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[libribook.com] Traumatic Scar Tissue Management 1st Edition
Figure 7.2Summay of the normal stress cascade with return to homeostasis.In times of acute stress, SNS mediated release of hormones readies us to respondto threat, real or perceived, by driving a host of physiological and psychologicalchanges. Heart rate, blood pressure and respiration rate changes enable quickactions to be taken (e.g. fight or flight). Skeletal muscle acquires additionalenergy from adipose and hepatic cells. Suppression of normal thought functionsenables our brain to switch into survival mode, further supporting the ability toreact quickly without the usual time taken for evaluation and planning. Suchchanges are considered beneficial adaptations.In the absence of stress or under normal circumstances, the parasympatheticnervous system (PSNS) governs self-preservative functions, such as homeostasisand wound healing (van der Kolk 1994). During stress response, SNSpredominance will suppress or alter functions that are normally governed by thePSNS.As previously noted, stress response is generally short-lived, lasting only longenough to get us out of harm’s way. All inessential activity in-the-moment (e.g.digestion, reproduction, feeding and growth) will be supressed, largely throughactions exerted by glucocorticoids (Vitlic et al. 2014). Typically there is aneventual return to homeostasis as the PSNS returns to the driver’s seat. Althoughstress response is normally short-lived, certain circumstances can set the stagefor prolonged or chronic (pathophysiological) stress response and in turn this canadversely impact wound healing – more on this later in this chapter.
Chronic Stress ResponseChronic stress response occurs when stress stimulus exceeds our naturalregulatory capacity and ability to return to homeostasis (Koolhaas et al. 2011).Overwhelming psychological stressors commonly result in chronic stressresponse. Without proper intervention a chronic stress state can persistindefinitely.Chronic stress response is characterized by the prolonged and/or elevatedpresence of stress hormones. The physical and psychological ramifications ofchronic stress presents a host of clinical problems and the chronic propagation ofstress response mechanisms have deleterious long-range effects (Miller &O’Callaghan 2002, Friedman 2015).If the stress response system fails to return to homeostasis or reset (i.e. remainshyperaroused or in a state of excess SNS activation and deficient PSNSactivation) the individual is at risk for allostatic overload, exhausting varioussystems and leading to the development of stress-related physiological andpsychological disorders (Padgett & Glaser 2003, Lusk & Lash 2005,Starkweather 2007, Von Ah & Kang 2007, Rosenberger et al. 2009, Lucas 2011,van der Kolk 2014, Payne et al. 2015).Many of the impairments that MTs address in clinic are clearly and inextricablylinked with the effects of chronic stress and trauma on the body.
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Chronic Stress Response
Chronic stress response occurs when stress stimulus exceeds our natural
regulatory capacity and ability to return to homeostasis (Koolhaas et al. 2011).
Overwhelming psychological stressors commonly result in chronic stress
response. Without proper intervention a chronic stress state can persist
indefinitely.
Chronic stress response is characterized by the prolonged and/or elevated
presence of stress hormones. The physical and psychological ramifications of
chronic stress presents a host of clinical problems and the chronic propagation of
stress response mechanisms have deleterious long-range effects (Miller &
O’Callaghan 2002, Friedman 2015).
If the stress response system fails to return to homeostasis or reset (i.e. remains
hyperaroused or in a state of excess SNS activation and deficient PSNS
activation) the individual is at risk for allostatic overload, exhausting various
systems and leading to the development of stress-related physiological and
psychological disorders (Padgett & Glaser 2003, Lusk & Lash 2005,
Starkweather 2007, Von Ah & Kang 2007, Rosenberger et al. 2009, Lucas 2011,
van der Kolk 2014, Payne et al. 2015).
Many of the impairments that MTs address in clinic are clearly and inextricably
linked with the effects of chronic stress and trauma on the body.
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