In this entry, I'll be exploring the science of stress, how it affects us as humans, and how faith itself can serve as an intervention against the adverse effects of stress.
Over the past few weeks, I have been working through a workshop on treating trauma led by Dr. Eric Gentry, PhD. He is a leading specialist in the treatment of trauma and he and others have put together a treatment approach, which he discusses in his book “Forward Facing Trauma Treatment”. I have found that one of the key components to his approach is the utilization of what’s known as “psychoeducation”. The purpose of psychoeducation is to dispel any myths that may be leading the client to some false beliefs which have a negative impact on their overall mental wellbeing. This is what is known as a cognitive distortion. An example of this would be “catastrophizing”. This is when our mind automatically ruminates on the “worst case scenario”. Usually this causes significant distress. Psychoeducation can be used to educate the individual on the probability of worst-case scenario—which is, in most cases, minimal. It can also be utilized to make the individual more aware of how this thought is affecting his or her emotions and behaviors.
One of the most fascinating and helpful psychoeducation concepts regarding trauma is the subject of the Autonomic Nervous System (ANS). Now, I want to be clear, I am not a doctor or neuroscientist, so my understanding of the ANS is merely relevant to what is helpful for the client. So, I will briefly introduce the concept, and then discuss why it is important to understand, and how it can be used as a tool to improve your mental health. Unless otherwise stated, my work concerning the autonomic nervous system is derived from my workshop which can be summarized in Dr. Gentry’s book “Forward Facing Trauma Therapy: Healing the Moral Wound” (Gentry. 2016).
So, what is the ANS?
The ANS is a system that works outside of our conscious control. It is a system of nerves that sends impulses from the brain to various organs which operate without us telling them to do so. An example of this would be your heart. There are two parts to the ANS: the sympathetic nervous system and the parasympathetic nervous system. These two parts can be conceptualized like a balance or a scale. Depending on the neurotransmitters produced by the brain’s central nervous system, the scale will tilt toward one side or the other—which sends the body into two opposite states.
The parasympathetic state is primarily a state of rest. It is in the parasympathetic, or “cold state”, that we do things like eat, sleep, and reproduce. In other words, when we are in a cold state, it is because we do not perceive that there is any nearby threat. The primary neurotransmitter involved in the activation of the PNS is acetylcholine—which works to slow down your heart rate.
Conversely, the sympathetic state is related to the activation of the fight, flight, freeze response. It is in this state that the heart rate increases, we get tunnel vision, and at the height of his state is a near complete shutdown of neo-cortical functioning (aka thinking). It might be trite to explain what the purpose of this state is, but it bears repeating. Most would speculate that this is for protection, and I don’t know that anyone has determined a better reason. Regardless, when the brain senses danger, it sends signals via neurotransmitters (norepinephrine) to go into emergency mode (Tindle, & Tadi,2020).
So, why is it important to understand this system and how it works?
Most people who I see in counseling (and other counselors I have consulted with would agree) come in because they have experienced something overwhelmingly difficult, and they do not like how they are responding to it. I often think back on the words of the Biblical author Paul who, in Romans 7:15, said “For I do not do what I want, but I do the very thing I hate.” (English Standard Version). This might be one of the most relatable lines ever written, Biblical or otherwise, especially in the context of counseling. The people who come into my office have real questions about why they abuse substances or pornography, or why they have outbursts of anger towards their wife or kids, or why they feel so anxious and/or afraid all the time.
The answer to any of these questions can seem complex, as symptoms of any problem can be influenced by genetics, personality, and environment, but in a general sense it is very simple. Either through a specific unresolved traumatic event, or through chronic stress, the brain has learned that there is danger all around even when there is no danger. The individual stays in a near perpetual sympathetic state (a state known as "sympathetic dominance”). Our brains adapt themselves according to our environment. Some of the symptoms of sympathetic dominance are: anger or irritability, reactivity, impulsivity, self-medication, hostility, irrationality, anxiety, sleep-disturbances, coerciveness, and tension in the chest area/clinched muscles. Notice that these are all action-oriented behaviors or symptoms and are exactly how you would expect a person to react if they were placed into a dangerous situation.
If a bear were to walk in the front door of the coffee shop you’re sitting in right now, you would not want to continue enjoying your delicious cinnamon roll and pumpkin spiced latte. No, you would be ready to throw your coffee and run. You might act impulsively and shout angrily. You may even lose sleep over this event for a week. This is the state that many of us find ourselves in when we are confronted with things like being cut off in traffic, having a difficult discussion with a spouse, or receiving constructive criticism from a boss or coworker. Why? Because our experience has taught us that this is the level of response required when dealing with such stressful situations.
The problem is that somewhere along the way, we learned that danger is lurking behind every corner to varying degrees. It may not be a bear, but it could be the potential of losing your job, financial ruin, or being ostracized by your family or community. While these are certainly difficult things, they are not real dangers to your health and safety, nor are they very likely to occur. Furthermore, when we dwell on these things, we often are missing out on the things that are happening in the moment like our kids playing on the beach, the beauty of a summer thunderstorm approaching after sunset, or any level of enjoyment in the career that we passionately pursued for so long. Then we look back on these moments and pile on the guilt and shame for not being there when we “should” have been.
Often, when we experience the symptoms listed above, we shame ourselves with negative self-talk. This only exacerbates the stress as we continue to hide our fears and insecurities from others, we miss the opportunity for someone to speak reality into our lives that might free us from that downward spiral of negative self-talk. And Jesus graciously whispers, “come to me, all you who are weary and burdened, and I will give you rest.” (Matthew 11:28)
Dr. Gentry says that instead of shaming ourselves, these symptoms should be a flashing neon sign communicating that we are in a sympathetic dominate state. Our ability to recognize the state that we are in is called “interoception”—cue epic Hans Zimmer music. Interoception is simply our ability to feel the internal sensations in our bodies and interpret what it is
communicating. The best example of this is feeling the sensation of an empty stomach and recognizing that you are hungry. If we can understand that we are in a stressed or “hot” state through interoception, then we will be able to do something about it.
So, what can we do about our sympathetic dominant state?
There are three ways to answer this question. First, we can develop our support system by reaching out to family, friends, or church community. This gives each of us an opportunity to talk through some of the more difficult experiences of our past and present. In many cases, professional help becomes necessary, and it can help to a have community that can recognize that and encourage that. Second, we can work to increase our “frame of tolerance” through things such as mindfulness, diet, exercise, and rest. One important way to reduce the sympathetic stress response is to keep the heart rate low. This can be accomplished by paying attention to our thoughts, the food we eat, and the amount of time spent working versus being at rest. There’s a reason that war fighters are so good under intense pressure, because they train at a very high level. Third, we can practice self-regulation through exercises such as breathing or relaxation techniques to lower our heart rate and activate the parasympathetic system when there is no actual danger. Many war fighters and first responders are taught these techniques to deal with actual danger because their job is to move toward the danger, and to do this, they must overcome the stress response system. Lieutenant Dave Grossman discusses this at great length in his book, “On Combat” (2004).
One example of a breathing technique (one that I have found most helpful) is something I learned from Dr. Andrew Huberman’s podcast on stress. The “physiological sigh” is a quick two inhales through the nose, and a long slow exhale through the mouth. (a quick YouTube search of physiological sigh will bring up a short video of Andrew Huberman demonstrating this technique). This technique can be used whether you are experiencing psychological stress or physical stress when exercising. In fact, using this technique to lower your heart rate during exercise is a good way to practice using it when experiencing anxiety or even PTSD symptoms. Being in a sympathetic dominant state often makes it difficult to remember to utilize such a technique, so the more you practice, the more you will naturally remember to utilize it under duress.
There are many other self-regulation tools that are all over the internet, and the important thing is to find what works for you. Dr. Gentry points out that the power of belief in a technique is often more powerful than the technique itself (see Dr. Alia Crum’s (2016) work on placebo, self-fulfilling prophecies). I have found that keeping it simple works best when attempting to self-regulate while in a sympathetic dominant state.
From a Christian Perspective.
When I think about the autonomic nervous system, I cannot help but think about the fruit of the Spirit. We often attempt to pursue these “fruits” by praying for things like patience and humility. Much to our chagrin we only seem to become more and more aware of our own shortcomings the more we focus on the virtues we wish to embody. But as a pastor friend of mine pointed out to me recently, the word fruit used by Paul in Galatians 5 is singular, meaning that the virtues listed are all symptoms of taking of the one fruit of the Spirit. In other words, we don’t become loving by white knuckling our way into being loving. God is not a genie who just grants us our wish to be patient upon request (no matter how eloquent our prayer is when asking). Rather, our ability to love or to be patient is a natural overflow of our sense of being loved by the Creator through the presence of the Holy Spirit. It is the objective truth of the Gospel which sets us free from the bondage of our traumatic wounds (John 8:31-32).
God is rich in mercy, and steadfast in love despite our sympathetic dominance, or “works of the flesh” (Psalm 103:8). He is also the ultimate source of comfort and hope in times of trouble (2 Corinthians 1:3-4). This is one of the reasons why Alcoholics Anonymous emphasizes that individuals look to a higher power. If we only look to ourselves, it can be easy to be stuck in our sympathetic dominance and negative self-talk. If we look at our environment, we will constantly be reminded of the things that cause us stress. But if we look above all of that, we can see that there is a God who is not only sovereign, but also compassionate and desires a personal connection with us. A God who has initiated a plan to make all things new and do away with everything that is wrong in the world. A God who sets the prisoner free and adopts the orphans. This is what gives Christian’s hope. But it is not always so easy to remember when in a stressed state. Which is why it is important to understand the state you are in through interoception, to regulate through breath work or relaxation techniques, and then begin to remind yourself the truth of the Gospel either through scripture or Church community.
References
Grossman, D. (2004), On Combat: The Psychology and Physiology of Deadly Conflict in War and in Peace
Crum, A., & Phillips, D. J. (2015). Self-fulfilling prophesies, placebo effects, and the social-psychological creation of reality. Emerging trends in the social and behavioral sciences, 1-14.
Gentry, J. E., (2016) Forward facing trauma therapy: Healing the moral wound.
Tindle, J., & Tadi, P. (2020). Neuroanatomy, parasympathetic nervous system. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK553141/
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