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How to successfully manage your extreme behaviours

I realised recently how much I work on ‘extremes’ with people, managing their extreme behaviours in multiple areas of their lives, a real ‘all or nothing’. One of the areas of extreme behaviours they struggle with is eating. This looks like them either trying to eat a totally clean, organic, healthy diet or finding themselves in a loop of fast food, ready meals and snacks. This can then ramp up to fluctuating between eating practically nothing or binge eating.

Another extreme is exercising, where they really go for it, fitting in as many sessions as possible, or they do the opposite, doing nothing, maybe just thinking about exercising, then watching Netflix instead. Alcohol is another extreme they struggle with, either drinking way more in the week than they were planning to, or going for abstinence. Smoking and any form of drug use also falls into this subject, either doing loads or trying to abstain totally.

There will be all sorts of places in our lives that we can see the same kinds of patterns. If we name the clean abstinence and highly motivated phase as ‘Phase 1’ and the other end of the spectrum as ‘Phase 2’, we can look at how they play out.

The problem with extreme behaviours, is that we end up swinging between the two phases, sometimes slowly but sometimes rapidly. It’s then easy to feel defeated, unmotivated and negative, as we don’t feel like we’re making any progress, or if we do make any progress, we can’t maintain it.

If we are in Phase 1 and we’re really keeping on track with our plan, but then something comes along to interrupt it, it can throw us off course completely. Sometimes one little slip or diversion can send us back into Phase 2. Internally, this might sound like, ‘well I messed up yesterday so I might as well just start again next week’. The more often this happens, the more time we tend to spend in Phase 2. We plan to get out of it but will find various reasons to delay the big shift it takes to move all the way over to Phase 1 again. During this time we’ll be very negative about ourselves. We might be making plausible excuses to tell ourselves and others why it’s too difficult, but we end up just berating ourselves.

So how can we make a change?

Deep down we know that this process isn’t really working, that we’re just going in constant cycles, yet we keep doing it anyway. Most of us have heard things like ‘diets don’t work’, ‘it’s about making changes in our lifestyle’ but it can be really hard to do things differently.

I can relate all these things to regulation issues. Our nervous system doesn’t operate well when we’re in extremes, we work best when we are balanced and in control. Sometimes we know when we need to be more activated and energetic, and then when we need to be more relaxed, we need to recharge our batteries and settle. It’s the same way we go about meeting our needs and managing ourselves. If we know we have a tendency to live in extremes, then we have to be prepared to start building some middle ground, a place where we stop bouncing from Phase 1 to Phase 2, and back again.

To really start to do things differently, we have to be realistic about the things we really want to abstain completely from, the things we honestly know we can’t have moderation with. This is different for each of us, but it requires being honest with ourselves, and it usually includes evidence from our past experiences. We might want to be occasional smokers or drinkers, but if we know that one slip sends us into the extreme again, then we maybe have to accept that we can’t be occasional with it.

We also have to look at what we think or feel about the idea of a middle ground. Could it be that we consider it dull or boring, or not enough? Do we think of it as too easy? That things that are worth having, have to be hard-earned? Do we believe that unless it’s extreme, it might not work? Are we too impatient to build a middle ground? Do we just want fast results?

We have gotten used to a very immediate way of life, we rarely have to wait for anything anymore and can feel quite outraged if we are expected to wait for anything. To create change, we have to know what we really think about building that middle ground, as our thoughts will creep in at any opportunity, urging us to do more or less, telling us it’s a waste of time or not working. We then have to decide what our middle ground will look like, how much flexibility we can have in it, and what signs would be there that tells us that we’re slipping into either Phase 1 or Phase 2. We also have to consider what support we might need to help us build our middle ground, and to maintain it until it feels like the normal. It will be a struggle at some points, but we need to expect that. Regulation takes work, whether it’s keeping us in a settled functional state, or making big changes in our lifestyle. Therefore, we need to know what’s going on in order to help and what isn’t. If we are trying to do less of something, then we need to know what we are going to fill the gap with. We might need to have a bit of structure planned in. If we are forcing ourselves to do something, then we have to accept that it won’t last. Relying on others doing things with us is also precarious, in case they drop out.

The more balance we can get into our lives, the more regulated all round we are going to feel. If we are constantly stressing about not doing something, or doing too much of anything, it’s going to be really hard for your nervous system to keep in balance. A holistic approach is always the most successful and actually, the easiest! Making little tweaks in several different areas can make an overall big difference over time, but we need to be patient and keep an eye on our extreme tendencies. This way we can successfully manage our extreme behaviours.

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How developmental trauma shows up in the body

Most of us understand what a traumatic event is. We often associate it with an accident, an attack, something terrible that is witnessed, etc. We know that extreme events can cause PTSD and trauma, however, we often miss or don’t fully understand developmental trauma. This is what I treat day in, day out, it is far more common and goes misdiagnosed and mistreated.

When we are little, we have very few defence mechanisms, we are far more vulnerable and we’re not able to understand complex situations. It’s much easier for us to then be terrified and overwhelmed, things that we wouldn’t normally give a second thought about can be a big event when we’re little. We usually recover from one-off events and often we don’t remember them at all. However, if we are consistently scared, if our punishment has been overly harsh, or if we are regularly shamed or humiliated, then this can result in developmental trauma.

I have many clients who actually have no clear memory of their trauma, they often have virtually no childhood memories and therefore no idea why they are struggling. Developmental trauma can have many different presentations, like feeling highly anxious for no apparent reason, they are often fearful and scared to go out amongst people, they may have panic attacks or dissociate easily. They often have body-related problems like IBS or unidentified pain, they may often have eating disorders and body image difficulties. They also may have self harmed, have substance addictions or a series of failed relationships. They all know there is something wrong but it can be difficult finding out what exactly is wrong, why it’s affecting them the way it is, and most importantly, what they need to get better.

99% of my clients have had lots of different prescription medications over the years. Many of them have been diagnosed with BPD, bipolar, ADHD, plus many more. As the medical profession are not trained to spot and treat developmental trauma, because it doesn’t usually come with flashbacks, the symptoms are treated with medication and the most they will be offered is talking therapy. Developmental trauma affects the body, the nervous system, all the regulation systems, the way we move, our posture and certainly our behaviour. When I begin working with people, they often are totally unaware of the movements their body is making and the reactions they have to certain things. It’s my job to notice these often subtle things, to spot patterns of behaviour and feed that back to my client. This way they can start noticing too and being curious helps them observe what’s happening. Because we know everything happens for a reason, the way the body responds can give us a huge clue as to why this might have been an effective strategy.

The most frequent things that I notice are: them pulling away when they talking about something, they go really quiet and still, they lose the ability to move certain parts of their body, or one half of them trying to hide. Developmental trauma will often show up in particular parts of the body, it’s not an overall uniform response. Sometimes the left and right sides of the body do completely different things. Clients will often have a certain place they sense the trauma, if they pull away or begin glancing over to one side, this will be consistent every time a particular subject is mentioned or thought about.

We bring up small pieces of memory, or a recent triggering event, then observe what the body does and give it a different experience. If our body tries to disappear, then we have to find ways to be seen safely and use resources to help achieve this.

It’s really hard for people with developmental trauma to work out what’s happening. They are so used to the body responses they don’t notice them. Also, if we have an activated part of the body, our first instinct is to stay away from it, to not pay attention to it. It takes an experienced therapist to make sense of all of this and help to find different ways to help and heal. Once the client gets on the right path, they can do so much on their own. Additionally, sometimes the memory comes back when the body trauma is revealed, but not always.

If developmental trauma was more widely known and understood, it would save so much heartache and time for everyone, including expense. Almost everyone I see for the first time has an overwhelming sense of relief, that finally someone gets them and knows what is needed for them to get better. It shouldn’t be such a mystery, having a troubled childhood is sadly an all too common experience, we should know how to help this.