Trigger Warning B-Side

Emma and I talked about triggers – about the word trigger in our modern vernacular and about how we perceive the word and our relationship to it. The metaphor at the head of the episode was one by Gabor Mate’s Myth of Normal where he talks about how the trigger is just one part of what causes people problems. If we don’t look at the rest of the ‘gun’, we are missing an opportunity to explore something. 

One thing Emma and I spoke about briefly which I would like to expand on here is the question of overcoming our triggers. And then I thought I would like to talk about the rest of the ‘gun’. Most significantly to look at the ways therapy relates to our ‘guns’, and how our (and the therapist’s) curiosity about the gun ultimately leads to it firing less readily. 

And this has led me to want to talk about trauma! This is perhaps the first time I am going to actually talk about trauma just a touch more explicitly, so consider this to be your trigger warning right now!

Please be confident that nothing, nothing I say in this episode breaches confidentiality. All scenarios are invented for the purposes of example and explanation.

This episode I am talking about Trauma Capital T. And here I am going to have to nail my colours to the mast, but I want to pre-empt this by saying it’s not exact science. Describing these things is not an exact science. Two people might live exactly the same experience, but that experience will land in each person differently based on innumerable factors. 

Some experiences are traumatic small t. By capital T I mean, for the purposes or this episode, an experience (or a string of experiences) so terrifying that our psyche at the time could not process it. One definition of psychological Trauma is a situation that is life threatening that we have no control over and cannot escape: From being in a crash of some kind, aeroplane, car, train… through to rape and sexual abuse, domestic abuse, to seeing someone else, maybe someone you love, go through something life-threatening … Like I say, this list is not exhaustive, there are many many other things that are traumatic. But even this definition is inadequate, because it excludes the definition of trauma which focuses on what we do with what happens to us, which opens up a whole extra dimension of trauma. In fact, I believe Gabor Mate himself says that trauma is our response to what has happened… 

Perhaps, it is fair to say that trauma is an experience so terrifying that it can not be assimilated into your system. This is not just a painful memory where you might spin off and start crying and feel pain. So this is not, how you feel bumping into your harmless but recent ex on the street.

I am talking this episode about people who, when they experience or sense something they are propelled backwards in time to experience something as if it were happening right now. Flashbacks which send us back to the moment or that leave us unable to be in the present are explained differently to grief or pain, no matter how painful. And flashbacks like this can happen in the therapy room. We aim to never let this happen, but it does sometimes happen. 

Let me explain. I will start with the window of tolerance. You can google this, or, if you’re driving or otherwise unable to Google, you can create an image in your head now. Let me paint you a picture.

Imagine two horizontal tramlines in front of you, much like flatlines on a heart monitor! Colour the space between those tramlines green. That band represents our regulated state. 

Now I want you to create two other regions just above and below this green band which represent states of dysregulation. An orange band either side. 

And then a red band either side of these orange bands.

What you end up with in your mind is something like the Spanish or Austrian flag but in different colours!  

Got it!?

Right, this diagram is, like I say, called the window of tolerance and it represents our tolerance for emotional distress and dysregulation.

If we are in the green band, we are regulated and calm, our heart rate is steady and we are present and able to engage with others and our surroundings.

If we slip outside of that then we slip into the orange band which represents an increasing state of dysregulation which, if we don’t notice, will quickly be traversed through into one of the two outer red states, The orange and red sections above represent hyperarousal and below: hypoarousal. 

Red zones mean we are overwhelmed – in hyper arousal (above) we are in fight or flight, we are on overdrive, agitated… our distress is likely to manifest outwardly as movement, anger, aggression, agitation, energetic. 

If our overwhelm send us into the red hypo arousal zone at the bottom then we are more likely to freeze, go numb, shut down. Our distress is likely to manifest outwardly as a kind of stillness. 

Ok, and so on to what all this means and how this is useful. 

When dealing with trauma CAPITAL T, in therapy, because this B-Side always discusses what is likely to happen in therapy, the therapist is always trying to keep us within our green band, within our window of tolerance. To take us just to the edge of what is tolerable to enable us to process as much of it as is possible, without us slipping into hyper or hypo arousal where we are essentially dysregulated and re-experiencing a traumatic event or time as if it were now.

EMDR therapy talks about it in a metaphorical way, which is beautiful, and quite evocative of the process. They talk about trying to catch a fish. If we are experiencing trauma we fly into one of the red states of hypo or hyper arousal, then essentially the boat we are in does not have the capacity to land a fish that size, we do not have capacity to process what is being felt. EMDR is asking us to imagine that we are trying to land a fish into a boat that is too small to hold the fish, so the boat capsizes. The point of early sessions of EMDR, and indeed any therapy, is to steadily build a bigger boat. We talk around and about the traumatic event or events, we discuss grounding techniques, we learn to feel safe, we learn the ways our body is alerting us to its increasingly hypER or hypo arousal; essentially we learn ways of keeping ourselves within the window of tolerance, and we deal bit by bit with smaller traumas – these are all ways to build a bigger boat.

So we are trying to make sure the client never takes themselves outside their window of tolerance, while, at the same time, building themselves a bigger boat, so that when we do finally talk about the traumatic event we are equipped to be able to land the bigger fish without capsizing the boat.

So what we are trying to do in therapy, with big traumas is to start very very small and never let your remembering or experiencing trip out of your window of tolerance. The therapist is watching ever so closely, and we don’t just watch with our eyes, we consult our own bodies too, because someone who is about to trip out of their window of tolerance affects the emotional current in the room. If that sounds woo-woo, then think about things like when someone yawns near you, you yawn too. Other people’s laughter is contagious. If someone is dropping down into hypo arousal, this means they are going into freeze or numbing, then the therapist will start to feel that dissociation too. I have felt it like a loosening of my hands at the wrist, like my hands we falling off. I have felt it as a real heaviness behind my eyes, not sleepiness as such, but a shutting down. Similarly, with hyper arousal, I have felt twitchy, like I wanted to run, like I wanted to punch the wall or door… Imagine if I am feeling this, and it is just a fraction of what the person opposite me is feeling, imagine what the person opposite me is feeling. 

And people with these kinds of traumas rarely jump in and say, I was abused but I am not ready to talk about that yet. They are much more likely to self censor, and to only broach something as slowly as their own psyche has the capacity to handle it. I could have known someone for 18 months once before they even cryptically bring up something which we later discover is a pathway to a traumatic event. Maybe they might talk about a ghost train of darkness which leads to a nursery full of unknown and scary people wearing masks. And even then they might not know, consciously, what this metaphor means. 

As a therapist, I try not to demand clarity about these cryptophors, like that train, or on these people or this nursery, instead I let the cryptophor (explain) just be there, talking only about what he wanted to talk about. When Trauma is involved I am extra specially careful to not lead the way. I am working incredibly hard to be alongside. To hold the torch, to show them that I am with them, but I am not going to take them anywhere beyond, further of faster than they want, or to try to land a fish that their boat is not equipped to manage. Using metaphor to distance the client from the trauma – sometimes to talk around the subject without mentioning the content, as a dark shadow, as black hole, as a room of knives… 

How useful metaphors and cryptophors are in revealing trauma to ourselves and to others is really interesting. If you want to know more, a man called Jonathan Lloyd has written and spoken lots on the matter. 

So, back to you. If YOU have experienced trauma and are terrified of having to bring it all up and discuss it early in therapy, then rest assured this is unlikely to happen, at least not in one go – certainly it’s a question you could ask a therapist on an initial conversation. If you come to therapy, your therapist is not going to drag you to the edge of your comfort zone and make you face things, rather your psyche will do that at its own pace, a pace that is right for you!

There is increasing research being carried out at the moment into how careful administering of micro doses of psychedelics like Mushrooms and ayahuasca are enabling people to open the trap doors on their experiences in ways that give insight and enable bigger fish to be caught, basically! But that’s for another episode.

This is just one tiny tiny perspective on trauma work. It is not meant to be a fix, or a guidebook, or even a brochure to how all therapist will work with trauma. But it is a thin slice of my work, and as such I hope it has been helpful. And if you think this might be helpful for someone you know, then do feel free to send it on to them.

Trigger warning B side could be inspired by Liz Gilberts 17th Nov episode