Can a car accident, slip and fall or workplace injury result in long lasting trauma? Can a single event change the course of one’s life? How can we support our loved ones after such events?
This months’ blog is focused on the 3 levels the body seeks for safety and how they can have lasting effects on our future experience.
For the purpose of illustrating the 3 levels I will use a hypothetical car accident experience. Let’s say you are driving down a country road at night and a deer jumps out, your car hits it and rolls. The car stops, you’re alive and awake but you’re hurt and cannot get out. What is the first thing you will try to do?
Likely, you will try to call for help; Our first physiological response is social engagement, but let’s say you cannot reach your phone and there seems to be no cars on the road. You are in pain and you realize your leg is bleeding.
At this point our nervous system reverts to a more primitive response. Fight or flight. In this example, there is nothing to fight, so you try to escape. You move as much as you can, but the door is jammed and your seatbelt is stuck.
When this response fails we must revert to an even more primitive response, and that is survival and self-preservation. This response is called ‘collapse, freeze, or shut down’. The person may experience this as shock or may simply lose consciousness to slow the use of the body’s resources.
I would say at this point the experience can feel quite traumatic. We know some people can come out of traumatic experiences and it completely transforms their lives in a good way. This is called post-traumatic growth. For others this kind of experience can lead to more negative health outcomes.
For some individuals when the trauma lives on it can cause a change in their neuroceptive network. The person develops an altered perception of risk and safety. They cannot accurately evaluate relative risk/danger and safety. What might this look like in real life?
Well it can lead to hyper vigilance, which is where you are constantly on the look-out for danger. For example, every time you get into the car you are anxious, unable to sit relaxed, or gripping the wheel and constantly thinking about what could hit you next. There is an over and above reaction.
Yes there is a risk every time you get in the car and of course we need to pay attention to the road, but having constant anxiety or a heightened response may indicate that the persons’ survival system is on hyper-alert and may be counterproductive.
What other responses might someone have? Well another response might be ‘freeze and avoidance’. Going back to our example, the injured person may completely avoid driving and activity due to fear of injury or pain. Rather than being hyper-alert they may respond by avoiding driving and exercise all together. We call this fear avoidance behavior. This response may not be helpful either as it keeps the person from living life and getting better.
We see this sometimes in our physiotherapy practice. We actually have a questionnaire to check for fear avoidance so that we can educate on concepts such as ‘hurt vs. harm’ and the benefits of exercise. As therapists we want to help our clients engage not just in therapy but socially, at work, with family and during activities of daily living. If there is a lot of fear, cognitive behavioural therapy (CBT) is very helpful in changing the way we think and approach situations.
So how can you help? If you know someone that can’t seem to think of anything but their pain, has lots of anxiety related to a life event, or avoids activities due to pain, acknowledge what they are going through. It is real. Support and encourage them to talk about it and seek out therapists who can help. Our clinic offers a multidisciplinary approach. We have a naturopathic doctor, a certified acupuncturist, physiotherapists , massage therapists and a psychotherapist. We will also work closely with your family doctor and specialists. Reach out and let us help you or a loved one.