This article was written by Dr. Matthew Welsh J.D., Ph.D.
This is one of the more difficult and sensitive articles I have written, but my hope is that it may help you find some peace or a healthy response if you have gone through a traumatic experience…
If you have gone through a traumatic experience, then you have experienced something that is extremely difficult and may have symptoms of PTSD. Symptoms of PTSD include:
1. Intrusive thoughts, memories, flashbacks or nightmares about the traumatic experience
2. Avoidance of internal and external reminders of the traumatic experience such as memories, feelings, people, places, or things.
3. Negative thoughts and emotions related to the traumatic experience such as believing the traumatic experience was your fault, difficulty trusting others or feeling safe, and feelings of guilt, shame, anxiety, or depression related to those thoughts or beliefs
4. Hyper-vigilance such as constantly feeling like you are on guard, difficulty sleeping, trouble concentrating, and feeling like you are being threatened by something
These symptoms can make life especially difficult and anxiety-provoking. People who have experienced a trauma often say they just want to be alone to avoid any thoughts or reminders of their trauma. Additionally, when they are out in public, they try to avoid large crowds. Sometimes, they may get easily startled if they hear an unexpected noise. Additionally, they often have trouble regulating their emotions and even maintaining relationships because they are constantly on guard for a potential threat and feel afraid. Some of them even stop going out to eat at their favorite restaurant because the anxiety associated with being around so many strangers in an environment they can not control is too much for them to bear. These symptoms are also caused by changes in the brains of people with PTSD that make people with PTSD hypersensitive to external and internal stimuli. Their fight or flight response in their brain is triggered much quicker than other people because their brain is much more likely to view something as a threat to their safety due to what they have gone through in their past.
One of the treatments that can help better manage these symptoms is prolonged exposure. In essence prolonged exposure slowly and gradually exposes people who have experienced a trauma to their internal memories and/or external triggers for anxiety and or avoidance to help them eventually become desensitized to the trigger and experience less anxiety. For example, if someone who experienced a trauma can not go out to eat at a restaurant that reminds them of their trauma, then he or she might first drive to the parking lot of that restaurant with a friend and sit in their car of the parking lot for a few minutes. Then, the following week, he or she might walk around the parking lot without going into the restaurant. Next, the person might walk in the restaurant, but not sit down. Over time, the person can gradually increase their exposure to the restaurant or whatever the trigger is for their trauma and experience a decrease in their anxiety which allows them to enjoy their lives more fully.
To a lesser degree, even if you do not have PTSD, I believe there is a lot to learn from prolonged exposure. Essentially, it allows a person to gradually expand their comfort zone and take on challenges that were once avoided because they were considered to anxiety provoking, such as possibly going on a first date, starting a new job, expanding your social skills, or simply taking on more challenges in your life with less anxiety and avoidance.
What happens psychologically and physiologically in the brain is that we slowly begin to habituate to our (at one time anxiety-provoking) circumstances or memories of the trauma and get used to them. A comparison is when you jump into a pool or lake with cold water. When you first jump in, the water feels very cold and uncomfortable, but eventually, your body gets used to the temperature of the water. Imagine if we apply this to all areas of our life. How can we expand our comfort zone and take on more challenges with less anxiety?
I believe one way is to start small and work our way up to bigger challenges using self-compassion. For example, maybe the idea of starting a romantic relationship or working a new job seems to anxiety provoking because it is a reminder of a past relationship or job that did not work out well. Instead of jumping in head first and trying to go on a date first, maybe you could try to make eye contact or small talk with the person who serves you coffee or cashier, or go to a networking meeting. Then, you can gradually expand your comfort with social interactions and relationships to help decrease your anxiety. This idea of habituating and expanding our comfort zone can be applied to any area of your life. It is also best applied using self-compassion, acceptance and understanding for what you have been through and how it may be affecting you today.
So, I would ask you, what are you feeling anxious, hesitant, or avoidant about that you KNOW is something you should do to help you move forward to your happiness, dreams, or success? Then, I would encourage you to take one small action or step to expand your comfort zone in that area and over time you can gradually move towards bigger and bigger actions to your ultimate goal.
Again, part of recovering from a trauma and moving forward is accepting that the trauma will always likely have some effect on you and then having self-compassion for what you have gone through. Simply knowing that your past trauma may be connected to any current difficulty feeling safe, intrusive memories or anxiety you are experiencing can help you develop self-compassion, understanding, acceptance, and kindness for yourself. Thus, when you are feeling symptoms of anxiety related to a past trauma or avoiding a reminder of your trauma, accept with self-compassion that the anxiety or avoidance is a natural response to a very unnatural experience. There is nothing wrong with you for feeling anxious, having those thoughts, or intrusive memories. Be compassionate to yourself for having those feelings of anxiety and/or avoidant responses without judging yourself or response. By practicing acceptance and self-compassion, eventually the levels of anxiety can decrease over time and it can become easier for you to function in those situations. Additionally, practicing self-acceptance and compassion can help you become more at peace with yourself, which will then help you take more focused actions that increase the likelihood of achieving your future goals.