This is the second in a series of three articles, which use a physiological and neurobiological approach to explain why relaxation is so amazing, and how it allows someone to let go of old fears and be more present. In the first article, which you can find here, I looked at how to understand rest in terms of various body systems, and I described what happens to those systems during the stress and fear responses.

Now we’ll turn to how people end up staying stuck in those stress/fear responses, and what kind of effects that can have in the longer term, in terms of a person’s physical and psychological health. I explain how getting “unstuck” can happen through learning to relax tension, and how this can allow old emotions to be processed. This bottom-up, physiological approach to emotions is at the heart of a bodywork approach to recovering from trauma.

Staying Stuck in the Stress/Fear Response

In the first article, we saw how being stressed/afraid trigger your body’s deeply wired “stress response”, which acts via the hypothalamus to release hormones like cortisol and adrenaline, and also activates your sympathetic nervous system (SNS). That response should ideally then be “completed” by your parasympathetic nervous system (PSNS) return things to normal. But often, our fear/stress responses are not completed on a physiological level, which this has drastic physical and psychological consequences.

One way this can happen is when someone has experienced trauma. What counts as trauma, from my perspective, is anything that a person experiences as threatening their existence, whether on a physical or psychological level, or both. This could be one event, like a car accident or sexual abuse, or can also be something that happens continually over a longer period of time, like an abusive relationship. If someone never managed to “complete” the fear response triggered by those situations, for whatever reason, then their system is in some ways “stuck” in a form of our primal, physiological fear response. This can take two broad directions.

Many people remain stuck in sympathetic over-activation, which over time can manifest as anxiety, panic, mania, hypervigilance, sleeplessness, dissociation, attention deficit, OCD, emotional flooding, and chronic hostility or rage. There is the sense of being alert and ready, trying to keep things in control, as if something bad could happen at any moment.

Others can get stuck in the parasympathetic side of the nervous system: in a shut-down state, rather than over-activation. Here, it’s as if the system managed to repress or shut down the sympathetic activation stage and skip straight to PSNS activity. In the longer term, this tends to appear as depression, lethargy, exhaustion, chronic fatigue, dissociation and low blood pressure. Things appear more grey, more flat, with little motivation present for what someone knows logically they are interested in.

Even without experiencing trauma though, many people get stuck in those responses by never having being guided during their earlier years with how to complete them. Let me explain. In psychological terms, the two ways of being stuck have been associated with the different styles of insecure attachment. This is shown by the resting level of cortisol and the reactivity of cortisol and the stress response in infants who are insecurely attached. This relationship between attachment and physiology has been excellently summarized by Sue Gerhardt in her book “Why Love Matters”, which explores infant neuro-psycho-physiology, showing the huge effect of primary caregivers’ ability to respond to infants’/children’s emotional needs. To a large extent, the sensitivity of our stress/fear responses get set during the first four years of life.

In short, we end up in these patterns because either we were never shown how to deal with uncomfortable emotions, or because they were too constantly present to be able to deal with them. Resistant insecure attachment is associated with having unreliably received attention or emotional regulation as an infant. The system is on alert, sensing, emotions bubbling close below the surface, ready for the moment to grab the caregiver’s attention, stuck in the activated, sympathetic nervous system.

Avoidant insecure attachment, by contrast, is more like pushing feelings away, and is associated with getting stuck in the parasympathetic system. It’s associated with the infant having received a negative response to their feelings, which could be because of “empathetic failure” by the caregiver (“you aren’t hurt”), or with a strongly critical parenting style, or with a child feeling that the caregiver was just not in a position to be able to deal with their emotions. The child effectively learns that there isn’t space for their emotional responses, and learns a way to control them or shut them down.

There can of course be different combinations of the two systems, or someone can oscillate between the two, as with disorganized attachment.

Nerves and synapses

Nerves and synapses, firing and firing and firing…

The Effects of Staying in the Fear Response

The long-term physical and psychological effects of not completing our stress/fear responses cannot be overstated. A chronic level of sympathetic dominance and high cortisol leads to a variety of negative symptoms and illnesses that have long been associated with stress. In the long term, these systems suppress the immune system, leaving someone more susceptible to infection, inflammation and risk of cancer. It interferes with digestive activity, raising the risk of developing food allergies and suffering from other gastro-intestinal issues, as I describe in my article on stress and the belly. It creates hypervigilance and arousal, which can lead to nervousness, anxiety and panic attacks. Another side-effect can be a detrimental effect on memory, through the damage to the hippocampus in the mid-brain.

High cortisol is also linked to the right frontal brain, which generates fearfulness, irritability, sadness and withdrawal from others. There are strong links between high cortisol and many emotional dysfunctions such as depression and anxiety, post-traumatic stress disorder, as well as eating disorders, alcoholism and obesity.

High cortisol and SNS activity also creates a constant release of stored fuel (sugars and fats) and the suppression of insulin (to stop sugar being stored), which can lead to type 1 diabetes and high cholesterol. The extended periods of high blood pressure and heart rate can lead to various heart-related problems. Being in a state of continuous stress can also cause a distortion of the usual cortisol cycle, creating sleeping difficulties.

When the HPA stress response is over-activated, there are chronically high levels of the hormone CRF release by the hypothalamus. Some research shows excessive CRF can result in the stomach and intestine cells becoming extra-sensitive to pain. Other research has linked, CRF in limbic brain regions to increased fear, alertness and decreased appetite and sex drive, which are all relevant to depression and anxiety disorders.

Relaxing Muscles and Unlocking Fear

So how do we learn to unlock those uncompleted stress/fear responses? To answer this question, we need to turn from the system level to the muscle level. At the start, we said that one aspect of relaxation is letting go of muscle tension. Our fear and stress responses create increased muscle tension, so that everything is either wound up and ready to act, or tensed in a frozen state. In order to complete this response, we need to be able to act and use all of this wound-up energy, and we need to able to rest and discharge afterwards. These two things allow us to release this tension: otherwise the muscles stay stuck in this state.

For the muscles themselves, being stuck in one of these states is like receiving a continual message from the nerves that they should be contracting. Muscles are made up of many muscle units. A muscle unit in turn is a group of muscle fibres supplied by one branching nerve, and muscle units operate according to an all or nothing principle; they can either be contracted or relaxed. There is no in-between. When you move with more strength or against a greater resistance, what you are doing is recruiting more muscle units, not increasing the contraction of one unit.

When the muscles stay contracted without being able to complete the fear/stress response, the state of fear becomes “trapped” in the muscles. During the fear response, the body is flooded with energy for dealing with the situation, and if we stay stuck in a tensed posture without actually acting or relaxing, this “energy” seems to get “locked” inside the muscles.

It is not clear how this trapping occurs on a physiological level, but it is clear that when this tension is finally released, when someone relaxes that tension, then energy is released and the body returns to the state of fear that it was in when the response was initiated. This happens even if the tension is released years later. And this happens for anything involved the fear response, meaning that someone felt a threat to either their physical or psychological safety.

Trauma should always be considered in the context of each person’s perception. This could have been sexual/physical abuse, an accident, war, illness, or an operation: things associated with big-T trauma. It could also have been the cumulative effect of emotionally distressing experiences as a child, like being criticized, ignored, or living with unpredictable surroundings: which we can call little-t trauma. Other cumulative traumas could be extended exposure to stressful/frightening situations, homophobia, transphobia, racism, sexism, classism or poverty.

This unlocking of the experience of fear is why various forms of relaxation are more powerful than they might seem, and it is also why mind-body techniques require guidance so that this process can happen in a safe way, without someone becoming further dissociated or re-traumatized. We will look at a few relaxation techniques at the end of the article, but first let’s go further into what happens during muscle relaxation, and how it can be the key to resetting the autonomic nervous system and dealing with trauma.

1009_Motor_End_Plate_and_Innervation

Completing Trauma: Muscles and Nerves

When we talk about releasing fear, we need first to consider fear and emotions in general. Emotions do not take place in a vacuum or just in your head. Emotions, especially fear, are physiological states as much as psychological ones. Recent research suggests that bodily states are interpreted in the brain to create emotions, suggesting that the visceral response is a necessary (but not sufficient) factor for the occurrence of emotion. In fact, there are more one-way neuropathic connections going up from the body to the brain than there are going from the brain down into the body. This bottom-up approach to emotions is different from the traditional approach in psychology, which goes first for the thoughts and emotions.

Often in psychotherapy the approach is to talk about problems and then try to get the client to feel what they’re feeling as they’re talking. When a person talks about emotions or memories, they are in an intellectual form of description, in which their cortex is active. But when someone is stuck in a fight/flight/freeze response, they are functioning in the limbic system and brainstem, which are deeper in the brain than the intellectual pars of the brain. Neurobiology research shows that the fear responses are controlled from different parts of the amygdala in the limbic brain, which projects to the brainstem. There are also feedback loops with the cortex, but the main activity happens below.

If you want to get out of the core of the fear/trauma response, you need to talk to this level of the nervous system, and the language of the brainstem is that of physical sensations. Since fear happens on a body-sensation level, going into this level is also the way to get out of it. In fact, functional MRI research has shown that when people are in a state of trauma, they actually shut down the frontal parts of their brain, in particular those responsible for speech (Broca’s area). This is why it’s difficult for someone who has been triggered into a fear state to be able to put into words what’s going on or what they’re feeling, which can lead to frustration if a therapist is pushing someone to describe that.

Only when the physiological stage of trauma has been dealt with can someone move on to dealing with the emotions related to it. Otherwise, relating to the emotions will either cause them to shut down or throw them back into their fear response.

Working on the level of physical sensations, a person can learn to notice which areas feel locked, tensed, frozen or paralyzed. Now we are in more of a position to understand why fear seems to be unlocked when someone activates paralyzed areas, or lets go of locked areas. As well as releasing fear, letting go of this tension can also provoke a state of counterattack rage, as Peter Levine has explained, talking about his work in somatic experiencing. Physiologically, this is related to the tonic immobility state, in which someone has frozen or collapsed. Sometimes when animals are seen coming out of this state they go into a state of non-directive flight, running as fast as possible in any direction, and sometimes they go into a counterattack of rage. When humans come out of an old, frozen fear response, the potential for experiencing rage is also very high. Many people are afraid or overwhelmed by the strength of this feeling of wanting to strike out and the sensations that come with it.

This is why people can be re-traumatized by therapies where people are encouraged to go into this rage, and scream and lash out, because afterwards they will return again into a shutdown state, only to have to repeat the cycle again without really coming out. This is also why it is incredibly important to learn to let go of those old tension responses in small steps, like slowly defusing a huge explosive, wire by wire. Doing small steps means that the fear that gets “unlocked” each time is a small and digestible quantity.

A key aspect of this stepwise learning is to guide someone to feel their own power to act when they release the tension, because usually remaining in a state of stuck fear happens in conjunction with feeling/being helpless, powerless and overwhelmed. Often, letting go of the long-time tensed muscles brings up those experiences of feeling powerless and vulnerable. It is extremely important that the person is then guided towards an active response to the energy that they just released, for example by first feeling the energy in their body, like in their arms and legs, and then moving with it rather than feeling paralyzed. This brings back feelings of strength and empowerment.

To summarize this section, we’ve now seen that the effect of muscle relaxation is to retrain the nervous system to not be stuck in the fear responses of the brainstem and sympathetic system, and to not be giving the muscles the continual message to contract. Old, uncompleted fear responses are brought to completion. The experience of the old fear is brought into a feeling of a person’s own strength rather than their powerlessness. This has a profound effect on someone’s psychological state.