What is Hypervigilance and How is it Related to Unresolved Psychological Trauma?

Hypervigilance is a heightened state of awareness that allows humans to sense threats in their environment.

Hypervigilance and Psychological Trauma

People who are in a perpetual state of hypervigilance feel like they are constantly under a threat.  The part of the human brain that manages emotions, the amygdala, is in overdrive.

What Causes Hypervigilance?

This article focuses on psychological trauma. However, there are other potential mental and physical causes of hypervigilance including:

• Anxiety
  

• Panic Attacks
  

• Depression
  

• Dementia

• Adrenal Disorders

• Fibromyalgia 

Hypervigilance and Unresolved Childhood Trauma

Children who grow up in a dysfunctional family where parents might be unpredictable, violent, abusing substances, physically abusive or neglectful learn to be hypervigilant as an unconscious survival strategy. They learn to sense their parents' shifting moods so they can be ready at all times to protect their safety.

Hypervigilance and Unresolved Childhood Trauma

Without help in therapy, these traumatized children usually grow up to be traumatized adults and they continue to be hypervigilant in their surroundings.

Examples of Hypervigilance in Adults

• Hypervigilance to Their Surroundings: People who grew up in an abusive family or who experienced abusive relationships as an adult might have a strong startle response reflex where they are startled by the slightest sound or movement.

• Hypervigilance to Other People's Thoughts, Feelings and Behavior: People who experience hypervigilance might be very observant of other people's thoughts, feelings, behavior and body language for any signs of change or potential danger.

• Hypervigilance of Their Own Body: People who experience serious medical problems or who have someone close to them who have experienced serious medical problems are often hypervigilant of their own body. A minor experience of pain might be perceived as a catastrophic disease.

Hypervigilance and Catastrophizinglo

• Hypervigilance and Catastrophizing: People who are hypervigilant tend to create negative narratives in their mind which can spin out of control. Small things, like a friend not responding to a text immediately, can develop into a catastrophic story where the friend has died. Even when things are going well, people who are hypervigilant might find it difficult to enjoy happy times because they are always waiting for the other shoe to drop (see my article: Are You Catastrophizing?).

• Hypervigilance and Insecurities: Since hypervigilance is mostly about preventing or avoiding potential threats, people who are hypervigilant might attempt to ward off threats by people pleasing or fawning. They might struggle with regulating their emotions or trusting others. They might have problems letting their guard down so they can relax or they might be fearful they will say or do the "wrong thing" (see my article: Trauma and the Fawn Response

• Hypervigilance and Avoidant Behavior: People who struggle with hypervigilance can be avoidant in ways that are detrimental to themselves and others. They might avoid people, places and things they fear. This can cause problems in their personal life as well as their career. For instance, if they experience minor turbulence on a plane trip, they might avoid ever getting on a plane again--even if it means they won't see close friends or family members or they might lose a job that involves travel. Another example is if someone is in a minor car accident where no one was hurt, they might avoid driving again--even if it means they can't visit people close to them or go to work.  A third example: If someone goes through a bad breakup, they might avoid dating or getting into another relationship. In other words, many other people, who don't experience hypervigilance, might be hesitant after having a bad relationship experience, but they learn to cope and they don't avoid.  In contrast, the person who is hypervigilant takes it to an extreme because it's their way of protecting themselves. However, in the process, they don't learn to cope or overcome their fears. They remain stuck (see my article: What is Avoidant Behavior?).

What is the Potential Physical and Psychological Impact of Hypervigilance?

People who experience hypervigilance might experience some or all of the following characteristics:

• Chronic Stress: A constant flood of cortisol and adrenaline is exhausting and can cause medical, emotional and psychological problems.

Hypervigilance and Relationship Problems

• Relationship Problems: While people who experience hypervigilance might be more aware of potential red flags in a relationship, they might also have problems getting close or trusting even in a healthy situation. They might be overly sensitive or emotionally overreactive to a partner's comments. Some people might avoid getting involved in relationships at all because o they fear getting hurt (see my article: How Trauma Can Affect Your Ability to Be Emotionally Vulnerable in a Romantic Relationship).

Hypervigilance, Loneliness and Isolaton

• Loneliness and Isolation: A fear of making friends or seeking romantic relationships due to fear of getting hurt, can lead to isolation and loneliness (see my article: Loneliness and Social Isolation).

How to Cope With Hypervigilance

Here are some interventions that might be helpful to you:

• Grounding Exercises: You can learn to calm yourself with breathing exercises, mindfulness meditation and journaling.

Coping with Hypervigilance By Meditating

• Limiting or Eliminating Coffee, Alcohol or Other Substances: If you notice you feel worse after drinking coffee or alcohol, consider either limiting your intake or eliminating these substances.

• Seeking Help in Trauma Therapy: If you work with a trauma therapist, you can learn to: 

• Identify your triggers

• Learn to overcome your triggers

• Be able to differentiate your feelings from objective reality (see my article: Discovering Your Thoughts and Feelings Aren't Facts)

• Work through the psychological trauma underlying your hypervigilance so you are free from your traumatic history

Getting Help in Trauma Therapy

Trauma therapy includes various types of therapy that were developed specifically to help people to overcome trauma. 

These include:

• EMDR Therapy (Eye Movement Desensitization and Reprocessing Therapy)

• Somatic Experiencing
  

• AEDP (Accelerated Experiential Dynamic Psychotherapy)

• Hypnotherapy
  

• Parts Work Therapy (including Internal Family Systems Therapy and Ego States Therapy)

When you work with a skilled trauma therapist, you can overcome hypervigilance and unresolved psychological trauma.

Getting Help in Trauma Therapy

Rather than struggling nn your own, seek help from a licensed mental health professional who is a trauma therapist so you can lead a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples) and Certified Sex Therapist.

I work with individual adults and couples (see my article: What is a Trauma Therapist?).

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Also See My Articles:

8 Tips For Coping With Triggers

What is the Difference Between Trauma and PTSD (Posttraumatic Stress Disorder)

What is Trauma-Related Dissociation?

Trauma Therapy: Combining EMDR Therapy and Parts Work to Overcome Emotional Blocks

As a trauma therapist, I have found it especially helpful to combine EMDR and Parts Work to help clients overcome trauma experiences.

    See my article: Parts Work Can Be Empowering)

There are many ways that EMDR and Parts Work can be used together in trauma therapy. 

In this article, I'm focusing on how the combination of Parts Work and EMDR therapy is beneficial to overcome a blocking belief.

What is a Blocking Belief in EMDR?

A blocking belief is a negative thought or belief that acts as an obstacle to integrating the trauma during trauma therapy.

Combining EMDR and Parts Work Therapy

Blocking beliefs are often longstanding. 

Often these beliefs developed during early childhood. They can originate in memories, family experiences, cultural issues, relationships or other experiences.

Examples of blocking beliefs include (but are not limited to):

• "I'm not good enough."
• "I'm unlovable." (see my article: Overcoming the Pain of Feeling Unlovable)
• "I'm powerless."
• "I don't deserve to get better."

As long as a blocking belief exists, it can get in the way of processing the trauma in any type of therapy.

I usually provide clients with psychoeducation about blocking beliefs before we begin processing the trauma because these beliefs are so common.

That's also when I talk to clients about using Parts Work therapy--either Ego States therapy or IFS (Internal Family Systems) to help overcome the blocking belief.

Combining EMDR and Parts Work to Overcome Trauma

During Parts Work therapy, I help clients to identify the various aspects of themselves, including the part that contains the blocking belief, the part of them that wants to get better and other parts that might be involved.

Once these parts are identified, the client can understand how the blocking belief is preventing them from progressing in therapy. They can also understand the positive parts of themselves that they can nurture and strengthen.

Clinical Vignette

The following clinical vignette illustrates how Parts Work can help to overcome a blocking belief in EMDR therapy:

John

John sought help in EMDR therapy to overcome complex trauma stemming from a childhood history of emotional neglect.

He was motivated to seek help in trauma therapy because he could see how his childhood history was affecting his adult relationships--both personal and work-related. 

Combining EMDR and Parts Work Therapy

In his personal life, he tended to choose partners who were hurtful and emotionally avoidant--people who were similar to his parents. 

At work, he wasn't able to assert himself to get a well deserved promotion and a raise because he lacked confidence.

His trauma therapist explained EMDR therapy to him. She also told him that during EMDR, it was common to find a blocking belief that becomes an obstacle to working through the trauma.

With his therapist's help, John identified the blocking belief, "I'm not good enough." After identifying this belief, John realized it had been an obstacle in his prior therapies. 

In the past, whenever John tried to work through his childhood trauma, he was overcome with a deep sense of shame and then he would drop out of therapy (see my article: Shame is at the Root of Most Emotional Problems).

He never understood before why he was overcome with shame to the point where he felt he had to leave therapy prematurely (see my article: Why Do Clients Leave Therapy Prematurely?).

It wasn't until his current trauma therapist helped him to identify the particular part of himself that carried this blocking belief that he began to understand why he left therapy in the past before his problems were worked through.

His current therapist helped him to give voice to this part, which John called "the sad boy." 

Using Ego States therapy, which is a type of Parts Work therapy, his therapist helped John to use the adult part of himself that felt strong and positive to show compassion and kindness to the "sad boy" part.

Over a period of time, John was able to transform the "sad boy" part so he could process his traumatic memories with EMDR therapy because he no longer had the blocking belief.

Combining EMDR and Parts Work Therapy

The work was neither quick nor easy, but John made steady progress with Parts Work therapy and EMDR and, eventually, he worked through his history of trauma so it no longer was an obstacle for him.

Conclusion

Combining EMDR therapy with Parts Work is an effective strategy for overcoming blocking beliefs.

Although I have focused on the combination of EMDR and Parts Work, Parts Work can be used in combination with any type of therapy.

Once the blocking belief part is identified, the trauma therapist helps the client to work with this part using other positive parts to transform the blocking belief so it is no longer a problem.

Getting Help in Trauma Therapy

Regular talk therapy usually isn't enough to help clients to overcome trauma, especially complex trauma (see my article: Why is Experiential Therapy More Effective Than Regular Talk Therapy?).

If you have been struggling with unresolved trauma, you could benefit from working with a trauma therapist who combines EMDR and Parts Work therapy.

Rather than struggling on your own, seek help from a licensed mental health professional who is who is an experienced trauma therapist.

Once you have overcome your trauma history, you can live a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work therapist, Somatic Experiencing and Sex Therapist.

I work with individual adults and couples.

As a trauma therapist, I have helped many clients to overcome trauma (see my article: What is a Trauma Therapist?).

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Understanding the Connection Between Unresolved Psychological Trauma and the Need For Control

When considering psychological trauma, it's important to know there are different types of trauma, including developmental trauma and shock trauma. 

Psychological Trauma and the Need For Control

In this article I'm focusing on unresolved developmental trauma, which is trauma that occurred over time in childhood, and the need for control as an adult.

What is Psychological Trauma?

Since I'm focusing on developmental trauma (trauma that occurs over time in childhood), the definition of psychological trauma in this context is a person's unique experience of feeling emotional distress in response to ongoing events that overwhelmed their capacity to cope.

Psychological Trauma and the Need For Control

It's important to emphasize that a traumatic response is unique to the individual. So, it's not the events per se that's traumatic--it's a how the individual experiences the events. 

Children who are identical twins might experience the same events in their family where one of them is traumatized and the other is not.  So, each person has their own unique psychological makeup and their own particular response to what happened.

Another factor is whether or not the person who experienced overwhelming events as a child had emotional support at the time or whether they felt alone (see my article: Undoing Aloneness: What is AEDP (Accelerated Experiential Dynamic Psychotherapy)?).

A child who had emotional support from a loving relative will usually have a better psychological outcome than a child who went through distressing event feeling alone.

Feeling Powerless as Part of Chronic Developmental Trauma

Feeling of powerlessness is an important part of developmental trauma.

A feeling of powerlessness is especially prevalent during chronic developmental trauma where there is ongoing exposure to emotionally overwhelming events.  These individuals feel they have no power to stop, change or control these events.

Psychological Trauma and the Need For Control

For instance, a young child who has repeated experiences of hearing their parents' arguments escalate into physical violence will most likely feel terrified and powerless to do anything about their parents' fights.

Even if this same child, who is terrified, is able to muster the courage to knock on their parents' bedroom to try to get them to stop the fighting, the parents might respond in ways that make the incident even more terrifying. 

One or both parents might invalidate the child's fear by saying, "Nothing is wrong. Go back to your room" which can be very confusing for the child. 

Alternatively, the parents might respond in other ways that make the event even scarier.  For example, one of the parents might threaten the child by saying something like, "Get back to your room or you'll get a spanking!" or "Stop crying or I'll give you something to cry about!"

This leaves the child in an untenable situation where not only can they not control what's happening but they also fear they will get physically punished.

An hour or two later these same parents, who might be highly volatile with each other at times, might emerge from their bedroom and act as if nothing happened in front of the child. 

Not only does this invalidate the child's fear and make the child feel alone, it can also makes the child wonder if there's something wrong with him or her to fear a situation where the parents are now acting normal.

Understanding the Connection Between Unresolved Trauma and the Need For Control

In the example given above, if there are ongoing events like this where the child feels powerless and alone, this child will mostly likely grow up with a strong need to feel in control of their own life, their loved ones' lives and the circumstances around them.

One of the consequences of a history of unresolved trauma and feelings of powerlessness is that individuals often become emotionally triggered when they find themselves in situations where they feel they can't exert control.

Psychological Trauma and the Need For Control

The need for exerting control will vary from one individual to another depending upon the person and the particular situation. But most individuals who experienced chronic trauma growing up don't want to re-experience the sense of powerlessness they experienced as children. This creates in them the need to exert control.

The need to feel in control is a self protective mechanism whereby the individual tries to create a safe space so they don't feel the same terrifying feelings they experienced as a child.

For individuals who grew up in unpredictable circumstances where it felt like anything could happen at any time, the need for predictability is paramount.

What Are Some of the Signs of a Need For Control Based on Unresolved Trauma?

The following are some of the signs people might experience when they have a need to be in control based on unresolved trauma:

• Fear of Ambiguous Situations: They can be very uncomfortable (maybe even panicked) when a situation is unclear. Ambiguous situations can be highly triggering for them which will, in turn, trigger their need to exert control over the situation.

• Setting Rigid Boundaries: They might set rigid boundaries so relationships and situations feel predictable with no second guessing about what might or might not happen.

• Fear of Vulnerability: They might have a hard time opening up to other people. As a result, they might not feel comfortable sharing personal information about themselves because they fear the other person might use this information against them (see my article: Vulnerability as a Pathway to Intimacy in a Relationship).

Psychological Trauma and the Need For Control

• Fear of Talking About the Past: They might not like talking about their past because they fear getting triggered again and also fear trusting someone else with this information.

• Fear of Allowing Others to Get to Know Them: They might be hard to get to know because they are protecting themselves from getting hurt again.

• Fear of Intimate Relationships: They might avoid getting into intimate relationships because of their fear of vulnerability.

• You're Either For Them or Against Them: They might feel you're either for them or against them. There might not feel anything in between (no gray area).

• Fear of Trusting Others: If they feel disappointed or letdown by someone, they might not trust that person again.

• A Need for Predictability: Due to their need for predictability, they might have unrealistic or perfectionistic expectations of others (see my article: Perfection vs Good Enough).

• Fear of Risks: They might be risk averse. They might avoid anything that is risky or feels dangerous to them in any way.  This can include the possibility of getting hurt in a relationship, making financial decisions that might involve a degree of risk, making a career change and so on.

• Fear of Abandonment: They might have a strong fear of abandonment. Since their childhood experiences might have included feeling emotionally abandoned by their parents, who were supposed to take care of them, they might fear abandonment in any close relationship.

What's the First Step in Healing Psychological Trauma?

Since developmental trauma occurs in the context of a relationship, healing also needs to occur in the context of a relationship (this is one of the reasons why self help books are often only minimally, if at all, helpful in terms of healing trauma).

Healing Psychological Trauma and Awareness

Unfortunately, people who experienced developmental trauma as children often don't trust relationships. They might have a strong need to feel loved, but they also dread feeling loved because of their early experiences of feeling unsafe (see my article: Wanting and Dreading Love).

Many people who have unresolved developmental trauma continue to use the same protective strategies they used as children. While these strategies might have helped them at the time, they no longer work for them. 

One of those strategies often included avoiding close relationships.

Developing an awareness about the impact of unresolved trauma is an important first step. 

Without an acknowledgement of the impact, there's often a lack of motivation and fear of getting help.

Getting Help in Trauma Therapy

Many people seek help in trauma therapy when the pain of doing nothing becomes greater than their fear of getting help.

Getting Help in Trauma Therapy

A skilled trauma therapist can help you to work through the issues that keep you stuck with the impact of unresolved trauma.

If you're feeling stuck due to unresolved trauma, seek help in trauma therapy so you can live a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist.

I work with individual adults and couples.

With over 20 years of experience as a trauma therapist, I believe people have an innate ability to heal from traumatic experiences with the help in trauma therapy (see my article: What is a Trauma Therapist?)

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Relationships: Coping With a Passive Partner

Coping with a passive partner can be very frustrating. 

When you ask them what they want to do when it comes to making decisions, you might get a response like, "Whatever you want to do" or "I don't know. It doesn't matter to me."

Coping With a Passive Partner

You're Carrying the Mental Load When It Comes to Making Decisions

Not only is it frustrating to get passive responses from your partner, but it also places you in the position of carrying the mental load for decision-making, which can be exhausting (see my article: Sharing the Mental Load in Your Relationship).

Passivity is Often Centered Around Anxiety That Originated in Your Partner's Childhood

Your partner might not realize it, but their passivity is probably part of a maladaptive coping strategy they learned unconsciously in childhood (see my article: Maladaptive Coping Strategies: Passive Behavior).

Coping With a Passive Partner

When stress goes up, your partner's anxiety and passive response get activated. This is often a learned response from seeing one or both parents respond to stress with passivity. 

Children, who grow up to be passive adults, often learn to stay under the radar by being passive, especially if they had siblings who responded to family stress by being vocal or acting out. 

If your partner witnessed the negative consequences to their sibling, your partner learned to be passive so they wouldn't suffer the same consequences.

Passivity and Low Self Esteem From Childhood

Your partner might have developed low self esteem in childhood from subtle or not-so-subtle messages they received.

For instance, it's possible that when they needed emotional support as a child, one or both parents, who might have been emotionally avoidant, might have criticized them ("Stop acting like a baby!" or "Don't bother me. Figure it out yourself").

When a child gets a negative response when they want emotional support, they usually don't think there's anything wrong with their parent--they believe their parents are right. 

The child comes away feeling, "I'm not good enough" or "I'm unlovable".  

They learn to appease their parents by not complaining and fawning as part of a trauma response.

These feelings of being unworthy carry over into adulthood including adult relationships. This can result in not trusting their own judgment so they either defer to you or find another way to avoid dealing with whatever decision needs to be made.

Another common childhood problem is that their parents might not have been capable of managing their own emotions so your partner, as a child, might have over-functioned for the  parents through a role reversal where the they took care of the parents.

Perfectionism Related to Childhood Experiences

Another way that a passive partner might cope with anxiety is to resort to perfectionism (see my article: Overcoming Perfectionism).

This usually involves all or nothing thinking. When they think they can't do it perfectly, they avoid the situation or leave it for you to handle.

Problems Expressing Emotions

Since your partner might not have learned to identify their feelings as a child because they deferred to a parent, they probably have problems identifying and expressing emotions now, especially so-called negative emotions, like anger or sadness, because they haven't developed emotional intelligence (EQ).

This means they can't assert themselves because they don't know what they feel and, even if they do, they're afraid to be vulnerable enough to express it.

Problems With Change

There might be many reasons why your partner might have problems with change. 

It's possible that their parents didn't cope well with change so your partner never saw this coping skill modeled for them.

Since change is an inevitable part of life, your partner probably struggles with transitions.  Rather than face the change in an assertive way, your partner might sink into passivity, which leaves you to deal with the change.

Problems Initiating Sex

If your partner's lack of confidence includes lack of sexual confidence, they might have problems initiating sex (see my article: How Unresolved Trauma Affects Adult Relationships).

This can make you feel your partner doesn't love you or doesn't find you sexually appealing. But their lack of initiation might not mean this at all. It might have nothing to do with you--it might have more to do with how your partner feels about him or herself.

If you're the one who is usually initiating sex, you might be fed up. 

This often results in no sex--possibly for long periods of time--because you and your partner might both be avoid dealing with sex (see my article: How to Talk to Your Partner About Sex).

If this has happened in your relationship and talking about it hasn't helped, you and your partner could benefit from seeking help in sex therapy (see my article: What Are Common Misconceptions About Sex Therapy?).

How to Cope With a Passive Partner

• Ask Your Partner to Be in Charge of a Particular Task: Rather than taking on all the decision-making responsibilities, ask your partner to be in charge of a relatively easy task to begin with so your partner is more likely to experience success with it. If your partner does it, don't try to manage it or criticize your partner's efforts.

• Talk to Your Partner About Upcoming Changes in Advance: If your partner has problems with change, try to provide advanced notice if you can. For instance, if you know there's an upcoming event you both need to attend, tell your partner in advance of the event instead of bringing it up at the last minute. This might not always be possible because change can occur without warning, but if you know in advance, tell your partner so your partner has time to adjust.

• Encourage Your Partner to Express So-Called Negative Emotions: Since your partner might have had their feelings squelched as a child, encourage your partner to express so-called negative emotions to you so they might feel safer doing it. Whether your partner feels sad, angry, frustrated, impatient or whatever they might feel, be supportive as long as they express their emotions in a healthy and appropriate way. When they do express these feelings, give them positive feedback.

Getting Help in Couples Therapy

If you and your partner haven't been able to resolve problems on your own, seek help in couples therapy.

Getting Help in Couples Therapy

Rather than struggling on your own and continuing to get stuck in the same negative cycle, get help from a skilled couples therapy so you can have a more fulfilling relationship.

    See my article: Overcoming the Negative Cycle in Your Relationship With Emotionally Focused Therapy (EFT) For Couples).

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, EFT For Couples, Somatic Experiencing and Sex Therapist.

I have over 20 years of experience helping individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Working Through Past Unresolved Trauma So It No Longer Affects You in the Present

In my recent articles, Global Pandemic Causes Significant Increase in Anxiety and Depression and How to Increase Your Tolerance For Uncertainty to Reduce Your Anxiety, I began addressing the psychological impact of the pandemic and how to cope with it. 

Working Through Unresolved Trauma Doesn't Impact the Present

In the current article, I'm focusing on how to work through past unresolved trauma so it no longer affects current uncertainties and anxiety (see my article: Reacting to the Present Based on Your Traumatic Past).

Increased Stress and Anxiety About Routine Decisions

While uncertainty has always been a fact of life, the COVID-19 pandemic has significantly  increased uncertainty and anxiety for many people (see my article: Common Reactions to the Pandemic: Fear and Anxiety).

This includes making what used to be considered routine decisions--like whether or not to dine out, take public transportation, go to the gym, go to the office, visit elderly relatives, go on vacation, and so on (see my article: Coping With Pandemic Reentry Anxiety).

Due to the health risks involved, especially for people with underlying health conditions, and the uncertainty about the future of the pandemic, many people find it stressful and anxiety-inducing to tolerate this ongoing uncertainty.

The Impact of Unresolved Psychological Trauma on Tolerance for Uncertainty and Anxiety

People who have a history of unresolved psychological trauma, including post-traumatic stress disorder (PTSD), are especially vulnerable to increased stress and anxiety.

Although many people find it challenging to deal with pandemic-related anxiety, people with unresolved trauma are attempting to deal with the current uncertainties as well as the emotional triggers related to their past.

Clinical Vignette: How Unresolved Trauma Impacts Tolerance For Uncertainty and Anxiety

Let's take a look at a clinical vignette about the impact of unresolved trauma on current uncertainties and anxiety and how trauma therapy can help.  As always, this case is a composite of many different cases with all identifying information removed to preserve confidentiality.

Mark

People who knew Mark professionally in his role as a successful sales executive saw him as a calm, confident, agreeable individual.  

His superiors, colleagues and customers praised his work.  But underneath his seemingly calm and confident exterior, Mark was often plagued with doubts and insecurities most people didn't see.  

Although he appeared outwardly confident, inwardly he often felt like an impostor, and he feared others would see just how insecure he felt much of the time.  

To try to alleviate his anxiety, Mark confided in his wife, Pam, and his closest friends. And most of the time he felt relieved for a while.  But by March 2020, when his office closed due to the COVID-19 pandemic without any certainty it would reopen, no amount of reassurance from his loved ones helped Mark to feel better.  

He felt so overwhelmed by anxiety that he had difficulty sleeping at night.  And when he finally fell asleep, he often had pandemic-related nightmares (see my article: How to Conquer Your Nightmares).

Even daily activities, like grocery shopping, household chores or paying bills, felt emotionally fraught for him.

Although Mark and Pam both had successful careers and substantial savings, he worried relentlessly that they could be wiped out financially and lose their home.  Usually Pam could help Mark to calm down, but that changed at the start of the pandemic.  

No matter what she said to reassure him that they had the financial resources to get through whatever came, Pam was unable to get through to Mark.  She had never seen him like this before during their 10 year marriage and she was concerned.

Pam was aware that Mark had overcome a childhood filled with adversity to become financially successful.  But she also knew this same history often left Mark feeling emotionally vulnerable at times--never more so than at the start of the pandemic.

Realizing Mark's childhood history of emotional neglect and upheaval was getting stirred up for him and making his life unmanageable, Pam suggested he seek help from a psychotherapist who was a trauma specialist (see my article: What is a Trauma Therapist?).

During the history taking phase of therapy, his therapist learned from Mark that he grew up as an only child in a chaotic home environment where his parents could barely cope most of the time.  

Since they couldn't cope, his parents were unable to help Mark cope with anxiety.  They also had their own unresolved childhood trauma that was affecting them in the present circumstances (see my article: Intergenerational Trauma).

As a result, as a child, Mark had to try to cope as best he could on his own.  Not only was Mark unable to depend on his parents for emotional support, but he was often in the role of trying to calm his distraught mother when the father disappeared for weeks during one of his unpredictable alcohol binges (see my article: Children's Roles in Dysfunctional Families).

Although Mark did the best he could in his parentified role of being emotionally supportive to his mother, his efforts came at a high emotional cost to himself.  This included stress-related headaches as well as debilitating anxiety which none of the adults in his family or at his school seemed to recognize.

By the time he was a teenager, Mark was often in the role of pleading with the landlord not to evict them for rent arrears because his father was often out of work and his mother was too distraught to deal with the family finances.

Uncertainty and anxiety was a part of Mark's everyday life as a child until he was able to get away to college.  By then, his father had sobered up, the family finances were stable, and his mother was coping better with the relative calm in the household.  But the history of adversity had taken its toll on Mark so that he frequently felt insecure and anxious throughout his life.

As his therapist listened to Mark's history, she could see how this traumatic history was getting triggered in his current life circumstances, so she provided Mark with psychoeducation about it (see my article: When Past Trauma Affects You in the Present).

But his therapist was also aware that insight alone wouldn't be enough to resolve his problems. So, she spoke to him about how experiential therapy could help him to overcome the impact of his unresolved trauma so he could cope with his current circumstances.

Specifically, she talked to him about the effectiveness of a form of trauma therapy called EMDR therapy.  

EMDR stands for Eye Movement Desensitization and Reprocessing (see my article: Experiential Therapy, Like EMDR, Helps to Achieve Emotional Breakthroughs).

As part of preparing to do EMDR therapy, Mark's therapist helped him to develop internal resources and coping strategies (see my articles: Overcoming Trauma With Somatic Experiencing and Using the Somatic Experiencing Technique of Pendulation to Calm Yourself).

These internal resources and coping strategies helped Mark to cope with his uncertainties and anxiety between his therapy sessions.  Although they didn't resolve his problems, they helped him to get by on a day to day basis so that his anxiety no longer spiraled out of control.

Over time, Mark worked on his unresolved childhood trauma so that the uncertainty of the present no longer triggered his past.  

The work was neither quick nor easy, but he made progress (see my article: Working Through Trauma: Separating the Past From the Present).

Like most other people, Mark still had pandemic-related concerns, but he was able to deal with them in a calm, objective way.  In addition, he had a realistic perspective about his current situation.  

Even though he had concerns about his current job, he felt sure he would find another job even in a worst case scenario.  

Trauma From the Past No Longer Gets Triggered in the Present

Whereas before he had insomnia and nightmares, after he worked through his childhood trauma, his sleep was restful and he no longer had nightmares.  And getting proper sleep helped him to stay calm.

Several months later, when Mark was called back to work a few days a week, he adjusted to this new change and looked forward to seeing his colleagues.  

In addition to coping better with pandemic-related uncertainties, Mark no longer felt like an imposter.  He felt genuinely confident in himself. 

Conclusion

Unresolved psychological trauma often gets triggered in the present by current stressors.  It can take its toll emotionally and physically.  

Experiential therapy, like EMDR, helps you to work through unresolved trauma from the past so it no longer affects you in the present (see my article: Why Experiential Therapy is More Effective Than Just Talk Therapy)

This allows you to deal with current uncertainties without the emotional triggers from the past because you're free from your history.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT and Somatic Experiencing therapist.

I work with individual adults and couples, and I have helped many clients to overcome unresolved trauma.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.