Why is there so much fatigue in CPTSD/DID?

[Music] foreign Clinic my name is Dr Mike Lloyd and I'm the clinic director we're going to be looking at a question today that has been asked by one of the subscribers Erica Regarding why is there so much fatigue in conditions such as dissociative identity disorder chronic post-traumatic stress disorder cptsd or Associated conditions like osdd or partial did and this is a very common question so again this is something that is that's relevant for many people because fatigue is something that is experienced and felt widely in the people of uh that we were considered today to be trauma survivors and often people are very very good at managing their energy levels so the well the exercise you know might have quite healthy productive lives they might not but for fatigue to be present in people that have those good energy resource skills it seems like an odd thing to happen and yet this is something that occurs time and time again and things like chronic fatigue syndrome or just general levels of chronic fatigue are very very commonly expressed as a problem in people's lives they might be functioning quite well in terms of the dissociation or the trauma and yet the fatigue persists so we ask her the question you know why is this and what I wanted to do today was look at one reason that we think might be relevant in answering the question is why is this so much fatigue in these conditions of a traumatic nature I'll start with the the perspective of what we're looking at that we understand that trauma is held within a dissociative system for people who are dissociative so the dissociation occurs to sort of wrap itself around the trauma it compartmentalizes it moves things around it shapes the organization of the trauma in a way that is tolerable for the person especially if we're thinking about trauma that occurred early in childhood that's the time when the person the infant the baby the child is least able to contend with and hold any kind of traumatic experience so as adults we can hold trauma we can make sense of it we can use all our cognitive abilities as children we can't do that sometimes children are precognitive so they are literally living as bodies existing in the world and that trauma has to be managed somehow to avoid being overwhelmed which is a threat to the system so the dissociation wraps itself around the trauma to sort of take the trauma away from the person's everyday life and functioning that exists and that works very well now the problem occurs when the person then grows and develops and moves into adulthood that that dissociative containment remains in place now that takes an awful lot of energy to look after that so as it's being held for years and years and years what we see then is that a person's basic default store of energy is already being used to work to keep that dissociation in place now we may think well why don't we just take the dissociation away and deal with the trauma but that's not what a lot of people want to do they want to dismiss the trauma think avoidance of trauma to avoid talking about the trauma thinking about it looking directly at the trauma is to deny that the trauma exists is to take away that experience that is a really natural response and we're totally okay with people doing that because it seems reasonable to just not want to go anywhere near it so what people do is they have this phobic response to the trauma to the memories of it to the sensations of it to sharing it to talking about it there might be shame there might be disgust there might be fear apprehension dread sense of consequence that something awful will happen they may have been threatened to keep the charm former quiet to keep it hidden to keep it secret there's loads of reasons why a person will not go anywhere near their trauma will not discuss it and maintain therefore that dissociative containment in place around that trauma this is all about energy it takes a huge amount of energy to actually maintain a dissociative response people are constantly then going through life trying to avoid anything or trying to manage triggers or deal with triggers deal with these traumatic consequences of anything that occurred and took place early in childhood what people end up doing then is just saying I just want to leave it alone I don't want to go anywhere near it I don't want to discuss it I don't want to talk about it I just want to leave it alone and that's fine and that's what people do but the trauma still exists so just because a person may want to leave it alone doesn't mean it's being left alone the body keeps the score it is held within the body it's held within the threat response system in all the neurological apparatus in the brain and all the physical response systems our gut our hearts our lungs everything our breathing everything is connected to this trauma so the amount of energy that is being used up on a daily basis to not deal with the trauma is enormous and as therapists we just turn around and go well you know the balance of probability says that if you expend the troll if you expend the energy in the here and now and deal with the trauma it will give you freedom of that energy later on down but people are terrified so even if they know it's the thing to do they're scared of it and then the dissociation can kick in as well so a person might come into trauma therapy in order to be able to process and understand what went on and then during that process the dissociation kicks in then they can't do it that makes them more apprehensive more Dreadful they flee therapy they might exit they might leave whatever and it stops them actually processing the traumatic experience so the dissociative containment remains in place I'm sure all of you will have heard at some point hearing a person say it feels like the weight has been lifted from my shoulders so they've said something they've shared something they've they've revealed they've exposed a secret or a shameful thing or an embarrassing thing or something and then they've been okay you know people have listened to it and they've gone you know that's absolutely fine I understand where that comes from and they people talk about they've shared it a weight has been lifted from my shoulders think that if that weight was your trauma how tired you would be having to walk around the place lugging that thing all your life we are designed as human beings to be able to hold on to enormous weights trauma instant things for a brief amount of time which is called the acute response we are not designed to deal with the chronic response you have to be heavily trained so if you put let's say if you're training to be in the military and you put a backpack on your shoulders with like a 30 kilo 50 kilo weight in it and you start running across across the hills you're going to be knackered really really quickly but soldiers trained to do that over a period of months and years and they can do it very very well we're not designed to do this naturally so when we have this traumatic weight of our childhood experience and we are carrying it around with this for years and years and years the end product is that we end up on our knees we are absolutely exhausted the goal of trauma therapy is to bit by bit lift all of those weights out of that rucksack start handing them over to the therapist who can take them away and process them and deal with them in a really structured and organized way that does not cause harm to the therapist if it's all done well and then the person is relieved of that burden and actually the trauma therapy then starts removing that phobic response develops confidence gives that person that autonomy over their traumatic experience the weight starts coming out of the backpack and they start being able to walk upright again possibly for the first time in their lives and we notice that the fatigue starts falling away that person's energy is already there it's just not being used to have to do this avoidant mechanism once the avoidant mechanism is taken away the person can then have that energy to use for positive things in life so enjoyment you know holidays trips spend time with friends spend time with family just being peaceful and not being exhausted actually brings out better levels of energy so confidence gives people energy phobic responses reduces People's Energy once we've got that equation balanced out a lot of the time the fatigue starts passing away now if there's physical things that have taken place as a result of the long-term consequences of this that has to be dealt with differently if we're thinking purely about the psychological construct of it the basis of this is in conclusion then is that trauma is exhausting and holding on to trauma for years and years and years and keeping it locked away inside the self and not being able to share it not being able to hand over and be supported by another person is exhausting so if we know it's exhausting why would we not expect fatigue to be present so if fatigue is present chances are it's because there is a trauma that has not yet been processed or understood or walked towards the avoidance leads to the fatigue it's a huge energy drain to avoid doing something in the long term so I hope that I hope that gives a few answers Erica I hope that slightly answers your questions as best as possible um it's it's looking at this as a normal thing it makes sense that if you carry a burden if you carry a weight in your character a long time you have to expend more and more energy and the weaker you get the harder it becomes the more tired you become the more energy energy you expend the more exhausted you become it's a another one of these closed loop systems so hopefully that's been a bit of an overview on to why fatigue might be present in cptsd did osdd all of those things and a few things that can be done to try and reduce the effects of that so keep watching the videos please keep commenting on them keep offering us questions it's great seeing the things that people want to talk about obviously we can't look at everything but but we try our best to uh you know figure out what the best answers might be to the questions that you bring so keep them coming and we'll keep producing the videos and uh in between now and the next one then please do take great care

Channel: The CTAD Clinic

Views: 13,770

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Id: 7A6hfAWjZ3c

Length: 10min 38sec (638 seconds)

Published: Thu May 25 2023