How does TRE help Post Traumatic Stress Disorder?

Post traumatic stress has been labeled as a ‘disorder’ suggestive there is something inherently ‘wrong’ with the person rather than as a normal response to an unresolved traumatic experience – hence the term Post Traumatic Stress Injury (PTSI) has been used here in place of PTSD.

PTSI occurs when a person continues to re-experience the acute effects of a traumatic event long after the event has ceased, often triggered by memories or experiences that remind them of the event and often in situations they can’t control. Effectively, in PTSI our body has not yet fully discharged or recovered from the original traumatic event and is still automatically operating as if the original threat is still present even though consciously we may be cognitively aware the event is no longer occurring.

Due to the range of cognitive, emotional and behavioural symptoms experienced, PTSI has traditionally been viewed as a mental health ‘disorder’ treated by psychologists and psychiatrists using cognitive based treatments  rather than concurrently using body based approaches to also address the dysregulated neurophysiological states of the nervous system underlying them.

Poor memory, concentration, flashbacks, anxiety, anger, sleep disturbances, physical tension and avoidance behaviours are not the cause of PTSI but are rather symptoms of an underlying autonomic nervous system  swinging between hyper-arousal states including panic, anxiety, anger and rage and hypo-arousal states of numbness and low energy in order to cope with, discharge and recover from unresolved past events.

While nearly every one is aware of our fight and flight response where our body mobilises its energy in order for survival, an even more heightened and more highly charged state of the nervous system known as the ‘freeze’ response occurs when our body immobilises, suppresses and contains this fight and flight energy in order for our survival  – at its extreme playing possum or playing dead.

This ‘freeze’ state where the body reaches a point of overwhelm and helplessness is really the difference between an event which is stressful and one which is traumatic – as neurophysiologically at least, trauma occurs when the body enters this ‘shutting down response – effectively like pulling the hand brake on the car and coming to a dead stop while internally our engines are still running at their maximum revs of fight and flight energy.

Understanding that our body enters these defensive states sequentially, moving first through fight and flight before shutting down into the freeze or contained response allows us to understand that when trying to resolve and come out of trauma our body moves back down through these states in reverse order.

This means that as we come out of numb/shutdown/contained states we begin to move back down through the hyperarousal states of fight and flight (resulting in either anger and irritability or anxiety and overwhelm) in order to discharge them and return to homeostasis.

This is a common pattern seen in soldiers returning from deployment who only begin to experience hyperarousal symptoms of anxiety and irritability many weeks, months or even years after their return as their nervous system begins to down-regulate from frozen or contained states that were activated and necessary to cope with ongoing combat or potential combat situations.

The initial ‘shut down’ or ‘freeze’ state is also the reason why husbands and wives of returned servicemen and women often experience a distinct ‘change’ in their partner upon their return home even if they are not yet displaying the traditional ‘arousal’ based symptoms of PTSD as their nervous system continues to operate in the survival mode required while on deployment.

Rather than assessing for and addressing these frozen or ‘containing’ states, it is primarily only the hyper-arousal states that tend to be recognised as the problems and symptoms of PTSI which are then often ‘treated’ in order to minimise or ‘manage’ them without understanding they are the body’s way of trying to discharge previously contained fight and flight arousal charges.

As these defensive states are created and perpetuated from deeper in the brain than our conscious mind, all too often, treatments that only focus upon cognitive approaches and talking to resolve PTSI do not provide an alternative avenue for the body itself to physiologically discharge these unexpressed fight and flight states to help down-regulate the nervous system to a more calm and relaxed state.

Consider a solider whose body is primed to tremor and shake in order to discharge any unresolved fight or flight energy  that without this understanding of the benefits of this natural process is likely to suppress it and contain it in order to not look scared or overwhelmed – effectively escalating their nervous system into even more traumatic states of freeze and shutdown rather than allowing the discharge of the arousal states through tremoring and shaking if it wasn’t able to be discharged through fighting or fleeing.

One of the primary ways the body naturally dissipates these fight and flight responses is through involuntary tremoring and shaking, just as we see in the animal kingdom after a zebra or gazelle tremors at the water hole after surviving a lion attack, and just as humans also experience whenever we are overwhelmed or overexcited such as during traumatic events such as car accidents and natural disasters or even in situations where we are nervous  such as public speaking.

Rather than allowing the tremors to discharge this defensive energy , we tend to suppress them through a lack of understanding and fear of appearing scared or nervous which effectively escalates the build up of the obvious fight and flight arousal responses to the even more internally charged  ’freeze’ state that leaves us appearing calm and relaxed on the outside (even to ourselves)  while internally our nervous system is still running to it’s absolute maximum.

When we understand this pattern of coming back down out of freeze states requires us to move through the arousal states of fight and flight that precipitated it, it makes sense that rather than trying to stop or inhibit these arousal states we provide the opportunity for the body to naturally discharge this defensive energy through involuntary shaking and tremoring in a controlled and safe way to down-regulate the nervous system towards homeostasis and assist the benefits of other cognitive based approaches.

[Please note While TRE is easily learnt and safely performed by the vast majority of people without need for ongoing professional assistance, for those who have experience severe post traumatic stress TRE is not recommended as a stand alone substitute for professional assistance  however is a resource that can be used in conjunction with and in order to support and enchance other professional approaches. For people with severe PTSI or dissociative dissorders, it may be necessary to initially perform TRE only under direct professional supervision until they have learnt safe and effective self regulation of the bodies release.]