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bioefeedback
Mind & Body

Just Breathe: Biofeedback And C-PTSD

Maryam Henein
Last updated: 2023/02/28 at 10:19 PM
Maryam Henein Published May 24, 2018
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13 Min Read
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Biofeedback and breathe helped me get back my life.

Contents
Life With C-PTSDLearning The BodyLearning To BreatheBiofeedback: One Breath At A Time

You’ve heard the adage: Just breathe. Stressed? Just breathe. Panicking? Just breathe. Truth be told, I’ve even used this saying with my children when they are overwhelmed by emotions and can’t seem to get grounded. Breathe, in and out, slowly. Just breathe.

I’ve been struggling with C-PTSD and its accompanying symptoms, including panic attacks, for over a decade. And despite the many well-meaning people who told me to just breathe, as many times as I repeated that in my own mind, it never seemed to do the trick.

Until, one day, it did.

Life With C-PTSD

C-PTSD, or Complex Post-Traumatic Stress Disorder, is not yet recognized by the DSM as its own disorder (it is currently a proposed disorder) but is recognized by many practitioners in the field as being separate and distinct from PTSD. While PTSD is often based on a single traumatic event (say, a car accident or being either a witness or victim of an act of violence), a person can develop C-PTSD when exposed to trauma for an extended period of time (such as in abusive relationships or hostage situations).

While there are many similarities between the symptoms of PTSD and C-PTSD, there are also some additional things that come along with the latter. Those who suffer from C-PTSD often experience, in addition to traditional flashbacks, emotional and somatic flashbacks. Dissociation of various forms is also a common experience of those with C-PTSD. With dissociation people struggle with maintaining presence in the world around them. This can manifest in feeling as if they are out of their body, periods of amnesia, or feeling cut off from reality.

At age 33, I’d become ill, with both physical symptoms (later diagnosed as ankylosing spondylitis, fibromyalgia, and myalgic encephalomyelitis/chronic fatigue syndrome), as well as with symptoms associated with C-PTSD and depression. At the time I got sick, I was a busy and active mom of two young children, a burlesque dancer performing multiple times a month as well as producing shows, a full-time graduate student, and the full-time Assistant Director of Correctional Education at a community college.

Within six months, I was unemployed and mostly housebound, sometimes bed-bound. The years I’d spent in an abusive marriage, and the following years I’d spent in survival mode, fearful of any interactions with my ex (the father of my children) had caught up with me, and my body gave in to the extreme stress I’d lived under for so long. I was in immense physical pain, exhausted at levels I couldn’t even put to words, and grappling daily with my emotional and mental health. I was disassociating multiple times a week which, for me, meant large portions of the day feeling as if I was living in a dream-state. I had a hard time discerning reality from what is going on my mind, and I’d occasionally “lose” chunks of time in my memory. I was also diagnosed with psychogenic, non-epileptic seizures. Essentially, when my stress levels would reach a certain level, triggering  my C-PTSD, I’d have a seizure. Three years ago, at the  age of 34,  I was in the depths of  my C-PTSD symptoms.

I went in to see my doctor to get some physical therapy lined up, and as I lay on my back for an exam, tears began streaming down my face. He looked at me and asked, “Does your pain ever make you depressed?” I just nodded, while thinking internally that yes, of course it did, and that my depression made me have pain, and that actually my body, brain, and spirit seemed to constantly be at war. While I’d done a lot of personal work around the brain-body connection, this was the first time I’d had a Western medical practitioner acknowledge the connection. I was in so much pain, physically and emotionally, that I was ready to try anything.

My doctor referred me to a six-week pain program that he thought might help me develop some new coping skills and give me some relief from at least the physical pain I was experiencing. The program, he explained, had one-on-one and group therapy, time to meet with an occupational therapist, accessible yoga, and biofeedback.

Learning The Body

Several weeks later, I was sitting in a rickety faded green chair, a heart rate and breathing monitor attaching me to what appeared to be a rather archaic computer. This was my first experience with biofeedback, and I wasn’t sure what it was, or what to expect. Biofeedback, as the assisting nurse explained to me, provides information about our own body processes, to teach us how to regulate our bodies. The computer program takes information on our breathing and heart rate and turns it into data that we can easily read and learn from. Specifically, using this data we can learn how to optimize our breath and calm our heart rates, therefore switching out of the “fight/flight” response our body naturally goes into when under stress.

The theory is that by being more aware of this response, and by also learning the ways our bodies react and how to counter these reactions, we can learn to bring our body into a calmer state. This then can help alleviate a myriad of symptoms.

A nurse walked me through the steps of how to get myself set up with the biofeedback, and showed me the computer options I could use for my session. There was a very scientific-looking option with data display, and some more game-oriented ones. This particular biofeedback program was based on the idea of establishing and maintaining “heart coherence,” or a rhythmic heart pattern that represents a calm state of mind. On the data-driven display, I could see my heart and breath rates and the rhythms that were being created, as well as track my progress with my heart-rate goals. On the more game-oriented displays, I was rewarded with visual stimuli when those goals were met. For example, in the garden game, flowers grew and blossomed as I began to achieve higher heart coherence.

So how does one achieve a high heart coherence and the resulting calmer state? The answer seems far too simple: just breathe.

Learning To Breathe

With each breath I took, my heart rate would either increase or decrease. It was a fascinating process, watching the ways a simple change in the depth or speed of my breath could change my heart rate. Over the course of several sessions, I learned how to control my breath so that my heart was consistently in that target zone (thus achieving “heart coherence”). Everyone finds different ways that work for them, but for me, I imagine a figure-eight inside my body that the breath travels along: it goes in through my nose, traveling down the back of my skull and neck, and crossing through my body at the heart and lungs, then dipping down along my belly before curving back along my pelvic floor and going up my spine until it crosses through my body at the heart area again and comes out my mouth. Visualizing my breath doing this with each inhale and exhale allowed me to reach heart coherence.  On days that my pain was stronger or my stress was higher, I had to focus harder in order to control my breath, but with time and practice I was able to consistently get myself there.

I’d originally been referred to the pain management program, and to the biofeedback sessions, in order to quell some of the pain of my physical health issues. What I found, though, was that as I practiced my breathing and more consistently achieved heart coherence, I also experienced a significant calming of my body and emotional states.

In the group sessions where we discussed biofeedback techniques, we delved into how it could reduce pain levels when having rough physical symptoms, but we had never talked about using it to combat emotional and mental health symptoms. I had been totally unaware of biofeedback’s use for the treatment of PTSD and other disorders. However, noticing the changes my breathing had on my body, I began to practice using these techniques when I’d experience C-PTSD symptoms. If I felt a panic attack coming or noticed the warning signs of disassociation, I’d engage the techniques I already had. These include strategies such as grounding myself through senses (using an essential oil roller, holding a stone, tasting bitter herbs), movements such as rocking or pacing, and repeating mantras of safety to myself. But, in addition to these other techniques, I also began incorporating the breathing techniques I’d learned through biofeedback. My breathing helped calm my body out of the “fight/flight” adrenaline response, and with this calmer body came a reduction in my C-PTSD symptoms.

Biofeedback: One Breath At A Time

So, while it is not nearly that simple, I’ve found there to be some truth in the saying to “just breathe.” For me, learning to breathe, in combination with other techniques I already held in my mental health ‘tool bag,’ has made it easier for me to get through daily life with otherwise debilitating conditions. I’ve been able to shorten or sometimes stop my panic attacks and dissociation and to significantly decrease the frequency of my non-epileptic seizures.

Instead of dissociating multiple times a week and having seizures several times a month, I am having two or three seizures a year, and dissociating once a month or less. Although I’m still not working full-time (I was recently approved for disability due to my physical conditions), I have progressed to a place that I am mostly no longer home-or-bed-bound. I have been able to return a few hours a week to my joy and passion for teaching, and am able to perform a few times a year.

I no longer feel like I did three years ago as if I was held captive in the trenches of my C-PTSD. Rather, through biofeedback’s lessons on how to control my heart rate through conscious and focused breath, I’ve developed ways to better manage the symptoms of my C-PTSD and I feel like I am, in all the ways I can, learning to live and thrive again.

Angie Ebba is a queer disabled femme. As a writer, educator, activist, and performance artist, she believes strongly in the transformative powers of words and performance. She teaches writing workshops and performs across the United States, as well as being a published poet. You can find Angie online at rebelonpage.com and nittygrittynakedness.wordpress.com

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TAGGED: anxiety, chronic fatigue syndrome, depression, fibromyalgia, panic attacks, ptsd

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Maryam Henein May 24, 2018
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