Monday, January 30, 2012

Understanding the Freezing Response in PTSD in order to Better Understand the Behaviors of the Survivors of Hephzibah House

This post seeks to explore the freezing response in trauma in order better understand why a survivor of trauma at Hephzibah House (HH) would have experienced confusing and constricted responses to threat. Survivors of HH specifically report that their responses to threats become flattened or frozen after leaving HH, specifically reporting a freezing response to threatened sexual assault.

Review of the Survival Response

When confronted with a traumatic or threatening situation, as discussed at length in a recent post, the brain of a person responds by activating a survival response which is profoundly physical in nature. If a person stopped to think about and plan a response to the threat, chances are that they would not be able to respond quickly enough to survive the threat. The brain's analytical or critical thinking faculties suspend momentarily, and lower brain structures kick in, enhancing the speed of physical response.

Before advances in science allowed better observation regarding the brain's response to threat, science took note of the “fight or flight” response. When faced with a serious threat, the body started into a cascade of hormones and neurotransmitters which enable the body to flee or to fight. The autonomic nervous system (the automatic system that governs unconscious physical response) shunts blood away from the gut and to skeletal muscle and brain, as the body releases hormones that raise blood pressure, heart rate, and blood sugar as they also speed the response of nervous tissue. It makes energy and oxygen available to the systems of the body that play the greatest role in either running from or resisting a threat.

Please take note: The mind processes psychological threat or perceived threat in the same way that it does a physical one, and the same cascade of neurotransmitters and hormones plays out, even if an individual is not in a situation where they would need to physically run or fight. The mind and body processes these threats in the same manner. Also note that these are not chosen responses but are deeply physiologic, and they actually bypass critical thinking or choice.

Chronic Stress

Those who cope with chronic experiences of trauma are often faced with these types of responses on a regular basis. The body cannot maintain this high level of energy and stress for long periods of time, and over time, the body learns to adapt because the pressure and stress becomes to great. The Doctrine Over Person response, redacting one's personal history and preferences, demonstrates one way in which a person adapts to the high level of stress created within a system of thought reform or spiritual abuse. And as previously discussed, some of these responses that result in a psychological change result from a physiologic cause.

Please recall our previous discussion of dissociation which can occur as a coping mechanism in response to trauma, a creative response of the mind which in some way removes the affected person from the threat. In the presence of an extreme threat, dissociation allows a person to feel emotionally removed somewhat from events so that they can appropriately respond to immediate and limited threats. However, in situations where a person operates under daily threat and constant pressure, dissociation becomes that affected person's new “normal state.” People remain in this altered state of consciousness, and the experience also alters the normal growth of children by their normal inhibiting the development of the full scope of their problem-solving and analytical thought. A prolonged trauma state also interferes with the adult's ability to maintain high levels of thought, as is true in depression and other conditions that affect blood flow and activity in the brain and mind.

This sense of feeling a little removed from reality becomes a type of escape from the overwhelming pain that the traumatized person experiences all the time. When chronic, this state of mind which is normally a healthy coping mechanism becomes problematic. People who develop Post Traumatic Stress Disorder (when the survival response fails to shut down after a threat has passed) and people who exit high demand groups that demand their compliance (including spiritually abusive Evangelical Christian groups which use manipulation against their followers) remain in chronic dissociative states. Spiritual abuse does constitute a type of psychological, emotional and spiritual trauma, producing the same types of symptoms. It creates a dreamlike sensation that suppresses a full state of mental acuity which allows the person under pressure to continue to function and remain productive.

Consider also what takes place in the brain and body when it must operate under constant high stress. The body resets itself and changes the way that it responds to certain hormones and neurotransmitters. Think of an unfamiliar noise that you hear in an new environment that is a part of it. If you grew up in the country away from traffic and then moved to a city where you could hear the sound of the traffic in your bedroom at night, for some time after relocating, that sound acts as a disturbance – until your brain learns to adapt.

A similar adaptation takes place in the body's production of neurotransmitters/hormones, its responses to those chemicals and how it responds to impulses related to stress. (An adaptation of the body we associate with high stress that is affected by these hormonal changes can be hypertension.) When under constant high levels of stress, the body readjusts its baseline to maintain function, but that function has been altered and is not ideal. The brain no longer responds to stress in the normal way. Some neurochemical production drops, some increases, and the degree of physical response can change also. There is so much cortisol all the time, it essentially becomes meaningless to the normal systems, so the body adapts to maintain the ability to respond immediately to serious threat, preserving that survival response as much as possible. But consider that chronic stress alters that system and how well it responds.

Previous Threat and Learned Helplessness

We have also already discussed that PTSD more frequently develops when a person's efforts to protect themselves becomes thwarted in some way. The intricate and marvelous system which involves generating a great deal of emotional energy as well as physical energy on a purely physical level sometimes fails to result in a beneficial outcome. That energy must go somewhere, and releasing that kind of energy is sometimes referred to as “blowing off steam.” When the release of energy doesn't result in protection in response to a trauma, if the affected person cannot find a safe way and an outlet for expressing that raw, hormonally driven energy, they can tend to turn it inward through negative emotion that they direct toward their sense of self. It contributes to the sense of pessimism that accompanies PTSD. When chronic, a person learns helpless behavior and believes that they are helpless, whether or not they are truly helpless. Perception becomes everything.

An example of this on a psychological level is experienced by a child who witnesses their mother being beaten by an abusive spouse. The child has an overwhelming desire to help the mother but lacks the skill and strength to intervene, but experiences all of the physical response of threat. The child may also fear being hit by the abusive parent as well in a way that paralyzes him. If the child never gets an opportunity to work through and express his fear and helplessness in a healthy way, it interferes not only with his ability to adapt, but also with the way his brain responds physically to threat.

The effects of such events do not even need to be chronic to produce a chronic problem with fear and helplessness. But, just imagine the psychological toll that watching this type of situation over and over again has for a young child as they grow into adulthood. When faced with a similar threat as an adult, because the child who never has an opportunity to work through the terror of their own helplessness as a child, they may carry the perception that they are always and indeed helpless against a similar threat. (Remember to not discount the physical adaptations of the body as a response to chronic stress.) Or they may just be overwhelmed with the memory of their previous experience and could enter a state of dissociation in response to a similar threat as a way of protecting their mind and emotions. They may feel as though “This cant be and this is not really happening to me.” We actually have two very plausible rationales for a freezing response through this single example of previous trauma.

Freezing and Immobility

The freezing response, a response of immobility when faced with an ongoing threat of harm, occurs in both man and animals, though not as frequently as the fight or flight response. But there is a physiologic basis for this as well, and it is another means of coping with threat.

And we also touched on the idea that when a person's ability to respond to a threat is inhibited and they are restrained from responding in some way, the brain routes and processes those impulses much differently in the brain. When a person is forced into a helpless position, the amygdala in the brain activates and would normally send impulses into the basal ganglia to finish the survival response, resulting in self protection. 

The Basal Ganglia and Amygdala

 Consider that when eating, if food that you chewed never made it all the way down your esophagus, you would not only fail to obtain energy from the food you swallowed, you would experience a crisis due to the blockage and would not be able to continue to eat. In some sense, the trauma response is similar, because the system of survival gets thwarted promoting the conditions for the development of PTSD (according to the modern research concerning trauma). This particular thwarting of the the survival response and the interruption of the processing of trauma is directly associated with a freezing response. An immobilization response is a trauma response, and it is one that is physiologic, not one that derives from conscious or deliberate choice. And new research concerning the survival response indicates that there is a high correlation between pre-existing levels panic and anxiety prior to trauma and people who freeze in response to threat. We also know that learned helplessness produces depression and anxiety.

The Freezing Response to Trauma in the Survivors of Hephzibah House

Our focus in these blog posts concerning the various aspects of trauma has aimed at understanding why many of the survivors of Hephzibah House leave the facility and then experience additional trauma. Many survivors have reported being raped, including Lucinda Pennington who serves as an advocate for the facility. Girls at the home are taught that the freezing response that many people experience during trauma and rape in particular is a sinful response, suggesting that sexual assault was deserved if not solicited by the victim. Bill Gothard also teaches that the Biblical account of Dinah makes her culpable in her own rape, for the “power of crying out” carries a mystical power that will result in a supernatural outcome. Based on these medical facts related to both trauma and to the freezing response in the experience of sexual assault, these teachings promoted within Independent Fundamentalist Baptist Churches could not possibly be a more poignant example of condemnation that shifts blame away from men (the aggressor) and on to women who are believed to somehow solicit their own rapes. And we have already discussed the esteem and benefit of the doubt afforded to men along with the prejudice against women within this religious system.

As we have explored already, if a young woman who has exited HH has demonstrated a lack of ability to adequately protect or care for herself, the effects of general trauma, thought reform, childhood roots of victimization/developmental deficits, the abuse of gender hierarchy, learned helplessness, bounded choice, dissociation, external locus of control, and chronic/complex trauma add to the likelihood if not encourage a freezing response to threat. Survivors were conditions to fail to respond to threat, and the HH experience could not have done more to actively promote immobilization and a freezing response.

In an upcoming final post on this subject, we will also consider the final consideration of the compulsion to reenact or re-experience trauma, another notable feature of PTSD.