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Homeostasis Theory of Trauma & Healing
Posted on May 16, 2014
I want to focus the next several posts on the role of homeostasis. Homeostasis can be utilized to give us a deeper understanding of our clients and how to position interventions targeted at behavior change and/or healing past trauma. According to Google’s Dictionary, homeostasis is “the tendency towards a relatively stable equilibrium between interdependent elements, especially as maintained by physiological processes.” Let’s start by building on this definition and how it relates to clients who have experienced chronic stress and trauma.
Starting with “equilibrium between interdependent elements,” for our purposes equilibrium is the sense of balance in one’s existence. The “interdependent elements” are two-fold. The first is a change in the environment. This can be an addition or subtraction of a stimulus into a previously stable situation. The second is our psychological and physical states (which are the “physiological processes” mentioned in the definition). These pieces are interdependent as the addition/subtraction of a stimulus elicits a change in our psychological and physical states, in order to reestablish balance or equilibrium.
How would you describe your psychological state right now? Hopefully, if you found time to read this post you have a minute to relax and be present with these words. Now imagine a co-worker walks by and throws a hornet’s nest into your environment and it lands right at your feet. As the hornets emerge from their nest looking to take out their anger on someone your “physiological process” reacts immediately. The new chaotic stimulus in your environment triggers a release of chemicals to systems that can best deal with this changing environment. In other words your internal state is changed to come into balance with the reality of the environment. These changes give you the energy needed to run like hell to get away from the stimulus that triggered these changes. Once you are at a safe distance, your “physiological process” again changes to match an environment without the threatening stimulus (though you still might need to deal with your hornet nest throwing co-worker!).
The above example is an easy one because of the sudden introduction of an obvious stimulus that demands a concrete physical response. However, the “psychological processes” we use to establish and maintain homeostasis are complex and often outside of our conscious awareness. We are either constantly adjusting our “physiological processes” to match the changing environment (shivering when we are cold) or changing our environments to match our internal states (turning up the heat on the thermostat when it is cold).
In order to efficiently adjust our homeostasis on a regular basis, the brain creates “maps.” An easy example is your commute to work. If you have ever pulled up to work, parked your car, and realized you cannot recall anything about your commute, you already know about maps. Our brain uses maps to connect our memories and experiences to the present situation. When these maps get strong enough, either through repetition or in relation to something important, we need less energy to execute the actions associated with the map. Think about the complexities of commuting. First, driving is something so complex we don’t let our species do it until they are 16 years or older. Second, we have to manage complex social situations. It is amazing to think how coordinated we are as a society when it comes to driving. We, for the most part, have all internalized rules that allow us to drive at amazing speeds collectively with only simple means of communication (turn signals and the occasional middle finger). Third, driving is a very dangerous activity. How many chances are there in a typical commute to get in a wreck, which could lead to serious injuries or even death? We unconsciously manage hundreds, if not thousands, of potentially dangerous situations all the time, with the understanding that an accident could be life threatening.
With all these demands we still manage the complex social, mental, and physical aspects of driving, all in our unconscious brain. The repetition of the experience of commuting creates a detailed map in our brain. While this map took energy to create, once it is established it is now a tool of efficiency. Our unconscious processes and associated maps are critical because they save the limited energy we have for our brain’s operation. In other words, your brain knows that you need all the energy you can muster to meet the demands of your job so it saves that energy by utilizing maps for your commute.
As the commuting map demonstrates, maps are more than logical and physical step by step checklists. They also include memories, emotions, and social cues that allow us to keep ourselves safe and maintain homeostasis in specific situations. In future posts we’ll see how maps and the search for homeostasis can help explain psychological phenomenon such as childhood attachment and Post-Traumatic Stress Disorder.
This week’s homework is to see if you can identify any maps in your own life, especially those like the commuting example that allow you to operate in unconscious autopilot. If you do identify any, ask yourself what purpose this map plays in your life? Does it save precious energy? Are you utilizing past painful lessons to interpret present potential dangers? Is your life improved by having these maps or do they keep you stuck in outdated ways of doing things? If you feel comfortable, please share your thoughts in the comments section of this blog.
We had a patient in crisis yesterday. My map kicked it when he first broke down, began to shake and then went in to panic attack. I didn’t have to think about what to do next or how to get there. I went first for my social work case manager and when he was still struggling I went for my RN case manager. We talked him through until we could get him down to the first floor medical clinic. All three of us were on auto pilot, getting the doctor’s team called to fit him in by emergency, calming the patient, taking the steps with an internal map that guided us. There are some tougher decisions in a day where a person needs to ponder and has time to think things out. In crisis mode, there’s no time for “should we call a doctor? should we talk him down?” Your mind map has been there before and points the way.
We had a patient in crisis yesterday. My map kicked it when he first broke down, began to shake and then went in to panic attack. I didn’t have to think about what to do next or how to get there. I went first for my social work case manager and when he was still struggling I went for my RN case manager. We talked him through until we could get him down to the first floor medical clinic. All three of us were on auto pilot, getting the doctor’s team called to fit him in by emergency, calming the patient, taking the steps with an internal map that guided us. There are some tougher decisions in a day where a person needs to ponder and has time to think things out. In crisis mode, there’s no time for “should we call a doctor? should we talk him down?” Your mind map has been there before and points the way.