Could you explain the topic to us in a little more detail.
I think that’s a very interesting thing that sometimes we think that trauma and phobias are kind of very specific to specific nations or areas of the world. I was back in South Africa a few years ago to do a refresher on one of the BWRT levels. And I bumped into the trainer who’s wife looked at me and said ” Really New Zealand, what trauma do they have there? “. It’s interesting that as people we have this idea that trauma is specific to certain areas of the world. Or doesn’t happen in other areas.
I predominantly work with trauma in my private practice. And I only see trauma and sexual abuse victims. I also work with the New Zealand department of corrections and invariably it’s the same kind of thing within the prison systems. I also worked for the department of corrections in South Africa and in both areas there is trauma across the board.
Humans have very different, but also very similar ways of responding to trauma. This is a topic with many rabbit holes that you can go down. And the more you understand the greater the impact you can have in people’s lives.
So when you think about traumas, phobias, anxiety, that kind of thing. Just to lay the basic groundwork there. I think the first thing that’s probably the most important thing to recognize is that that’s a completely natural and adaptive response of our brains and bodies. That’s how we got to be so successful. Is we’ve got this threat detection system, that when it works, well, it keeps us alive, and it keeps us safe.
And it’s interesting, we can kind of get into the nitty gritty as well. But it’s when that gets overtaxed in specific ways, or we overestimate using the most animalistic part of our brain. Our brain also has ways of tricking the early part of the brain to think that things are more dangerous, or threatening. Then they may they are, and then that’s where that kind of disconnect happens.
Have you always been facinated with the topic of phobias and trauma.
I stumbled across it because I worked in Upington in the Northern Cape where I grew up. The Department of Corrections came to me and advised they had not had a prison psychologist for four years. They needed one, it was something I didn’t anticipate but it just kind of went there. And quickly realized I had a knack for that kind of work because I was able to tolerate it. It was difficult work to do, but I enjoyed it. And began to realize the breadth of trauma that the prisoners had gone through and had perpetrated against other people.
It’s such a complex thing to experience and go through when you work in the prison system. Because there is so much work to be done and they are so under-resourced that you use everything you can to help. So I stumbled across BWRT, and trained in that as an additional resource. And realized how effective that was working with specific types of trauma, anxiety and phobias.
And I think in New Zealand, I kind of jumped in corrections again because I really liked the book. But also there’s kind of specific contracts that they have for specific types of problems here. And one of them is kind of a sexual abuse specific one. So I jumped into that because I just kind of feel like my skill set kind of works towards that. And so and it is interesting and super rewarding. When you can help someone understand the trauma, and kind of make sense of that. And then also help them alleviate some of that. So a tangential way of describing it. But yeah, it’s kind of happenstance, but I’ve gotten stuck here, but I’m enjoying the work.
What is intergenerational trauma.
I think that in intergenerational trauma, I’ve seen hundreds and hundreds of clients, in treatment, for assessments, and corrections. And I may have only seen a handful of people where I can’t figure out, how this person got on to this. A lot of the time when you hear someone’s history, look at that you’re like, wow, you know, it’s difficult to see how you couldn’t have gone through this. I think the problem is a lot of people do go through that kind of trauma. But sometimes you can really just see, it makes so much sense that what they’ve gone through is also what their parents have gone through. And their parent’s parents and, it’s all they know, it’s a model to them.
And it’s always that it is nature and nurture because it’s the kind of temperament when they’re growing up. It also depends on how they respond to it or even birth order. If you’re the oldest child, and mum, is violent towards your dad or father towards mum, then the oldest child is kind of expected to stand up. So he may receive the brunt of the violence, which then creates this kind of aggressive side to come out. And that leads to even more kind of pathology and around that. So it’s rare that you see someone in prison, especially for serious crime, where you look at the history and you say, oh, there’s nothing here is this. Most of the time, there’s a lot to empathize with.
Does physical harm cause mental health problems.
It definitely can, I think it depends on what kind of physical harm or physical trauma happens. If you’re kind of thinking at a very basic level if you’re in a car accident. And you are debilitated or there’s chronic pain or you lose a limb or anything like that. That definitely leads to, mental illness or mental health problems that could lead to depression or self-esteem issues.
So that in itself could be the actual traumatic event as well could possibly lead to something akin to PTSD. Where, you have this life-threatening situation happen, and you felt completely out of control. And I think that’s kind of core aspects of, developing negative consequences from a traumatic event. Is it’s not only something that’s life-threatening but also to be completely helpless. I think that that’s a very bad prognostic factor, for someone developing PTSD. So definitely it could, depending on on the person, depending on the specific characteristics, their temperament and personality, and then actually what happens as well. Some people have just the ability to shrug that off and move on and, and some people struggle, and it’s just, been different.
How do phobias tie into mental health issues.
I like to kind of think of phobias and fears or kind of phobias, and anxiety, it’s a little bit kind of in the same plane. Also as PTSD to extent, but due to extreme wear, phobias is sometimes linked to a very bad memory of a specific event. Where pretty much the same happens where a very specific stimulus might have.
Or it could be that when you were five or six years old, it could be this incident where a dog bites you. And that’s, like, extremely terrifying. Then in your kind of threat perception is anything that is dog or dog like, is in a massive threat. And that’s not something you can conjure up in your prefrontal cortex. You don’t think about it, it’s something that is kind of comes bottom up. So from the brainstem and cerebellum, it’s like, it’s an instant kind of fight flight or freeze reaction.
That’s why you know, that that’s such an extreme thing, that phobia. When it becomes a phobia, you would have the same reaction to a Rottweiler, that’s almost as big as you as to would to a chihuahua. So it’s an inappropriate estimation of the level of risk and level of threats. So you respond to both of those stimuli in the same exact life threatening manner to absolutely avoid and go away. Everything in your body praises, emotions, kind of physiological response presses you to just get, get out of there. Whereas, that’s basically not appropriate or not kind of a good estimate of what that is, or what, the threat is.
When would a fear become a phobia.
I think it’s about proportionality. Like it’s, it’s when when your brain struggles to differentiate the levels, and it’s just anything related to that specific type of stimulus. Anything dog like that could then become anything and animal like or cat like, or anything like that. So it’s then just that overgeneralization that can happen.
So I think at that point, where it just is actually actually not proportionate to to the level of threat. Like you said, is an appropriate level of threat for you know, a dog that may be dangerous. So you could have fear, or you could be cautious. You know, it’s probably not good to be over, you know, over confident in terms of all dogs, because that’s not going to be good for you, as well. So it is, it’s that proportionality. So I guess that’s kind of where the pathology versus the adaptive function comes in. When it’s not appropriate to the actual stimulus, and then it becomes a problem then becomes, then it hampers your functioning.
Is there a correlation between phobias and PTSD.
I think, they feel like they are kind of distinct things. And there’s obviously some overlap, sometimes kind of phobic responses. So that kind of extreme fear responses can be definitely part of PTSD in some some cases. But not necessarily, so it kind of overlaps, but they’re not necessarily same thing.
Phobic responses in the Diagnostic and Statistical Manual, the DSM, our kind of psychological psychiatric Bible, in a sense, talks about specific phobias. So it’s quite a very specific thing, say, a phobia of snakes. You want to say irrational, but then disproportionate fear of, something specific, that can have kind of a traumatic memory or difficult memory attached to it? Or sometimes with things like snakes, there is kind of an appropriate level of fear as well. So it doesn’t necessarily have to have like one specific memory.
But PTSD, when you diagnose that, it’s got a range of, specific features that describe the syndrome. There’s different ways of thinking about it. But if you diagnose Post Traumatic Stress Disorder, you know, you’ve got, first of all this traumatic incident that happened that’s kind of, life threatening or perceived to be life threatening. And then you’ve got three different aspects to it. You’ve got the re experiencing where they either have flashbacks where they feel like they’re back there, or just intrusive thoughts. So a re experiencing memory kind of playing in their mind, very actively or just kind of intrusively. And then there’s also an avoidance. So this, you can have anything that related to it.
So similar to phobias, but a little bit more general. You know, can be just anything related can be colors can be smells, whatever is related to the traumatic incident. And then the last one is heightened vigilance. So just kind of, like overall just being more hyper vigilant when anything comes to that. So it’s almost kind of a broader thing than a kind of specific phobia.
Would emotional trauma or abuse have similar reactions or responses to physical trauma or abuse as somebody grows up?
Mostly, definitely, I think you see slightly different responses. They are sometimes equally negative. I have worked with lots of clients in the past as well who’ve had just chaotic, early environments where there was no physical trauma, there was no sexual abuse, physical abuse, that just kind of the emotional abuse that dad suffered at the hands of siblings of parents of you know, kind of uncles and Auntie’s or people in the you know, or bullying. And even that kind of psychological trauma.
Once again, if we think about it, it affects your sense of self, it affects how you see the world in effects how you engage with the world, if you feel like you know, you’re not worth it, or you can’t trust anyone that severely limits the kind of relationships that you can have, or, or, you know, that though, that how open you can be in general in life and, you know, go for new things. So, yeah, emotional trauma definitely does create, like a range of problems and can very similar effects to that.
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