There is a feedback-loop between our thoughts, emotions and body. A picture you will often see to describe it is this
It is the foundation of CBT interventions. We change the thought, that will change our emotion and physical state. It is called top-down approach and it works well with many psychological problems but its use seems limited when it comes to PTSD. Some thoughts turn out to be highly resistant to change. Treating our mind is not touching the core of trauma, which is very much a problem of chronic stress locked in our bodies.
Scientists suggest approaching the feedback loop from the other side.
Our body gives feedback to our brain about how we are doing. Our posture, muscle tension, heart rate etc give signals about our physiological state. Our brain responds by interpreting this information.
Research shows that our physiological state of arousal influences our thoughts and limits the way we can think. The idea is that the story (our thoughts) follows the state (arousal level).
This works for us as long as we are in a physiological state that matches the situation. Then our perception of safety will lead to feelings of connection and social stories, a perception of real danger will create fear or aggression and the story becomes one of self-protection and assertiveness.
With PTSD our physiological state often does not match the situation though. We get stuck in hyperarousal or chronic dissociation. It might be the reason why thoughts are stuck too. To change our thoughts we first have to change our state. The thoughts will follow eventually.
Hyperarousal shows in 2 different ways, the flight and the fight response.
When our state is that of flight our thoughts will follow. We will think things like that we are being watched, judged or rejected and we will expect danger everywhere.
Because we are in high stress we lose our ability to read faces and situations as safe and social, so that we interpret meaningless things as cues that we did something wrong. The emotion we will feel is chronic anxiety.
When we are in fight our mind will find an enemy, even if there is none. We will think thoughts of judgment and blame and interpret neutral faces as a provocation. Our body tells us that we are in a fight, so our whole world becomes a battlefield and we are surrounded by bad guys who want bad things for us, be it casemanagers, nurses, institutions, immigrants or political systems. Chronic fight means chronic anger and hatred cause where there is a readiness to fight in the body, there surely must be an adversary, says the brain.
The state of shutdown and dissociation comes with thoughts of defeat. We know there is no way out and our brain will be unable to have creative ideas for problem solving. We will just spin back to the problem. We are actually unable to think the thoughts that would get us moving again or remember the things that have helped in the past or that we learned in therapy. Dissociation is not only accompanied by thoughts of helplessness but also by shame. It is here where we have our deepest convictions that we are nothing and can do nothing, that there is no future, we will never make it and we should better die. It is how our mind reacts to the state of dissociation of the body. Some chronic depression in PTSD is based on chronic dissociation.
There is a chronic mis-attribution happening between our arousal states and the world today.
Treating the thoughts just won’t work. We cannot think new thoughts when our body is stuck in a state that doesn’t correspond.
But changing the arousal state through stress relief, relaxation and grounding will communicate back to our brains to think different thoughts. This is the bottom-up approach to influence the feedback-loop. You can find tools for that in body work. It is not as focussed as a mind approach and will take a while, but it’s powerful in its own way.
It is wise to use both approaches for the best results. But I would really recommend trying to do it bottom-up if feelings and thoughts are chronically stuck.
I would also ask you to remember that ‘the story follows the state’ when you are despairing and the thoughts in your mind get dark and hopeless and aggressive against yourself. The story your mind is telling you might not reflect the reality and instead be based on a dysregulated physiological state. Getting better might be easier than you think at that moment, if you take the time to regulate your body. Don’t believe everything you think. Instead, become aware of your body and your arousal levels. It might explain why thoughts are so painful and damaging at that moment.
Becoming chronically grounded will change the story of our life. We will be able to think safe and social thoughts and thus create a sense of connection and belonging. It is worth every minute we spend learning to relate to our bodies and regulating them.
More about the polyvagal ladder
This is very powerful. Thank you.