Traumatic Stress, Posttraumatic Stress and PTSD
WHAT’S THE ISSUE: Some people argue that reframing stress to try and get students to believe that stress is a positive thing works. But what if a student’s nervous system is stuck in a level of chronic stress that is above a certain threshold? Or what if they are experiencing traumatic stress? What you’ll find is that in these cases, just talking to them to give them stress management advice doesn’t really work.
In this article you will:
- learn about unhealthy levels of stress that require body-based stress management strategies.
- becoming more informed about the stress and trauma spectrum
- understand why unhealthy levels of stress prevent learners from achieve their academic and well-being potential.
I believe we need to have informed conversations about the degree of stress a student may be experiencing. This allows us to be sensitive to the emotional needs of students who are stuck in overwhelming levels of stress that may require professional assistance with a relevant qualified coach or therapist.
When school and university level educators have a good understanding of the biology and the psychology of stress, they can enjoy more success in their efforts to help students become more productive.
TRAUMATIC STRESS: GOING BEYOND THE BASIC "NOT ALL STRESS IS BAD" POINT
“Traumatic events produce profound and lasting changes in physiological arousal, emotion, cognition, and memory…The traumatized person may experience intense emotion but without clear memory of the event, or may remember everything in detail but without emotion…Traumatic symptoms have a tendency to become disconnected from their source and to take on a life of their own.”
Dr Judith Herman (2015) Trauma and Recovery
When we speak of stress in a binary way – “good stress” vs “bad stress” – it oversimplifies reality. The truth is that there is a spectrum of healthy and unhealthy stress. Oversimplified descriptions of a student well-being issue can lead to oversimplified (and therefore unsuccessful) attempts to address student mental health issues.
More and more educators, parents, and students are becoming aware of the need to speak about stress in a more informed and nuanced way. In Trauma-Sensitive Mindfulness, Dr Treleavan talks about how some people who are suffering from traumatic stress, posttraumatic stress, and even full-fledged PTSD, may have been advised to just keep meditating and it shall pass. That if they just stay with the pain long enough through meditation, it will just go away. But just meditating for stress management is sometimes not enough if the stress is above a certain threshold.
Similarly, it’s problematic to assume that all stress can be dealt with by simply having an educator or a parent cognitively reframe for a student a stressful period of their life as “a positive thing that will make you more resilient”. That’s because getting stuck in a state of traumatic stress is not just a cognitive problem. Nor is it just an emotional problem. It’s also a biological problem. Verbal interventions are not enough for such cases.
When we are stuck in an overwhelming level of (di)stress, we need stress management interventions that take all three stress components into account. The three components of stress are: the biological component, the cognitive component, and the emotional component. EFT Tapping, also known as Emotional Freedom Techniques, are one way of addressing all three of these areas.
Traumatic Stress VS POSTTRAUMATIC STRESS
“For many, being exposed to a single traumatic event won’t produce long-term consequences. We’re impacted, but can metabolize the experience – meaning we can process through the thoughts, memories, and emotions without becoming overwhelmed and stuck. Sometimes, however…some kind of alarm system inside of us doesn’t switch off, and a traumatic experience comes to wreak havoc with our body and mind. This is known as posttraumatic stress – an experience where traumatic symptoms live on past the traumatic event.”
Dr David Treleaven (2018) Trauma-Sensitive Mindfulness
Traumatic stress occurs when our Autonomic Nervous System becomes overwhelmed by a real or perceived existential threat. For example, while the fear of failing an exam may not present a real threat to one’s existence (there’s no saber-toothed tiger that’s about to attack), it can still be perceived as a real existential threat. This can trigger a lot of anxiety, overwhelm, or panic in teenagers and Uni/college students, both while studying for, and while sitting an exam.
Posttraumatic stress occurs after a traumatic event, whereby the symptoms of hyperarousal and hypoarousal continue in a person’s daily life after the real or perceived danger is over. Let me give you an example. When someone had an existential crisis from a traumatic stress experience with COVID, followed by post-COVID health complications, they may find themselves stuck in a posttraumatic stress state of hypoarousal that exacerbates their long-COVID symptoms.
A period of chronic stress can also contribute to the dysregulation of the Autonomic Nervous System (ANS). The key word here is “autonomic”, meaning automatic. This means that overwhelming levels of stress cannot be consciously controlled. The automatic biology of stress influences our thoughts, feelings, and behaviors, when we are in a state of too much (di)stress.
Here are some signs that a student has a dysregulated Autonomic Nervous System (ANS):
- hyperarousal (e.g. unproductive anxiety, panic attacks, anger outbursts, restlessness, inability to concentrate)
- hypoarousal (e.g. low energy, low motivation, numb to feelings, foggy brain, moving slowly, emotionally disconnected)
Some students may even be oscillating between hyperarousal (e.g. panicking) and hyperarousal (e.g. “I can’t be bothered”). Whatever the case, when we are stuck in such high levels of stress, we need support. We need people who have the knowledge, skills, and level of emotional regulation we need to help us co-regulate and renegotiate our way back into the healthy range of stress.
So what does the unhealthy stress spectrum look like in terms of student behavior? See below.
I find educators aren’t always aware that study procrastination is stress-related. They aren’t aware that avoiding studying is a fear-based behavior. When the thought of working on an assignment or studying for an exam repeatedly triggers procrastination, it’s a sign that the student may be affected by traumatic or posttraumatic stress. They are in the unhealthy ‘flight’ mode of the stress response.
Basic self-care routines like going for walks, exercising regularly, joining a yoga class, and doing self-soothing meditations can help us get back into the healthy range of stress. But what if a student’s stress goes up to a 10/10 every time they try to face the assignments they haven’t yet handed in that are piling up….AFTER coming back from a relaxing walk or yoga class? Then you know that basic self-care acts will not solve the problem of what’s triggering a school-related hyper or hypo aroused stress response every time they try to sit down to study.
How can a student study when they feel overwhelmed and triggered just from thinking about working on an assignment? How can a student study when they feel overwhelmed and triggered just from thinking about starting an academic assignment? If they struggle to get started on schoolwork, even after taking part in a relaxing yoga or meditation class, and they continue to avoid their work? That’s when you know that they need targeted support for the particular school-related stress that’s triggering their fear-based flight response (also known as procrastination).
Students who are experiencing this level of stress need more than just conversational interventions to help them get unstuck. When a teenager or university/college student is feeling overwhelmed by academic deadlines and tasks, they need a personalized, body-based approach that helps them shift from the maladaptive Autonomic Nervous System levels of stress. They need one-to-one stress management support that works.
In a nutshell, when a student’s ANS is stuck in a state of hypoarousal and/or hyperarousal due to traumatic or postraumatic stress, they need 1:1 or small group support with relevant professionals who can help them get back into the healthy range of stress. Uninformed parents and educators can (inadvertently) cause harm by making blanket statements like “Stress is good for you! It’s all about how you think of stress.” Really?!
Let’s please engage in a more nuanced, educated dialogue about the traumatic stress spectrum. Only then can better serve the mental health and learning needs of students in schools and universities around the world. We need to be careful not to be dismissive when a children and or young adult say they feel really stressed and overwhelmed.
SO, WHAT CAN BE DONE?
Until recently, Cognitive Behavioral Therapy (CBT) was seen as the best approach for helping students overcome exam-related stress. Another approach that’s been used to help these students is Exposure Therapy. Cognitive reframing and repeated exposure can eventually lead to a positive result to help overcome unhelpful levels of exam stress. However, these can be quite drawn-out and painful approaches to solving the problem of exam-related hyperarousal.
What I love about the Emotional Freedom Techniques (EFT) is that these stress management techniques work quicker than CBT, last longer, and are less painful than pure Exposure Therapy for unhealthy levels of stress. And once the stress drops to below a certain threshold, you witness the student starting to access their prefrontal cortex as their brain starts to spontaneously come up with solutions to their study problems.
The bottom line is we are social creatures. While we can certainly sometimes let our ego get the best of us, and think illogical things like “I don’t need anyone – I can figure this out on my own”, the truth is that we need other humans to survive and thrive. When we are stuck in a state of hypoarousal or hyperarousal, we can sometimes make the mistake of believing “I have to go it alone” or “It’s weak to ask for help”. It prevents us from seeking assistance when we need it.
PTSD AND COMPLEX PTSD
“Traumatic events overwhelm the ordinary systems of care that give people a sense of control, connection, and meaning. It was once believed that such events were uncommon. In 1980, when post-traumatic stress disorder was first included in the diagnostic manual, the American Psychiatric Association described traumatic events as ‘outside the range of human experience’. Sadly, this definition has proved to be inaccurate.”
Dr Judith Herman (2015) Trauma and Recovery
An important distinction needs to be made between posttraumatic stress, and Post-Traumatic Stress Disorder (PTSD). If you have never seen what PTSD “looks like” in that initial shock stage, you’ll find lots of war history documentaries by typing things like “PTSD in WWI” and “PTSD in WWII” in YouTube.
If you study the footage and compare WWI to WWII manifestations of PTSD in war veterans, you will notice that historical context influences how PTSD symptoms present themselves. Changes in historical context have led to shifts in how intense the involuntary PTSD “tics” present themselves in war veterans. You will notice that the involuntary movements that occur when someone is reliving the old trauma as if it was still happening have become more and more subtle as time goes on.
This is partly due to increased social pressure of what involuntary movements are seen as socially acceptable. In a nutshell, if you compare the “tics” that WWI Veterans who suffered from PTSD had, to the WWII Veterans, you will see how historical context influences how some PTSD symptoms present themselves.
Beyond the external tell-tale signs of PTSD (“tics”/involuntary movements), other key symptoms include tormenting nightmares, restless behaviors, traumatic memory flashbacks. Symptoms also include being jumpy or easily startled and a constant state of vigilance or irritability. Reminders of the traumatic event(s) may make anyone with untreated PTSD feel panicky, or trigger the unprocessed traumatic memory/memories, causing them to feel like they are reliving the event in the here-and-now. These are gender neutral signs or symptoms of PTSD.
Generally speaking, men with untreated PTSD tend to display more rageful outbursts and aggressive behavior towards others than women with untreated PTSD. This is due to gender-specific socialization. Meanwhile, we also know that very young children are more likely to reenact parts of a trauma through play, or they might draw parts of it, than adults are.
In recent years, a distinction has also been made between PTSD, and Complex PTSD, or C-PTSD. PTSD is related to adult onset trauma, often single-event trauma. C-PTSD is trauma that dates back to childhood trauma or neglect. While it is a difficult book to read (before you decide to read it, make sure you are in a place in your life where you can handle it), Dr Judith Herman’s seminal book in the world of PTSD and Complex PTSD, Trauma and Recovery: The Aftermath of Violence – From Domestic Violence to Political Terror. Emotionally, it’s a difficult book to read. Before you decide to read it, make sure you are in a place in your life where you can handle it. If you do read it, you will see that she makes it crystal clear that even within a PTSD diagnosis, the severity of this extreme form of psychological and biological stress varies greatly. So there is a stress intensity spectrum, even within clinical levels of PTSD.
Another thing you learn from reading Dr Herman book is that many of Sigmund Freud’s “hysterical” female patients were actually suffering from what we now call Complex PTSD. In other words, “hysterical” was a term used in the 19th century to describe what we would now understand to be the effects of severe childhood trauma. These young adult women were children of the bourgeois families of Vienna. This was where Freud established his practice. Early in his career, Freud concluded that these young ladies must have been the victims of “perverted acts against children” during their childhood years. This conclusion was based on the eighteen case studies Freud published entitled The Aetiology of Hysteria.
But Freud’s went on to retract his initial discoveries of the root cause of his patients’ severe distress. He did a U-turn. This may have been to due this inability to come to terms with how widespread severe child abuse was among the Viennese elite. Perhaps he also decided to put his business interests over ethical code of conduct – after all, the Viennese elite had to be kept happy for them to keep paying for Freud to work with their daughters. Freud then spent the rest of his career gaslighting the young ladies who were brought to him by their fathers for mental health treatment. He would further traumatize his already traumatized victims by making them believe that the traumatic flashbacks they were having of horrific childhood abuse were just ‘in their head’.
In conclusion, I believe that more educators need to be aware of the danger of overgeneralizing and oversimplifying the various wellbeing issues related to student stress. That way students in crisis can get the appropriate specialist support they need for their level of dysregulating (di)stress. And in cases of severe psychological distress, such as with students who are showing signs of possible PTSD or CPTSD, they need to be referred to safe and licensed trauma therapists and professionals who use effective methods of treating ‘big T’ Trauma.
SUPPORTING A STUDENT IN (DI)STRESS: HOW I CAN OR CANNOT HELP
Treating a child or adult who is suffering from any form of PTSD goes beyond my level of expertise. As a trauma-informed EFT Practitioner specialized in stress, anxiety, and academic performance, I can help students who are experiencing overwhelming levels of stress in the traumatic stress and posttraumatic stress range of distress. This is because EFT Tapping is one of several emotional first aid tools in my professional toolbox.
I can help kids, teens, and adults who are being held back from achieving their academic and wellbeing potential by too much stress. I’m qualified to teach and apply a scientifically proven, evidence-based stress management method called EFT Tapping to help students who are in the mid-range levels of dysregulation to return to the healthy stress range. But I cannot diagnose or treat mental illnesses.
Some of the students I coach using EFT Tapping and academic coaching tools do not have an actual addiction to gaming or social media. But the amount of time they spend on social media or online entertainment platforms is affecting the progress of either their social skills or their grades.
Others have too much stress or anxiety, causing stress-induced health problems. For example, they may be experiencing stress-related stomach pains and migraines, trouble sleeping, allergies, or stress-related skin problems like persistent acne or dermatographia. They may have had one or two panic attacks in tests or exams that caused them to forgot everything they studied.
In other cases, the student has been diagnosed with one or more learning difficulties like ADD/ADHD or borderline ADD/ADHD, Dyslexia, or Dyscalculia. Many of these parents have tried hiring Study Skills tutors to teach their child how to study and organize themselves prior to coming to me. But they have realized that these study techniques cannot work if their child continues to feel stressed and overwhelmed.
Stress management techniques that help student with ADHD shift back into healthy levels of stress can help them focus more and organize their time better as they prepare for an important test or exam. While I do include some time management skills training and study skills within my mentoring programs (if needed), most of the work I do is focused on reducing student stress levels.
Low energy and motivation issues can also be due to too much stress. Too much energy and anxiety issues (hyperarousal) can be exacerbated by bad sleeping habits or excessive gaming/time on social media habits.
Whatever the case may be, people I work with are held back from achieving their academic potential and succeeding in meeting deadlines due to unhealthy levels of stress. When a student’s stress shifts into the healthy range, they have more energy to think of solutions to their time management problems. They can focus more. They feel empowered to organize themselves and to problem solve in order to make progress on their study-related and well-being goals. That’s where I can help.
REFERENCES
About the author
Eleni Vardaki works online as an Academic and EFT Tapping therapist and coach specialized in stress, anxiety, and academic success. She works with kids, teens and adults. She uses research-based strategies to help her clients achieve their goal and experience more well-being.
EFT TAPPING FOR STRESS RELIEF
- “Tapping for University Students” with Eleni Vardaki
- “Tapping Away Dissertation Procrastination”, listen to Eleni working with a final year undergraduate student to help them get it done on time – and well.
- “Final Exams Stress: Tapping into Confidence” listen to Eleni coaching a final year undergraduate student using EFT
