Why trauma causes insomnia
The Problem With Insomnia and Trauma
I looked at my sleep therapist in irritation as she valiantly tried to be encouraging. “One goal with Cognitive Behavioral Therapy for Insomnia is for you to learn to catch the negative thoughts and change them before they can have an impact.”
That was all well and good, I thought, but just how do you change a negative thought? Do you repeat a positive mantra over and over? Do you simply tell yourself it isn’t true and ignore the sick feeling in your stomach? As I worked with my therapist using CBT-I I had become more aware of my negative thoughts about sleep, and I could catch them earlier on, but all that did was make me feel worse because I couldn’t change them. I still felt the same way. Taking away naps did not make a dent in falling asleep. In fact, I now felt so ill I didn’t know how much longer I could go on.
Keeping a sleep diary created more anxiety. Though it was helpful in showing patterns, it also created great dread about the coming night. What was my sleep going to be like tonight? I knew I was going to have to write it down. As night approached, I became more and more anxious. When sleep turned out to be as difficult as I thought it was going to be, my anger set on low boil all the next day. Then the cycle would repeat itself. In desperation I read over my therapist’s handouts yet again.
And I quote:
Some common goals of CBT-I Treatment might involve:
-A way of acting, like relaxing before going to bed
-A way of feeling, like feeling less anxious about sleep
-A way of thinking, like learning to keep worries outside of the bedroom
-A way of dealing with physical or medical problems, like relaxing muscles
-A way of adjusting, like avoiding compensating naps and setting up sleep schedules
These were goals I would have loved to achieve, but the more I tried to follow the regimen, the more they slipped away. All the sleep hygiene guidelines and relaxation exercises, and calm sleeping environments and caffeine, nicotine, alcohol, cannabis avoidance etc. etc. etc. did not translate into better sleep for me. Why? Because CBT-I leaves out the core cause of insomnia for trauma survivors. Heart belief. And heart belief, the things you believe and have learned because of abuse are what drive hyper-arousal. And hyper-arousal overrides the sleep drive.
“Do you want me to lie?” I asked my therapist. “Pretend my feelings have changed?” She blinked back at me like a deer in the headlights. “I can catch these thoughts,” I told her. “But I cannot change them because I believe them. They aren’t from somewhere outside of myself or something my brain just came up with. I believe them, deep down in my heart. So, now what am I supposed to do?” She had no answer. If you are reading this as a survivor of childhood trauma, I bet I am singing your tune. Because insomnia for trauma survivors is not a sleep problem, it is an anxiety problem.
Great, now what do I do.
Why Trauma Impacts Insomnia
I was six and the shadow of the possibility of attack followed me everywhere. I never knew what my parents were going to do. Even when I was away at school, I remained terrified I would make some small mistake that would get reported. Grades were a constant source of terror. I learned to read my parent’s moods, but no one, not even me could get it right 100% of the time. Inevitably, something would happen, or perhaps nothing would happen, and I would be the brunt of my mother’s rage and my father’s frustration and anger. Beatings, screaming, denigration, isolation all these and more would be my punishment. I learned the lessons of childhood well.
The world is not a safe place
People are not safe
Something bad will always happen
My response? Control everything as much as possible. Always be on the alert. Don’t trust anybody. Those lessons saved my life as a child, but as an adult, they wreaked all kinds of havoc not the least of which was insomnia. I didn’t know how to explain to my sleep therapist that these were not just negative thoughts. These were survival mechanisms that had kept me alive and I could not turn them off just because I wanted to.
I went to another therapist of a different sort this week. And this time, I got to the root of the problem. Survivors of childhood trauma do something called splitting or dissociating. Different parts of ourselves carry trauma from different times in our life. Mine was especially focused on me as a six-year-old. I rejected her. In fact, I hated her. She was the cause of all my suffering. In a way, I was living as a six-year-old still stuck in that house of horrors with all the sorrow, fear, loneliness and powerlessness that accompanied it.
That’s what CPTSD looks like and that was what was behind my insomnia. Over the years, I had a hard time embracing the little child that was me. She was too vulnerable, too powerless and too hurt. I did not even want to look at her. But as long as I refused to deal with her suffering, the more CPTSD symptoms took charge including insomnia. As most of you already know, healing this type of trauma is like peeling an onion, and I had now come to a very deep layer.
When insomnia kept me up at night, I often sifted through the past—grieving or just trying to make sense of it all. Problem solving is what the brain is supposed to do. But this was problem solving of a different kind. One that stayed in endless loops without resolution causing hyper-arousal to override my sleep drive night after endless night. I would google my abuser’s names and sometimes look at their pictures posted on Facebook. I would ask myself questions that had no answers and wonder if I had done something different would it have changed anything. If I wasn’t doing that, I would watch videos on the holocaust or other images of suffering trying to figure out the meaning of it all. No wonder I couldn’t fall asleep.
All this activity was an expression of distress. The distress of a little child that needed tending to, and I was the only one who could do that. Sigh. Here I was, yet again. I had done so much work, I couldn’t believe that there was still another layer that needed healing. All this revelation helped to understand the problem, but understanding is only the first step to change. The structural tools for overcoming insomnia were not available to me as long as my heart belief thought that sleep was a threat. As long as the distress of the six-year-old was running the show, I was not going to conquer insomnia.
To sleep was to lose control. To sleep was to relax (danger!) The more I chased sleep, the more elusive it became. Because sleep is a passive process. You can’t control it. It’s a biological need built in to the body’s system and the only way to let the system proceed is to stop trying to control it. To let go. Geez! This is complicated. We need a new category of insomnia therapy. I’d name it Complex Insomnia Therapy because it’s just like its cohorts Complex PTSD and Complex Grief.
I kept all the concrete suggestions my sleep therapist gave me and then, I went back to the drawing board. The threat response had kept me in flashbacks for most of my life but I had been able to make significant improvements. I was able to feel joy, I could participate in friendships and relationships without feeling terror. I had come back to life. If those things could heal, I knew insomnia could get better as well. Already my heart belief was beginning to change.
I decided to stop trying to solve insomnia by working harder at if. If indeed it was a passive process, solving insomnia wasn’t going to come by doing the structural suggestions better than anyone else. It was going to come by leaning into life not trying to control it. I divided the process into three categories: Body, Mind, Spirit.
In this week’s blog downloads, I’m including concrete exercises to tend to the first of those. The body. We all know trauma is held in the body. Hyper-arousal is expressed through the body. The best book on hyper-arousal I have ever found is Dr. Eric Gentry’s “Forward Facing Trauma Therapy.” His gentle exercises on how to invoke a relaxation response are found on page 55 and are also included in today’s downloads. The downloads also include one more structural handout from my sleep therapist called, “About Insomnia.” (If you are not subscribed to my newsletter, send a request for the free sleep packet via email at: hello@defytraumaembracejoy.com) and please! sign up for the newsletter on this website.
“About Insomnia”, gives good general information. Read over it, but know it includes little to nothing about hyper-arousal. I suggest keeping all the downloadables you’ve received so far but temporarily setting them aside if they cause distress. If you are like me, you are going to have to work on hyper-arousal first. Maybe make a few small changes like avoiding long naps that ruin your sleep drive at night. Try to get up at the same time every morning. Those two things alone will help tremendously, but also remember, any effort towards insomnia can quickly turn into anger, anxiety and hyper-arousal if you do not tend to the deeper problem of trauma–heart belief. I can KNOW in my head I am safe but that doesn’t mean my heart believes it. And that will be the topic of next week’s blog: Addressing the mind and the spirit so that change in heart belief is possible. Meanwhile, try out the body relaxation exercises and think about getting Dr. Gentry’s book. Let me know how it’s going. I’d love to hear from you.