Healing the body

     Throughout my work with the survivors of emotional traumas I have noticed that people, who have survived multiple traumatic events or whose PTSD was chronic, tended to experience multiple physical health problems. Some of the survivors experienced chronic pain that seemed to travel throughout the bodylodging into different parts at different times. Others had autoimmune conditions, such as fibromyalgia, Lupus, Multiple Sclerosis, or chronic fatigue. Yet others had type 2 diabetes or heart diseases. I have always wondered about the connections between emotional impact of trauma and physical symptoms.

     Recent research shed a lot of light into the impact of psychological trauma on the body.  For example, we now know that trauma may lead to the increase in chronic inflammation response (Gill ey al., 2009), which in turn may be connected to the dysregulation in the function of Hypothalamic-Pituitary-Adrenal Axis and excessive amounts of cortisol secreted by the adrenals for long periods of time, when a person experiences flashbacks or being triggered in any other way. Some studies suggest that the more traumas an individual has survived the more his/her physical health will be affected. In other words, multiple traumas have a cumulative effect on physical health. Moreover, the impact of trauma on physical health may be independent of PTSD symptomatology (Sledjeski et al., 2008).

     Connections between specific diseases and disorders and PTSD have been supported by multiple studies. Thus, McFarlane (2010) in the review of this topic discussed connections between post-traumatic stress and chronic fatigue, fibromyalgia, irritable bowel syndrome, hypertension, obesity, and coronary heart disease. Trief et al. (2006), as well as other researchers, connected PTSD to the risk of type 2 diabetes.

     I can continue going on and cite study after study, as well as case after case, showing connections between traumatized psyche and malfunctioning body. But I think I made the case already. SO, I would like to focus on the treatment implications. Given that body is deeply affected by prolonged exposure to traumatic stress, we need to include body in the treatment and healing process. I summarized a number of different suggestions based on my clinical experience and bits and pieces of information from the psychotherapy literature and different seminars I have attended on the topic.

1.      RESTORATION
Early in the process of healing it is important to focus on restoring your body’s immune function, level of energy, and general resilience. This phase may take long time. There is no magic to it. Here are the things that tend to heal your body on a very basic level:

a.       Sleep and rest are the most important gifts  you can give your body (and your mind too). Create a habit of giving yourself AT LEAST 8 hours to sleep at night. In the beginning, you may need more than 8 hours. Some people need 9 or 10 hours every night as they are letting their bodies heal. If you have sleeping issues, address them in your work with your therapist and/or your primary care physician. Your body NEEDS sleep in order to heal. In addition, give yourself 15 to 20 minutes during the day for a nap or just rest. When I was in the phase of actively healing my body and struggling with a lot of fatigue, I used to take 20-30 minutes every lunch break and lay down on my yoga mat on the floor in my office. During this time I dimmed down the lights, put an eye pillow scented with lavender on my eyes and practiced white light meditation. Sometimes I fell asleep, at other times, I did not. But I felt refreshed and a little bit more energized afterwards. Depending on your level of physical depletion, you may need two or more of such breaks during the day.

b.      Stay hydrated. Drink 8 or more glasses of purified drinking water a day. Coke, mountain dew, coffee, and juice DO NOT count. Drink as little of those as possible. If it is difficult for you to drink plain water, squeeze a piece of lemon or grapefruit into the water glass. You may also opt for herbal tea with a tiny (1/2 tea spoon) bit of honey, or make some fruit water or iced green or herbal tea.

c.       Nurture your body with fresh and healthy food. Proper nutrients are essential to healing. There are many books and articles available on the topic. In general, eat three meals a day. Include plenty of fresh vegetables and fruit in your diet. Also, eat foods that are good sources of protein, such as organic eggs, organic chicken, tofu, nuts and seeds. Consult a nutritionist if you have some special concerns or need to modify your diet due to allergies or specific illnesses.

d.      Supplement. Unfortunately, our food sources lack vitamins and microelements, which often results in the need to supplement our diet. Consult a holistic health practitioner, such as an oriental medicine practitioner, an integrative physician, or a chiropractor for help in creating supplementation program that is right for you.

e.       Exercise. Every body NEEDS movement in order to heal and maintain health. Even if you are completely depleted or badly physically injured, you can do chair yoga (https://www.youtube.com/watch?v=Fkl88Nq3BiU ) or restorative yoga (https://www.youtube.com/watch?v=MZn6ZnT_mI8 ). If you can, choose something more active, such as walking, swimming, dancing, lifting weights or any other form of movement that appeals to you. Try a class, such as yoga, tai chi, cycling, Zumba, or anything else that appeals to you. Work on incorporating movement into your life, while accommodating for your current limitations and being gentle with yourself.

f.       Acknowledge and deal with your limitations.  This is very difficult for many trauma survivors that I have worked with. Often chronic trauma comes with either pushing self too hard and creating more physical and psychological damage or wallowing in disease and hardship and not dealing with limitations properly. The idea is to honestly acknowledge your limitations and special needs while finding a way to work with them. For example, if you need a lot of rest in order to function properly, working as a nurse with 12-24 hour shifts is not for you, but it does not mean that you have to stay home on disability. You maybe able to work part-time or volunteer.

2.      SPECIAL CARE
      In addition to the basic restoration regimen discussed above, make your body a special focus for a few months or years. The length of healing depends on how much damage has been done, more specifically how many traumas you survived, how long-stretched traumatic events were, and for how long you have been suffering with PTSD-related symptoms. Most trauma survivors that I encountered needed to do some additional things to help their bodies heal. Some examples of those are discussed below.

a.       Massage. Find an experienced massage therapist and try a couple of massage sessions. I would suggest just general massage focused on stress relief. If you like it, make massage a part of your life. Depending on your finances, get massage once a week or once a month, but do it regularly.

b.      Reiki is a special form of energy therapy. It involves a trained practitioner channeling healing energy through their hands into your body. If nothing else, a reiki session is often very restful and restorative. It can also help alleviate pain, reduce inflammation, and lower stress. There are multiple anecdotal accounts of reiki helping with all kinds of chronic health conditions. Again, try a couple of sessions. See how it feels to you. If it seems helpful, make it a part of your regular life.

c.       Aromatherapy is an approach that uses natural essential oils to heal different body problems or concerns. Multiple books have been written on the topic (for example, see this book http://www.amazon.com/Complete-Book-Essential-Oils-Aromatherapy-ebook/dp/B0090QVWA2/ref=sr_1_2?ie=UTF8&qid=1407364555&sr=8-2&keywords=aromatherapy or a quick guide http://www.amazon.com/Aromatherapy-Quickstudy-Health-Inc-BarCharts/dp/1572229551/ref=sr_1_7?ie=UTF8&qid=1407364555&sr=8-7&keywords=aromatherapy). Aromatherapy can be used in a self-help fashion or you can find a trained practitioner to work with you. I personally like adding 10-15 drops of lavender (for restful sleep and relaxation) or sweet orange (for mood improvement) or peppermint (for pain relief and to reduce inflammation) to a bath and soaking in it for 20 minutes.

d.      Mindfulness meditation is an approach to training your mind to focus on the object of your choice, such as breath. You can use a mindfulness tape, a book, or take a mindfulness class to learn how to meditate. See http://marc.ucla.edu/body.cfm?id=22
for a number of meditation instructions and tapes. According to multiple studies, regular meditation practice was connected improvement in multiple chronic conditions, such as fibromyalgia and other autoimmune conditions, hypertension, diabetes,  heart diseases, and asthma. It improves immune system function and sleep.  

3.      PROFESSIONAL MEDICAL HELP
     Having a primary care physician that knows you and wants to help is a must for a trauma survivor. If your physician is well-informed on the impact of psychological trauma on physical health, it is even better. At the minimum it should be a person, who is willing to listen to and address your concerns. Make sure that you are also current with your physicals and all age-appropriate tests, such as mammograms and colonoscopies. Follow your physician’s recommendations for the treatment and management of your chronic health concerns.

          It is very important for you to understand and remember that as a trauma survivor, your body has special challenges and needs. There is no shame in it. If your doctor is making you feel bad for seeing them too often or for not being able to determine what is contributing to your symptoms, CHANGE your doctor! In this country, there is no lack of primary care physicians. You have the right to heal and to be supported in your healing. It is NOT indulgence, it is a necessity.

4.      PSYCHOTHERAPY with BODY IN MIND
     If  you do not have a psychotherapist yet, please, find one. Dealing with chronic and complex trauma without a good therapist is an extremely challenging enterprise. When searching for a therapist and interviewing potential candidates, ask your therapist if they pay attention to the body in their work with trauma survivors. The idea of including a body in the therapy process is becoming more and more mainstream. A number of therapeutic approaches that include body have been developed for the treatment of trauma, such as Somatosensory psychotherapy, Internal Family Systems, EMDR, Somatic Experiencing and so forth. Even if your therapist has not been trained in any of those approaches, it is important that they pay attention to the bodily sensations during therapy and can help you find healthy ways to regulate your nervous system functioning.

AS A CONCLUSION, your body needs help in healing just as much as your mind does. Focus on it, pay attention to it, love it, and it will pay you back with increased energy, reduced pain, and overall improved health.