Trigger warning: This article contains themes of suicide, trauma and mental health.
Last November, I witnessed a stranger taking their own life.
At that moment my body experienced the fight-or-flight response, an automatic physiological reaction to an event which is perceived as stressful or frightening. It occurs when the perception of threat activates the sympathetic nervous system and triggers an acute stress response that prepares the body to fight or to flee.
My body chose to fight, which is why I was able to respond in the manner that I did. But when I arrived back at my boyfriend's house after giving a witness statement to the police, my body was still shaking from the shock and my mind kept replaying the incident over and over, trying to fill in the gaps and mostly trying to explore whether there was anything I could have done differently to prevent it from happening. The next day, my doctor signed me off work for five weeks and suggested therapy.
As we were in the middle of the pandemic, receiving therapy proved rather difficult. I was unable to access urgent therapy and spent weeks firing off emails to my psychiatrist, GPs and therapy providers until I eventually received an appointment for talking therapy in February of this year. My mental health was in tatters, which in turn impacted my appetite, and I lost two stone in a month.
Three months after the incident, I was still experiencing vivid flashbacks, nightmares and was jumpy in response to loud noises. Sometimes I would sit in complete silence. Other days I would randomly weep alone in my room, afraid to leave the house completely.
I received six weeks of counselling through my local NHS's free TherapyForYou service. My counsellor and I went through grounding techniques and talked about my feelings of guilt and my persistent depression and PTSD symptoms, as well as recognising that my previously diagnosed mental health issues and trauma, as well as the ongoing coronavirus pandemic (and the stress that comes with it), had made this incident worse. I mentioned in passing that I don't go anywhere without my hot water bottle and, surprisingly, she said this was normal behaviour for trauma survivors.
She said that heat provides comfort and warmth, which is the opposite of how you would feel when your fight-or-flight response kicks in, therefore reminding you that you are safe.
According to PTSD UK, hydrotherapy can be useful for PTSD sufferers because it can ease muscle spasms, helps you relax and provides pain relief. This is usually administered via a hydrotherapy pool in which the water is heated to 35 degrees Celsius and patients are encouraged to undertake intense exercises, such as squats underwater.
Of course, in the middle of a pandemic, it was near enough impossible to access a hydrotherapy pool or spa. So instead I committed to having a bath every night before bed, per my therapist's suggestion, and it really helped me to relax, lower my stress levels and put me at ease so I wouldn't be jumpy.
According to Sarah Lee, a UKCP registered psychotherapist who specialises in complex trauma, feeling warm and safe can promote feelings of relaxation and slow our breathing and heart rate. "Most people have heard of the fight/flight response that occurs during stressful or scary incidents," she tells me. "There are actually five responses that can be triggered: fight/flight/freeze/friend (also known as fawn) and flop. During this stress response, the body activates the sympathetic nervous system and one of the processes that occurs is the direction of blood to the internal organs of the heart, brains and lungs and the large muscles," adding that this promotes survival and may be required if we actually need to flight or flee.
"In trauma," she continues, "the scary thing is relived and retriggered either by external similarities (I saw/heard/smelled/tasted/felt something that reminds me of something scary) or internal sensations (my heart rate increased which reminds my brain of feeling scared). So we have a situation where the body doesn't know that the scary episode has finished and re-experiences it as if it were still a threat."
While there are a variety of therapies that work well for trauma survivors, such as hydrotherapy and EMDR (eye movement desensitisation and reprocessing), the effects may vary from person to person. "Any therapy that helps trauma survivors reconnect with their bodies in a safe and non-threatening way is helpful because trauma survivors often feel betrayed by their body and therefore disconnected from it."
Award-winning senior therapist Sally Baker agrees, although she adds that clinical therapies such as BWRT (brain working recursive therapy), which is designed for trauma and can be completed in three sessions, will be beneficial too because they help to stop the trauma reoccurring. "The core is trauma," she says. "With BWRT you don't have to relive the trauma because you already know the narrative. It works content-free, which is really important to keep clients and therapists safe. It works with the subconscious mind, not the narrative."
My free therapy sessions have come to an end and while I may need further therapy to ensure that the trauma is resolved, holding a hot water bottle is a great reminder — for now— that I am well and, most of all, safe.