Post Traumatic Stress Disorder (PTSD) can make you feel very helpless. At times you can feel you have no control of your emotions, thoughts, feelings and actions – however understanding more about how and why the brain works in the way it does, can provide comfort and feelings of empowerment over the condition. If if you know why you’re experiencing the symptoms you are, you can be one step closer to managing them too.
Living in your Window of Tolerance
The Window of Tolerance refers to the zone you can be in when your emotions are balanced and controlled, and you are thinking clearly and reacting rationally – you’re functioning at your most effective. When you are in your Window of Tolerance, you can manage everyday life well, including planning ahead, stress, pressure, and defusing perceived ‘threats’ to your emotional balance.
If you’re in this optimal arousal zone, you:
Feel and think simutaneously
Experience empathy
Feel "present"
Feel open and curious (rather than judgemental and defensive)
Have awareness of boundaries (yours and others)
Your reaction adapt to fit situations
You feel safe
For most people, the Window of Tolerance is wide, and it takes a lot to drive them beyond it – they can manage stress and emotions quite easily. However, for people with PTSD, this Window of Tolerance can be much narrower and it can feel that more emotions and situations are intense and difficult to manage. A narrowed window of tolerance may cause people to perceive danger more readily and react to real and imagined threats with either a fight/flight response (they go above the window) or a freeze/flop response (they go below the window) more often and with more intensity than they used to expect.
What’s on either side of a Window of Tolerance?
When you’re ‘inside’ your Window, your sensitivity (arousal) is regulated. If you’re above your window, you’re hyperaroused, and if you’re below it, you're hypoaroused. In either of these states, people find it hard to process the world around them effectively. The prefrontal cortex region of the brain shuts down, affecting the ability to think rationally and often leading to the development of feelings of dysregulation, which may take the form of chaotic responses or overly rigid ones. In these periods, a person can be said to be outside the window of tolerance. In someone with PTSD, because their window might be so narrow, something ‘seemingly’ innocent or trivial to others, may tip them into hyper or hypo arousal very easily – these are often known as triggers.
Hyperarousal
When something stresses, upsets or frightens you, or you have a reminder of a traumatic memory, or specific emotion, your arousal level heightens, and you can tip outside of your window upwards, and your whole body can go into ‘alarm’ mode. This is called hyperarousal. You may not feel in control of your actions and can get ‘stuck’ in this phase for quite some time making it difficult to sleep, manage emotions and concentrate. Physically, your body may be tense and on the brink of an ‘explosion’, which can result in angry outbursts and hostility.
This could appear as an instinctive flight or fight response, extreme distress, anger, feelings of being overwhelmed and flashbacks to trauma. Hyperarousal can occur quickly, and be hard to prevent or come back from and you may experience:
Angry outbursts and impulsivity
Fear
Flashbacks
Tension/shaking
Anxiety
Unable to rest
Emotional overwhelm
Racing thoughts
Feeling unsafe
Sleep issues
Panic
Defensiveness
Hypervigilance
Intrusive Images
May be very difficult to be in busy or crowded environments
Difficulty concentrating
Tight muscles
“Deer in the headlights” freeze
Hypoarousal
At the opposite end of your Window of Tolerance is a state of hypoarousal, this is due to an overloaded parasympathetic nervous system. Like hyperarousal, it can often be triggered by feeling threatened, recounting traumatic memories, or feeling emotions associated with past trauma. Even a perceived threat can be enough to send you into shutdown or even dissociation. In this instance, you dip down outside your window of tolerance, and your reaction to a perceived threat or deep distress could be a natural instinct to freeze, shut down and become emotionally withdrawn. Hypoarousal can manifest as physical lethargy, emotional numbness and not wanting to talk to people or carry out tasks you normally enjoy and you may experience:
Depression
Emotional numbness
Emptiness
Feel disconnected
Low energy
Flaccid body
Memory loss
Shut down
Physical lethargy
Disabled cognitive processing ‘I just can’t think’
Blank stare
Feelings of shame
Inability (or lack of desire) to speak
Dissociation
Slow digestion
Blood pressure may drop
Managing PTSD and your Window of Tolerance
Most trauma survivors spend a lot of time on a superhighway to hyperarousal or hypoarousal. Think of developing your Window of Tolerance as getting off that superhighway of rapid defence response. The more you practice living within the Window of Tolerance, and the more you identify when you are outside the Window, the wider the new path becomes and the more often you find yourself on a peaceful path of your own creation.
So, if you have PTSD, you can use the concept of a Window of Tolerance to focus on three things.
How can you stay within your Window?
How can get back within your Window, when you start to experience hyper and hypo arousal?
How can you widen your Window?
Staying within your Window of Tolerance
Everyone’s experience of trauma is uniquely their own, and the things that can upset and trigger you on a daily basis are equally personal to you. However, by gaining self-awareness of your triggers and stress points, you can take steps to manage or avoid them, to keep inside your Window of Tolerance. Grounding and breathing can also help people remain in their window, in the present, by calming and soothing themselves enough to effectively manage extreme arousal.
Grounding Exercise Stand, in a relaxed position, focusing attention on the sensations in your feet. Put weight on different areas of your feet: front, back, sides. Then play a bit with movement — bending your knees, moving up and down. Sense the ground through your feet and legs.
“4 x 4 x 4 breathing” Inhale deeply for four counts, then exhale for four counts, and repeat the cycle for four minutes several times a day. I find this a good practice to do before starting work or appointments, and while commuting. It’s also a great way to get back in the Window of Tolerance after stressful experiences. You can use your smartphone to time yourself so you can give full attention to your breath.’
When hyper and hypo arousal starts – how to get back within your window
Growing your self-awareness can also help in identifying the first signs and symptoms that you are becoming alarmed, worked up and overwhelmed due to hyperarousal, or beginning to shut down due to hypoarousal. Knowing what can help you ‘tip back’ inside your Window, can help immeasurably. For example, Music can help some people prevent hyperarousal – it can calm and ground them. However, music can help at the other end of the scale too. When you feel the beginnings of lethargy and a desire to hide away, lively music can lift you.
How to Self-Regulate Hyperarousal
If you feel hypervigilant Lengthen your spine while taking full breaths. Pay attention to the rise and fall of breath as it alternatively fills and empties the chest and/or belly.
Release your anger
give yourself a 10-second hug by wrapping your arms around yourself and holding tightly
stretch your arms out in front of you to relieve that tension built up
shake it off to relive that stress
take a drink of water to cool yourself down and calm your nerves
If you feel the impulse to hurt yourself or someone else Push against the wall without aggression, and instead focus with awareness on a sense of grounding, starting with your feet and then moving through your body. Breathe full breaths, and keep bringing your thoughts back to your body sensations and away from the focus of your desperation, anger, or rage.
Feel less overwhelmed Sit in a chair with your feet fully planted on the ground or stand with your spine fully extended. Then slowly scan the environment, naming the objects within your field of vision
If shaking or trembling Take full, yet slow and easy breaths. No need to breath too deeply, though. If you can, sit in a chair or on a sofa, and wrap a blanket or comforter around yourself. Some people feel better if they also cover their heads
If your heart rate increases Take your attention away from the heart region by paying attention to the sensations in your feet. Notice the feeling of being grounded and connected to the floor or earth beneath you.
How to Self-Regulate Hypoarousal
Activate your senses (tap into your five senses) perhaps with a warm bath, massage, aromatic candles or scents, music or natural sounds or tasty food
If you feel numb Gently squeeze your forearms with opposite hands. Also increase awareness by noticing the environment through the five senses. What do you see, hear, smell? If you can, try touching or tasting something mindfully.
If you feel disconnected or are experiencing depersonalisation Start by slowing the pace of whatever you are doing. Then firmly but gently squeeze the forearms, calves, thighs — whatever feels enlivening to you.
If you feel frozen or panicked Sit comfortably in a chair, and wrap yourself in a blanket. Begin to focus on taking full, slow breaths, continually bringing your thoughts back to the present moment.
Expanding your Window of Tolerance
Practice Mindfulness Being mindful helps to deal with undue stress and emotions by paying attention and staying in the present moment. It’s not about stopping any unwanted stress or anxiety, but rather allowing those moments to pass without your body reacting in a negative way. You can practice mindfulness by:
Building Awareness
identify what you are feeling
ask yourself why do you feel that way
question why those feelings matter
Be More Open
let yourself feel everything, be open to both positive and negatives
don’t push away unpleasant thoughts or emotions
let negatives flow and pass through your mind
Be More Accepting
accept feelings of both positive and negative experiences
avoid judgment or censoring of your thoughts and feelings
don’t be ashamed, embrace it instead
Be Present
stay in the present moment and focus on what you are currently doing
pay attention without judgment
avoid multitasking as this is mentally draining
Increase Happiness When you are happy and have a positive experience, your window of tolerance will naturally expand. There are four happiness chemicals that your brain releases when you feel good. By understanding how each of the chemicals works, you can trigger the release of one of the chemicals to improve your happiness.
Dopamine
make a to-do list (each time you tick off a task you increase dopamine levels)
create something such as writing, music, arts and crafts
meditate
Oxytocin
physical touch, cuddling, hugging, and even eye contact
socialising with friends and family
listening to music
Serotonin
getting sunshine outdoors
cold showers
getting a massage
Endorphin
laughter and crying
eating dark chocolate or spicy foods
creating music or art
Reduce Shame It is common for everyone to experience shame from time to time. But if you are constantly feeling embarrassed and self-critical, it can be debilitating to your mental health. Here are simple steps to reduce shame:
Listen to how you speak to yourself
Write about your shame
Tell someone you trust
Reframe it by using affirmations and self-compassion
Build Resilience Resilience is important for adapting in the face of adversity, trauma, tragedy, or stress. Building up your resilience will directly expand your window of tolerance and improve your ability to deal with difficult life experiences.
Foster Wellness
focus on all three aspects of health, not just one or two of them (physical, mental, and social)
Avoid negative outlets (masking your pain with substance abuse)
Find Purpose
look for opportunities for self-discovery
take steps towards your goals (long term and short term goals)
Physical health and your window of tolerance
It’s important to realise that your general health plays a role too. Your Window of Tolerance will be easier to manage – and you can self-regulate more successfully – if you get sufficient sleep, good nutrition, fresh air and exercise.
Supplements for Wellness
Opmerkingen