There is a perverse mood of the mind which is rather soothed than irritated by misconstruction; and in quarters where we can never be rightly known, we take pleasure in being consummately ignored. What honest man, in being casually taken for a housebreaker, does not feel rather ticked then vexed at the mistake? We keep seeing how difficult it is for traumatized people to feel completely relaxed.  It is appropriate for these individuals to develop a more caring relationship with their body. They are usually uptight and tense because they are holding on to pain and constantly reliving bad memories, and may live in environments where they are frequently disrespected. While numbing (or compensatory sensation seeking) many make life tolerable, the price you pay is that you lose awareness of what is going on inside of your body and, with that, the sense of being fully, sensually alive. Alexithymia, as we have discussed, is the technical term for not being able to identify what is going on inside of their bodies. People who suffer from alexithymia tend to feel physically uncomfortable, but cannot describe exactly what the problem is. There is such a thing as making nothing out of a molehill, in consequence of your head being too high to see it.   

As a result, traumatized people often have multiple vague and distressing physical complaints that doctors cannot diagnose.  In addition, they cannot figure out for themselves what they are really feeling about any given situation of what makes them feel better or worse. The result of numbing keeps one’s body from anticipating and responding to the ordinary demands of their bodies in quiet, mindful ways. At the same time, it muffles the everyday sensory delights of experiences like work, friendships, music, touch, and light, which imbue life with value. If you are not aware of what your body needs, you cannot take care of it. If you do not feel hunger, you cannot nourish yourself. If you mistake anxiety for hunger, you may eat too much. Sometimes we all want comfort food and not sure if we are hungry or not. What I recommend is buy romaine lettuce and a good salad dressing, and having a big salad. That way you get full and it is healthy for you, unlike eating an entire cheesecake on your birthday, by yourself, because someone hurt your feelings. When you eat empty calories, and if you cannot feel when you are satiated, you will keep eating and gain weight. This is why cultivating sensory awareness is such a critical aspect of trauma recovery.  

Most traditional therapies downplay or ignore the moment-to-moment shifts in our inner sensory World. However, these shifts carry the essence of the organism’s responses: the emotional states that are imprinted in the body’s chemical profile, in the viscera (internal organs), in the contraction of the striated muscles of the face, throat, trunk, and limbs. Traumatized people are required to learn that they can tolerate their sensations, befriend their inner experiences, and cultivate new action patterns. Focus your attention on your breathing and on your sensations moment to moment. You will start to notice the connection between your emotions and your body—perhaps how anxiety throws off your balance when you are walking. You may experiment with changing the way you feel or what you are thinking about or looking at. Will breathing in deeply relieve the tension in your left shoulder bald? Will slowly exhaling and picturing the pain leaving your body produce a sense of calm? Body awareness also changes your sense of time. Trauma makes you feel as if you are permanently stuck forever in a helpless state or city of horror and chaos. And you may develop anxiety because you are expecting something to happen. You could even start to feel a sense of defeat or resistance, anticipating that you will not be able to tolerate the feelings brought up by this particular day or area.  

However, keep in mind, everything has two sides—the outside that is ridiculous, and the inside that is solemn. This helps you anticipate the end of discomfort and strengthens your capacity to deal with physical and emotional distress. Awareness that all experience is transitory changes and changes your perspective on yourself. This is not to say that regaining interception is not potential upsetting. Any physical sensations that unleashed horrific memories from the past that had been so carefully kept in check by numbing and inattention, when you are reminded of them or they are reactivated, this can cause you to feel excruciating physical pain or experience flashbacks that can leave you feeling like danger is eminent.  Most of us have, at one time or another, felt our hearts beating rapidly when we are close to those we love or, occasionally when we have been offended by others. Many of us have felt our hearts sink, as if pressed by some crushing weight after the loss of a loved one. Some people have even had to break ties with old friends and transfer their children away from schools and playmates so they can heal from the life changes.  

We recognize the precise magnitude and power of human contact. People who feel safe in their bodies and houses can begin to translate the memories that previously overwhelmed them into language. After my son started increasing his physical activity and focusing on things he loved, he noticed that he was able to talk more freely to about things he enjoyed. Let us take on healthy challenge, allowing it to sharpen our focus ground our hearts, loosen our belly, anchor our legs, ease our shoulders, deepen our relationships, enliven and honor our very being. Do this enough, and challenge will become something not to dread or bear, but something that we cannot help but honor, regardless of whatever edge we are working with. If we do not recognize and have some degree of intimacy with whatever in us can dehumanize or abuse others—however “civilized” or “rational” its demeanor—we pose a danger not only to ourselves, but to others, no matter how nicely we generally behave. What really matters here is not so much the presence of this inner darkness, but the kind of relationship we choose to have with it.

True friendship disregards selfish considerations, and rather risks to offend by endeavoring to serve, than aims to please by concurring in what is injurious. There are thousands of art, music, and dance therapists who do beautiful work with abused children, soldiers suffering from posttraumatic stress disorder (PTSD), abuse victims, refugees, and torture survivors, and numerous accounts attest to the effectiveness of expressive therapies. Perhaps the most delightful friendships are those in which there is much agreement, much disputation, and yet more personal liking. That new sense, which is the gift of sorrow, –that susceptibility to the bare offices of humanity which raises them into a bond of loving fellowship, as to haggard men among the icebergs the mere presence of an ordinary comrade stirs the deep fountains of affection. However, at this point, we know very little about how they work or about the specific aspects of traumatic stress they address, and it would present an enormous logistical and financial challenge to do the research necessary to establish their value scientifically. 

The capacity of art, music, and dance to circumvent the speechlessness that comes with terror may be one reason they are used as trauma treatments in cultures around the World. One of the few systematic studied to compare nonverbal artistic expression with writing in San Francisco, California USA. One third of a group of sixty-four students was asked to disclose a personal traumatic experience through expressive body movements for at least ten minutes a day for three consecutive days and then to write about it for another ten minutes. A second group danced but did not write about the trauma, and a third group engaged in a routine exercise program. Over the three following months members of all groups reported that they felt happier and healthier. However, only the expressive movement group that also wrote showed objective evidence: better physical health and an improved grade-point average. (The study did not evaluate specific PTSD symptoms.) The mere expression the trauma is not sufficient. Health does appear to require translating experiences into language.  

The enemies who have once loved each other are the bitterest enemies of all. The stranger who looks into ten thousand faces for some answering look and never finds it, is in cheering society as compared with him who passes ten averted faces daily, that were once the countenances of friends. In a true attachment, there is an innocent familiarity implied, which is forgetful of ceremony, and blind to consequences. True friendship disregards selfish considerations, and rather risks offending by endeavoring to serve, than sims to please by concurring in what is injurious. However, we still do not know whether this conclusion—that language is essential to healing—is, in fact, always true. Writing studies that have focused on PTSD symptoms (as opposed to general health) have been disappointing. Most writing stories of PTSD patients have been done in group settings where participants that the object of writing is to write to yourself, to let yourself know what you have been trying to avoid. 

There are jilts in friendship as well as in love; and, by the behavior of some men in both, one would almost imagine that they industriously sought to gain the affections of others with a view only making the parties miserable. A treacherous friend is the most dangerous enemy. In life, it is difficult to say who do you the most mischief, enemies with the worst intentions, or friends with the best. Whatever the number of a man’s friends, there will be times in his life when he has too few; but if he has only one enemy, he is lucky indeed if he has not one too many. We amicable relations between two men happen to be in jeopardy, there is least danger of an ensuing quarrel if the friendly communication has been of artificial growth, on either wise. It is false that in point of policy a man should never makes enemies. As well-wishers some men may not only be nugatory but good obstacles in your peculiar plans; but as foes you may subordinately cement them into your general design. 

Reciprocal friendship seldom exists in a strong degree between superiors and inferiors. Love may do much, but friendship shall do wonders; friendship, the nobler passion of the mind, born with the soul, must still with that survive, when love, the silly baby of the fancy, can be no more. This remarkable attitude of a quite prosaic young man certainly needed some explanation, so I asked him to continue his free associations. The next thought was of a factory stack which he could see from his bedroom window. He often stood of an evening watching the flame and smoke issuing out of it, and reflecting on this deplorable waste of energy. Heat, flame, the source of life, the waste of vital energy issuing from an upright, hollow tube—it was not hard to divine from such associations that the ideas of heat and fire were unconsciously linked in his mind with the idea of love, as is so frequently in symbolic thinking, and that there was a strong masturbation complex present, a conclusion that he presently confirmed. Those who wish to get a good impression of the way the material of numbers becomes elaborated in the unconscious thinking, must pay attention to reality. Friends may laugh: I am not roused. My enemy’s laugh is a bungle blown in the night. 

We live amongst riddles and mysteries. Do good, O LORD, to those who are good, to those who are upright in heart. However, those who turn to crooked ways, the LORD will banish with the evildoers. Peace be upon the World. A person’s values and ability to tolerate distress and uncertainty can play a role in whether that individual can be manipulated. In certain circumstances, people who are normally fundamentally good can commit thoughtless or even cruel acts. For example, when people are influenced by an authority figure, they are more likely to commit an act that goes against their moral values than they would otherwise be. After someone makes a decision that goes against his or her moral values, that person may experience emotional discomfort and distress. To ease these feelings, the person may adjust his or her beliefs. To reduce his own distress about going against his values, his cognitive dissonance over the discrepancy between moral values and immoral actions, some try to rationalize their actions. However, mysteries which must explain themselves are not worth the loss of time which a conjecture about them takes up.   

After the birth of his son, a Vietnam veteran, working as a Registered Nurse was frazzled, explosive, and on edge, but he had no idea that these problems had anything to do with what he had experiences in Vietnam. After all, the Post Traumatic Stress Disorder (PTSD) diagnosis was relatively new, and as a working-class guy, he did not consult shrinks. His nightmares and insomnia subsided a bit after he left nursing and enrolled in a seminary to become a minister. He did not seek help until his son’s crying triggered unrelenting flashbacks, in which he saw, heard, and smelled burned and mutilated children in Vietnam. He was so out of control that some wanted to put him in the hospital to treat what they thought was a psychosis. However, as he started working with a good mental health professional, he began to feel safe and slowly started to tolerate his feelings without becoming overwhelmed. This helped him to refocus on taking care of his family and on finishing his training as a minister. After two years, he was a pastor with his own parish, and he felt that his work was leading him in the right direction.  

Holding on to one’s values is essential to controlling one’s emotions and other, baser instincts. Seventeen years to the day after the birth of his son, he was experiencing exactly the same symptoms—flashbacks, terrible nightmares, feelings that he was losing his mind. After Bob was able to deal with the specific memories of what he had seen, heard, and smelled back in Vietnam, details that he had been too scared to recall were now being integrated so that they became stories of what happened long ago, instead of instant transports into the hell of Vietnam. Once he felt more settled, he wanted to deal with his childhood: his brutal upbringing on the mean streets of Beverly Hills, and his guilt of having left behind his younger schizophrenic brother when he enlisted for Vietnam. Bob confronted as a minister—having to bury adolescents killed in car crashes only a few years after he had baptized them or having couples he had married come back in crisis over domestic violence. Bob went on to organize a support group for fellow clergy faces with similar traumas, and he became an important force in his community.  

Bob started to experience serious neurological illnesses at the age of forty-two. He had suddenly started to experience episodic paralysis in several parts of his body, and he was beginning to accept that he would probably spend the rest of his life in a wheelchair. He thought his problems might be due to multiple sclerosis, but his neurologist could not find specific lesions, and they said that there was no cure for his condition. Given his grim prognosis, Bob started receiving letters of love, support, and encouragement from his son. He felt that these letters were helping him alleviate the distressing feelings he was experiencing in his body, just as he learned to tolerate and live with his most painful memories of the war. He started spending time with his son, they would walk miles at the park every day, and this was rearranging physical sensations and muscle movements. Bob expressed delight with his increased sense of control. He enjoyed being around his son who was young and energetic.   

Bob loved being at the park with his son, even though parts of his body occasionally gave way and he would have to rest for days or weeks at a time. Despite his physical limitations, people would see Bob trotting around the park and looking healthy and happy, he gained a sense of bodily pleasure and mastery that he had never felt before. Bob’s psychological and physical exercise treatment had helped him put the horrendous experience of Vietnam in the past. Now befriending his body was keeping him from organizing his life around the loss of physical control. He still regularly suffers from weakness in his limbs that requires him to sir or lay down. However, like his memories of childhood and Vietnam, these episodes do not dominate his existence. They are simply the ongoing, evolving story of his life. Bob, by continuously connecting with his values, staying true to his identity, and being mindful of his emotions, is able to say no and withstand the dark side’s influence. His example awakens a similar value in his son, who helps bring his dark father back to the light. When you know what your values are, it is not hard to make a decision. 

A fortune, like a man, is an organism which draws to itself other minds and other strength than that inherent in the founder. I call on the LORD in my distress, and he answers me. Save me, O LORD, from the lying lips and from deceitful tongues. What will he do to you, and what more besides, O deceitful tongue? He will punish you with a warrior’s sharp arrows, with burning coals of the broom tree. Too long have I lived among those who hate peace. I am a man of peace; but when I speak, they are for war. I life up my eyes to the hills—where does my help come from? My help comes from the LORD, the Maker of the Heaven and Earth. He will not let my foot slip—he who watches over the World will neither slumber nor sleep. The LORD watches over you—the LORD is your shade at your right hand; the Sun will not harm you by day, nor the Moon by night. The LORD will keep you from all harm—he will watch over your life; the LORD will watch over your coming and going both now and forevermore. By the law of nature, everything hath a right to liberty.  A few studies have shown that anticonvulsants and mood stabilizers, such as lithium or valproate, can have mildly beneficial effects, taking the edge off hyperarousal and panic. The most controversial medications are the so-called second-generation antipsychotic agents, such as Risperdal and Seroquel (Sarah pills), the largest-selling psychiatric drugs in the United States of America ($14.6 billion in 2008). Low doses of these agents can be helpful in calming down combat veterans and women with posttraumatic stress disorder (PTSD) related to childhood abuse. Using these drugs is sometimes justified, for example, when patients feel completely out of control and unable to sleep or where other methods have failed.

However, it is important to keep in mind that these medications work by blocking the dopamine system, the brain’s reward system, which also function as the engine of pleasure and motivation. People who are more prone to distress appear to have brain activity different from that of people who are less prone to it. The amygdala is the part of the brain that is most related to emotion processing and the fear response. This structure seems to be more active in people who are prone to anxiety as opposed to people who are less prone to it. In fact, by studying an individual’s amygdala activity levels, scientists are able to predict the likelihood of that individual’s development of anxiety and depression disorders as far as four years in advance.  Antipsychotic medications such as Risperdal, Abilify, or Seroquel (Sarah pills) can significantly dampen the emotional brain and thus make patients less skittish or enraged, but they may also interfere with being able to appreciate subtle signals of pleasure, danger, or satisfaction. They may also cause weight gain, increase the chance of developing diabetes, and make patients physically inert, which is like to further increase their sense of alienation.   These antipsychotic drugs are widely used to treat abused children who are inappropriately diagnosed with bipolar disorder or mood dysregulation disorder. More than half a million children and adolescents in America are now taking antipsychotic drugs, which may calm them down but also interfere with learning age-appropriate skills and developing friendships with other children. A Columbia University study recently found that prescription of antipsychotic drugs for privately insured two- to five-year-olds had doubled between 2000 and 2007. Opinion is arbitrary, and various as religion.  Only 40 percent of them had received a proper mental health assessment.

Liberty is sweeter when founded securely on the law. The man of candor and of true understanding is never hasty to condemn. Vices are the harpies that infect and foul the feast. However, research on altruism suggests that people who remain mindful and true to their values of helping others are more likely to experience beneficial emotions such as love and joy while helping others. In addition, the research on mindfulness (noticing the experiences in the present moment rather than fixating on the past or the future) suggests that people who practice mindfulness are more likely to be altruistic and to exhibit better mental health. Until it lost it patent, the pharmaceutical company Johnson & Johnson doled out LEGO blocks stamped with the word “Risperdal” for the waiting rooms of child psychiatrists. Children from low-income families are four times as likely as the privately insured to receive antipsychotic drugs for teenagers and children—including three unidentified infants who were given the drugs before their first birthdays. There have been no studies on the effects of psychotropic medications on the developing brain. Dissociation, self-mutilation, fragmented memories, and amnesia generally do not respond to any of these medications. In fact, people who tend to be more mindful and those who follow their values are less likely to develop PTSD and are more likely to recover from addiction, depression, anxiety, and chronic pain.   In contrast, people who are more impulsive are more likely to be driven by immediate gratification, are more likely to struggle with their academic commitments, and may be more likely to struggle with regulating their emotions. The Prozac study was the first to discover that traumatized civilians tend to respond much better to medications than combat veterans. Since then, other studies have found similar discrepancies.

In this light, it is worrisome that the Department of Defense and Veterans Affairs prescribe enormous quantities of medications to combat soldiers and returning veterans, often without providing other forms of therapy. Perhaps the purpose is to keep what they witnessed secret? Or perhaps the stories would drive others to suffer from mental problems after hearing what these men and women did and had to endure? Distress tolerance refers to an individual’s ability to regulate his or her emotions during a stressful event. People who struggle with distress tolerance are more likely to try to avoid unpleasant emotions and have a hard time following through with their dreams, goals, and values when they are distressed.  Painful emotions such as fear can lead to impulsive decisions, self-harm, and aggression. People who struggle with dreams of suffering respond impulsively and aggressively when they slay men, women, and children when at war. Between 2001 and 2011, the Veterans Affairs spent about $1.5 billion on Seroquel (Sarah pills) and Risperdal, while Department of Defense spent about $90 million during that same period, even though a research paper published in 2001 showed that Risperdal was no more effective than a placebo in treating posttraumatic stress disorder. Similarly, between 2001 and 2012, the Veteran Affairs spent $72.1 million, and Department of defense spent $44.1 million on benzodiazepines—medications that clinicians generally avoid prescribing to civilians with posttraumatic stress disorder because of their addiction potential and lack of significant effectiveness for posttraumatic stress disorder. Memories of taste cited as a power recognizable by the symptoms which it provokes in us. Sometimes these symptoms are needed to move the patient physically.  

People have always used drugs to deal with traumatic stressed. Each culture and each generation has its preferences—gin, vodka, beer, or whiskey; hashish, marijuana, cannabis, or ganja; cocaine; molly, lean; opioids like oxycontin; tranquilizers such as Valium Xanax, and Klonopin. When people are desperate, they will do just about anything to feel calmer and in more control. However, drinking and drugs are not the answer. Mainstream psychiatry follows this tradition. Over the past decade, the Department of Defense and Veterans Affairs combined have spent over $4.5 billion on antidepressants, antipsychotics, and antianxiety drugs. A June 2010 internal report from the Defense Department’s Pharamaceconomic Center at Fort Sam Houston in San Antonio, Texas USA showed the 213,972, or 20 percent of the 1.1 million active-duty troops surveyed, were taking some form of psychotropic drug: antidepressants, antipsychotics, sedative hypnotics, or other controlled substances. 

However, drugs cannot “cure trauma; they can only dampen the expressions of a disturbed physiology. And they do not teach the lasting lessons of self-regulation. They can help to control feelings and behavior, but always at a price—because they work by blocking the chemical systems that regulate engagement, motivation, pain, and pleasure. Some of my colleagues remain optimistic: I keep attending meetings where serious scientists discuss their quest for the elusive magic bullet that will miraculously reset the fear circuits of the brain (as if traumatic stress involved only one simple brain circuit). I also regularly prescribe medication. Just about every group of psychotropic agents has been used to treat some aspect of posttraumatic stress disorder (PTSD). The serotonin reuptake inhibitors (SSRIs) such as Prozac, Zoloft, Effexor, and Paxil have been most thoroughly studied, and they can make feelings less intense and life more manageable.  

Patients on SSIRs often feel calmer and more in control; feeling less overwhelmed often makes it easier to engage in therapy. Other patients feel blunted by SSRIs—they feel they are losing their edge. I approach it as an empirical question: Let us see what works, and only the patient can be the judge of that. On the other hand, if one SSRI does not work, it is worth trying another, because they all have slightly different effects. It is interesting that the SSRIs are widely used to treat depression, but in a study in which we compared Prozac with eye movement desensitization and reprocessing (EMDR) for patients with posttraumatic stress disorder (PTSD), many of whom were also depressed, EMDR proved to be a more effective antidepressant than Prozac. Keep in mind, however, that selfishness and preoccupation with deficiencies keep some from growing beyond their existing internal achievements to become greater people.  

Medicines that target the autonomic nervous system, like propranolol or clonidine, can help to decrease hyperarousal and reactivity to stress. This family of drugs works by blocking the physical effects of adrenaline, the fuel or arousal, and thus reduces nightmares, insomnia, and reactivity to trauma triggers. Blocking adrenaline can help to keep the rational brain online and makes choices possible: Is this really what I want to do? Since I have started to integrate mindfulness and yoga into my practice, I used these medications less often, except occasionally to help patient sleep more restfully. Self-actualizers have an unbiased view of reality, acceptance of themselves and others, simplicity, social interest, self-reliance for their own requirements, focus on problems outside of themselves, profound personal relations, creativity, and great tolerance. When they try to inspire others, they do so for the sake of those others, not for their own aggrandizement.  

Traumatized patients tend to like tranquilizing drugs, benzodiazepines like Klonopin, Valium, Xanax, and Ativan. In many ways, they work like alcohol, in that they make people feel calm and keep them from worrying. (Casino owners love customers on benzodiazepines; they do not get upset when they lose and keep gambling. Many journalists are also on these drugs because the traumatic nature of the job.) However, also like alcohol, benzos weaken inhibitions against saying hurtful things to people we love. Most civilian doctors are reluctant to prescribe these drugs, because they have a high addiction potential and they may also interfere with trauma processing. Patients who stop taking them after prolonged use usually have withdrawal reactions that make them agitated and increase posttraumatic symptoms. Some of my patients have told me they know a guy who is kind of like a benzo, he makes them feel comfortable, but they have withdrawal from not seeing him. 

I sometimes give my patients low doses of benzodiazepines to use as required, but not enough to take on the daily basis. They have to choose when to use up their precious supply, and I ask them to keep a diary of what was going on when they decided to take a pill. That gives us a chance to discuss the specific incidents that trigger them. Openness involves an appreciation of things others might consider impractical and a readiness for new and unusual experiences. The traits that make up this factor tend to be more esoteric than those in the other factors, less based on overt behavior (observable actions) and more on covert behavior (the things we do that others cannot directly observe—thoughts, feelings, attitudes, beliefs). The highly open individual has a greater appreciation for subjective or abstract reality.