Hi Lottie,
Thanks for posting and welcome here!
It's a bit of a coincidence because I was reading Bessel van der Kolk's book about trauma (Title: "The Body Keeps the Score") and I swear the chapter that I just started this morning on my e-reader is called: "Dissociation and Reliving".
I will be quoting and/or paraphrasing this book below, as it is one of the best resources for understanding and healing trauma in my opinion. You can find lots of free talks the author gives on YouTube. Let me see what I can share from the recent chapters I read:
"The most important job of the brain, for all of us humans, is to ensure survival, even under the most miserable conditions.
Everything else is secondary." Trauma can cause an interruption and interfere with the ways the different parts of our brains and bodies work together.
The first time I experienced traumatic symptoms was after my ex boyfriend attacked me, and every time I heard a car that made a similar engine sound to his, my body would get stiff, my breathing became shallow until I'd feel dizzy at times, and my heart was racing immediately, blood pressure went up, jaw got tight, and I felt anxious and panicked and in severe distress. My body wanted to run away, even when I was sitting in a university classroom far away from my ex abuser.
That is what trauma does.
The threat is long gone. But the body has not yet had the time and support it needs to complete the trauma response and arrive in the here and now.
Dissociation is a very common symptom of PTSD, and given you have experienced this since childhood, I would highly recommend working with a licensed clinical counselor/psychologist who specializes in complex PTSD trauma recovery. It sounds like you are already working with a therapist, and I really like how she keeps you there after a session to monitor how you are feeling.
Trauma - especially childhood trauma- is incredibly complex. My own diagnosis is complex PTSD, stemming from childhood abuse and neglect. I did not - as far as I know- experience sexual abuse as a child, but there was emotional incest. (= when a parent or both parents brag about their own sexual activities and describe in pornographic details what they do with your other parent in bed. This is something my mother used to do in order to show off her grandiose sense of self)
What helped and helps me still, is reading up about C-PTSD. Pete Walker (The Tao of Fully Feeling / Complex PTSD from surviving to thriving) and Bessel van der Kolk "The body keeps the score" are some examples of books I recently read and liked a lot.
Dissociation - especially with trauma - is a way of the brain to keep you safe, until it is safe enough to ask the frightened and traumatized inner child:
"Where does it hurt?
What do you need?
I can take care of you. I see you. I hear you. I believe you.
You are safe now."
Sometimes a therapist can be good, but he or she may not be the right fit for the trauma work. EMDR ( a trauma therapy technique) and other body/mind techniques can work really well. I did quite a few EMDR sessions, and then also some people take meds for a while. Treating mental health is a bit like going to a buffet. There are quite a few dishes that taste good - and each person will need a different plate. Some might prefer more EMDR, while EMDR does very little for others. For some, CBT (cognitive behavioral therapy) is enough, others need more "Gestalt therapy" maybe. Mindfulness (meditating, yoga, etc) is usually always a good idea too, trauma or not trauma.
I personally like to listen to Tara Brach a lot, she has short meditations and longer talks (love them all) on her website for free.
www.tarabrach.com/talks-audio-video/You might like these to begin with:
1.
www.tarabrach.com/ask-friend-love/2.
www.tarabrach.com/spiritual-reparenting/The breath is usually one of the most basic and first things that can ground the body and calm the mind.
You might notice that when you dissociate how your breathing is flat, hectic, and shallow. Our nervous systems are built to work together. When we forget to pay attention to the breath, it can send false warning signals to the brain. Danger! Danger! Be careful.
This then leads the body to use one of the (often learned) trauma responses. If you were unable to run away from danger as a child (flight response) you only had three other options to survive - freeze, fight, or fawn.
Most kids (but adults too, especially in DV households) cannot overpower their attacker/abuser, so "fight response" is ruled out too.
That leaves the victim/young child two options: "fawn or freeze". Fawn means to "please and comply" and freeze is of course the shutdown of everything.
Kind of like when a gazelle is attacked by a lion, it freezes and plays dead. Then, when the lion loosens its grip because it thinks the gazelle is dead, the gazelle can get up and flee. You will see how wild animals do a couple of "shakes" after escaping a threat or fight. It's the bodies way to get rid of the trauma and complete the trauma response. Humans often don't do that, so the trauma gets stuck in the body.
When you mentioned you "flip" after talking for a bit, I was not surprised at all. In fact, you described one of the main features of trauma- "the flip of the lid". Our brains are complex and beautiful. Our rational cognitive brain is the youngest part of the brain, and was only added fairly recently in human history. It also only occupies about 30% of our brain. This part of the brain is concerned with the world outside of us - manage our time, sequence our actions, understanding how things and people work etc.
Beneath that rational brain lie two older separate brain systems which are in charge of everything else. Like in a motor of a car they are all supposed to help the car move forward, but in trauma what often happens is a bit as if someone was to push down the gas pedal of the car while simultaneously pushing the break. The car won't move, or maybe it spins a bit in a circle, and there is a LOT of energy being generated and trapped (hypervigilance/hypertension of muscles etc.)
These two older brain parts do the groundwork. They are responsible for the management of our physiology, they identify safety, threats, hunger, thirst, desire, longing, excitement, pleasure and pain. Out of those two, the most primitive part is often called "the reptilian brain" or "lizard brain". It is located in the brain stem and together with the hypothalamus (which sits directly above it)functions just like animal brains. That is why newborn babies can do primitive basic survival things, like eat, sleep, wake, cry, breathe, feel temperature, wetness and pain, - basically breathing, pooping, sleeping, eating.
These basic functions are so fundamental, that their significance is easily neglected - we simply don't give those functions a whole lot of thoughts....as long as they work just fine by themselves. However, if your sleep is disturbed, or your bowel movement, or if you always feel hungry, or if being touched makes you want to scream (as it is often the case with traumatized children and adults) the entire organism is out of balance and thrown into disequilibrium.
It is crazy how many psychological problems involved difficulties with sleep, appetite, touch, digestion,and arousal.
An effective treatment for trauma has to address these basic house-keeping functions of the body.
Right above the reptilian/lizard/animal brain part is what we call "the limbic system". It is also known as the mammalian brain, since we humans are mammals. We might drive cars and type on fancy iPads, but...we are mammals and belong to the primate family of mammals. Whether someone believes in creation or evolution is set aside - on a biological level we are related to monkeys, and like all mammals, we live in groups, nurture our young, and the development of this mammalian part of the brain begins after the baby is born. Unlike the lizard brain stem, which was there when we were born.
This is the seat of our emotions. This part is the central command post, the headquarters of coping with the challenges of living within complex social networks. This part of the brain judges what is pleasurable or scary, it decides what is important and what is not in order to survive.
Now here is what is important to know about trauma - this limbic system is shaped in response to experience, in partnership with the infant's own genetic makeup (our DNA) and inborn temperament. Babies differ from birth in the intensity and nature of their reactions to similar events. Whatever happens to a baby contributes to the emotional and perceptual map of the world that the developing brain creates.
When abuse (sexual, emotional, verbal, physical, spiritual) or neglect happens (what was NOT there but should have been there, like for example unconditional love, compassion, empathy, etc.) your neurons fire together again and again and again. Especially repeated over years and during those formative years. Neurons that fire together, wire together.
This means it becomes a default setting in your brain. The response to most likely occur in the future is therefore a trauma response. (dissociation is a form of trauma response) If you are frightened and unwanted, this part of the brain specializes in managing feelings of fear and abandonment.
These two older parts of the brain are often referred to as "the emotional brain". Their development begins long before we have words to talk about how we feel in our bodies. An infant cannot say "Mom, I am about to poop my pants and would therefore like a bath in about 10 minutes and a fresh diaper please. Also, I am feeling a bit anxious and would like a long warm hug please."
The textbook example of how our brain works is leaping back in terror when you see a snake (the two older parts of the brain alerting you to danger) and then realizing it is only a coiled rope (the neocortex/ the youngest part of our brain).
This new part of the machine begins to develop at a rapid pace in the second year of a child's life. This is "the lid" of the brain.
You can remember it a bit like this:
1. Look at your right hand
2. Fold your right thumb, so that it is nestled into your palm
3. Now fold your other four fingers gently around your thumb, as if you are making a fist, but with the the thumb covered up by the other fingers
The thumb is your old part of the brain.
The other fingers are the new part, the lid.
When we are in trauma response or actual traumatic situations, you four fingers suddenly release and your thumb, the lizard brain takes over. Your lid flipped.
Trauma therapy comes in right there, and helps us to gently get back down those other four fingers, to integrate all parts of the brain and balance it out. The emotional brain usually has first dibs on interpreting incoming information. This occurs at lightening speed, so when a threat (real or perceived) is detected the amygdala sends messages to the hypothalamus to secrete stress hormones (cortisol and adrenaline) to defend against the threat. In the traumatized brain this reaction is very strong and the new parts of the brain sometimes not as strong, so the brain is literally hijacked by fear and terror.
So in a way, your older parts of the brain are like a smoke detector. (danger! danger! flee, freeze, fawn, fight!!!)
And your new part of the brain is kind of like a watchtower. (Hold on a second, there is no fire. It's just a bit of steam from the shower that set off the alarm, settle down everyone, everything is ok!!!)
In trauma this process is not working right. It is out of balance. It is a bit like a horse (old part of brain) and rider (newer part).
In regulated bodies the rider can regulate the horse, and even calm it down when the horse believes there is danger and wants to flee. But when the rider is not as strong or developed, and when the horse overtakes everything, it feels like holding on for dear life as the horse runs off.
Now back to Bessel van der Kolk's chapter on dissociation-
I was just reading this morning that:
"Dissociation is the essence of trauma. The overwhelming experience is split off and fragmented, so that the emotions, sounds, images, thoughts, and physical sensations related to trauma take on a life of their own. These sensory fragments of memory intrude into the present, where they are literally relived. As long as the trauma is not resolved, the stress hormones that the body secretes to protect itself keep circulating, and the defensive movements and emotional responses keep getting replayed."
So that is why a car engine sound triggered my trauma, or why a war veteran might get triggered by a child playing in the street or a bump in the road- and he or she is right back in the warzone. Victims of child sexual abuse may anesthetize their sexuality and then feel intensely ashamed if they become excited by sensations or images that recall their molestation. If trauma survivors are forced to discuss their experiences, their blood pressure might increase, while others respond with a migraine-like headache.
Others might shut down emotionally, and not feel any obvious changes, but in a lab you could easily detect their racing hearts and out of control stress hormone levels.
Sometimes naming feelings can help the lid to come back on. Like for example "There is fear. Sadness. Anger. Shame. More fear. etc."
I can only speak for myself, and my own individual trauma experience, but for me naming my feelings, learning in therapy how to feel my feelings, learning how to feel my body right here and now helps.
What works for me, may not work for you. This is where your therapist can help and offer you different tools.
EMDR and gestalt therapy and cbt therapy did wonders for me, but a lot of it was also physical activities (hiking and water activities work for me) But also distancing myself from family members who either caused the trauma, or who did not believe me, or who chose "to be neutral about it all".
As children we depend on our caregivers for survival.
What they did or did not do, can cause a lot of trauma. Trauma often causes toxic shame, because a child really only has two options-
It is either mom's/dad's fault or it is mine. In order to survive, and in order to keep that relationship that ensure survival, no matter how bad it is...means the child has only one option: to blame himself or herself.
Self-compassion is another tool you can practice and grow over time, to combat and heal this trauma and the shame.
The book "Self Compassion" by Kristin Neff is a great starting point, and her website offers free resources as well.
Hang in there. Keep going to therapy and keep on reaching out to professional mental healthcare providers.
If yoga or other body-mind connection activities feel safe and right and comfortable, add those as well.
In sum, trauma is exhausting.
But there is help.
I NEVER in a million years thought I could get better- and to be honest my childhood trauma was much much much worse than my domestic violence experience, and I am still in therapy for the childhood trauma. (3 plus years) simply because childhood trauma is often ongoing for many years, but also it happens during years when the brain is still growing and forming, and the perpetrators of the trauma are often our most important primary caregivers or relatives.
You don't have to live like this forever, and it can get better.
Talk to your therapist about your concerns if that feels comfortable. If you haven't done yet, maybe ask her if she able to try out EMDR.
Maybe ask her if involving another trauma specialist would be a good idea.
Trust yourself, trust your gut.
You got this and you take good care of yourself and your inner child.