepting approach to stress and to understand the effects stress has on the body and its ability to function. By understanding the impact of stress, it can act as a motivation to continually work on and develop relaxing practices and defences to stress.

All life events can cause some stress, the good and the bad. For example, preparing for academic and professional qualifications can cause people a great deal of stress, but with potentially life changing results which most people would say are worth the psychological endurance they require. Furthermore, the career of our dreams may cause us high levels of stress that is only likely to increase as do our responsibilities; the option to quit our job may not be a realistic one, so it is necessary that the individual alters their outlook, manages their time better or simply ensures that there is a balance between stress and relaxation.

Where possible, excessive or unnecessary stress should be avoided. This will require the ability to reason and be realistic with oneself about what is manageable. To push oneself to take on the same amount, or more stress than what we perceive other people are coping with is often an unproductive strategy. The stressor is the stimulus prompting a reaction which is calling for the need for adaption, the stress is the response we make to the situation. Selye recommends measuring stress through a series of factors, that are tailored to the individual, and where necessary adapt so that stressors are minimised.

The way that the body responds to stress is mostly unknown outside professional practice; only the general physiological reactions such as heightened heartbeat, shallow breathing and perspiration that most people experience once they are faced with a challenging situation.

Often it is only when the effects of stress over long periods of time manifest itself into disease or serious physical or psychological disorders will lead a person to realise that they are suffering with considerable stress and must put more thought into their ability to adapt.

The extent of physical and psychological challenges that exist within a social context, therein lies individual social status. The central nervous system administers and responds to challenges based on genetic predispositions, such as mental health conditions, developmental maturity and how a person has been taught to handle challenges, either through education or behaviour modelling. For example, if a child has witnessed their parents respond to challenges with aggression, or demonstrated fear at certain situations, it is likely the child will grow up to respond in a similar way. Furthermore, factors such as socioeconomic status, gender and age are significant elements. It is not to say that those who have a higher socioeconomic status, or a specific age or gender deal with less stressors, however it is likely they will be confronted with different situations they deem challenging and respond in a way they consider effective.

What Selye defines as stress is what he refers to as a ‘high cost response’ to a perceived threatening situation, which would be to respond using aggression, maximising physiological arousal and require energy; this is opposed to a ‘low cost response’ which is generally to either ignore or accept the situation, or deem it unthreatening. If a high cost response is ignored or overpowered it can lead to an extended period of aggression, or a sense of helplessness whereby future responses may become unachievable, as it has been learnt it yields no results and is simply a waste of energy.

All responses to perceived threats and challenges, either vigilance, helplessness or aggression have biological equivalents which aid psychological processing of the incident and stimulation experienced. The biological responses are supplemented by neural and neuroendocrine responses that impact the immune system, cardiovascular systems and adipose tissue and muscle. If the body is continually faced with real or perceived threatening situations and met with high cost responses it can lead to allostatic load which, over time can significantly increase the risk of pathology and disease. 

As it is impossible to be fully conscious of all the complex intricate processes that occur throughout the body when we are faced with stressors, it therefore means it is impossible to know when our body is close to reaching it’s limit of resistance and begins to manifest itself into psychological and physiological conditions. For this reason it is vital that people recognise the importance of stress management and value the importance of prevention, rather than depending on treatment.

If you have a client, or know of someone who is struggling to find the right help for any form of mental health issue, including stress, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and out-patient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

1. https://pdfs.semanticscholar.org/8bdd/71f8ffa51174d160fd67ef99139b243f6dce.pdf – accessed 11/01/2020

2. McEwen, Bruce S., and Eliot Stellar. “Stress and the individual: mechanisms leading to disease.” Archives of internal medicine 153, no. 18 (1993): 2093-2101. 

The post How The Body Copes And Responds To Stress appeared first on Khiron Clinics.

This article will attempt to clarify what is meant by the term stress, from the perspective of Hans Selye, known as ‘the father of stress research[1]’. Selye labelled what he initially described as the ‘syndrome of just being sick to stress-response theory[2]’ after extensive research on patients who were suffering from different conditions and diseases, all of which reported losing weight, losing interest in work and hobbies and feeling low in mood. It occurred to Selye that it was likely there was a relationship between psychological functioning and physiological conditions that, if identified, could help ease aspects of the suffering patients of diseases, such as low motivation to eat, dress or wash. Furthermore, Selye felt that by understanding in more detail the relationship between disease and stress, it could be possible to prevent disease forming in the instance, or advancing into potentially fatal cases.

Selye’s theory 

Selye’s theory was the first that focused on stress as a biological function rather than the term used in physics to describe the interaction between objects. He hypothesised that stress is likely to be a manifestation of the body defending itself against overwhelming stimuli or demands[3] and therefore is interconnected with inflammatory diseases and other physical diseases.

Selye found that over time, resistance to stress can cause the body to become exhausted, and as a result of weakened resistance, the body is more susceptible to inflammatory diseases, chronic fatigue and a shorter life.

Defining stress

In order to distinguish what stress is, Selye chose to clarify exactly what it is not in 10 succinct points, which is particularly helpful given that the meaning and understanding of what it has become confused and largely dependent on specific context[4].

• It is not simply nervous tension; it has been identified in organisms without a nervous system and can occur in people who are under anaesthetic or unconscious, it is the response to the stressor, not the stressor itself.
• It is not a rapid discharge of hormones stemming from the adrenal medulla, despite catecholamines being understood to be a part of the reaction to a stressor, they are not activated in isolation and have no part in generalised inflammatory diseases or stress reactions.
• It is not a reaction that causes an emission from the adrenal cortex, such as corticoids, as adrenocorticotropic hormone (ACTH) can elicit a release of corticoids without a stress response.
• It is not always the response to extraordinary or extreme situations that cause damage; a stress response can occur when playing sports or in intimate moments without causing any noticeable or even slight damage.
• Stress response is not the same as a divergence from homeostasis, which is the body’s steady state, devoid of any stimuli. The body can go out of homeostasis when reacting to a noise, blinking an eye, or stretching; causing muscles to contract without any evidence found of a stress response.
• It is not caused by something that causes an alarm reaction, such as witnessing or experience a traumatic incident or hearing a loud noise; the stimulus in this context is the stressor, not the response of stress.
• Furthermore, the stress response is not the same as the alarm reaction. The alarm reaction is typified by specific endorgan changes as a result of stress and therefore cannot be the same as the stress response itself.
• It is not a vague, non-specific reaction to stimuli; the pattern of the stress response is consistent and specific despite varying causes and effects on each person.
• It may not necessarily be a response to a negative experience; a person can experience a stress response after overcoming challenges in their personal or professional life or while engaging their creativity, these situations are positive, whereas the stress response of anxiety, disease or failure can be negative.
• It is not something that can be avoided; it is a part of life that is necessary for personal growth, as uncomfortable as it can often be. Learning how to deal with stress is as necessary for a healthy life as recognising how long to sleep for, or how to achieve a balanced diet.

By understanding exactly what stress isn’t can go some way to help one understand what exactly is the causal factor that leads to diseases and conditions, such as cardiovascular disease, liver disease, sexual dysfunction, psychological conditions and even cancer. By understanding the above points, medical professionals may be able to prescribe general advice such as rest, healthy diet and ask more questions around lifestyle, as to what may be one of the causes and likely a factor in advancing illness.

If you have a client, or know of someone who is struggling to find the right help for any form of mental health issue, including stress, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and out-patient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5915631/ – accessed 11/01/2020

2. https://pdfs.semanticscholar.org/8bdd/71f8ffa51174d160fd67ef99139b243f6dce.pdf – accessed 11/01/2020

3. ibid.

4. Selyes, H. (1974). Stress without distress. Philadelphia, PA: J. B. Lippincott – accessed 11/01/2020

The post Defining Stress; As Conceptualised By Selye appeared first on Khiron Clinics.