Systemic Inflammation

Systemic Inflammation: an inflamed system

It’s interesting that burnout is something that shows up in public and private helping professions, secular and faith-based, for-profit and non-profit collectives. The systems themselves seem to have complex trauma and inflammation. In the same week, I had a client with 3 attending trauma specialists unable to find a sense of stability and safety after her system was overwhelmed with flooding* and the most trained trauma specialist in the area look at me with tears streaming down her face say, “Corina, I can’t hold one more traumatic story, I’m done”.  Both the client and the counselor were saying the same thing. “I’m being flooded by trauma and I can’t find safety or peace anymore.” I hear this from pastors, from missionaries, from parents, from business owners, and victims of sex trafficking.

It’s indeed striking how pervasive burnout is across various professions and environments. Burnout, especially in roles where individuals are constantly exposed to trauma and high levels of stress, can lead to a deep sense of helplessness and exhaustion. In 2021, The American Journal of Medicine released an article, “Burnout, Posttraumatic Stress Disorder, or Both – Listen Carefully”. The author, Barbara L. Schuster, MD, writes, “As concerned as I am about increased ‘burnout’ among medical personnel, what I learned while a resident, residency program director, and a chair of a department of medicine, is that burnout is more likely to be observed with an array of interventions that can have significant positive effects, while posttraumatic stress disorder is more likely to be missed, with a greater chance of significant problems, including suicide.”

Just as our bodies can become overwhelmed by physical trauma or chronic stress, organizations and communities can similarly suffer under continuous pressure without adequate support or relief. This systemic issue reflects not only individual struggles but also broader societal and institutional shortcomings in addressing and mitigating stress and trauma.

Those who are trained to help others often need as much support and care as those they are helping. The emotional toll of consistently dealing with trauma can be immense, leading to compassion fatigue and burnout.

Throughout my 20 years of concurrent lay ministry and professional counseling, I found complex trauma within every cross section of society. Hearing from various sectors—pastors, missionaries, parents, business owners, victims of sex trafficking, survivors of all types of neglect and abuse, further underscores the universality of the problem. Each group faces unique challenges, but the underlying experience of feeling overwhelmed by trauma and unable to find peace is a common thread.

Addressing this issue likely requires a multi-pronged approach, including better mental health support for those in high-stress roles, systemic changes to reduce unnecessary stress and trauma exposure, and fostering environments that prioritize self-care and resilience.

Being only one person, trying to survive under a buckling caseload during COVID and beyond, I started to ask, How can we begin to tackle these systemic issues to better support those affected by burnout and trauma? How can I live in a way that also models a healthy lifestyle and protect myself from burnout? I cannot help anyone if I am stressed to the place of being critical, condemning, overwhelmed, judgmental, or hopeless.

I began hearing about Concierge medical care and psychiatric care. What was this? These were professionals on a financial retainer offering a small amount of people individualized care. They were accessible any time of day. They made house calls.

In contrast, the outpatients practices had waitlists, returned voicemails, and caseloads of 30 weekly clients, 60 or more open cases. Maybe less was more. I recalled in grad school, we read a study that multiple counseling sessions with one person in a single day showed as much process, progress, and change than those spread out in to once a week sessions. Simultaneously, we saw semester classes turn into weeklong intensives and experienced the advantages of being able to focus on a single subject at a time.

I believe the beginning all helping professions begin with a “do no harm” attitude or even an ideology. But this systemic overwhelm creates a cruel compassion fatigue. It makes “uncurable” boxes. The boxes read: “Major Depressive”, “Borderline”, “C-PTSD”, “Narcissistic”, “Auto-immune”. We sort people in to these boxes, to feel better about not being able to help everyone. We work on the more “manageable” masses. We shower these masses with drugs to alleviate symptoms.

The secret is, “You are not the problem”. You may feel like that is true. The problem is, The System is not the Healer. And it’s burnt out from trying to be.

#2

BALANCE

The beginning and the end of most wisdom traditions disagree with each other. How did we get here? What happens when we die? People have debated these questions for millennia and will continue to do so.  They disagree on what motivates life and what gives it meaning. One common thread of any sustainable belief system is balance.

As removed as we are in the modern world to the rhythms of nature, they continue to go on around us. The sun encouraging us to lay down our labors and calling us to rest. Winter beckoning us to allow ourselves a snow day or two (if you live in a more moderate climate like Virginia), huddle in by the fire with a cup of cocoa and a good book.

When I started studying about bodywork, I did what I always do and hyper focused. I got so excited about my new topic of study and I consumed as much information as I could as fast as I could. The irony came when my body started telling on me. Through out the day, as I practiced the energy work assessments which I was learning, my body repeatedly indicated that it was in need of more grounding skills and more time outdoors. “Put the books down and get out of your head!”, it screamed at me.

Over my 19 years as a therapist, I’ve had more bodies than brains accurately indicate the direction of therapy. One of these reasons is that the body often knows where to start and it’s not the most obvious or severe instance of trauma. The most pressing direction may very well be the most silenced, overlooked and counterintuitive need uncovering years of minimization and neglect.

Muscle tests, energy assessment (Eden – move back, move forward),

#3

What makes PTSD Hard to Heal?

I asked Google. Don’t we are start there? The AI replied, “Post-traumatic stress disorder can be difficult to heal from if left untreated for too long”. Wow, that’s the best news I’ve ever read. It shows me people will not be turning to AI counselors telling them there is no hope. They’ve waited too long to heal. The AI would probably refuse to treat based on the duration of the traumas and how long those memories have gone untreated.

There is no expiration date on your healing. Most trauma is unable to fully surface until the person is in safe and stable environments and/or relationships. For those who know DID terminology, many people remain a closed system, detached and not fully aware of their trauma history well in to adulthood. How can they talk about much less fully heal from something they don’t have any memory off? They don’t have the memories but what they do have are symptoms.

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​TRAUMA & COMPLEX /​PTS(D) TREATMENT

I just wanted to note that I don’t like to go by such titles such as ‘expert’ or ‘specialist’ when it comes to trauma therapy as I believe the subject of trauma is one of those things that you can never know enough or everything about. If I go by the term ‘expert’ it closes me off to the un-known, the unconious, it creates a hubris, an attitude of self-righteousness, that for me is not what psychotherapy is about.

I do not proclaim to heal you, or your trauma, your brain and body heals itself. The therapies that we do, and what you do outside of therapy will be what aids your healing (just like physiotherapy helps)

However, I would also like to note I have had a significant amount of training and experience in the area of psychological trauma. So, I will write a bit about what I think about it as a guide to help you, and also so you can get a feel for my knowledge and experience.

Trauma is a Greek word for ‘wound’. Trauma is the effect from any experience that you have been involved in, either directly or indirectly that you have been witness to.

​So, if you are involved in a trauma, you actually have a form of ‘wound’ within your brain – as trauma impacts the brain – what’s in the brain is also in the body and vice versa. Despite what some therapists say, ‘trauma’ is not the thing/s that happened to you, but the imprint/wounds the events have left behind.

The wound in the brain is within the microscopic circuitry known as the ‘neural network’.

The good news is wounds heal, but sometimes they just some more attention to help them heal, just as any other wound might need some attention from a nurse, surgeon or physiotherapist.

We can think of trauma as a piece of glass that has been dropped – it breaks into pieces or ‘parts’, sometimes known as ‘Ego States’.

The parts of glass are fragmented from each other, and the spaces between the glass are the effects of the trauma. These parts of glass can hold different memories, so sometimes we might not be able to remember all the details of an event or time, memory may seem vague, or we just remember a couple of things… However, the brain is not made of glass, it’s more like a jelly, so parts are more on a continuum or spectrum, imagine looking into an ‘infinty mirror’.

Trauma therapies allow the reintegration of the pieces of glass so that trauma is healed. Note: that not all therapies are designed to heal ‘trauma’, and some can do more harm or act as a ‘sticking plaster’ while underneath the plaster the wound decays.

​Because talking therapy or CBT is usually not enough to heal (and sometimes challenges and goes against healing), different styles of therapy are required to reach the areas of the brain where the trauma resides. Normal talk therapies such as ‘solution focused therapy’ and cbt do not target the where the trauma is in the brain, and talking therapy alone has shown to be largely ineffective at the treating trauma, and can actually further embed the trauma or bury it further into your system.. just because a counsellor says they work with trauma doesn’t mean they have the adequate training to work with all aspects of the traumatic injury and symptoms.

Unprocessed difficulties, and traumas may re-occur or be ‘triggered’ if they have not been dealt with. Trauma is so deep rooted within the neurological network of the brain & body that we need to work at this level to help ‘process the unprocessed’.

Traumatic response in the therapy world is said to be a ‘normal response to an abnormal experience’.

Any event that is, or is perceived to as distressing, or life-threatening is traumatic. Trauma will affect you emotionally, your behaviour, mentally, and physically. In fact, it always affects you physically because the trauma resides in close to the ‘fight/flight’ area in the brain. ‘Not feeling’, ‘feeling empty’, or ‘numb’ are also physical feelings.

Traumatic experience often leaves people highly ‘attuned’ or on ‘hyper alert’ to their environment, further stresses and threats in the future. This is a natural way your brain and body protect you from further harm. You may feel as you losing your mind – as your brain, body and nervous system takes over to keep you safe.

Trauma response could even be being ‘highly tuned’ to others, and sensing another’s inner world at a felt sense. The most traumatised people can be the most sensitive to atmosphere and other people’s energy and emotions.

If you are experiencing the effects of trauma you may be feeling more ‘jumpy’, or overly worried that the event will happen again, anger is very common too.. You may not actually be aware you are suffering from ‘trauma, C-PTSD or PTSD’ because for so long you have ‘just got on with it’.

Trauma may be more general, than specific to a ‘one-off’ event. You may have suffered constantly over a period of time, which has created a ‘trauma network’, this may be known as C-PTSD.

‘Trauma can go unhealed on the inside, and cause difficulties on the outside”

BSP, EMDR, EMI, IFS Therapy, Lifespan Integration and Sensorimotor Psychotherapy are trauma therapies that access the trauma to process the ‘unprocessed’. Brainspotting, IFS, and some EMDR techniques are really useful for people who find it too traumatic or difficult to talk about what has brought them into therapy. Another way to think about trauma therapy is that – trauma therapies ‘do something about it’ rather than just talk about it.

Signs of trauma – C-PTSD – PTSD may include:

Aches and pains

Addictions & compulsions

Alcohol & substance use

Anger, irritability, mood swings

Anxiety and fear

Avoidance of others or situations – particularly busy places or crowds.

Being startled easily

Body dysmorphia (BDD)

Confusion

Depression

De-personlaisation or dissociation

Difficulty concentrating

Disconnecting/Dissociation (Spacing out, feeling far away, fuzzy, floaty etc.)

Drinking alcohol or using drugs/substance as a way of coping, blocking out or ‘self-medicating’

Eating problems

Edginess and agitation

Fatigue

Feeling disconnected, low or numb

Feeling sad or hopeless

Fibromyalgia

Guilt, shame, self-blame

Irritable bowel syndrome / I.B.S

Insomnia, nightmares or flashbacks

Isolation

Lashing out

Memory problems

Muscle tension

Nightmares

O.C.D behaviours & thoughts

Phobias

Revisiting or avoiding the place where the trauma happened.

Racing heartbeat

Self-harm

Sexual difficulties

Shame & guilt

Sleeping problems inc. sleep paralysis

Shock, denial, or disbelief

Shutting down, unable to feel ‘love’

​Suicide

Stuck-ness

Tinnitus

Tics & involuntary movements

Newer theories are discussing the healing properties of attachment.

PTSD and other trauma-related conditions