Chronic Pain After an Accident

When people get in a car accident or have another type of sudden injury, we notice that some people seem to heal just fine and others can get stuck with chronic pain.  There’s nothing fair about it.  For those of us who get stuck with chronic pain, we can also get stuck feeling helpless.  If this has been your experience, I’m deeply sorry.  I really want you to know that often, there is more that we can do.  Let me explain.

Our nervous systems are intelligent and know just what to do when we get in an accident.  They kick in something we call the threat response cycle.  This cycle comes from part of the brain that doesn’t involve conscious thinking so that it can happen so much faster.  This is why we aren’t usually aware of all the ways that our brains are working to protect us in a traumatic incident.

If we slow down the threat response cycle, it would look like this:

1. Arrest/Startle – We stop instantly and notice the disruption. (Think of a deer in the woods happily munching on leaves. He hears another animal in the trees, and stops, noticing the sound).
2. Orienting – We look for the danger, and find where it is coming from. (The deer looks around and listens.)
3. Specific Defense – Fight, Flight, or Freeze. Our system uses energy to take whatever action is the best fit to protect ourselves. (The deer runs away from the hikers.)
4. Completion – If our defense works and we see a resolution, then the energy gets used for action, and is discharged from the body.  Only then can our nervous system settle again, allowing us to return to a relaxed alertness. (After running for a little while, the deer realizes she’s far enough away from the people and she can rest and eat again.)

The trouble begins when this cycle doesn’t get to be completed.  If we can’t complete the cycle in the way that our bodies want to, then the energy gets stuck.  Here are two examples of that:

• Perhaps a car accident occurred while you were looking around to see if traffic was coming.  Then the energy gets stuck in the orienting phase.  This could show up as neck and shoulder pain that doesn’t seem to get better despite quality care.  The body still wants to complete the action of looking around to successfully see the danger.
• Perhaps your body chose to freeze in reaction to a threat.  If the energy is stuck in that phase, you might find that some muscles still will feel stiff and tight for seemingly no reason.
• We can even see a pattern of “hyper-arousal” which is a body being stuck in the “on” position.  That might feel like chronic anxiety, finding it super hard to relax.  One of the causes for this can be feeling like there was constant threat while growing up.  For the same reason, some people can get stuck “off”, in a freeze position.  When that happens, it can feel like you are never fully waking up and that you are constantly on mute.

The human body is complex and amazing.  Because of this, there are lots of ways that trauma can show up psychologically, physically, and emotionally such as:

• Nightmares or flashbacks
• Feeling on “hyper-alert” for threat
• Depression
• Anxiety
• Low self-esteem
• Chronic inflammation
• Muscle tension
• Brain fog
• Digestive or stomach issues
• Fatigue or chronic fatigue
• Physical ailments like headaches or stomach pains
• Addictions or compulsions
• Sleep disturbances
• Chronic pain that doesn’t seem to resolve with medical care
• Withdrawal from the community or the feeling of wanting to hide
• And so many more

The good news is this: there are tools to help you get unstuck.  Thanks to neuroplasticity, we can change our brain’s responses at any age!  Here are some tips to help you get started:

• Use a long out breath—extending our exhales so that they are longer than our inhales lets our nervous systems know that we are safe so that our bodies can heal.
• Make a “vu” sound—take a deep inhale and on the exhale, make a low “vu” sound, extending the “uuu” sound until the end of the breath.  This can be helpful as a way to gently move out of a freeze state, as well as to bring more regulation into the system.
• Notice what’s working—Noticing the parts of our lives that are already working and pay attention to when you find moments of safety, connection, or ease, even if only momentarily.  This is the beginning of trauma work that builds new neural pathways in our brains.
• Practice checking in with what is happening inside your body—ask the question: “What am I noticing in my body right now?  What sensations am I aware of right now?”  (hot, cold, expansion, constriction, tightness, tingling, . .).  If you find some place that feels less comfortable, you can make some contact with your hands in a gesture of support, maybe find some gentle movement, like rocking or swaying, and notice if it helps you feel a bit more regulation.  Practicing body-scan meditations is another helpful way to do this.
• Practice Self-Compassion.  No matter what we’ve been through, we can see the ways our nervous system has worked hard to protect us, and we can cultivate an attitude of kindness toward ourselves, with the understanding that where we are makes sense, given our experience.
• Read Peter Levine’s book, “Healing Trauma”.  It’s full of exercises to help us gently become more connected with our bodies and begin the process of recovery.

All of these tools above are only a beginning.  They are simple practices that we all can do regularly, whether we have experienced trauma or not.  For many people, the support of a practitioner trained in Somatic Experiencing or another somatic or body-oriented psychological model will be essential to a full recovery.  We can help you get unstuck, work to safely complete the self-protection responses that did not get to complete, and help to reorganize the survival energy that’s “all dressed up with nowhere to go.”

Author:

Cheryl Verheyden, MA, RCC, SEP, is a counsellor and a Somatic Experiencing Practitioner in British Columbia who is passionate about helping individuals heal their nervous systems, uncover personal strengths, and return to a sense of vitality and authenticity.