Thoughts about trauma and rigidity

Stuck!

The new framework for therapy, Process-based therapy (PBT),  as proposed by Hoffman & Hayes (2018) describes mental health pathology and healing through an evolutionary approach. Simply, healthy mental wellbeing includes a variety of different coping and behavioural responses (internal and external), and we adapt to changing conditions and context through a ‘natural selection’ process of changing our coping and behavioural responses and retaining those that allow us to live a meaningful life (adaptive response).


Sometimes, we lose our flexibility and become ‘stuck in the rut’ with regards to certain behaviours, in certain contexts. For example, we may start to persistently respond with anger whenever we experience the emotion of frustration. PBT suggests that regardless of the therapeutic approach we choose, the path to improving wellbeing, in this case, is to learn to include additional behavioural responses, such as being willing to experience the frustration or learning to express it.


Associatively, I am reminded of our bodies response to trauma. Imagine whilst lifting a heavy bag, we slightly overdo it and injure our shoulder. Our body may immediately respond in various ways including with involuntary muscle contractions. The contractions are a normal healthy response. However, in certain situations, the contraction may develop into an incredibly painful condition in which the shoulder freezes up for an extended period of time (adhesive capsulitis). In other words, a healthy involuntary response can become rigid over time causing much pain and suffering. 


Looking at the manifestation of emotional trauma, there seems to be a lot of similarities. Our immediate involuntary response to a traumatic event may be dissociative (or form of flight and/or freeze), aggressive (fight) and we may become hyper-vigilant. These are just examples of possible immediate responses. The thing about trauma is that it seems to make us rigid, we become stuck in our defence mechanism, losing over time our ability to maintain and develop flexible responses to changing situations, contexts.


This is not a new idea. Research has demonstrated that childhood trauma may impact the development of the brain. Maté  Gabor (2018) describes in great detail the impact and rigidity in our behavioural repertoire that various forms of trauma may have. Pery et al (1995) used the apt term from ‘states’ to ‘traits’. Indeed many psychological approaches relate to traumatic events (in particular in the context of attachment to a parent) as the source of mental wellness issues. I wish to emphasize the reduction of flexibility, the lacking of variation in our response resulting from trauma. 


This may be also true at the level of society. A healthy society adapts to change. There is a healthy evolution of social norms and culture that allows a society to thrive and proliferate. During eras of traumatic events, a society may rapidly respond to the event, see for example our social response to COVID. A quick response is crucial and healthy. However, it may develop into a more permanent response mechanism causing the society to remain stuck in a specific response e.g. maintaining social distancing, minimizing healthy bodily contact. 


Maybe we should view maladaptive post-traumatic response of either an individual or of society as frozen response syndrome - and our role, whether as therapists or social leaders or influencers,  is to unfreeze the client, applying warmth and helping regain flexibility.


Finally, as writing this blog, I remembered my favourite physics lecturer, Dr. J. Pfeffer from the Hebrew University. Dr. Pfeffer summarised physics as “it’s all about stickiness”. Apparently, this is also true about mental health.


Hayes, S. C., & Hofmann, S. G. (Eds.). (2018). Process-based CBT: The science and core clinical competencies of cognitive behavioral therapy. New Harbinger Publications.


Lewis, W. D. (1894). The Adaption of Society to Its Environment. The ANNALS of the American Academy of Political and Social Science, 4(4), 37-64.


Maté, G. (2008). In the realm of hungry ghosts: Close encounters with addiction. Random House Digital, Inc..


Perry, B. D., Pollard, R. A., Blakley, T. L., Baker, W. L., & Vigilante, D. (1995). Childhood trauma, the neurobiology of adaptation, and “use‐dependent” development of the brain: How “states” become “traits”. Infant mental health journal, 16(4), 271-291.


Robinson, C. M., Seah, K. M., Chee, Y. H., Hindle, P., & Murray, I. R. (2012). Frozen shoulder. The Journal of bone and joint surgery. British volume, 94(1), 1-9.



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