We have read thousands of articles, studies and theories about the growing obesity problem in our country and many of them have some validity. But the one newly identified physiological cause is shock.
More and more Americans are realizing that, yes indeed, we do have trauma and it is time to address it. And there is a growing category of previously unacknowledged people who have daily and insidious trauma: all the first responders in our culture such as critical incident responders, therapists, medical personnel such as doctors and nurses, fire and police men and women, ambulance drivers, crisis workers, psychologists, social workers, combat veterans and now we need to include journalists who travel the world to bring back news of war and other threatening situations. There are literally millions of workers who experience vicarious trauma, or secondary trauma, everyday which goes completely unnoticed and therefore untreated.
Therapists listen to and respond daily to people who have been seriously sexually and physically abused. These professionals take on to some degree the fears and traumas of millions of patients who tell their stories of domestic violence, being bullied, becoming homeless and on and on. They witness the effects that these traumatic events have on family members, including children. Because of extreme insurance coverage restrictions, they are mostly able to put Band-Aids on horrific wounds.
And then there are all the doctors, nurses, emergency room technicians and EMT’s. Statistics show that these professions have a high rate of alcoholism, drug abuse and obesity (especially nurses). Because of easy access to drugs, self medication is rampant in hospitals and medical facilities. An example is an oncologist who recently committed suicide. The investigation showed that of course he was having to give the horrible, most dreaded diagnosis to his patients and their loved ones multiple times every day: “I’m sorry to have to tell you this, but you have cancer!” This doctor began to numb his pain with drugs combined with alcohol at night. Then one day he was faced with the diagnosis that his beloved wife had an incurable form of breast cancer. It was more than he could bear and he overdosed soon afterwards.
The body’s physiological reaction to this insidious trauma is called shock. On a daily basis all these first responders (as we shall call them for this article) are in situations where they must respond quickly to the many traumatic events daily. The body usually goes into sympathetic activation which is the well know fight or flight syndrome. We move quickly, a “cocktail of hormones” is released into our bodies and we find solutions. This is why we are so well equipped to be first responders, because most of us in these professions have been responding to one crisis after another since we were small children.
Going into this stress response is not a problem; in fact, it is necessary in order to be able to “get the job done”. When first responders are faced with traumatic situations on a daily basis with no relief in sight, their stress levels build as an adaptive preparation to deal with the situation. Only when the stress is prolonged or becomes chronic does it become debilitating. For example, responses to acute stress facilitate wound healing, while responses to chronic stress impede recovery, according to 2009 research by Firdaus Dhabhar published under the title Enhancing Versus Suppressive Effects of Stress on Immune Function.
The problem is not going into this stress response, but rather not coming out of it. Stress becomes chronic and therefore harmful when it is undissipated and stored in the body as muscular tension, digestive dysfunction, and nervous system shock. As psychiatrist Robert Scaer says, “The syndrome of trauma has now literally taken control of the body.” Our body knows when there is an imbalance, and the body, with a logic all its own, often attempts to create counterbalance through accidents, disease, pain or disability: “If I can’t get him to slow down from this unsustainably stressful pace, I’ll just have to ____________.” To repair the damage we must discharge the accumulated stress tension, and to maintain ongoing physical and mental health each day we must create ways to discharge that energy on a regular basis. The first responder, unconsciously, is determined to take back that control.
However, in using substances and behaviors to “take back control”, the individual is unfortunately blocking the necessary "discharge" of the undissipated trauma-response energy. When the imbalance is too much stored sympathetic energy (hypervigilance and irritability), the remedy is to activate the parasympathetic system as a counterbalance. And food or drink is the easiest and most readily available way to accomplish that, especially sugars and carbohydrates. When the imbalance is too much stored parasympathetic energy (numbing, withdrawal and flattened affect), the remedy is to activate the sympathetic system as a counterbalance. For many, some stimulant type of substance is ingested, the most common being coffee, energy drinks, caffeinated colas, and chocolate. And the means is available at every Starbucks, corner candy store, bakery or drug store. Tobacco and sugar can serve to activate both systems, so it can calm the nerves of someone overexcited, and it can stimulate someone whose energy is fading.
Obviously maintaining this incessant pattern of self-medication of our physiological states of shock, day in and day out would cause a person to gain weight that could not be controlled by a diet. It would change social drinking into addictive drinking and cause occasional drug users to become addicts.
No wonder it is so difficult to change these habitual or addictive patterns: continuing them we get the twofold “benefit” of (1) temporary relief from the distressing overwhelm of vicarious stress and trauma; and (2) the illusion of control in an area of life that seems out-of-control. These addictive behaviors are “self-medication”, and the obesity or alcohol/drug dependence are just side effect nuisances of the “medication”. And this is what we believe has fuelled the major food, drug and alcohol addictions so prevalent in our country. We look around and wonder why so many Americans are obese. Unrecognized and untreated shock could certainly contribute to these addictive behaviors.
There are resources to assist traumatized first responders, self-care ways of helping the individual to release the stress, keeping it from becoming chronic and debilitating, and preventing symptoms of secondary trauma: traumatic event debriefing, when it is available; regular exercise; fulfilling hobbies or pastimes; drawing clear boundaries between “work” and “personal” time.
Hypnotherapy, and specifically Heart-Centered Hypnotherapy, is a “real” treatment for helping individuals such as first responders to repair the damage to the body and the mind by the accumulated stress and vicarious trauma. The chronic state of shock or secondary traumatic stress as it is sometimes called can be reversed and healed through this powerful body-centered deep therapy.
Please read the follow up Blog to this one in which we speak about the ways all of us can increase our experience of vicarious resilience, and promote trauma stewardship. And you can order our new book, soon to be released by New Horizon Press, Overcoming Shock: Healing the Traumatized Mind and Heart.