Clinical psychologist. Deals with clients who are undergoing health and/or well-being problems. These problems can involve emotional distress (like anxiety or stress), physical symptoms related to these emotions, behavioural disorders, relationship problems, as well as psychological disturbances.
From September 1st 2016, Clinical Psychology will be recognised as healthcare profession.
Neurovegetative system, autonomic nervous system. This is the system that allows us to regulate different automatic bodily functions (heart rate, blood circulation, blood pressure, breathing, muscle activity, digestion,…). It includes an accelerator and a brake.
Sympathetic system, orthosympathetic system. The accelerator, the stress and alert system, the one that prepares for fight or flight, or more simply that prepares us for physical and/or intellectual activity. It functions with adrenalin and is very useful to survival and/or to general performances when it’s briefly activated over a limited period of time.
Too much activation induces stress.
Parasympathetic system. The brake, the one which helps us to fall asleep, relax, digest. It functions with acethylcholine.
Too much activation provokes extreme fatigue.
The hyperstimulation of the orthosympathetic system, also called hypersympathicotony, can induce problems as diverse as pain related to muscle contractions, headaches, agitation, thoracic pain, dry mouth, stomach pain, diarrhoea or constipation, sweat, hyperventilation, dizziness, tingling in the extremities of limbs, sexual problems, increased heart rate, raised blood pressure…
This hyperstimulation will often lead to the back swing of the pendulum, strongly activating the parasympathetic system and provoking an extreme fatigue, sudden falls in blood pressure, fainting attacks…
The important point to understand here is that this hyperstimulation can come from different causes like everyday troubles, a lasting pain, problems from the past that haven’t been resolved yet, unresolved grief, a lack of social of family support…
We’re here in front of a functioning problem. Nothing is broken, there are no lesions. Therefore, it’s possible to deprogram and then reprogram the system in a different way.
It’s always useful to check with your Doctor to exclude any underlying causes which may be behind the symptoms. If it’s a functioning problem, it’s possible to start reprocessing the system with specific methods.
The stress agent. It’s the stimulus, the trigger of the stress reaction.
The stress reaction. It’s the chain of physiological reactions, related to an activation of the orthosympathetic system (see above).
The attitude. Concerns our own way to perceive the stress reaction. This attitude differs from one person to another, depending on the stress agent, our resources, life experience, the support we receive at that moment…
When we’re confronted with a strong emotion that we are unable to handle or integrate, this event can be experienced as traumatic. Whether the trauma has happened to oneself, whether it has been witnessed or whether one has heard that a traumatic event has happened to someone close, it may affect us.
Whether we talk about “traumas with a big T” : the horrors of war, rape, violence, being a victim of a mugging or a robbery, sudden loss of a loved one, natural disasters, hospitalisations or medical problems in early life…
Or we talk about “traumas with a small t” : repeated acts of humiliation, bullying, neglect, verbal aggressions,… especially during childhood.
All of these can potentially hurt us. Even little words that seem harmless can, if repeated, make us more vulnerable.
This vulnerability will make us react more strongly to difficulties that arise at a later date. This can explain how 2 people can have such a different reaction to the same potentially traumatising event. One of them will undergo a PTSD (Post Traumatic Stress Disorder) and the other one will integrate the event without any further symptoms.
Post Traumatic Stress Disorder. May appear when a person has been confronted with a potentially traumatising event.
It’s characterised by :
“Reliving” the event : nightmares, flashbacks, intrusive memories of the event, strong reactions to stimuli associated with the traumatic event.
Avoidance of elements that recall the trauma : memories, places, objects, actions,…
A hyperactivation of the orthosympathetic system (see above) : hyper reactivity, irritability, nervousness, insomnia, difficulties in concentrating,…
Some emotional and cognitive changes : persistant negative beliefs about oneself or the world, feeling too many or not enough emotions, inability to remember some parts of the trauma,…
These symptoms last at least one month and in certain cases can last years.
The characteristic feature of a PTSD is paradoxal : the person knows perfectly in a rational way that the trauma is over but is not able to stop feeling symptoms and emotions. A part of the system knows that the trauma is over while another part is stuck in it. This can explain why one continues to reproduce certain behaviours and to feel certain emotions without knowing why. These behaviours or emotions were probably helpful during or right after the trauma but aren’t helpful anymore in the present.
LWhen the parts which are stuck in the past feel that the difficult events are over, behaviours and emotions related to the trauma tend to stop because they aren’t useful anymore in the present.
Talking about the traumas is generally not enough to move on. Specific methods like EMDR or LI help the system understand that the traumatic event is over. It will be classified as completed as any other experienced event.
Complex traumas. After repeated early life traumas, one can observe difficulties of affect regulation, behavioural disorders, somatic complaints, relational, dissociative and/or identity disorders that truly affect in depth the personality of traumatised people.
Dissociative disorders. During what is considered to be a “normal” development, our life experiences are integrated in a relatively stable and unified whole that forms the story of our life and a self-awareness that will be strengthened by the new events we live as well as by our reaction to these events. This self-awareness is the sensation and the image of who we are.
“This experience is mine, it’s me in these pleasant or unpleasant events.” “I have the deep feeling that what I’ve done, felt, thought, experienced is mine.” This integration allows our autobiographic memory to develop harmoniously.
The word “dissociation” covers the the separation, the lack of integration of elements that were associated. It can occur temporarily, when we’re tired, ill or under pressure. It can become chronic when there are many repeated traumas during childhood. It then becomes a way to function. In the future, every event which brings to mind a trauma will trigger a new dissociation. This lack of integration will ensure that certain experiences will not be considered as experiences of the self.
“These experiences don’t belong to me, it’s not me who was scared in that event.” Dissociation is defence mechanism that allows to protect oneself and thus ensure survival. The traumatic content is dissociated, put on the side, to protect oneself from extreme emotional sensations. Youth, degree of seriousness, chronicity of traumatic events and lack of support during the difficult events will ease dissociation.
For those of you fluent in french, there is a nice explanation of a peri traumatic dissociation on Dailymotion.
Dissociation may touch different levels, give different symptoms :
Dissociative amnesia : an event or part of an event is discarded from the memory.
Depersonalisation : when there is a loss of sense of self, one can feel detached from one’s own body, feel as if not in one’s own body.
Derealisation : an alteration in the perception or experience of the external world so that it seems unreal.
One can also suffer from intrusive thoughts that come automatically, from strange sensations that don’t seem to belong to oneself, from behaviours that seem to come from nowhere.
One can suffer from pain that has no medical explanation.
Some people can hear voices in their head.
There may be an uncertainty with respect to one’s own personality, a confusion or a change of identity.