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Mental Illness or Human Suffering?

In recent years, we are becoming more acceptant of labels belonging to the medical professions in our everyday life. For example, mental illness, bipolar, depression. Some of these terms are increasingly used to identify human states of mind and mood that might have been considered in the past as a normal part of human suffering. So how do we know when we are mentally ill or just suffering as humans?

Human suffering is usually a temporary condition, whereas mental illness can be more permanent. If someone close to you dies, it is normal to feel sad. But if you continue feeling sad years after it happened, you may be struggling with something more serious, like a depression. However, there is a very fine line between these two concepts because if you believe that you are mentally ill, or depressed, then you will be. Society might influence your own judgement and your doctor’s or counsellor’s judgement regarding whether you are effectively ill or just suffering as a human being.

As Summerfield states in Cross cultural perspectives on the medicalisation of human suffering, “the attitudes of wider society (which may change over time) shape what individual victims feel has been done to them and the vocabulary they use to describe this, whether or how they seek help, and their expectations of recovery.” If the wider society believes that a traumatised person must be carrying a heavy load that will impact negatively on their future life, that person will be prone to carry such a load and feel that negative impact. That would prevent them from seeing the other side of trauma, which normally brings growth and a deeper appreciation of life.

Many of the people that I work with are suffering due to the heavy load of living in an individualistic society that tends to label them and does not leave room for their human suffering and recovery. In some cultures, there are no words for depression. A person is part of a group, and the group will help and accept what is happening to the person. This person does not feel stigmatised and isolated, and eventually moves on. There is no stigma as suffering is considered a human characteristic dealt with in a community of human beings. In our society, there seems to be an expectation to be independent and happy. In such a society, is there a place for human suffering? Are we able to ask for help to family and friends? Are we too quick to label human suffering as mental illness, as something that needs fixing?

I wonder whether we need more communities to accompany each other in this journey that is our life and especially when we experience human suffering. I wonder whether we can accompany another person and let another person accompany us when our life seems like a challenge. In my opinion, counselling is a journey in which one person feels accompanied by a professional who is able to accept and understand human suffering. This acceptance and understanding makes the “sufferer” accept and understand his or her predicament and transform his or her life. Counselling is also a tool to help the “sufferer” learn how to find resources within themselves and in their communities so that when further suffering occurs, they would know how to cope with it.


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5 symptoms of compassion fatigue in carers

Compassion fatigue, also known as burnout, can appear in workers exposed to suffering on a daily basis. Nurses, care workers, doctors, counsellors are all exposed to compassion fatigue. They work with people who are not well every day and their suffering can affect them. Early detection of symptoms of compassion fatigue can prevent more serious symptoms. Five early symptoms of compassion fatigue are as follows:

  • Frequent colds: We may think they are related to the weather, to not wearing the right clothes, to the children being frequently ill as they catch colds in school, to a temporary stage of our lives. Be careful. It could also be a symptom that you are developing compassion fatigue.
  • Reduced sense of accomplishment: Did your job feel like you were really helping others and it is starting to put you down? Does the day feel longer than it used to? You may have forgotten the reasons that brought you to this job in the first place. You may start developing some symptoms of compassion fatigue.
  • Headaches and fatigue: This may be a normal part of your life by now. You have a headache, take an Ibuprofen and forget about it. You tell yourself that it is normal to be tired trying to joggle work, family life and caring for your parents. It may well be, but it can also be a sign that you are doing far too much for others and starting to burn out.
  • Moodiness and increased interpersonal conflict: If you find yourself snapping at your loved ones for no good reason, having frequent mood swings, and/or starting to feel like you would like to be on your own for often than usual, you may be developing compassion fatigue.
  • Lack of meaning: Eventually, if you don’t pay attention to those symptoms, they may deteriorate, and you may feel numb, disillusioned and you may lose meaning. Your life may appear as having no sense at all.

Some of the more serious symptoms of compassion fatigue are similar to PTSD symptoms, experienced by trauma sufferers. Compassion fatigue is also known as vicarious traumatization. Good news is that you can recognize these symptoms and allow yourself to put yourself first. You need to look after yourself and discover your own ways of making yourself fulfilled and happy on a daily basis. This is known as post-traumatic growth. Empathy can bring you to experience human suffering and develop compassion fatigue; looking after yourself (post-traumatic growth) can help you find higher meaning and connection to others.

Also read: 5 tips to avoid compassion fatigue


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Body awareness for trauma

According to Babette Rothschild, one of the most respected trauma authors, body awareness is a most practical tool in the treatment of trauma and PTSD. When we are more aware of our bodies, we enter the present moment, separating past from present. We do not get distracted by our mind and we gain control over unpleasant somatic memories.

Our brain has different ways of remembering events: explicit memory and implicit memory. Explicit memory is what you normally remember happening to you in a narrative. It is what we usually call “memory”. It is mediated by the hippocampus. Implicit memory includes all automatic processes that you remember, like knowing how to tie your shoelaces. They are unconscious processes because you don’t need to think about them to remember them. They are mediated by the amygdala.

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When faced with a danger, your body will activate the fight or flight response. In those circumstances of high stress, the stress hormones suppress the activity of the hippocampus but they don’t appear to affect the activity of the amygdala. This is the reason why traumatic events are more often recorded in the implicit memory. Your body remembers the trauma, but your mind cannot make sense of it because your hippocampus was not working when it happened. Remember that your hippocampus managed the explicit memory (narrative of the events).

fight-or-flightYou may not remember a traumatic event, but you may feel the signs of fight or flight when something triggers the event: a smell, a certain look, a thought. You may not recognise the triggers, but you may feel your heart racing, a cold sweat, shallow breathing, or any of the signs indicated in the image. You can recognise these signs as fear. With body awareness, you are able to slow down and stop this hyperarousal. Body awareness allows you to stay in the present and helps you to feel more empowered regarding your body responses and emotions.

Body awareness has been cultivated for centuries by the Eastern practices of meditation, yoga, tai chi or qigong. But you don’t need to be a yogi to become more aware of your body. Your counsellor can help you. Body awareness can become a precious tool when processing past trauma with the help of a professional counsellor.

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10 Symptoms of PTSD

PTSD (post-traumatic stress disorder) is a common condition that affects people who have experienced a traumatic event, have witnessed a traumatic event or have heard about a loved one experiencing such an event. The symptoms of PTSD may start after the event or months or years after the event has passed. Not everyone who experiences a traumatic event develops PTSD.

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If you are looking for help for PTSD, you may recognise some of these symptoms. Because your autonomous nervous system is hyperaroused, you often experience the bodily symptoms usually triggered by a dangerous situation. But the danger is no longer there. Here are some of the symptoms:

  • Hypervigilance
  • Cold sweat
  • Rapid breathing
  • Heart palpitations

When some of these symptoms become chronic, they can result in:

  • Difficulty sleeping
  • Loss of appetite
  • Sexual dysfunction
  • Difficulty concentrating

If you remember the traumatic event (or being told or witnessed it), you may also have the following symptoms:

  • Flashbacks (or nightmares)
  • Avoiding situations reminding you of the event

You may or may not develop all of these symptoms. If you are in doubt whether you have PTSD, consult your GP or contact a qualified psychotherapist.

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If you have PTSD, your nervous system is hyperaroused due to your previous experience. You can look for help for PTSD in a relaxation, meditation or mindfulness regular class (yoga, tai chi, qi gong). This will help your nervous system calm down. Additionally, look for help for PTSD with a qualified counsellor and psychotherapist to find out what triggered your PTSD and start processing your trauma.


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5 tips to avoid compassion fatigue

Compassion fatigue, also known as burnout, can appear in caregivers exposed to suffering on a daily basis. Nurses, care workers, doctors, counsellors are all exposed to compassion fatigue. We work with people who experience suffering every day and their suffering can affect us. Early detection of symptoms of compassion fatigue can prevent more serious symptoms. Here are five tips to recognize and avoid compassion fatigue:

  • Take care of your body: If you start feeling the effects of compassion fatigue, such as rapid heartbeat, dizziness, headaches, difficulty sleeping or falling asleep, remember the basics of looking after your body: healthy diet, daily exercise.
  • Look after your mind: Cognitive symptoms of compassion fatigue include lowered concentration, disillusionment, apathy, preoccupation with trauma. If you have any of these symptoms, it may be useful to calm your mind through meditative practices: yoga, tai chi, qi gong, meditation.
  • Express your feelings: Working with people suffering on a daily basis can be taxing for anyone. You may start experiencing powerlessness, anxiety, guilt, anger, numbness, fear, sadness. You may also experience dreams similar to your patients or you may suddenly recall frightening experiences. It may be useful to share your feelings in a supportive environment. Check if there are support groups for caregivers at work or in your area. Do some counselling sessions with a qualified counsellor.

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  • Stay connected: Caregivers who are close to burnout often tend to isolate themselves. Because of their mood swings, irritability, poor sleep and other symptoms, they may have more interpersonal conflicts at work and in their families. If you observe that you tend to isolate yourself, watch out. You may be starting to develop compassion fatigue. Stay connected with your family and friends. Find a new hobby and create new relationships with other people. Go out, dance, walk, be creative in the ways you can relate to others, but stay connected.
  • Find space for spirituality in your life: If you start questioning life’s meaning, feel that you have lost your purpose and you become sceptical about things that made a lot of sense earlier in your life, it is time to start a spiritual practice. Being spiritual doesn’t mean that you need to join your local parish and go to the regular services. It can mean just walking in nature and commune with the divine within or outside. Find some quiet time for yourself.

If you believe that finding time to look after yourself is indulgent or selfish, think twice. If you get burnout, you will be of no help to anyone. It is altruistic to actually look after your health, spend some time doing what you enjoy doing in life, stay connected with family and friends, develop a spiritual practice. All of those things will make you a better carer and will help you avoid compassion fatigue.


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Understanding PTSD

A person may develop PTSD (post-traumatic stress disorder) after having experienced a terrifying or traumatic event. Or they may have witnessed a harmful event happening to a loved one or strangers, or heard about a loved one experiencing such an event. They may develop PTSD after the event or years after the event has passed.

This experience triggers the fight or flight response in their body. The fight or flight response is designed to be triggered when we are faced with a danger, mobilising all our bodily resources to cope with that danger. Some of the usual bodily symptoms of our fight or flight response are: cold sweating, rapid breathing, heart palpitations, hypervigilance…. Our body feels that it is under attack.

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If you have PTSD, you probably recognise some of these symptoms. This is so because you go into fight or flight long after the danger has passed. The memory of the traumatic event is in your body, even though your may not cognitively remember the traumatic event or some of the feelings attached to it. Your fight or flight response is started because you may have come in contact with a trigger that reminded you of the event, such as a smell, a person, a look, etc. But you may not be aware of what the trigger is. For example, a person may be triggered by a perfume because it was the same used by his or her abuser, even though his or her mind doesn’t cognitively remember the abuser’s perfume. When the person smells the perfume, she or he will go into fight or flight with the symptoms mentioned above, even though the danger is no longer there. When the fight or flight symptoms become chronic, they can result into sleep disturbances, loss of appetite, sexual dysfunction and difficulty concentrating.

Understanding this is the first step when looking for help for PTSD. If you suspect that you may have PTSD or have been diagnosed with PTSD, you may benefit from working with a professional psychotherapist. Because your nervous system is hyperaroused, your therapist will generally provide you with some tools to calm down your nervous system. The tools usually include meditation, relaxation or mindfulness exercises. After learning that you can control your nervous system activation, there is usually a sense of relief.

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Once your body becomes more relaxed, you can start looking at your symptoms as messages from your body to discover what triggers your fight and flight response. When you find professional help for PTSD, your therapist will help you to listen to these messages and they may start making sense to you. This may enable you to process your traumatic event in a safe environment and get rid of the emotional charge and symptoms that accompanied it.

Multicultural Counselling and Psychotherapy in Exeter, Teignmouth, Skype

Alda Gomez BA PGCEd GCCI HDIPCP MA Psych (Psychotherapy) MBACP

01626 778048 – 07437 332032

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