“Why are some people afraid to succeed but not to fail? Why are some more afraid of failure? How can one learn to embrace these two fears? What is the difference between them?”

A young Canadian woman wrote to me recently with these inquiries. I thought they were excellent questions, and decided to share my thoughts and findings here.

We are all so complex, and the way we react to situations and anticipate results is based on many physiological and psychological factors. So many, in fact, that it can be difficult to generalize why different personality types might handle success versus failure in such drastically polarized ways.

As a psychologist specializing in trauma and PTSD (Post Traumatic Stress Disorder) I’ve had firsthand experience coaching clients whose past experience feeds their current fear of success. For them, the excitement of success feels uncomfortably close to the feeling of arousal they experienced when subjected to a traumatic event or multiple events. (This feeling of arousal can be linked to sexuality, in certain cases where trauma has been experienced in that realm, but that is not always the case.) People who have experienced trauma may associate the excitement of success with the same physiological reactions as trauma. They avoid subjecting themselves to excitement-inducing circumstances, which causes them to be almost phobic about success.

There is another layer to the fear of success. Many of us have been conditioned to believe that the road to success involves risks such as “getting one’s hopes up” — which threatens to lead to disappointment. And many of us—especially if we’ve been subject to verbal abuse—have been told we were losers our whole lives, in one way or another. We have internalized that feedback and feel that we don’t deserve success. Even those of us who were not abused or otherwise traumatized often associate success with uncomfortable things such as competition and its evil twin, envy.

In order to have a healthy relationship with success (and it’s flip side, failure, or disappointment), the first step is to learn to differentiate between feelings of excitement and a “trauma reaction.” Here is an easy exercise:

1.    Recall an event where you were successful or excited when you were younger, and notice what you are feeling and sensing in your memory. Stay with the sensation of for 5 minutes.

2.    Recall an event where you were successful and excited recently in your life, and notice what you are feeling and sensing. Stay with this sensation of for 5 minutes.

3.    Now tap into the sensation of a memory of an overwhelming situation. I suggest not to start with a truly traumatic event, at least not without a therapist’s support. Start with something only moderately disturbing to you.

4.    Now, go back to visualizing your success story. Do you notice a difference?

While corresponding with the young Canadian woman, I asked her to do look up bodily response to fear and excitement and let me know what she found. This is what she wrote back:
“I was looking up how the body responds to fear, and it said that when we sense fear the brain transmits signals and our nervous system kicks, in causing our breathing to quicken, our heart race to increase… we become sweaty, and we run on instinct. When we get excited or enthusiastic, doesn’t our nervous system work the same way?”

I assured her that, yes, the physical reactions to stress and to excitement are very similar. So, when we experience a traumatic event—such as a car accident or a school bullying incident— our body associates the fear we experience with the same physiological feelings we get while excited. Once we have been through enough trauma, we start to avoid those types of situations that trigger memories of fear. For this reason, trauma victims can tend to avoid excitement, and that can lead them to avoid success.

I work with trauma victims to get past their fears and associations and help them embrace and follow the path to success and healthy recovery.

Postpartum PTSD is very different from Postpartum Depression. The former occurs as a result of trauma (or perceived trauma) during delivery, while the latter happens because of hormonal changes in a woman’s body as a natural result of giving birth. Nevertheless, these two conditions are linked together in some cases, and can certainly exacerbate one another. It’s important to distinguish between the two so that you can seek the most effective means of treatment.

Postpartum PTSD happens most often when mothers give premature birth to infants who begin their lives in critical condition. According to a new study from the Stanford University School of Medicine **, “… over half the parents whose babies were in the NICU for an extended period of time either had Post Traumatic Stress Disorder (PTSD), or were at high risk for developing it.”

Along with parenting premature babies who must endure Neonatal Intensive Care, PSI* also lists the following types of childbirth trauma that could potentially lead to PTSD:

·     Prolapsed cord
·     Unplanned C-section
·     Use of vacuum extractor or forceps to deliver the baby

Feelings of powerlessness, poor communication and/or lack of support and reassurance during the delivery can also contribute to Postpartum PTSD.
In 1993 The Journal of Obstetric, Gynecologic, & Neonatal Nursing printed the results of a study conducted to conclude how mothers of premature infants were affected by PTSD.***  Out of thirty mothers who had given birth to premature at-risk infants, sixteen of them showed symptoms of PTSD and a whopping 24 reported “re-experiencing” and “avoidance” characteristics. These reactions were still happening six months after the expected birth date.

The trick is to distinguish PTSD symptoms from those of postpartum depression and regular healthy recovery from childbirth. PTSD symptoms are generally grouped into three categories: re-experiencing, avoidance, and increased arousal.

Here are some of the signals to look out for:
·     Intrusive re-experiencing of a past traumatic event (which in this case may have been the childbirth itself)
·     Flashbacks or nightmares about the childbirth experience
·     Avoidance of stimuli that remind the mother of the childbirth experience—including thoughts, feelings, people, places and details of the event
·     Persistent increased arousal (irritability, difficulty sleeping, hypervigilance, exaggerated startle response)
·     Anxiety and panic attacks
·     Feeling a sense of unreality and detachment

The good news is that Postpartum PTSD is treatable and temporary. The key is to get competent professional help as early as you can.  It’s important to treat PTSD before it begins to manifest as something harder to treat—such as an eating disorder, addiction, compulsive behavior, chronic panic disorder, or suicidal tendencies. If in doubt, contact your health care provider for advice right away.

More information:
Solaceformothers.org does a nice job of differentiating between “normal” biological postpartum depression and birth-related PTSD, and provides more detailed information, a breakdown of PTSD symptoms, and a helpline for those in need: http://www.solaceformothers.org/PTSD_info.html

SOURCES:
* http://www.postpartum.net/Get-the-Facts/Postpartum-Post-Traumatic-Stress-Disorder.aspx
** http://ksmu.org/content/view/6578/66/
*** http://onlinelibrary.wiley.com/doi/10.1177/0884217503252035/abstract

Victims of a mugging incident may experience any of the classic symptoms of PTSD:

• Reoccurring, terrifying flashbacks or nightmares
• Avoidance of situations that remind one of the incident
• Irritability or anger
• Emotional numbness
• Trouble concentrating
• Withdrawal from friends and family
• Physical anxiety symptoms
• Problems eating or sleeping

Victims express their distress in varying ways, and it’s not always obvious that someone is struggling with the aftereffects of experiencing trauma.

According to the National Institutes of Health*:

PTSD symptoms seem to be worse if they were triggered deliberately by another person, as in a mugging or rape. Most PTSD sufferers repeatedly relive the trauma in their thoughts during the day and in nightmares when they sleep. These are called flashbacks. Flashbacks may consist of images, sounds, smells, or feelings. They are often triggered by ordinary occurrences, such as a door slamming, a car backfiring, or being in a place that looks like where the trauma took place. A person having a flashback is likely to feel the emotions and physical feelings that occurred when the incident happened despite no longer being in danger.

There is a scientific, physical reason why trauma impacts us so strongly, and it can be traced to the amygdala—a very small nugget of our brain lodged deep inside the temporal lobe, it processes memory and emotion. Unlike conscious memories that we are aware of—for instance, a victim returning to the scene of a mugging would recognize the environment and perhaps remember details about what happened—the amygdala is in charge of deeper, unconscious emotion that can develop into PTSD. The amygdala is also responsible for the Fight/Flight/Freeze response. **

When we experience an “emotionally arousing event” such as a mugging, the amygdala is activated and it then produces a protein in the neurons of the hippocampus. This protein helps the nervous symptom to convert immediate memories into permanent ones.  ***

Because of the unique way the brain processes traumatic memories, they can actually become more vivid and intrusive over time, rather than fading away like most memories do naturally. Any memory associated with a life-threatening event has this capacity to grow and transform into PTSD.

According to NYU’s Le Doux Laboratory (Center for Neural Science):

Neuroanatomists have shown that the pathways that connect the emotional processing system of fear, the amygdala, with the thinking brain, the neocortex, are not symmetrical—the connections from the cortex to the amygdala are considerably weaker than those from the amygdala to the cortex. This may explain why, once an emotion is aroused, it is so hard for us to turn it off at will.

This is not to say that PTSD and anxiety disorders cannot be solved. Somatic Psychology has been particularly effective in treating the symptoms (and the root neurological cause) of PTSD. Recovering from the trauma of a sudden violent attack like a mugging requires a re-wiring of the brain’s fear response associated with memories of the event. With patience, we work with a victim to heal themselves.

* Citation: NIH Medline Plus Magazine http://www.nlm.nih.gov/medlineplus/magazine/issues/winter09/articles/winter09pg10-14.html

** Citation: NYU’s Le Doux Laboratory (Center for Neural Science)

** Citation: Medical News Today http://www.medicalnewstoday.com/articles/28124.php

Sexual abuse is a particularly sinister type of trauma because of the shame it instills in the victim. With childhood sexual abuse, victims are often too young to know how to express what is happening and seek out help. When not properly treated, this can result in a lifetime of PTSD, depression and anxiety.

The trauma that results from sexual abuse is a syndrome that affects not just the victim and their family, but all of our society. Because sexual abuse, molestation and rape are such shame-filled concepts, our culture tends to suppress information about them.

In the U.S (according to childtrauma.org), one out of three females and one out of five males have been victims of sexual abuse before the age of 18 years. And according to the American Academy of Experts in Traumatic Stress (AAETS), 30% of all male children are molested in some way, compared to 40% of females.

One of the most startling statistics unearthed during research into sexual abuse are that children are three times as likely to be victims of rape than adults. Stranger abuse constitutes by far the minority of cases. It is more likely for a child to experience sexual abuse at the hands of a family member or another supposedly trustworthy adult.

Sexual abuse is a truly democratic issue. It affects children and adults across ethnic, socioeconomic, educational, religious, and regional lines.

Exactly what constitutes “sexual abuse” when it comes to children?

The Incest Survivors Resource Network states that “the erotic use of a child, whether physically or emotionally, is sexual exploitation in the fullest meaning of the term, even if no bodily contact is ever made.” It’s important to notice this clause about “no sexual contact.” Often, victims of sexual abuse will try to downplay their experience by saying that it “wasn’t that bad.” It’s vital to recognize that abuse comes in many shapes, colors and sizes, and that all abuse is bad.

Outcomes of sexual abuse

The most common effect of sexual abuse is Post Traumatic Stress Disorder. Symptoms can extend far into adulthood and can include withdrawn behavior, reenactment of the traumatic event, avoidance of circumstances that remind one of the event, and physiological hyper-reactivity.

Another legacy of sexual abuse is that children abused at any early age often become hyper-sexualized or sexually reactive. Issues with promiscuity and poor self-esteem are unfortunately common reactions to early sexual abuse.

Substance abuse is a common outcome of sexual abuse. In fact, according to the AAETS, “specialists in the addiction field (alcohol, drugs, and eating disorders) estimate that up to 90 percent of their patients have a known history of some form of abuse.”

Specific symptoms of sexual abuse:
(citation, the American Academy of Experts in Traumatic Stress)

• Withdrawal and mistrust of adults
• Suicidality
• Difficulty relating to others except in sexual or seductive ways
• Unusual interest in or avoidance of all things sexual or physical
• Sleep problems, nightmares, fears of going to bed
• Frequent accidents or self-injurious behaviors
• Refusal to go to school, or to the doctor, or home
• Secretiveness or unusual aggressiveness
• Sexual components to drawings and games
• Neurotic reactions (obsessions, compulsiveness, phobias)
• Habit disorders (biting, rocking)
• Unusual sexual knowledge or behavior
• Prostitution
• Forcing sexual acts on other children
• Extreme fear of being touched
• Unwillingness to submit to physical examination

Studies have shown that children who experience sexual abuse tend to recover quicker and with better results if they have a supportive, caring adult (ideally a parent) consistently in their life.

Because most child sexual abusers were once abused themselves, it’s crucial for victims of sexual abuse to seek counseling and care so that they don’t end up repeating the pattern themselves.