Phobias

When you think of chronic pain, people often think that physical injuries or medical conditions are the primary culprits. However, there is actually a significant connection between trauma and chronic pain, such as migraines, headaches, IBS, back pain, and other persistent physiological issues. There is an intricate relationship between your mind and body, and how past traumatic experiences can be unconsciously carried through life when not healed, manifesting as ongoing physical discomfort.

Traumatic events can have a way of rewiring how your brain and nervous system responds to pain, leading to increased pain sensitivity. This can explain why people are able to experience chronic pain without apparent physical causes. Understanding this shows why treating both the physical symptoms as well as underlying trauma and emotional elements of chronic pain is so important. Healthcare professionals should encourage, especially in cases where the cause of pain is inorganic or not clear, that psychotherapy is included in the treatment plan for people struggling with chronic pain.

The Link Between Trauma and Chronic Pain

The complex relationship between mind and body plays a significant role in how trauma can lead to chronic pain. Traumatic experiences, especially when severe or prolonged, can alter the way the brain processes pain, which can result in responding with persistent pain even without ongoing physical injury actually happening. This is especially notable when present experiences emotionally trigger old trauma, causing pain to increase in the body, triggering migraines, and more.

Trauma can also cause the nervous system to become hypersensitive. This heightened state can cause the brain to perceive normal sensory signals with pain responses, contributing to chronic pain without an apparent physical cause. Additionally, chronic stress and trauma can induce an inflammatory response within the nervous system that can further alter pain signal processing, which can increase both the duration of pain, and amplify the experience of pain, as well.

When you experience trauma, your body enters a heightened state of alert, which involves the release of stress hormones like adrenaline and cortisol. Although this is an effective short-term stress response to help with fight or flight, ongoing stress from unresolved trauma can result in several health issues as well as inflammation, muscle tension, and more.

Migraines and Stigma

As a therapist who specializes in trauma and working with people with chronic migraines, one of the more complex issues I've encountered is actually the worry some people have that linking migraines to mental health will validate the idea that the migraines are "all in their head". For many migraine sufferers, they have gone through life tortured by migraines, but since it's not visible in the same way other physical illnesses are, they have been told by people around them that they're causing the migraines or that it's all in their head. Therefore, many feel they need to be able to point to a medical-only cause of their migraines in order to prove the legitimacy of their suffering (one could also say it's a trauma for many migraine-sufferers being blamed for their suffering throughout their lives and not understood or really heard).

Unfortunately, this stigma has caused many people to not seek treatments that could ease their suffering, such as therapy focused on migraines and headaches, and what may be emotionally reinforcing or playing into the chronic pain in this area. Obviously, there are certain times where migraines are caused by something more purely medical. But I have seen the difference it makes for people when they are able to allow themselves to explore beyond the medical and look at the emotional side of migraines and other forms of chronic pain. This doesn't mean that your pain is any less real or that it's all in your head. The pain and experience of the struggle is still valid and real. This goes for any chronic pain that has been unseen or invalidated over time.

Childhood and Emotional Trauma

Adverse childhood experiences can significantly increase the risk of developing chronic pain in adulthood. These traumatic events may include physical or emotional abuse, neglect, or bullying. Family dysfunction or witnessing discord between parents on a regular basis can also play a role, as well as other experiences not included here. People with multiple adverse childhood experiences are generally more likely to experience trauma responses later in life. (While this post is more about chronic pain, trauma responses can include a number of different mental health struggles such as anxiety, depression, phobias, and more).

Getting Help and Reducing Your Struggle

Understanding the connection between physiological, psychological, and emotional is important for developing effective treatment strategies that addresses both the emotional and physiological aspects of chronic pain. As mentioned above, it's important that healthcare professionals encourage people struggling with any form of unexplained chronic pain to round out their treatment with therapy. I've seen people who've felt helpless with medical treatments make significant strides forward in the reduction of frequency and intensity of chronic migraines and other forms of chronic pain. It is possible to break free from the cycle of trauma and chronic pain, and to reduce your suffering.

#Migraine #Trauma #ChronicPain #IrritableBowelSyndromeIBS #Headache #MentalHealth #Anxiety #Depression #Fibromyalgia

I was quoted in the Wall Street Journal this week in an article discussing flying anxiety from the recent incidents in D.C. and Philly over the last week or so. In the article, I mentioned how following stories in the media has a way of "reversing normalization" about flying. What does this mean?

First, it is always unnerving and sad whenever accidents happen. And for people who are already afraid of flying, and for others as well, it has a way of increasing anxiety, and even serving to validate fears about flying and traveling. When something happens, it becomes very easy to say, "Look, I was right to be afraid." Of course, increased anxiety makes sense when there is a tragedy -- whether in a plane or anywhere else. It can be very hard to keep perspective when the worst case scenario and the thing you may fear most is happening to witness in the present.

However, one of the significant parts of managing and overcoming fear of flying isn't to become convinced that nothing could ever happen. Pretending the risk is zero doesn't help, because you know better. It's more about how to help your body and brain normalize and align with the realistic risk -- not the perceived risk, which feels much higher for most people. What I refer to as "normalization" of flying is one big part of internally aligning with reality.

How "Normalization" Helps

Every day we are normalized to risky situations. This means we have internalized the risk and the context of situations to the point that allows us to feel safe doing things that have risk to them. As I've discussed in past articles, people drive every day of the week without having panic attacks before they get into their cars, even though driving is much more risky than flying. Same thing with eating meals, showering, walking down the street, or any other activities that can end badly in a catastrophic moment. We know there is risk, but because of normalization in the brain and body, you're able to engage in these scenarios without any thought, even with no guarantees available.

Part of the experience of normalization is helping your mind and body to fully understand something as routine. This means that you are experiencing flying (and driving, etc.) from a perspective that you are engaging more with the safety than the lack of safety. For example, if you were to follow how many planes take off and land every single day, you'd never have time for anything else in your life. In this scenario, you'd be constantly engaging with the safety of flying. One or two incidents in twenty years time would certainly be sad at any time, and it might be jarring, understandably. But when you're normalized to an experience and the realistic risk level of it, it tends to not change that internal meter too much, even if it knocks it around temporarily. This is why you can hear about terrible car accidents and then still get in the car right after anyway.

"Reverse Normalization" and Its Impact on Fear of Flying

"Reverse normalization," however, is what I call it when the opposite experience happens. If you are reading or watching videos about accidents and scary airplane moments more than you are taking in the safety and routine nature of flying, then you're going to internally start to respond as if flying is actually much more dangerous than it is.

A significant issue that I've seen over time working with people on flying phobia is how affected people become when they see articles about flights diverting to different airports, or doing "go arounds" during landing, or when a passenger creates havoc in the cabin, etc. When something out of the ordinary shows up, even if safety was never really at risk, and these stories find their way to the public, it increases reverse normalization, and people become more afraid. The sensationalizing of accidents when they happen drastically increases this, and often leads to more scary airplane stories for a while after. It can make people feel like the danger is actually more real or the risk is greater than it really is.

Keeping Perspective and Calming Fears

When tragedies like this happen, the first step in managing anxiety is to do the best you can in these moments to maintain a sense of perspective. The reality is that the risk isn't actually any greater than it was before. However, it is incredibly jarring when it does happen. Keep in mind also that one of the reasons it's so jarring when it happens (aside from how tragic and upsetting it is) is because of how rare it actually is. The fact that these incidents are *not* normalized actually demonstrates just how rare it is, and therefore the increased anxiety and fear in these moments makes sense.

There's more to overcoming fear of flying that I'm not discussing in this article (I've written extensively on this on my blog if you wish to see more). However, if you're finding yourself stressed over the last couple of weeks about flying, try to remember that the risk isn't suddenly greater. If you see scary airplane stories in the media -- if everyone lands safely, maybe question if what you're reading needed to be published in the first place. If you see repeated stories about the recent accidents (which may be the case for a while), either try to ignore it, or if you must read it, try to keep perspective that it's still the one incident you're reading about. The tricky part with the brain is that each time you engage with the same incident, each engagement counts in the brain as another negative incident anyway.

#fearofflying #flyinganxiety #Anxiety #phobias

There are many different reasons that people fear flying and experience forms of flying anxiety. It isn't a one size fits all phobia, even though the struggle with flying from the outside can often appear somewhat similar. What goes on underneath for each person however is actually quite different for everybody. Many who fear flying are not actually afraid of the plane crashing, for example. Many do trust that the plane will make it to the destination, but it actually becomes very scary to be in a vulnerable environment where they have no sense of control, and not be able to get up and leave when they feel scared.

Feeling trapped when flying can be terrifying. If you're in turbulence, of taking off, or even just cruising mid-flight, it can be the most vulnerable space for some people to be in. If you feel fear and anxiety ramp up when turbulence is happening, you can't do anything to stop the turbulence, and you also can't just leave the plane and come back in twenty minutes. It's a powerless feeling. When you're good at being in control of your environment in your daily life, and in ultimate control of your own body, it can be very difficult to sit in the plane and not be able to control the environment or leave it when you need. You just have to sit in it. In many ways, flying is a space where people have to learn how to hold their vulnerability while staying in it at the same time.

Fear of Being Trapped Happens for Different Reasons

For each person, however, it's different why being trapped causes such distress. For example, some fear being trapped because they're worried they're going to need medical attention and they're not going to have access to what is needed. Others may fear being trapped when flying because their anxiety and panic may become so big that they don't quite know how they'll react. Will they jump up and scream? Will they run up and down the aisle? Others fear being trapped because when they have a lot of people around them they feel enclosed, stuck, and like they can't breathe. And so on.

It's also very hard for many people to be in a space where they feel they may not be able to hide their fear and panic, and it will be noticed by others. The shame can be so great about being noticed that you're struggling, and the idea that you're not able to hold it all together, especially when it feels like you should be able to hold everything together. Every minute having to try to sit on the emotions can feel like an intense pressure and losing battle. Especially if you've grown up feeling there's never been much room for your emotional needs to be attended to, it may feel like you're supposed to hide the emotions, or hold it all together when you're feeling scared. This pressure in a plane, when the vulnerability can be the most intense, feels so overwhelming for people that every minute is filled with anxiety and dread, just wanting to get off the plane again so you can breathe again. There are other reasons that being trapped can be such an unnerving feeling when flying, but these are just some of the reasons that show up most often.

Trapped Within Your Own Skin

In many ways, a fear of being trapped when flying isn't necessarily just about being trapped within the airplane, it can often actually be a fear of being trapped within oneself, and all of the emotions that may feel they're going to become bigger than your body can hold. It's really hard to feel such big emotions and feel like there's nowhere left within you to put them all. This is where anxiety in flying can become more of a panicked feeling. Like there's no space left to breathe and you're becoming trapped.

Basically, it doesn't just feel unsafe inside the plane, it may feel unsafe even within your own skin.

Sitting With Yourself Differently, and Overcoming Fear of Flying

While it's important to learn how to sit in an environment where you don't have control (over the plane, or the people, etc.), there actually is still room to create control within yourself and your own body. But it's not always in the way people are used to creating control in themselves. People often create control by controlling the outside space. It is common to not know how to be with or handle emotions and discomforts on the inside, when the outside is out of your control. Alongside normalization and other elements of the personalized fear of flying therapy approach I created many years ago, part of overcoming fear of flying and being trapped is learning how to listen to yourself, understand yourself, and sit with yourself in a way that can help you feel more safe and calm, even if the environment is uncertain.

#fearofflying #Phobia #phobias #Anxiety #PanicAttacks #PanicDisorder #Claustrophobia

There are four main components involved in overcoming fear of flying: normalization, underlying issues, emotional regulation, and passenger flying education. Each one addresses a separate and relevant pathway that feeds fear of flying. I won't go into all four in this post. However, for each person, it varies what's presently needed. It all depends on where you are emotionally, your own history, and your own experiences. It isn't step-by-step, as much as it is understanding where your needs are in order to help you feel comfortable to fly.

Normalization and Decreasing Flying Phobia

Normalization is an important element of being able to resolve flying anxiety. The concept of normalization is to be able to emotionally experience the normalcy and routine nature of something so your brain and emotions don't react like there's a catastrophe about to happen. Even if there is technically some variable risk in many parts of life, we are able to do things every day that have risk in them because we experience them as normalized. We know that driving has a much, much greater statistical risk attached to it than flying. However, it's easy for many people who fear flying to still get into their cars every day and drive multiple times per day because it's so normalized that the brain doesn't react to it as a threat. You may know there's risk, but emotionally it's become an every day routine that you can trust.

With flying phobia, most people who have a fear of flying have not been able to normalize the experience in this way. This can be for a few reasons. Therapists for cognitive-behavioral therapy (CBT) would tell you that you just need exposure. But I'll tell you now that traditional CBT does not tend to work well for fear of flying. First of all, it's not possible to provide people enough appropriate exposure with flying unless you can fly regularly (on a weekly basis at least), or get past security in an airport without flying. However, even if you could in theory make this happen, many people come to me who do fly regularly for work and still feel anxious about flying every time they travel. Every time they land they feel they've just gotten lucky and it's a sigh of relief. Exposure on its own doesn't create normalization.

Blocked Normalization

When people aren't able to internalize normalization, it's usually because there is something underlying that is blocking it. Getting to the underlying issues reinforcing your fear of flying is another main component of overcoming this phobia. For everybody, it is different what's happening underneath the surface that is feeding the fear, but it's imperative that what's bolstering your flying anxiety is understood and worked through so you can make room for the normalization. The underlying component is the part of the process that brings the rest together. Removing the underlying blocks while working on the normalization opens the space to internalize normalization, which ultimately allows you to feel more like you're just getting in the car to go from one place to another, rather than a daunting feeling of dread or fear of catastrophe that can appear with getting on an airplane (or can keep you from getting on the plane).

Reverse Normalization

Another part of what reinforces fear of flying for people is the idea of reverse normalization. This is when you are exposed to more negative images and stories about flying than positive, and it leads you to understand flying as dangerous. The images that people often have in their minds of the scary things they imagine can happen, or things they see on tv or in the movies, or even stories in the media that call up these scary images is part of this. This leads to blocking and even undoing normalization. So part of achieving normalization is helping you to be able to let go of the images you may carry about flying while bringing in positive engagement with flying.

Fear of Flying is Emotional -- Not Logical

When flying is normalized, you're able to experience it in your body and emotionally as routine. It's worth knowing that flying phobia is rooted in emotions. You may know statistics, you may know everything about how flying works, you may have all the logical reasons that you'll be okay. But when you fear flying, your body may react before you even have the chance to slow it down. The emotions and body cannot align with what you logically know. This is why people can go into a flight equipped with logic, but then still find themselves afraid anyway.

When the attention is given to what you need emotionally, normalization to flying becomes possible. I have seen people come to either feel indifferent about flying -- where they fly and it's a just a mode of transportation -- to actually enjoying flying and wanting to do it more, even when they used to cancel flights and not get on the plane because it was once so scary. It is possible to overcome this fear.

#fearofflying #flyingphobia #flyinganxiety #Anxiety #Phobia #phobias

I have helped people overcome fear of flying for many years with the personalized approach I developed in my practice. There are a few phases of flying that tend to cause the most anxiety for people. Turbulence is one of the phases that seems to be scary nearly across the board for people who struggle with flying phobia. Occasionally, I do see people who are okay with turbulence, but still struggle with other parts of flying. However, turbulence is something that holds such a feeling of dread and creates panic of certain catastrophe for many.

Different Types of Fear of Turbulence

There are a number of reasons that turbulence can be so unsettling for people, and it often varies from person to person. Sometimes anxiety can come up when not understanding or knowing what is going on. However, it's worth noting that even when people understand it , it often isn't enough to stop the anxiety. Usually turbulence fears can really stir up deeper feelings beyond just not understanding. As I've written about previously, fear of flying is more of a "back of the brain" issue based on emotional responses. You can know all of the statistics in your favor, and you may know that turbulence is not a problem for airplanes. But no matter how much you know in the "front of your brain", the emotional part of you in your mind and body can't seem to align with what you mentally may know.

Anticipation of Turbulence

There are actually different aspects of turbulence that creates worry for people. It isn't just turbulence or no turbulence. For many people, the anticipation of turbulence has them on edge throughout cruise. You may be cruising gently for the majority of the flight, but you can't relax and you may even be paralyzed, waiting for that moment where it's all going to fall apart and the shoe is going to drop. For people in this area, you can't enjoy the moments where things are going fine because there is always a crisis about to happen, at any unknown moment.

Once turbulence starts, there may actually be a moment of slight gratification -- that you've been waiting for this to happen all along and you finally can stop wondering when it's going to happen. However, that gratification is quickly replaced by the anxiety of the unknown of how bad it's going to get.

Loss of Control

For other people, they may be fine in a calm and smooth flight, but the moment turbulence shows up they begin to feel fearful. As long as things are in control, they are calm and feel in control. But the moment bumps happen, they've now lost the feeling of control in the situation. You can't will the turbulence to stop, and you can't just leave the plane, either. This loss of control becomes experienced as an intense vulnerability for some -- one that they can usually avoid in life since there are usually ways to control their way away from the vulnerability in most situations. People in this category struggle to sit in the space of having to sit and wait for the situation to improve no matter how rough it gets.

People in this area tend to experience turbulence as more all-or-nothing. Either there is turbulence or there isn't -- in control or out of control. It's like an on-off switch of flying anxiety, and once the turbulence goes away, it's a sigh of relief because the feeling of control has returned.

Unpredictable Turbulence and the Unknown

Then there are other experiences of turbulence where it isn't so all-or-nothing, or anticipatory. For example, some do okay with certain patterns of turbulence. There might be a noticeable pattern of airplane movement that they can pick up on. Such as, the plane dips a little every ten seconds or so, and then bumps to the side a few seconds later before bumping back up a bit. This pattern repeats in a way that can become predictable. When there is a sense of predictability, this is a form of knowing and control and this can be okay with some people even though it's bumpy.

However, once the flying and turbulence pattern becomes unpredictable, this is when the anxiety comes back in. When the bumps become varied and you don't know which way the plane is going to move, or how much drop or movement will happen each time, it starts to feel like the worst is going to happen at any moment. Anything unpredictable or unknown becomes terrifying. Maybe it will drop too far, or maybe it will get bigger and stronger until it can't recover. For people in this area, the lack of predictability and being in the unknown is the most difficult part.

Difficulty With Trust

And then there is the element of trust for others. For people in this group, it's less about the sensations or the control. The moment the turbulence starts they fear that the pilots don't know what they're doing, or that they're not paying enough attention. Or, what happens if the turbulence gets so bad that the pilots become overwhelmed? While we can call this another form of lack of control as well, to some extent, for people in this area, the worry with turbulence is less about the turbulence itself and more about the lack of trust in people and the systems in place. It feels like no one or anything will be able to handle all of the pressure and stress. It's a scary, vulnerable, and out of control feeling to know that you are relying on people who you're maybe not sure can come through in the roughest moments.

In each aspect of turbulence discussed above, there are different reasons that people struggle in each of these areas. It's also common that people may experience more than one or all of the above types of turbulence fear, rather than just being in one category.

Overcoming Fear of Turbulence

People can and do overcome fears of turbulence, as well as fear of flying. I see people come through these fears all the time, even when they feel it's hopeless to improve. It is possible to sit with turbulence without having to be so overwhelmed with fear. It starts with understanding you and your own personal experience.

#fearofflying #Phobia #phobias #flyinganxiety #Anxiety #PanicAttacks #flyingphobia

If you've ever been in a "talk therapy" (not behaviorally-focused), you've likely been in a form of psychodynamic therapy. Psychodynamic therapy is like peeling back the layers of an onion. It helps you explore the depths of your mind to understand why you think, feel, and behave the way you do. This approach involves uncovering the unconscious patterns and life experiences that shape your present life and mental health.

At its core, psychodynamic therapy understands that the unconscious mind plays a significant role in everyday life. People are complex, and the solutions aren't only about what’s seen on the surface—it’s more about learning and resolving deeper patterns of past relationships, childhood experiences, and hidden desires. A psychodynamic therapist will help you connect the dots between your past and present, giving insights into why you might struggle with specific issues. It also goes beyond only awareness and insight. A significant part of effective psychodynamic therapy also involves working through and processing the emotions that have been carried over time. When you've processed and worked through the carried emotions, they no longer hold power over you and your life.

How Psychodynamic Therapy Works

Beyond building a supportive foundation and a trusting relationship with your therapist, which is important in any therapy, in psychodynamic therapy (which is also known as psychoanalytic therapy) we will explore your deeper thoughts and feelings, which also includes relational and emotional patterns over the course of your life. Experiences such as dreams are also important in understanding your unconscious motivations and stored emotions that are having an affect on your present life as well. The outward and underlying conflicts that are getting in the way of your emotional health or your present life are worked through as we get to more deeply understand where they are stemming from.

Why Psychodynamic Therapy Stands Out From Other Therapies

Focus on the Unconscious

When you engage in psychodynamic therapy, you explore the depths of your unconscious mind. Unlike cognitive-behavioral therapy (CBT), which focuses more on changing thought patterns and behaviors, psychodynamic therapy helps uncover the deeper underlying motivations that often keep people repeating the same unwanted patterns again in the present. As you peel back the onion, you gain more insight and are able to release the stored emotions as you go.

Emphasis on Past Experiences

In a psychodynamic therapy, your childhood experiences and past relationships are fully relevant in shaping your current behavior. How we are as adults stems from a younger age where we learn about the world through experiences, which shapes who we are in the present. It’s not about dwelling on the past, but understanding how your past influences your current relationship with the world (and other people), which all influences your mental and emotional health.

The Therapeutic Relationship

In psychodynamic therapy, your relationship with your therapist plays an important role. It’s not just about getting advice; it’s about creating a safe space to express yourself freely. This relationship often mirrors patterns in your other relationships, giving you valuable insights into your interpersonal dynamics. You are also able to work through negative patterns from your life that may start to show up in your therapy. It is actually quite common for patterns from your life to come into your therapy. People often think it means their therapy or therapist is bad when they see or feel something negative in their therapy. However, this is often a good thing as it means the issues that are plaguing you are showing up in a place where you and your therapist can give attention to it together.

What Psychodynamic Therapy Helps With

If you’re struggling with persistent emotional challenges, relationship issues, or simply seeking deeper self-understanding, psychodynamic therapy is a good option. It’s particularly helpful if you:

Find yourself repeating unhealthy patterns

Struggle with emotional regulation

Struggle with unresolved childhood or past experiences

Want to explore the roots of your thoughts and behaviors

Find yourself often ruminating or fantasizing about present issues or other points in your life

Psychodynamic therapy can be a helpful approach for people who are struggling with a variety of mental health issues, including:

Depression

Anxiety

Panic Attacks

Relationship issues

Trauma

Phobias

Other issues that have persistently been unresolved

The Psychodynamic/Psychoanalytic "Talk Therapy" vs. CBT Debate

There has been a debate about whether psychodynamic therapy or cognitive-behavioral therapy (CBT) is "better". I have worked with both, and I can say that while CBT has its helpful points, CBT often is at its most helpful when it's used as a supplement to psychodynamic therapy. I've found over time that psychodynamic therapy works much better for longer-term success because of its depth, and going at your pace. CBT generally seems to have short-term success (as CBT is a shorter term therapy that doesn't get to the deeper core of issues). CBT usually works well to provide coping skills for symptom management for certain issues while doing the deeper psychodynamic work.

Something that people often don't realize is that psychodynamic and psychoanalytic therapy also addresses your behaviors. The difference is that CBT believes that changing behaviors resolves mental and emotional struggles (sort-of a 'fake it till you make it' approach), whereas psychodynamic therapy understands that it's not nearly this simple (it's often very hard to create longer-term changes when you're struggling emotionally on a deeper level).

The way I've always described the difference between CBT and psychodynamic therapy is that CBT is the bandaid over the wound, and psychodynamic therapy cleans out and heals the wound. When the wound isn't healed, however, eventually the bandaid isn't enough.

Finding Help

I always recommend to be sure your therapist has been trained post-graduate in a certified psychoanalytic institute if you're looking for psychodynamic therapy, or "talk therapy". There are many therapists who abuse the term "talk therapy" and don't have the appropriate training or experience to truly provide an effective depth therapy. It's okay to ask a therapist when searching what their background or training is in.

#Psychotherapy #MentalHealth #Anxiety #Depression #Trauma #Phobia #Relationships

Complex Post-Traumatic Stress Disorder (C-PTSD), also known as complex trauma, generally stems from enduring repeated traumatic events, frequently within a close relationship, over an extended period.

Unlike single-incident PTSD, complex trauma can lead to a range of psychological and emotional challenges manifesting additional symptoms, including impaired emotional regulation, altered consciousness states, distorted self-perception, and relationship difficulties.

These challenges can significantly impact your daily functioning, relationship dynamics, and overall wellbeing.

Causes of Complex Trauma

Causes may include physical, sexual, or emotional abuse, consistent neglect (especially in childhood), bullying, exposure to domestic violence, or living through intensely threatening circumstances (such as war, for example). However, complex trauma can also develop in adulthood due to ongoing mistreatment, such as domestic violence.

Childhood Abuse or Neglect: Physical, emotional, sexual abuse, neglect, or bullying can have a profound impact on a child’s development.

Witnessing Violence: Exposure to violence, such as domestic violence of parents in your childhood, or community violence, such as repeated fights at school growing up, or worse, can be traumatic.

Prolonged Exposure to Traumatic Events: People who are repeatedly exposed to traumatic events, such as war or natural disasters, may also develop complex trauma.

How to Recognize Complex Trauma

Psychological and Emotional Symptoms

Complex trauma often manifests through intense emotional experiences, including deeper shame, guilt, or feelings of alienation. You may experience altered states of consciousness, such as memory gaps in adulthood when trying to recall parts of childhood, or a sense of detachment from your emotions or physical self. To cope, you might avoid certain places, people, or experiences in general that trigger discomfort.

Complex trauma can also affect your psychological wellbeing. You may experience a persistent sense of worthlessness and shame, significantly affecting your self-perception and self-esteem. Emotional regulation can become really challenging with C-PTSD, leading to outbursts of anger or prolonged periods of sadness. It can also lead to phobias and fears that seem to be irrational, or anxiety that danger is lurking in places (or people) even when they aren't displaying actual signs of danger. These issues can significantly disrupt social interactions and daily functioning, limiting your life, making healing a complex (but essential) journey.

Physiological Symptoms

Complex trauma can also manifest physically. You may experience hyperarousal, feeling constantly on edge with heightened startle responses. Physical symptoms often include panic attacks, light-headedness, brain fog, fatigue, nausea, recurrent headaches and migraines, persistent muscular tension, gastrointestinal distress on a consistent basis, and more. These stress-related reactions can significantly impact your daily functioning and overall health.

Healing

Complex PTSD needs a mind-body therapy approach rooted in trauma healing. While this should involve some coping techniques, a trauma approach generally requires getting to know and work through what you are carrying on a deeper level in order to reduce and be able to shed the power these traumas have asserted over your emotional, psychological, and physiological wellbeing.

Other Coping Strategies

Self-Care

Self-care plays an important role in managing complex trauma symptoms and enhancing overall wellbeing. This includes anything from diet, to regular physical activity, such as walking, running, yoga, or swimming, for example. Physical activity generally helps to reduce stress, release tension, and help with mood regulation. Self-care also includes finding things that nurture you in other emotional ways, as well -- for some this can be reading, writing, art and other creative outlets, seeing friends, and anything else that's helpful for you.

Trauma Therapy

Remember, self-care is an essential part of healing, but it doesn't replace the deeper healing work that needs to be done. Often people try to use coping techniques to replace the deeper healing, and what eventually tends to happen is the deeper traumas that go unaddressed start to grow and take over, and can make it so the coping tools are no longer as effective. It's important in therapy to figure out the coping techniques that work for you, so you also have them available to you alongside the deeper explorative work.

#complextrauma #Trauma #Anxiety #MentalHealth #Depression #Migraine

When I work with people on overcoming their fear of flying, there is almost a collective wish that it would always be a quick concrete solution. Of course, that's normal. Who doesn't want to be in-and-out for any issue that can involve debilitating anxiety and significantly limits your life? However, in reality, when it comes to flying anxiety, there are almost always varying elements and layers to the issue. And, for each person, what fuels the fear and anxiety around flying tends to be different from the person next to you. (You can each be afraid of turbulence, but for each person, where this stems from, what it means, and what it needs is often different).

Trust Issues Look For Catastrophe

Trust issues can have a heavy hand in fear of flying. When you have a hard time trusting, there is often the worry of what will happen if you were to allow yourself to be vulnerable. For example, you may not easily trust in relationships out of worry you will be hurt, left, taken advantage of, cheated on, etc. You may not trust the people fixing your car, providing you dental work, or anyone outside of yourself, even. Or, one of the most crippling forms of trust anxiety with flying -- the idea that humans are imperfect and limited as a species, and therefore something must be likely to go wrong. It may be almost automatic for some to see exactly how they are going to suffer, lose, or worse when allowing themselves to trust, or rely on others, or be vulnerable. This is a significant issue with fear of flying.

Trust Issues Often Start At Home

It's important to keep in mind that there are generally reasons for fear around trust. Most people who struggle with trust have either had distrust modeled for them from a young age, or they have been hurt before, or a combination of both. When it comes to fear of flying, trust issues often embedded from childhood can have a way of catching up and wreaking havoc. (Depending on the circumstances, they can also develop later on in ways that can impact fear of flying, as well). This can be especially difficult if you grew up in a home that didn't tend to feel safe on a regular basis -- where there was chaos, abuse, emotional shaming, or a sense of having to walk on eggshells for an emotionally volatile parent or sibling, or otherwise.

Either way, trust issues are complex. Because there likely have been times where trusting didn't work out, as a child or later on. You or someone else may have experienced deep pain from one experience or a collection of them. Some may even experience ongoing pain. Trust issues aren't all fantasy or paranoia. It becomes difficult though when you emotionally feel that the chances of catastrophe weigh equally (or greater) to the chance of being safe in certain situations. It is very possible that one's trust meter can be negatively skewed due to these past experiences -- and unnecessarily increasing your flying anxiety (or relationship anxiety, or otherwise), as a result.

The Plane Becomes The Momentary Home, Internally

When it has been baked in through critical stages of your life that the people you are relying on don't always feel capable of keeping you safe, it can be very hard to go into a vulnerable environment and be able to feel safe. Especially if you are in a position of being completely out of control of the situation, which is often how flying is experienced. When you don't know who's flying the plane, or if you can trust who's building and maintaining the plane, or if they really have your best interest in mind, fear becomes the next response, especially if you can't do anything but sit in your seat and wait. It can feel like you're just waiting for the shoe to drop and everything to fall apart.

This is why trust issues can often lead to panic in flying. If something doesn't go as smoothly as hoped -- turbulence, a flight delay, seat change, an uncooperative passenger, etc. -- it can start to feel like things are getting ready to break down. You start to see all of your worst fears and catastrophes playing out in your mind, and they feel very real.

You Can Let Go Of Trust Issues, While Staying Safe

Trust is only one of a number of possibilities that can make flying difficult for people. When wanting to overcome your fear of flying, it's important that you take the time to learn and come through what's feeding your own fear. No one can convince you that flying is safe when you're scared. Fear doesn't hear reason.

This is why I work from a deeper, more comprehensive and personalized approach to flying anxiety, that centers on you. It is also the reason that when I work with people, people often leave not only feeling better about flying, but also feeling less anxious, more grounded, and more trusting throughout their lives in general, even outside of flying. It is possible to move forward from this fear and open the world for yourself. Reach out if you'd like to discuss your situation or learn about how I can help you through this issue.

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