I Aced the Test! Part 4: Know thy enemy

I promised we’d take a look at the consequences of long-term stress (and, by association, trauma) on the body, didn’t I? That’s today’s topic so buckle up, Class.

Before I jump in, I want to define a few terms so we’re all speaking the same language.

The amygdala is a little almond-shaped cluster that controls your emotions–namely, fear and the fight/flight/freeze response. Memory and decision-making are also controlled by the amygdala.

The autonomic nervous system controls all unconscious processes, like breathing, blood pressure, and heart rate. Think of it like a car with automatic transmission, or being on autopilot.

Adrenal glands produce adrenaline and cortisol when the body reacts to a stressor. The inner medulla is the part that produces the hormones epinephrine and norepinephrine, which help kick off the whole fight-or-flight response.

In a nutshell:

Stressors trigger the sympathetic nervous system and hormones come rushing in full-bore. The amygdala enters the chat, which sets off a chain reaction with the adrenal glands and other endocrine systems. Your blood pressure goes up, your heart rate increases, you sweat. Without you even noticing it, your body is preparing to take one of three paths: fight, flight, or freeze.

When in crisis, our bodies and minds work in tandem to respond to the situation. The good old autonomic nervous system kicks into gear, triggering an immune response (which is designed to protect the body and fight off “intruders,” so to speak)¹. This immune response releases histamines, which are also the cause of hay fever symptoms like itchy eyes and hives. It may sound counterintuitive, but all of these unpleasant symptoms are part of your body’s fight to keep you alive. The second the stress hit that tiny little amygdala, you were no longer in the driver’s seat. Ever since that moment, you’ve been on autopilot–think of your body as a kind of gundam suit designed to protect you by any means necessary. This response is as effortless and natural as breathing. 

When most people hear the word “adrenaline,” they often imagine a scene such as a mother lifting a car off her baby. Our entire autonomic nervous system is wired to keep us alive, and the body can do incredible things when under acute stress. 

However, you can’t sustain that level of intensity forever. Think of a rubber band. You can only stretch it so much before it begins to lose some of its elasticity, and the same principle applies to stress and the body. Our bodies are not built to sprint at 84,000 miles per hour 24 hours a day, 8 days a week, and that’s precisely what long-term stress demands of you. 

Miller, Chen, and Parker (2010) describe stress as something that “accumulates” in the body’s cells. What this means for you, dear Reader, is that your body is in a constant state of inflammation because those hormones are poppin’. Even if it’s more of a wallflower than the life of the party, that inflammation is still there. 

This leads us to our next point: vulnerability for chronic illness. When your body is constantly on high-alert, it reacts to stimuli that may not bother the average bear. Many trauma survivors have at least one, if not multiple, chronic health conditions. Autoimmune disorders such as lupus are more common in adult cis female trauma survivors². Additionally, the odds of an autoimmune disorder causing an individual’s first hospitalization were higher among adults who reported two or three different types of childhood adversity, such as physical, sexual, and/or verbal abuse; parental neglect; or having a parent or caregiver who struggles with substance abuse or mental illness³. 

There is a strong behavioral component to this complex issue as well. Early trauma leads to hypervigilance and mistrust, meaning there are cognitive and emotional factors layered on top of the biological aspect. (It’s like the world’s worst sandwich, basically.)

Let’s pause for a visual aid. I wonder how many of you are familiar with our good friend Ouroboros. 

Picture the biological factors as the head of the snake, and the cognitive/emotional factors as the tail. Or reverse it. Either way, they are simultaneously feeding and devouring each other. Much like our old pal Anxiety, stress feeds itself. 

So, that probably sounds terrifying, right? It doesn’t have to be. Here are some platitudes to explain why:

• Knowledge is power.
• Know thy enemy.
• If it bleeds, we can kill it.

If we know what our own vulnerability factors are, we can find ways to counter them. If you have a chronic illness, make sure you’re keeping in touch with your doctor and taking any medications you’re prescribed. Try to eat well, stay hydrated, get enough sleep. Take at least a minutes throughout the day to do something you enjoy and celebrate being alive. A client once very astutely described living (versus surviving) as “nurturing the being as well as the human.” We exist on many levels–physical, emotional, cognitive, spiritual. Please be kind to yourselves and send love into the darkness.

One final note:

Take care of yourselves, Readers. Go take a safe, socially distant rainbow walk. Get some vitamin D–it’s good for you! Read a book. Plant a tree. Take a hot shower with a frozen orange. Meditate. And for the love of god, wear a mask and stop touching your face.

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1 Quas, J. A., Bauer, A., & Boyce, W. T. (2004). Physiological reactivity, social support, and memory in early childhood. Child Development, 75(3), 797-814.

2. Roberts AL, Malspeis S, Kubzansky LD, et al. Association of trauma and post-traumatic stress disorder with incident systemic lupus erythematosus in a longitudinal cohort of women. Arthritis Rheumatol. 2017 Nov;69(11):2162–2169.

3. Miller, G. E., Chen, E, & Parker, K.J. (2011). Physiological stress in childhood and susceptibility to the chronic diseases of aging: Moving toward a mdoel of behavioral and biological mechanisms. Psychological Bulletin,137(6), 959-997.

I aced the quiz! Part Two: That face.

Okay, so now that we know what ACEs are, let’s get a little more personal.

To begin, I’d like to share with you two pictures from my childhood.

1993, age four

1994, age five – kindergarten photo

Are these the same child?

Yes.

In the photo on the left, I am dolled up and mugging for the camera. I’m not sure who took me to get my photo taken that day (probably at Sears). If it was my biological mother, she was having an exceptionally good day. The reality is that one of my aunts probably arranged the whole thing. But I look happy, round-cheeked, grinning at the camera with a twinkle in my eyes.

In the photo on the right, taken roughly a year and change after the first, I am posing for my kindergarten photo. I was grumpy partly because of that damn cowlick, but also because my home life had basically gone to hell in a handbasket in the space of a year. My mother was drinking again, heavily. She would often leave me alone in the house at night to go out to bars. One of my earliest memories is waking up alone and wandering through the darkened house. I walked outside and paced the sidewalks for what felt like hours, watching as the lights in the houses lining the street flickered off, one by one by one.

Readers, that is the loneliest I have ever felt in my life.

If we ignore the backstory and focus only on the images (lighting and photo quality aside), what remains is this: The girl on the right has lost all the baby fat from her cheeks. Her eyes are huge, dark, and sunken. She is trying to smile but her teeth are gritted. She does not look at the camera, but rather past it, as if trying to see something in the distance. You know, that old chestnut–the Thousand Yard Stare.  Still a cute kid, but not the type of child you’d look at and go, “Oh, yeah, she’s doing well.”

Chronic stress changes the body in a myriad of different ways. I’ll touch on the biology of chronic stress (behavioral medicine is a fascination of mine) in the next post, but for now, let’s focus on face.

They say the eyes are the windows to the soul. If we peeked through your windows, what might we find? I’m looking forward to hearing from you, readers!

I aced the quiz! Part One: Know thy enemy.

Disclaimer: The information contained in this post is not intended to diagnose or treat any condition. I am a licensed therapist, but I am not your therapist. 

I ACEd the quiz! Tongue firmly in cheek, of course. There is no quiz, but today I would like to touch on trauma and its physical effects–hence the reference to ACES, or the Adverse Childhood Experiences Scale.

As any even casual reader of the blog knows, trauma is kind of My Jam. I love working with clients who are struggling with the same core issues I struggled with the first 20+ years of my life. I knew that was going to be bailiwick from the time I started therapy myself, at 18, but I didn’t really do much with it until I entered grad school and suddenly had to write a thousand different papers (that were not centered around arguing whether the box of money in Faulkner’s The Sound and the Fury is actually a box of shit. Look it up. It’ll change your life).

When I got my very first assignment, my brain went “PING!” and told me trauma was the area to hit. It’s a touchy area, for sure. Go too fast, and you risk re-traumatizing your client and damaging rapport. Go too slowly, and your client will stagnate. It’s like a dance.

The ACES study began in an obesity clinic in 1985, believe it or not. Physicians were interested in figuring out why people kept dropping out of their weight loss program; long story short, they developed the Adverse Childhood Experiences Scale and administered it to their patients. The results were unprecedented: they uncovered a link between childhood trauma and struggles with controlling their weight later in life. 

I’d love to wax poetic about the biology of chronic stress and implications for adulthood, but that needs its own post.

On to the significance of ACEs. The instrument itself is simple–ten self-report items, scored either “0” or “1.” I’ve re-typed it here for the sake of your eyes, but you can see the original and lots of great info on acestoohigh.com.

To avoid inadvertently triggering readers, I’m going to put the actual scale underneath this spoiler tag, as the questions do involve all forms of child abuse.

An Audio Post!? 4-7-8 Breathing Exercise

Hey readers! I haven’t posted any sort of “There’s a real person in here!” content in a really long time, so here’s a quick clip of me walking you through an even quicker breathing exercise. Click below for the transcript and let me know what you think!

(Side note: I love transcribing stuff because it makes me uncomfortably aware of my verbal tics. Sorry ’bout that.)

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Reflection: Grad school so far.

I’m entering my third week of grad school (online-only this semester because of the move) and man, it’s been a wild ride. I’m only taking two courses–Lifespan Development and Theories of Counseling and Psychotherapy, both of which I’ve had before in undergrad, so I’m familiar with the content. It’s a good thing I’m not struggling with that because the workload is something I was unprepared for, having been out of school for five years now.

Every day, I set aside two or three hours for work. Mondays are reading days, primarily. Both of my classes are heavy on Blackboard discussion posts, so I usually knock out a few of those on Mondays as well. My Theories class requires participation on four separate days, so I try to space out the rest of my posts throughout the week along with my papers.

Lifespan’s discussions are pretty research-heavy (as in, find an article based on these criteria and summarize it), which is something I’ve always hated. Thankfully, the summaries only have to be a paragraph or two, but I always overshoot in terms of length on all my written work because I have no idea how to thoroughly break down a twenty-page study into a paragraph.

All told, I probably spend about thirty hours or so per week on school stuff, so I’m thankful that my fella is willing and able to support my lack of a job right now–there’s no way I’d be able to maintain my mental health/overall sanity along with a full-time job plus the school stuff. My only concern is that I won’t be able to find another school in Baltimore that will take me sans the psychology undergrad (despite grad school credits in the field).

My plan once we move is to take a semester off to scout out schools and perhaps get back into the tutoring game to earn a little cash on the side. Aside from that, I’m just trying to chill out and get ready for the big move in a few weeks!

How are your summers going so far, readers? Are you taking time out for self-care? I hope this post finds you lovely and healthy as always.