Thursday, August 14, 2014

Heidi Hanson - 7 PTSD Feedback Loops

This post comes from the Healing from Trauma blog by Heidi Hanson, many of whose posts are being compiled into a book tentatively called the Trauma Healing Resource Book.

This particular post, which was shared with me by some friends on Facebook, presents some of the essential experiences of PTSD within the context of feedback loops. Based on the experience of my clients, this seems quite useful.

7 PTSD Feedback Loops

by Heidi Hanson

In the book I have been working on, Trauma Healing Resource Book (tentative title), which chronicles my healing journey through PTSD, I identify 7 Feedback Loops that act like quicksand, pulling one further into PTSD even as one desires to find one’s way out. This needs further research, but feedback loops could be one reason some cases of PTSD become chronic.

Note: This article and all articles on this blog are based on my personal experience as someone recovering from PTSD. Much is theoretical material, however it is material I consider worth being studied in depth in a scientific manner at some point in time.

Excerpt from the book:

Definition: The technical definition of a feedback loop is “a system where outputs are fed back into the system as inputs, increasing or decreasing effects.” *

I would define a feedback loop related to human psychology as a group of external life circumstances and internal patterns that keep reinforcing each other, making it difficult to change either the circumstances or the patterns.

Feedback loops can be propelled by internal patterns of thoughts, perceptions, emotions, and behaviors, each element stimulating the next.

Negative feedback loops frequently lead to downward spirals, in which case some aspect of the situation worsens slightly every time one or several loops are completed.

Experiences of trauma may lead us to develop mental habits; feedback loops are mechanisms that keep maintaining and deepening these habits. One could theorize that feedback loops contribute to reinforcing specific neural pathways in the brain and to developing chronic imbalances in the nervous system and physiology.

Negative feedback loops lead to what I call a “trauma-based reality.” This is when we perceive all of our reality through a filter created from our past traumatic experiences. The “normal” reality we experienced prior to the traumatic experiences can only be sensed for brief moments.

In the following illustration, the individual is in a room dancing with trauma, and through the windows she can see momentary glimpses of the reality that exists outside of the trauma-based reality.


Book Illustration: Trauma-based Dance Floor
Sometimes, dancing, I catch hints of Life, outside

I have identified seven feedback loops based on my own experiences. I’m sure there are more; there are also variations on these seven, not included here.

* http://psychology.wikia.com/wiki/Feedback_loop

1. A Dangerous World Feedback Loop


Synonyms: Magnifying Triggers Feedback Loop, Environmental Triggers Feedback Loop

This feedback loop occurs when we have experienced trauma, and we happen to be in an environment that continuously triggers memories of the trauma. If constantly triggered, we can be reminded of the trauma and automatically feel fear over and over again, which makes the environment around us seem more frightening, and we end up imprinting the idea of trauma more and more deeply onto the environment. Seeing increasingly more danger makes us more likely to experience triggers, and makes the triggers more impactful when they come.

It’s not just the perception of the environment as more and more dangerous that increases the impact of the triggers. Being triggered a lot can gradually increase our sensitivity and raise our overall level of hyperarousal. In turn, feeling more sensitive increases the impact of the triggers.

In this scenario, all levels of danger are perceived as a red alert – there are no orange and yellow alerts; danger is stuck on High setting and only increases from there.

This feedback loop is one reason it is so important to get to an environment that gives some relief from triggers, or change the environment (get rid of furniture, redecorate, put new scents in the air etc.).

If the amount of stress puts the system into immobility more and more frequently, this feedback loop can lead to the Immobility Downward Spiral – getting increasingly immobile e.g. feeling numb, unresponsive, still, paralyzed.


I noticed this Dangerous World Feedback Loop and Immobility Downward Spiral happening early on in my experience of PTSD. This is an illustration that shows how too many triggers can feel like an invasion, or a kind of poison that is constantly being inserted into the brain and nervous system, causing the mind to go into meltdown or immobility on a regular basis.


2. Constricted Reality Feedback Loop / Downward Spiral


Synonyms: Self-isolation Feedback Loop, Resource Avoidance Downward Spiral, Resource Rejection Downward Spiral

Being extremely sensitive and being hit constantly by a wide variety of triggers can also lead to a Constricted Reality Feedback Loop. In this case, each time some life situation is associated with trauma, we may decide to avoid it as well as anything related to it. In the following illustration, we see that this individual’s hypersensitivity to triggers in his community make him cut off his connection, automatically and without thought, to resource after resource, until he is alone in his room, isolated and disconnected from the rest of the world.

Without any resources, it is unlikely he will be exposed to things that demonstrate that his triggers are false – in other words he won’t have experiences that deconstructs the triggers and rewire his brain to re-perceive reality in a new way, for example encountering someone who at first appears to be a perpetrator but is actually a friend, or an authority figure who appears to be abusive and turns out to actually be a resource. In this scenario there is no way for healing to happen because the individual is isolated from all potential resources.

This one is similar to the Dangerous World and Lack of Trust Feedback Loop (#5). They are all ways of illustrating how fear leads to fear, mistrust leads to more mistrust and isolation leads to more isolation, just with slight variations. Dangerous World has to do with one’s perception of danger, Lack of Trust is specifically in relation to other people, and Constricted Reality has to do with isolation from all types of resources in one’s community including places, events, groups, people etc.

Note: click on the image to see a larger version


3. Dissociation Feedback Loop


Being frequently dissociated means for much of the day we are not present in the body.

Some synonyms for this state of dissociation are:
  • space cadet
  • spaced out
  • absent-minded
  • head in the clouds
  • not paying attention
This could lead to accidents which may be somewhat traumatizing. If traumatic, these accidents could possibly lead to further tendency to dissociate.

The illustration for this one may be simple, but being dissociative can create messy problems. Dissociation can lead to small accidents, like stubbing one’s toe; it can also lead to worse incidents, like doing things that are dangerous without knowing it. General disorganization can lead to problems, for example, a woman who is out late and misplaced her cell phone and is looking for it and then gets mugged whereas she would have been at home by that time if she had been more organized. Dissociation is an escape from the present and it may lead to bad decisions due to lack of awareness of details. Underneath dissociation is a wound(s) that causes tentativeness or rejection in relation to being in the body. In order to heal, we need to be committed to our bodies and ourselves, aware of our surroundings and alert to who is doing what with us, to prevent more accidents.


4. Hyperarousal Feedback Loop


Synonyms: Panic Loop

If we are in hyperarousal a large percentage of the time, it means the nervous system is strung tight like a rubber band pulled almost to the breaking point. We may be jumpy, prone to panic, tend to do things too quickly, rush about in too much of a hurry, and act on impulse. Hyperarousal makes it difficult to process information well because it keeps one stuck in a survival level of thinking, preventing access to the higher mind/rational thought. If we are panicking, we are also more easily manipulated by other people. This chaotic fear state could easily lead to getting into bad situations or accidents/injuries. It is possible this could lead to another trauma, which would only increase the hyperarousal.


5. Lack of Trust Feedback Loop


Synonyms: People Avoidance Feedback Loop, Other People Rejection Feedback Loop, Help Rejection Loop

Sometimes, a traumatic experience includes a breach of trust. Trust can be broken within a close relationship, such as with a partner or parent. Trust can also be violated by an authority figure we had confidence in. Sometimes, when we try to seek help with PTSD, we encounter healing practitioners who do not understand PTSD enough to help us, and can even do or say things that re-traumatize us. So, in some cases, we will develop a lack of trust.

Due to this lack of trust we may feel more comfortable spending time alone. Spending more time alone makes us more vulnerable to the symptoms of PTSD, because there is no information coming from outside to challenge the trauma-based reality. We avoid the very people and situations that may have a positive effect on the nervous system.

Not getting the help we need can lead to issues in the following areas:
  1. Triggers automatically create hyperarousal; we do not learn ways to intervene.
  2. We experience more triggers and this leads to more disregulation and hyperarousal.
  3. Disregulation, hyperarousal, fear and anxiety cause confused information processing.
  4. Due to difficulties with processing information we can’t figure out how to escape or change the situation.
  5. Also, triggers lead us to remain in helplessness/immobility/paralysis; helplessness leads to not feeling one has the power to help themselves.
  6. Low self-esteem remains unchallenged; low self esteem from trauma can stop us from seeking help.
  7. When we perceive ourselves in a constricted reality, we may not see what exists outside it.
  8. The level of sensitivity being unintentionally maintained can lead to more experiences of being traumatized by healing practitioners and other people trying to help.
Thus, the lack of trust seems to be justified by many aspects of our experience, and we spend more time avoiding people. Being alone with our PTSD symptoms can lead to experiencing reality as harsh and other people as unhelpful; we continue to avoid people and our reality becomes more and more constricted.

The Lack of Trust Feedback Loop can lead to a Constricted Reality Feedback Loop/Downward Spiral.



6. Trauma Seeking Feedback Loop


Synonyms: Resolution Block Feedback Loop

Peter Levine has theorized that one of the key reasons human beings do not process and release trauma within minutes like animals do is because we have developed a higher brain, the neocortex. The neocortex gives us great advantages such as the ability to think rationally, but it can also suppress the pent-up trauma related energies the system needs to process and release successfully in order to heal PTSD, such as rage and terror.

In the trauma seeking feedback loop, we may get into a situation where there is the possibility for the pent-up energy to completely release once and for all. We may suddenly feel powerful, primitive uncontrollable rage, hatred, sorrow, fear, or shame. But because of the controls we maintain, we do not recognize this as the opportunity it is. Rather, we think something is terribly wrong with us and force ourselves to push the emotions back down, and thus fail to release the pent-up energy. In other words, when the reptilian brain’s instinctive manner of releasing trauma begins, the neocortex or rational mind automatically suppresses it to escape and avoid the powerful emotions. When the experience is over, we have stabilized again but nothing has changed and the system continues to unconsciously seek a way to discharge the trapped life energy and return to a truly non-traumatized state of calm alertness. The system will unconsciously seek out another situation to stir up these powerful emotions, in the hopes that they will finally be processed to completion.


7. Survival Mode Feedback Loop


Synonyms: Problematic Memory Encoding Loop, Arrested in Time Loop, Siege Mode Loop

The seventh feedback loop is the state of being immersed in survival instincts, a perpetual state in relation to the reptilian brain managing an eternal moment of shock and trauma, without ever coming out. This is most likely due to the way traumatic memories are encoded. It creates a kind of life in siege mode, a severe experience of life, a survival focused life. Even if one’s survival needs are met one may feel like life is about surviving in basic ways and not about living/thriving (the higher level needs on Maslow’s hierarchy are not in the picture).

The experience of being in shock becomes a timeless moment, a never-ending moment, from which the body does not re-enter time. It is as if the reptilian brain is telling you you are still in shock and need to survive, dominating your experience and keeping you in survival mode forever. The experience cannot be metabolized, psychologically, by the system, and until it becomes metabolized it is holding you hostage. In order for it to be metabolized, the times of the worst dissociation (shock) need to be integrated in the body and brain/memory in a different way than they were at the time of the trauma. There are theories to the effect that the memory of the trauma needs to be moved from short-term to long-term memory.

So the theory about how this one works is that because going into these memories feels too threatening, the procedure seems complex, one lacks skills and also lacks skilled help, one never figures out how to integrate the moments of the worst dissociation, and so the person remains stuck in time and in survival mode. Sorry this one is not clearer, when I understand it better I will update this section.


One feedback loop I have not included in this article is Learned Helplessness. Learned Helplessness (Seligman) is a kind of feedback loop because if we are in a situation in which we are legitimately helpless, we learn that in those kinds of situations we are helpless. Then, when in a similar situation, we behave helplessly even if we truly have power to act. This reinforces our perception of our self and internal experience (felt sense) of being helpless. And so it continues. Learned helplessness is related to depression; I am not sure the relation to PTSD. In my case, because I was injured I have felt helpless in a lot of situations and I feel much more helpless than I did before. I would have to do more research to understand if this is learned helplessness as defined by Seligman or something else.

When I first found Somatic Experiencing and realized how much of healing PTSD is just about using somatic techniques to calm the nervous system and re-enter the body, I thought it would be a clear road out. I was wrong. I am still falling into these feedback loops on a regular basis, and I’m still trying to find ways to outsmart the downward spirals.There is a lot more work to be done, and my first step is to simply acknowledge that these feedback loops are still here and still need addressing.

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Heidi Hanson is an artist and writer in Asheville, North Carolina currently working on an illustrated book chronicling her journey healing from Post Traumatic Stress Disorder.
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