Rapid trauma Therapy Explainer for Vets

Hi, I'm Dr. Sharryn. 

 

I'm coming to talk to you about trauma therapy and how it might be something that could really benefit you. 

 

To start, I wanted to say that we've all been through something. 

 

Everybody's been through something. 

And I know this is particularly true for veterans, the subject of this video. 

 

You'll have been through things while you were in service, but you'll also have had things happen to you that were quite difficult before you ever joined the services and since you've left them. 

 

It's not just your time in service that's the thing that causes trauma to you. 

And when those things happen, they affect you for the rest of your life. 

 

So, we've all been through something, and we all deserve to be healed from it. 

All of us. 

The other thing I really wanted to say, and I have to repeat this several times, is that trauma isn't a competition. 

 

We always think, well, I'm not so bad. 

Somebody else has had it worse. 

This isn't so bad. 

Someone I know that they've been through this. 

I know that they've had these other problems. 

In the context of your life, the things you've been through that still affect you today.

 

They deserve to be healed, and you deserve to be healed and to have a better life as a result.  I want to show you that it's so fast, so gentle, and so effective that you'll be able to tell other people, and that, collectively, we'll all start to say this needs to be more available. 

 

This needs to be out there. 

We need this to be available to more people. 

That's what my motivation for doing this is. 

 

It's a fast bilateral stimulation technique. 

So you've possibly heard of EMDR. 

 

Many of you might have experienced EMDR, where you follow a lighted pen from side to side, and that allows reprocessing of memories. 

Many of you will have experienced that now. 

For some people, it'll have worked fantastically well. 

 

It doesn't work for everybody, and it's a relatively long process. 

You have to commit to probably six to eight weeks in general for it to work. 

It's actually your own brain doing the processing that it should have been able to do at the time had it not been flooded with stress hormones. 

 

Your brain is the magician. 

I'm not the magician doing the technique. 

Your brain is the magician. 

Since whatever's happened to you, your brain has never ever stopped trying to fix it. 

It's always tried to resolve it, to reprocess it, and to do that logically. 

 

The problem is it's the point where it can't. 

The things that are the issue are underneath the surface level of your brain. 

The subconscious bits that you don't have easy access to, they're not working. 

So, logically, you might know that everything's fine. 

Logically, you know, it happened then, and it's done. 

It's finished. I'm safe. 

 

Now, underneath it, you just don't feel that. 

You just don't feel that. 

You just see the threat all the time, and you keep going back to it. 

And that's what's still driving some of these reactions you're having. 

 

Now, what is it not? 

It's not talking therapy or counselling in the way that you try to talk things through and make sense of them.

Again, that's trying to make things that's trying to make sense of things logically. 

That's not going to work. 

Logically, you get it. 

The logical part of your brain is working. 

It's the subconscious part, the limbic system, the emotional system that keeps saying threat, threat, threat, threat. 

 

And that's why you can't resolve it. 

Logically, you've thought it through. 

You've already done everything you can to try to make it better. 

And that doesn't work anymore. 

We have to address the bit underneath that's not easy to access, and that you can't really reach on your own. 

 

It's also not CBT. 

So CBT takes the views that you have and the reactions that you have and says, is this the right reaction to that situation? 

Tries to reprogram how you react to things. 

There is a form of CBT for trauma that does work for a lot of people.

It doesn't work for everybody, and sometimes it can make things worse. 

So CBT is one of the things in the NICE guidelines that we should use to treat trauma, but it's not always effective. 

 

This is different from that. 

This doesn't try to reprogram how you think about things.

It tries to switch what it does, which is switch that threat off. 

And once the threat's switched off, the natural processing happens that would have happened at the time had you not been flooded with those stress hormones. 

 

And it happens really quickly. 

It happens right there in the room. 

Carries on for a few days afterwards, but in general, you'll see a difference and feel a difference right there in the room .

 

It's also not EMDR. 

EMDR works slightly differently. 

It uses the same bilateral stimulation, the same light pen from side to side, or you can use clicking, or you can use an auditory clicking sound, or you can use tapping. 

There are many different ways to do it, but essentially it's the same. to stimulate one side, the other side, the other side, the other side. 

And that's what allows the reprocessing to happen. 

EMDR works on following breadcrumbs. 

Not going for one particular bit of the trauma and using that as the nub or the gnarly nub or the root of the trauma and trying to address that. 

 

It uses tiny wee bits of the reaction, said sit with that. 

What do you feel there? 

Sit with that. 

What do you feel there? 

And to resolve all of the breadcrumbs sequentially until you manage to get the whole trauma sorted. 

This is different to that. 

It says, "What's the bit that really gets you? What's that gnarly nub of the trauma?" 

Let's go for that. 

We're not going for the whole thing. 

We're not diving in. 

We're just going for that one tiny wee bit coming in from the side while you feel safe and just letting the whole thing collapse. 

That's how we're going to look at it. 

 

So, EMDR also takes a bit more of a neutral stance is sit with that. 

Just allow those emotions to come up.

 Just sit with that. 

This is much more supportive, saying you're doing really well. 

You're doing fantastically well. 

Well done. 

Let it go. 

Completely different approach. 

Although they both use the same bilateral stimulation, it's a bit different. 

 

Okay. It's also not somatic therapy. 

Now, somatic therapy, you probably heard of it, but not necessarily heard it called that. 

So, it's the things like holding your breath, that kind of 4-7-8 breathing or 4-4-4-4 square breathing. 

 

You'll also maybe have heard of a physiological sigh where you take a big deep breath in and then another little bit on the top. 

So you kind of go and then breathe out. 

And that's supposed to engage your vagus nerve and make you feel much more relaxed and calm. 

 

It improves your parasympathetic system, which is the one that's the rest-and-digest, not the fight-or-flight sympathetic system. 

So you'll have heard of things like that.

There are also things that Bessel Van Der Kolk talks about in his book, The Body Keeps the Score. He talks about singing, dancing and drumming, the things that just get you into your body to make it work. 

 

Interestingly, humming works. 

So breath work is the only one that you're supposed to have real conscious control over, but actually, you do for humming, too. 

There's a really interesting time when humming came up as, I think, a regulating response. 

 

Remember when David Cameron left 10 Downing Street, and he was caught on the recording as humming as he walked away from 10 Downing Street, and he doesn't care. 

He just thinks the whole thing's blasé, and he's very glib about it. 

 

I don't think so. 

I think what he was doing was a really, really traumatic experience, and he was using that humming to regulate himself. 

 

It's actually one of the best examples I've ever heard of that. 

 

So, somatic therapy does work. 

It doesn't work on specific memories in the same way that EMDR might, but it does help you feel safe and make things feel better from that point of view.

It actually pairs really well with this. 

Really, really well with this. 

So, it's something that we may well come back to. 

Okay. So, what we're going to look at first is that everybody's been through something. 

And it's not a competition. 

That's the first and most important thing. 

It's pretty difficult for others to understand what you've been through. 

 

That's particularly true if you've been in the services. 

We're going to talk a wee bit as well about big T and little T trauma. 

So we'll come back to that again in a wee minute as well. 

 

What happens in a normal memory? 

What happens if you process a normal memory? 

What happens, and then what happens if you start to process but don't complete processing a traumatic memory? 

 

Then we'll look at headlines versus roots. 

So you very often tell people what the headline is, but the headline's not the bit that gets you the most. 

The root or the nub, the gnarly nub is usually the bit that gets you.

It’s how it affects your identity. 

Because it does affect your identity. 

Part of what you project to the world is your personality. 

 

If you keep having fight-or-flight reactions, you might get angry, irritable, or just shut down. 

That's what you're projecting to the world. 

That's a reaction to what's happened to you. 

That's not you. 

That's not the real you. 

It's not your identity.

 

 It's what you had to do to get through. 

 

And it's kind of like what happened…

 

What did I have to be that I lost sight of me?

 

Those reactions become you.

They're not you. 

They're not your personality. 

 

So what is your identity? 

And then we'll talk about what helps? 

 

What actually happens in this therapy that's actually going to help, and why should it help?

And a little bit about my motivation….

 

So my motivation, we'll come back to in a wee bit, but essentially it's just to prove that this works in this particular group because I think you guys need something that really works, that's really accessible, that you can get anytime you need it. 

You don't have to wait a long time to get it. 

 

And then finally we say thank you for coming because I really do appreciate you for listening to all to I really do appreciate you listening to this and and trying to take benefit from it and feeling brave enough perhaps to to book the therapy afterwards.

 

Right, stop there for a second. 

Okay, let's go through my little list then. 

So, the first thing was that everybody's been through something. 

Everybody's been through lots of things, not just through something. 

And it isn't a competition. 

If I told you the things I've had this therapy for or this type of therapy for, you'd honestly think it's first-world problems. 

What on earth is wrong with you? 

But honestly, they affected my life. 

They affected my life for about 30 years. 

They’d be nothing to most people, but actually, they really, really affected me. 

 

So, everybody's been through something and whether that's arguments within the family, whether it's a car accident, whether it's something that you may have experienced while you've been in service, whether it's the way you've been treated by somebody senior or the system of being in the army. 

 

I tell you, the NHS isn't much different, or in some ways it's not much different. 

Obviously, it is very different. 

Everybody's been through something, and it is not a competition. 

And if everybody has been through something, and this therapy is so fast, so gentle, and so effective, it needs to be out there, and it needs to be available and accessible for everybody when they want it, when they need it. 

 

It isn't currently; there's a 9-to 18-month waiting list for EMDR around the country, which is the only other thing that works quite as well, though it takes much longer. 

It's a bit more of a commitment. 

So that's the first thing. 

 

The second thing is that, particularly for people who've been in service, it's really difficult for others to understand what you went through. 

Other people don't understand what that team was like, what that situation was like, what those threats were. 

 

Whatever happened in this is the thing that you may feel traumatised about; it's within the context of being in a particular situation that most people will never experience or ever understand.

 

You tend to talk to people who experience similar things. 

They understand what that situation is like. 

So they understand what you went through. 

You don't need to explain that to them. 

That's one particular thing Bessel Van der Kolk also talks about in his book, The Body Keeps the Score, that the veterans would talk to each other. 

They would never really include him because he could never really understand what they'd been through. 

So I understand that. 

Also, we were going to talk here about big T and little tea traumas. 

 

Interestingly, while I was away on holiday in the States, there's a picture, one of the pages is the Anthony Gormley statue. 

So, the Angel of the North, you know, the big T-shaped statue. 

That’s like a big T trauma. 

 

And also just down the road here in Crosby, we've got another place with the smaller statues of Anthony Gormley's own body. 

They're like the little t trauma. 

Some of them are under the water, some of them are out of the water. 

 

So big T trauma is something a bit like the Angel of the North.

If you're driving up to Newcastle, you can't miss it. 

Everybody's going to see it. 

So it's a big headline. 

Everybody would recognise this as a trauma. 

Everybody understands. 

They may not understand the bits. 

That's the bit that gets you the gnarly knob, the root. 

They may not understand that, but they'll understand the headline. 

 

Little t trauma is a bit different. 

So say I was on a ward and one of the professors says, "What did they ever teach you in medical school when you don't know the 35 interactions or whatever drug?" 

 

Now that's humiliating to me, and I might carry that for 20 or 30 years and react to it. 

But other people might have noticed it at the time, but they probably forgot the next day. 

It's not a great big thing that they're going to remember. 

It doesn't impact them or obviously register as something traumatic for them. 

 

Interestingly, that’s changing. 

If we do see people humiliated like that in medicine now, it affects the people around us. 

We're starting to recognise that, but in the old days, we didn't. 

We didn't. 

So, little t traumas are the ones that'll affect me, but they're not necessarily obvious to the people around me. 

 

There's also another version of little t traumas, which are the things that should have happened, particularly as you're growing up. 

It can happen as an adult as well, particularly growing up. 

 

The things that you should have been able to get the support you should have been able to get that you didn't get, or small things that happened, small little comments along the way that really gnawed away at you, but individually, nobody else would necessarily have noticed that there was a trauma. 

That's a big T trauma and a little T trauma. 

Okay. 

 

So what happens in number three is what happens with a normal memory. 

If you think of normal memory, you get it; it doesn't come in as a fully formed memory that just goes, great, file it at the back. 

It doesn't come in like that. 

It comes in as different fragments. 

So you get what you see, what you hear, what you feel, what you taste.

 

Smells are slightly different. 

Smell is an ancient sense that goes along the base of your skull and straight in. 

It doesn't go around the same circuit as everything else. 

You probably know that from having smells that can trigger you very quickly. 

 

So all of these fragments come in through a wee bit in the middle of the brain called the hypothalamus, which is quite a big bit. It says, "Okay, can I trust this? Is this quite safe?" 

 

If it is, it packages it, timestamps it, and files it away. 

It's there if you want it. 

You can get it if you want it, but most of the time you probably won't remember it. 

 

If it's a traumatic memory, that's quite different. 

So the fragments come in the same. 

They go in through the thalamus. 

The thalamus thinks there's a threat here. 

 

So it goes sideways into your amygdala. 

Tiny little kidney-shaped thing, kidney bean-shaped thing that's just sitting in your brain. You’ve got one on either side that triggers that, and it says threat.’ There's a threat here. 

 There's a surge of hormones. 

So, adrenaline, noradrenaline, cortisol, stress, stress, stress. 

So the amygdala state is heightened like that because it can't switch off due to that whole bath of stress hormones. 

The next bit it would normally go through is called the hippocampus. 

It's called the hippocampus because it apparently looks like a seahorse. 

 

So it goes through this wee bit next, and then it would get filed away. 

The hippocampus goes offline. 

So the amygdala gets all kind of it can't switch off. 

It just keeps going, keeps going, keeps going. 

 

It can't switch off because it's in this bath of stress hormones. 

The hippocampus doesn't work. 

It just goes offline, and it can't do its job because it's also sitting in a bath of stress hormones. 

 

So it's the stress hormones that stop you from processing it at the time. 

Now your brain's clever. 

So what it does is when you go to bed that night, it says, "Okay, so all of these things came in when there were lots of other things happening. It was too much." 

 

So when you're lying in bed that night, it says, "Well, okay, we'll replay these things in normal speed without all the other distractions of everything else that's going on." 

And see if that's enough to file it. 

So it tries that maybe once or twice. 

 

If it still can't file it away, it still says, "No, no, no. Every time I go near this, I get stress hormones again. It's too much. I can't do it. It doesn't work." 

 

So the processing can't happen. 

Every time, the amygdala is still heightened. 

 

The hippocampus is still offline.

It's just not working. 

 

Everything's disconnected. 

It's just not working. 

So, it never gets filed. 

 

Then, the weeks, months, years, decades after that, you start to have quite vivid dreams, really vivid dreams of your brain saying, "What on earth have I been through in the past that I can bring in that might help me process this?" 

 

So, you bring in things you think, "What was that about?" 

But actually, the brain's just saying, "What else is there? What else have I got that can try and make sense of this?" 

 

And that can go on for decades. 

Absolutely decades. 

We've treated somebody with this who had had a trauma 50 years earlier that resolved very quickly, and they were still having dreams about what had happened 50 years earlier. 

 

If it still doesn't work, then things keep getting stuck. 

And every time, logically, you go back to it and try to think, well, I'm going to try to resolve this. 

 

I understand this. 

It happened on such-and-such a date. 

I know it happened then. 

I know it's gone. 

And I know I'm safe now. 

I am safe now. 

Your brain goes, yeah, yeah, yeah. 

But you still experienced it, didn't you? 

We still haven't resolved the kind of emotional response to that. 

We've got a logical response to it. 

We've got a kind of verbal narrative about it, but we haven't resolved the emotional response. 

 

So, you keep going back there. 

Keep going back there. 

And every time you go back there, you get another surge of these stress hormones, and the things go offline again. 

 

The amygdala gets heightened. 

The hippocampus goes offline. 

Just disconnects, and it doesn't work. 

 

So, our job is to bring those things together to say, well, okay, we need to get to that memory in a way that we don't get all that stress hormone bath. 

 

If we can do it without that, then what should have happened back then will happen naturally anyway. 

And that's what the idea of this therapy is. 

Okay. 

That's the normal memories, traumatic memories, headlines versus roots. 

You all probably understand this. 

When you try to talk about what you've been through, if you do talk about it at all, you'll probably give people a headline, something they can understand, something they'll go, "Oh, yeah, yeah, that's trauma. I understand that's trauma." 

 

So you tell people the headlines. 

The headline probably isn't the bit that gets to you the most. 

There's probably another bit that's somewhere hidden inside all of that that actually is much more traumatic to you than the actual headline. 

 

We had this recently when we had the Southport attacks when the three little girls were murdered in that knife attack. 

 

So I worked with some of the staff who'd been involved with it. 

Some people were very close to what had happened, and some people were a bit further away. None of them actually came with the incident itself. 

 

It was all something something that happened, either things we would normally do that we couldn't do. Things that we wouldn't normally do, we had to do.

 

So it wasn't to do with the trauma headline at all, even though the Southport attack is the big headline. It was about something personal to them in their situation regarding what happened that day. 

 

And that's probably what happens with a lot of you. 

So it's not necessarily the headline that's the big thing.

It's the kind of gnarly nub, the root of what happened, that's the thing that keeps coming back to you. 

 

One little vision, one little v video of what happened at that point. 

Okay. 

So, identity. 

 

You'll have heard of the fight-or-flight response. 

 

When I was at university, we only really talked about the flight and flight response. 

It was a long time since I was at university, 30, nearly 40 years ago. 

There are actually five Fs. 

So, it's very handy. 

 

They've all got Fs, haven't they? 

Fight, flight, and 3 others? 

 

Your muscles are kind of all primed and ready to go.

Whether you can start punching your way out of the situation, and sometimes you'll see that as anger or irritability rather than actually punching and fighting. 

 

Or flight, your muscles are all primed, run away. 

You can't always do that. 

In situations where you can't fight, or you're not, you've got no chance of winning; you can't do the fight response. And the next one is freeze. 

 

Freeze is when fight or flight aren't options, and you effectively stay where you are, don't move, and hope that things just pass and you don't get noticed. 

 

The other two are fawn and flop or fold. 

So fawn or friend, um, they all begin with F, don't they? 

Fawn or friend is making yourself small, is making yourself feel less and not saying what you want to say, holding back. 

That could be the fawn response.

 

It's not just about going there; you're being really nice to people. 

That can be part of it, but it's not always just that. 

So that's the fawn response or the friend response. 

 

Fold or flop is something that we see quite a lot in FND, actually. 

 

So I've treated some people with FND who have had this, that if they are not necessarily, if they get a trigger, but just randomly, almost, they seem just to collapse or have a seizure or just the legs give way.

 

They collapse to the floor, and that's the fold-or-flop response.

That's quite a long stage along. 

So if you think of the fight-or-flight response, freeze is the next stage. 

 

Fawn's probably a bit closer to here with fight-or-flight. Flop or fold is a more serious thing when nothing else is an option. 

 

You can even get stages beyond that that don't fit within those five Fs that are more serious than flop, flop, or fold. 

There are risks even beyond that. 

So the trauma responses can have quite significant physical effects. 

 

There's another version of freeze called functional freeze. 

 

So if you're out and about and seeing people, you put your best foot forward. 

You're trying to respond as if things are going well or you're working and can manage to make things work during the workday, but then, as soon as you're out of that situation, you're just like, "Okay, it's just me now." 

Collapse. 

You just can't do anything. 

That's functional freeze. 

So you're frozen, except for the times when you have to function to keep life going. 

Okay. 

So what helps? 

EMDR helps. 

That variation of CBT that's for trauma can help. 

Sometimes they make things worse, and we're all different. 

Some people it's going to work really well for, and some people it won't. 

This works by saying, " Okay, let's go back in safety to access this memory. 

 

So we're not going to trigger all these stress hormones. 

If we do, we'll take a step back. 

And if we go back to the trauma and we trigger it again, then we'll take another step back and we'll gradually….

 So, we're going to sit there. 

The two of us are going to sit there quite close together. 

You almost need your knees to your knees because, to get the light from side to side close enough, you need to be close enough that I can reach right over there and right over here. 

 

We're going to have your heels permanently here. 

Your heels are here in the present, and you're safe. 

Your toes are pointing at the trauma. 

They might be sitting in the trauma. 

You need to be beside it. 

Not necessarily right in it. 

You need to be right there with it. 

You can't do this from a distance. 

We have to go to the trauma to be able to treat it. 

 

But your heels are right here in the present, and they're safe. 

Your toes are pointing towards sitting in or right immersed in the trauma in a way that you feel safe. 

 

We're not triggering those stress hormones, and that's what should have happened at the time: packaging it together, timestamping it, and filing it away will just happen naturally. 

 

And it happens like that. It happens right there in the room. and you feel it happen right there in the room. 

You're like, I know something's changed. 

You might not know that it's completely better until you're out again in the world again, but you know something shifted. 

You can feel something shifted. 

That's how this works. 

And it works quickly. 

It works quickly. 

It works gently, and it's effective. 

 

And again, we'll come back to my motivation for doing this. 

I learned relatively late that it was possible to do trauma therapy quickly and that there were different ways of doing it. 

We had a lot of research to support how to do it and to bring in some of the solution-focused things I'd also learned early on. 

This asks what would change if things were better, what difference would you notice if things were better, so bringing all of that in, bringing in the identity work that I'd done already, so I named my company Caramocare after Kuramo Brown, who's the identity guy in Queer Eye.  

 

So, queer eye may not be your cup of tea. 

I didn't think it was going to be my cup of tea. 

He's the guy who works on your identity and how that works and how that determines whether what you project to the world is actually what your identity is. 

I think that's really important that work. 

So my motivation now is to show that it works in these groups. 

I don't necessarily want to be working with veterans for the rest of my life, although I find it incredibly rewarding. 

 

I want to sow the seeds so that other people can take it forward, so that more and more people can benefit from this sort of therapy. 

I'm not the magician here. 

I want to show that it's possible and support other people in taking it forward. 

And finally, thank you for spending the time. 

 

Thank you for committing to think, well, okay, let's have a listen to this. 

It may not be my cup of tea at the end of the day. 

It may not be something I want to dive into immediately, but for giving it your time, being open to listening to how it might work and how other things might not, and maybe even talking to other people and saying what you want to try.

 

So, thank you. 

Thank you for your attention. 

I hope it is something that you feel brave enough to try, and I hope that, in a way, it's healed things for me and it's changed my life. 

I hope it does it for you, too. 

And I tell you what: some of the people who've had this therapy in the past are the ones who became my students, wanting to learn it and help other people because they were so blown away by how well it worked. 

 

I hope that happens for you. 

Thank you.