Saturday, August 28, 2010

What the Breeze Brings

Today, temperatures in the metro Atlanta area dropped to a cool 83 degrees. Thus, in anticipation for fall, we shut down the AC, threw open the windows, and let the breeze blow in. For me, the change of seasons has always been an exhilarating time. The subtle shifts in temperature, humidity, light, and wind, signify new beginnings, movement, and possibility!

This isn't the case for everyone, though.

For some, the change in seasons can be a time of angst. Perhaps, one year fall was hard for you, or even traumatic. Perhaps something dreadful happened one fall, years ago, that you have never fully healed from, and every fall thereafter you feel as though you are reliving the pain of "back then." If this is true for you, then the change in seasons, fall itself, or any element associated with that season, may be a trigger for you.

Last post I wrote about the spectrum of dissociation and how trauma-related dissociation is brought about by triggers. In 1984, Bennett Braun outlined a 4 part model of dissociation using the acronym BASK. BASK stands for Behaviors, Affect, Sensation, and Knowledge. In my experience and opinion, triggers can be classified along similar lines. At the time of a trauma, the brain encodes the experience along theses four axes; later, when any of the four are re-experienced, in any context, the brain is likely to recall the traumatic memory. With that recall, may come dissociation, or flashback. Ya with me so far?

Let's break it down. B is for behavior. This represents the action or actions associated with the trauma. Some examples of behavioral triggers might be sleeping, bathing, eating, running, exercising, yelling, crying, being stuck in a small space, etc. If that happened "back then" and the trauma has yet to be resolved, the same action in the present is likely to be triggering and result in some manifestation of dissociation or flashback (behavioral, emotional, sensory, or knowlege).

A is for affect. In short, affect is another word for feelings, or emotions. Let's say the trauma involved feelings of fear, helplessness, or sadness. And lets's say in the here and now, you decide to spend your Saturday night watching a scary movie with your best friend, and before you know it, you are feeling panicky, disconnected from your body, and have an incredible urge to run. Feeling fear is a trigger for you that initiated a trauma response.

S is for sensations, anything experienced with the 5 senses: touch, taste, sight, smell, or sound. A pat on the back, the temperature of the air around you, the taste of salt, the sight of darkness, the sound of a gunshot, the smell of vanilla. . . That which was felt, tasted, seen, smelled, and heard at the time of the trauma is imprinted in the brain as being associated with that experience and may be a trigger for dissociation in the weeks, months, and years that follow.

Finally, K is for knowledge. This is how most of us think about memory. This represents explicit memory, or narrative memory- a conscious recollection that one has experienced something at a particular place and time, and has a story to go along with it. The other three forms of memory mentioned above (behavior, affect, and sensation) are considered implicit memory. They are stored via different mechanisms in the brain; we may be triggered by a certain smell, and be kicked into an intense dissociative state without having the knowledge, or explicit memory of the trauma associated with that smell.

Whew! This feels like alot of info, so I will stop here.

All the Best,

Sunday, August 15, 2010

The Rest of the Spectrum

Generally, dissociation is thought of as occurring on a spectrum.

Last post, I talked about the way in which we all use dissociation as a way to conserve energy or take a "mental vacation." That's one end of the spectrum. I also mentioned, however, that sometimes dissociation occurs as a defense or protective mechanism in the face of a perceived or actual threat. As we move through the spectrum, we see dissociative experiences which are more in line with trauma responses.

I think it's time for another operational definition. For the sake of our conversation here, lets define trauma as "an event or experience that, at the time of occurrence, exceeds the range of that which one believe him or herself able to manage." Implied here is the fact that trauma is a subjective experience. What may be traumatic to a child might not be to an adult. What may be traumatic to someone in America may not be to someone in Afghanistan. What may be traumatic to someone with little support network or resources may not be to someone with a network of family, friends, and professional supports. What may be traumatic to me may not be to you.

So, dissociating is one way we humans have to cope with traumatic experiences- those experiences beyond that which we believe ourselves able to manage. When something happens to us that is so bad we can't manage it in it's entirety, we may dissociate. Some trauma survivors report having checked out, fuzzed out, or blacked out at the time of the trauma. Others report feeling as though they left their body and were standing beside themselves or floating above. Some report experiencing a split of self through which one part of self experienced the trauma, but not all of self. Sometimes we dissociate an aspect of our experience but not the whole experience, for example: being able to see the trauma as it unfolds, but not hear sounds, feel somatic sensations, or experience the accompanying emotions. In these cases, the dissociation is protective. It allows our experience to be managed, to be lived through, by limiting our awareness of it. In the cases of extreme or prolonged trauma, this dissociation may be so significant that entire occurrences, events, or parts of self may become unknown.

Long after a trauma has "ended," individuals may still dissociate when they are reminded of the trauma. These reminders are called triggers. They come in many different forms. Stay tuned!!!


Tuesday, August 3, 2010

Why We Do It

So now that we have a working definition of dissociation, and we know that we all do it, the next logical question seems to be, "why?"

Each of us uses dissociation on a frequent basis as a way to conserve energy or take a mental break. A perfect example of this, one with which most of us will be able to identify, is that of driving home. How many of you find yourself kinda zoned out on your daily drive to and from work? How many of you have ever gotten home and thought to yourself, "wow, that was quick," and not had a coherent memory of every inch of your journey?

Or here's another one. Ever found yourself in a classroom setting, a business meeting, or even a boring conversation with a friend and felt yourself kind of fuzzing out? Maybe the speaker's voice seemed like it was getting farther away. . .Maybe your vision seemed to blur almost as if you were crossing your eyes. . . Maybe you caught yourself out in "la la land" and realized that you couldn't remember what the person you were supposed to be listening to had said last. . .

These are some examples of normal, every day dissociation. After reading these, you can probably think of more from your own experience.

Other times, dissocation occurs as a defense or protective mechanism in the face of a percieved or actual threat. This type of dissociation is more closely linked with trauma. I'll talk more about that, but am going to sign off for now. I want to keep you interested in this really interesting topic! (And plus, I think long blogs are boring :) I don't want you checkin' out on me!)

Can you share any times when you have caught yourself zoning out or dissociation as a way of conserving energy or taking a mental vacation?

All the Best,