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|Delayed Stress Response after Experiencing a Shock
Q: Hi Joyce,
Maybe Frank can help me with this....I wish I could understand why I have a delayed reaction to scary or traumatic things. We had a small accident yesterday (case in point). Jim was pulling a car hauler with another truck on it. He didn't have the hauler truck in gear and when I yelled at him to stop it rolled forward and smashed in to the back of the truck he was driving. He was obviously upset. I wondered if it was my fault for yelling at him to stop too quickly. He was not angry with me, nor did he blame me. I began to contemplate a recent accident, here in our town, where one of my doctors was killed in an accident where he was trying to hook up his boat trailer. Anyway it didn't hit me until tonight, over 24 hours later. I began to cry non-stop, was shaking, felt extremely weak, almost like my head was in the clouds,spacey. This is a common thing for me when something like this happens. It is extremely frustrating. I'm not sure where my emotions go when I need them. While I am learning to express my opinions, thoughts, needs and wants more and even beginning to express anger, I still have these moments of delayed reaction. What is causing this and is there anything I can do about it?
A: Dear Joyce, This is interesting and it reminds me of a dramatic incident from 40 years ago. A survivor who was held hostage on a train in the Netherlands told me about the first day when the terrorists burst in, shots were fired, one passenger was slung up by his clothes forming a human shield between the assailants and the captives, and then. little by little, everything calmed down. "I was cool, cooler than usual," Mr. Vaders told me, "also, I took notes, writing in my journal." He slept that night, but in the morning he was full of fear--terrified. And he should have been because he was told he would be executed and he was lucky to come out alive. He had a delayed display of terror.
I also remember calling down to the newsroom of the Daily Oklahoman where I knew the reporters who covered the Murrah Federal Building bombing. Months later there were terrible tornados and many fellow citizens were injured or killed. I thought I might offer some comfort to my friends who knew post traumatic stress injury first-hand and were now exposed again as reporters covering mass casualty. "Give them a few days," the editor's secretary advised. "They are all out working now. Later it will hit them and they will need you." And that proved true. So, Patti, you are not alone in experiencing a shock and having a delayed response.
Let's think of it this way. Our stress response system is designed to help us act effectively in the face of lethal threat. Blood is shunted from the gut to the large muscles. Pupils dilate to take in more light. The heart pumps faster and breathing accelerates, so that oxygen gets to our cells and we can fight or flee. Pain perception is reduced.
When the threat is not that extreme, but we are more sensitive to triggers because we were traumatized in the past, we go into that biological mode, but as long as we have something to do, be it write a report or yell at a spouse or run a mental inventory of similar challenges, we defer having our PTSI episode. Then, the next day, it hits us. We are in a safe place. We are calm. We do not have to be mobilized for action. But the alarm system still goes off and we tremble and sweat and, in some cases, burst into tears.
I remember that after my Mom died when I was 16. It didn't hit me at first. Boy did it hit me later.
Maybe some expert knows more about the exact biological mechanisms involved. I just know that it happens. It seems to me that the delay of emotion is related to the fact that emotional energy serves a purpose as a threat unfolds, but does not serve a purpose after things calm down. That lingering state of arousal with no real object to combat or to escape is part of the definition of post-traumatic stress (stress after rather than during trauma),
In addition, we have had time to judge ourselves or to be judged by others. It shouldn't be but it is embarrassing to be a victim. Now we can add shame to the stew of emotion. We might also resent being looked down upon or contradicted. Add anger to the mix.
Sometimes we make unconscious connections and move from present day stress to major stress from the past. That happened with a man in Lansing who was rear-ended in his car, had a very minor neck sprain, was placed in a collar and taken by ambulance to the hospital. En route he had a catastrophic emotional release. Why? He was, in his mind, back in Vietnam, hiding under a refrigerator, while his compound was strafed and his buddies were killed. It took him a while to figure all this out. He had a delayed stress response.
Patti, it sounds as though your stress response includes "spacing out." That is called dissociation and some people experience it more than others. Dissociation protects us, to a point, from the full experience of terror. We move into a trance rather than into a painful panic. The trance may just delay the onset of panic. I've explained dissociation elsewhere, I believe in a Q&A with you!
Dissociation is an intriguing aspect of PTSI and being a person who can dissociate makes you a bit more likely to have PTSI after a trauma, but also a bit less likely to suffer the full-blown panic effects.
You ask, "What can I do about it?" You can try to figure out where the emotion is coming from. Is it all due to the event that just occurred? Is it a ghost from the past -- an old war wound that is acting up? Is it the voice of the victim you once were, feeling hurt or betrayed or angry, rather than the voice of the survivor you have become? By now you have tools to manage and mitigate each of those emotional conditions. If it is simply a delayed reaction to a real threat, but now you are safe and secure, appreciate your safety and thank your body for having an alarm system that works, even though it sometimes goes off when there is nothing to be alarmed about.
Thank you for posing interesting questions. I hope these comments are useful.
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