Friday, October 15, 2010

Post Traumatic Stress

Towards the end of last year, my best friend from high school (oh so many years ago) contacted me and informed me that his 15 year old son (Cam) had been attacked on the way to school. Cam is a fit, strong and muscular (unlike his father and me at the same age ... or ever), and confident young man who is a talented Aussie Rules football player. Unlike his talented father, Cam also plays the game quite aggressively, not being too shy about playing the game on a physical level.

On the way to school one day, Cam was jumped by two young men who initially king-hit him and laid into him while he was on the ground. The 'reward' for their efforts was five or ten dollars. According to the police, it is a common practice for some young lads to travel from the poorer northern suburbs to the middle-class southern suburbs, buy a burger (breakfast of 'champions'), and mug some unfortunate before jumping on a train to return home. A day out if you will.

What made this experience even more devastating was that as Cam attempted to stand up, one of the assailants took out a stanley trimmer and slashed at Cam's face. Fortunately Cam put his hand in front of his face in a defensive reflex, receiving lacerations to the palm of his hand rather than to his face and/or eyes which had been targeted. This is a young man's first experience of violence other than on the football field, movies, television, or computer games - none of which prepares one for violence with the ugly face of an intention to do serious harm. There is a significant difference between an opponent who wants to 'win' and one who wants to hurt you.

Cam's father asked if I'd show Cam some defensive tactics and techniques (obviously not using those technical terms). Of course I immediately agreed. However, due to my research in writing my book(s), I was in a far better position to assist Cam and his family than I have ever been.

While researching/writing my originally proposed book on the tactics and techniques of Jan de Jong jujutsu, I intended to provide a couple of paragraphs on why pain is experienced when a joint is moved towards, but not necessarily beyond, its range of movement. This led me to a body of knowledge on pain which I hitherto had been sorely ignorant, and which came to form a chapter dedicated to pain in the aforementioned book. A part of that chapter was devoted to 'stress induced analgesia' which refers to increased pain tolerance due to hormones released in times of stress.

I recalled a particular incident when a 'customer' of the Jan de Jong Self Defence School and Martial Arts Supplies pulled a knife on me and placed it on my throat. What was my physiological response? Nothing, nada, zip. There was no 'hormonal cascade', no adrenalin dump, and consequently no increased pain tolerance. Why not? This led me to investigate stress from which I uncovered the most amazing concepts and theories which facilitate the understanding and study and possible development of the tactics and techniques of the martial arts.

My research uncovered the stress process and a stress process model. The input (stimuli) elicits a physiological, feeling, and behavioural response which is the process which produces an output. This is the nature of a process - input, process, output. But the stress discipline did not tend to study the feeling and behavioural response and tended to define the output in terms of health issues or effects of stress on performance. This did not help explain why I didn't gain the benefits of our evolved responses to deal with threats.

I'm an accountant (among other things) and so reconciliation is something I gravitate towards. I couldn't reconcile the theories and concepts of the stress discipline with the stress process model and my experience. More research (the story of my life for the past few years). I cannot remember how I did it, but I stumbled upon the emotion discipline which studies the exact same process. The stress discipline and emotion discipline study the exact same process but do not refer to each others concepts and theories - unbelievably so. Surely the very definition of inefficiencies. The emotion discipline tends to focus on the feeling response and behavioural response, have a more detailed process model, and define the output in terms of the intended effect on the initial input/stimuli. A threat elicits a physiological, feeling, urge to act (unique to the emotion discipline and humans), and behavioural response which is designed to interact with the initial stimuli and reduce the threat. Brilliant! A model which explains all interpersonal violence to a large degree. A model which can be used to study and understand all interpersonal violence. A model which can be used to study and understand all martial arts. A model which offers the promise of developing new and improved methods of dealing with interpersonal violence, both pre, during, and post the actual event.

The responses are evolved responses designed to assist humans in dealing with harm, threats, and challenges. Unfortunately, these very useful adaptive features have not been fine tuned to only be turned on when an actual threat is present. There is an appraisal element to the process. The reason, I have postulated, why I didn't experience the hormonal cascade designed to assist me in dealing with the threat of a knife on my throat, the reason why I didn't feel fear, anger, apprehension, well anything other than slight annoyance, was that I did not appraise this situation as being threatening. Post traumatic stress (PTS) is associated with this process being activated when there is no immediate and present threat, when the threat is imagined or remembered. There does not have to be an immediate or present threat for this evolved response to be elicited, but the body, mind, and feelings act the same as if there was one.

I was in a position to inform Cam's father of this possibility. To keep an eye out for the symptoms and provide an understanding of why they might be occurring. I was also in a position to inform him that PTS, the eliciting of these responses, was not only possible within the survivor (who we no longer refer to as 'victims')of an assault but also within others close to the survivor. Cam's father then could understand why his daughter, Cam's sister, had been acting differently since Cam's attack.

A couple of days ago I received an email from Cam. Even though we don't see a lot of each other (that would appear not to be my makeup) Cam considers me to be a close friend and supporter of his family. He is not wrong in that assumption. His suggestion that I am wise I put down to him not knowing me well enough or to the ignorance of youth. In his email he asked me my advice on boxing and certain training regimes. More tellingly, he confided in me he had been experiencing moments of anger he couldn't understand. He asked my advice concerning these anger issues.

Firstly, I am in awe of a teenager who identifies an emotional issue within themselves which they do not wish to be part of who they are. Secondly, I am in awe of a teenager who asks for help concerning these issues. Particularly when they are a young man living in a testosterone, ego, macho fueled sporting environment/society.

One of the ways being used to initially treat PTS is in understanding the process. Understanding what is going on within oneself so that it may be possible for that person to process the responses on an informational level rather than an emotional level. This provides the opportunity of reducing the intensity of the responses and managing the process. Here I was in a position to provide that information to Cam and his father. This information provides the opportunity for Cam and his father to understand and manage the PTS effects of the initial attack.

This understanding the process and processing the experience on an informational level rather than an emotional level can also be seen in chronic pain management. In fact, when you receive a needle and the nurse explains what you are about to experience, this is an example of providing information about the process in order that you might process the experience on an informational level and not an emotional level and thereby reducing the intensity of the negative experience.

Another of the benefits associated with understanding this process from an evolutionary perspective is that the responses are not judgement laden. You are not a coward because you felt scared. You are not 'bad' because you get angry. You are not weak because you didn't fight back. Judgemental attitudes have a lot to answer for in terms of human pain and misery and if society could embrace the Buddhist non-judgemental approach it would, in my opinion, be far more healthy.

So Cam and his father are more likely to seek professional help if the symptoms of PTS continue. Cam, to his credit and my humility, already raised the issue of seeking professional help when he asked for my advice. I've advised him before to look upon himself in the third person. We are often so more helpful and supportive of others than we are ourselves. I was a far better teacher to others than I was to myself. We look objectively on another in this situation and keep an open mind on professional help whereas so many would close their mind to this 'sign of weakness' if considered within oneself.

Cam's situation forced me to recall a private lesson I once had at the Jan de Jong Self Defence School (JDJSDS). This young man had been out with some young women who 'mouthed off' to other young men in a car park outside a pub. These young men took exception to the 'attitude' of the young women and confronted them. The young women responded by locking themselves in their car and leaving their lone male companion outside to deal with these irate young men. Long story short, the lone male companion got the s&*t kicked out of him and was rendered unconscious. He came to the JDJSDS seeking help. I can see the look of emasculation and doubt that was on his face. How he doubted himself, and judged himself. He was a nice young man, not physically inclined, not macho oriented, and this experience had caused him to question who he was and doubt himself.

We as instructors are often on the front line in these situations. People come to us seeking help after they've been involved in these experiences. If we want to truly help them we need to do better. We need to know more and provide more than just tactics and techniques. It behoves us to understand the nature of violence. This is one of the driving forces behind my now intended third book. It may be dedicated to the young man who came seeking help from the JDJSDS and with the assistance of the information contained within that book, I could have done a far better job. A far better job that I am fortunate enough to be able to provide to young Cam.

1 comment:

  1. I think your work is inspirational and gives everybody a lot of knowledge.
    There is to just to many myths in the MA comunity.
    What we really need is solid research giveing us facts that are credible, and I really belive that is what you are doing John - well done :)))

    keep up the good work :)

    Christian Hvidberg


Your comments make my work all the more relevant as I use them to direct my research and theorising. Thank you.