A number of years ago I took a volunteer job with a community service agency that I thought would be great fun. At the same time that I showed up, so did a woman my daughter’s age. When the director of the agency introduced me to Carolyn and told her that I was a neuroscientist, I immediately noticed her eyes grow wide. Pupils in the eye dilating can mean any number of things, and it’s happened to me often enough upon people finding out what I study that I don’t lend too much significance to it. Any interest a person might show I don’t take personally. Mostly I expect it’s interest in what they might find out that can help them live their lives with increased happiness, satisfaction and well-being. Instinctively, on some level many of us know that neuropsychiatrist Bruce Perry is right: “We’re all fundamentally in the brain change business.”
Over several months Carolyn and I got to spend increasing amounts of time together working for the agency. As people will do, we shared bits of our personal history with each other. It was no surprise to me when one day Carolyn identified herself as “an intuitive,” nor when she self-identified as an HSP – a Highly Sensitive Person.
Healing Searching for a Happening
When, later on she felt safe enough to confide in me that she was also had a history of incest and rape, I wasn’t surprised either. What I was surprised by, was how genuinely happy Carolyn mostly seemed to be. By day. But HSPs are often highly sensitive for good reason – usually an amplified need to detect and assess threats in the world around them.
By night, things for Carolyn were much different – not so joyous and light. She frequently suffered nightmares and insomnia and had trouble with environmental toxins and a wide variety of foods that she was allergic to. She also had difficulty sustaining relationships of any duration. When I asked her once what strategies she used for repairing relationship ruptures, you can probably guess her answer: “None.” Essentially, once she had a disagreement with someone, she wrote them off for good. Needless to say, loneliness was a recurring theme in Carolyn’s life.
Learning all this about Carolyn, and knowing what I know about trauma and the brain, I began to consider how I might help her after she specifically asked me to. In an attempt to come up with something that might be useful when the inevitable rupture of our friendship showed up, I thought it might help to introduce her to SUDs.
I first learned of the SUDs (Subjective Units of Distress) Scale when I worked with people as a grief counselor. Essentially it’s a way for caregivers to find out how much subjective pain people immersed in the end-of-life trajectory are in. We ask them to give us a numerical rating of their pain on a scale of 1-5 or 1-10. We can agree ahead of time what number will necessitate receiving more medication.
For people who’ve suffered trauma that may have been accompanied by “speechless terror,” a SUDs scale of 1-5 is a better fit, since it only requires holding up one hand. With Carolyn I explained that anytime I say or do something that disturbed her, all she had to do was hold up one hand and show me five fingers. Whenever I saw that I will either stop talking, lower my voice and/or move away from her. Then, as her distress begins to subside, she can show four fingers, then three or any other indicator she’s able to in order to regain control and successfully emotionally regulate herself.
An Unqualified Unsuccess
I wish I could say that the use of SUDs was an unqualified success. It wasn’t. The first time Carolyn had need to use it with me in response to what I thought was an innocuous comment, I wasn’t near her. I made it in an email. Email is a terrible medium to try to address and resolve emotional issues. All the many cues we unconsciously take from face-to-face interactions are missing – body language, facial expression, voice tone, etc. What often happens is email can trigger a traumatic memory and flood our system with stress hormones, which the brain then associates with the sender, overlaying past trauma onto the present – all outside our conscious awareness. After she received my email (explaining how the brain stores trauma from the past and overlays it onto the present!) Carolyn immediately refused to have any further contact with me.
Needless to say I was sad and confused by what had happened, and deeply disappointed that our experiment didn’t turn out anything like I had expected or intended. Since then though, I have had opportunities to introduce and used SUDs with other HSPs quite successfully. The single thing I changed was that I introduced it with several low arousal experimental practice sessions immediately afterward and included suggestions about what to do when you’re triggered by an email: send back a picture of The HAND! And do your best to stay in some kind of contact. That is afterall, how brain cells work best.