Why the Treatment Doesn’t Hold: The Truth About SGB for Complex PTSD

Posted on May 1, 2026 by Shay Seaborne, CPTSD

I’ve had 28 Stellate Ganglion Blocks (SGBs) for Complex PTSD, hypervigilance, quadrilateral Complex Regional Pain Syndrome, and other sympathetically driven conditions. These are symptoms of extreme central sensitization from a lifetime of environments adverse to my well-being, especially repeated sexualized violence by caregivers, followed by consistent institutional betrayal when there is no justice or accountability.

There is a version of this treatment promoted as a one-and-done fix for PTSD. That has not matched my experience, and it doesn’t match the conditions under which many of us live. It cannot fix the environment. It does not remove the ongoing threat. It does not create the relational and material conditions required for homeostasis.

What it can do, in my experience, is give the system a break. That is important, because when the system does not have to allocate everything toward threat detection and protection–even temporarily–it has more resources for other things. It can more easily think, plan, connect, and make changes that are otherwise out of reach.

From a Relational Neuroscience perspective, such a break does not hold if the conditions stay the same. The system will reorganize again around what the environment requires. So the question becomes “What can be done with that window?”

For me, the SGB has been a tool, not a fix. It has bought time and energy. And over the years, especially during the periods when I experience the benefits, I have used that time and energy to focus on building conditions that support my system.

I’m doing it in a culture that is very much against supporting human nervous systems. Which means the work is slower, more deliberate, and requires ongoing attention to where energy goes and what demands can be reduced. But even a temporary reduction in hypervigilance provides an opportunity to redirect resources. To move something, even slightly, in a different direction.

By understanding what my nervous system needs, I’ve been able to slowly and carefully build better conditions. This includes improved physical environment, but especially the relational environment. My focus is on building and strengthening safe connections with the people around me.

Understanding a few basic concepts about how this works at the neurobiological level changes how that time is used. It gives us language for what is already happening in the body and in lived experience. It makes the pattern visible. And that creates options that were invisible before. When you can see the pattern, you can change it.

The SGB does not resolve the conditions that created the need for it. It does not replace attunement, safety, or consistent support. But it can create a window where those things become more possible to pursue. That has improved my quality of life because of what I have been able to do with the time and energy it gave me.

SGB is a tool. It buys space. What happens in that space depends on the conditions and on what can be built despite them.

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What Happened to Empathy in medicine?

Posted on April 29, 2026 by Shay Seaborne, CPTSD

Empathy in healthcare is strongly shaped by the conditions practitioners work under and the training culture that forms their habits of attention.

Most medical education emphasizes hierarchy, speed, and diagnostic authority. Students learn early that their role is to control uncertainty and deliver answers. That focus can narrow their attention toward symptoms and protocols rather than the lived experience of the person in front of them.

Work environments add further pressure. Short appointment times, productivity quotas, administrative surveillance, and constant exposure to suffering place practitioners under chronic strain. Under those conditions, people tend to narrow their field of awareness to keep functioning. Emotional distance becomes a practical strategy for getting through the day.

The result is not necessarily indifference but a contraction of the capacity to stay present with another person’s experience.

Institutional culture also plays a role. Many systems reward efficiency and compliance while discouraging reflection about relational impact. When patients question decisions or describe experiences that do not fit the clinical framework, the response can shift toward defensiveness.

The practitioner’s professional identity and the institution’s reputation become priorities that override curiosity about the patient’s perspective.

Another factor is training that privileges abstract knowledge over embodied understanding. Practitioners are taught to observe and categorize, but often receive little support in recognizing how their own stress, fear of error, or discomfort affects the interaction. Without that awareness, empathy can be replaced by technical problem-solving alone.

The loss of empathy in these settings reflects a set of social and organizational conditions that repeatedly pull attention away from relationship and toward control, speed, and institutional protection.

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Seeing the Pattern Changes Your Options: Contempt, Power, and the Environment

Posted on April 27, 2026 by Shay Seaborne, CPTSD

Contempt is not just a tone or a facial expression. It is a way of organizing a relationship around power. It places one person above and the other below, and it does it in a way that shuts down curiosity, mutual influence, and repair.

I have seen this up close in my own family. A relative showed contempt toward me during a first introduction to someone important to them. That moment was not random. It set a hierarchy in real time. It defined how I was to be seen and how I was expected to participate, without my agreement and without space to correct it.

From an IPNB perspective, that kind of moment is shaped long before it happens. People learn how to position others through repeated exposure. If contempt is present in their environment over time, it becomes a familiar way to manage relationships. It simplifies things. One person is right or aligned, the other is reduced. That pattern stabilizes certain relationships while distorting others.

The environment matters here. If someone is consistently around narratives that diminish another person, and there is no meaningful counterbalance through direct, respectful contact, those narratives start to organize perception. Over time, they can feel like fact. When there is little or no ongoing interaction to update the relationship, the system fills in the gaps with what it has been given.

Contempt also has a strong effect on the person receiving it. The body shifts quickly into protection. Attention narrows. Energy moves toward managing exposure rather than engaging. If this happens repeatedly, it shapes expectations. Future interactions are approached with more monitoring and less openness because the pattern has already been established.

It is often overlooked that these are not isolated “attitudes.” They are patterns maintained by context. Family dynamics, long gaps in contact, unequal access to influence, and unchallenged narratives all reinforce them. Without a change in those conditions, the pattern tends to hold.

Reducing the impact of contempt does not come from convincing the other person to change in the moment. It is recognizing the structure you are being placed into and deciding what level of participation you are willing to have. It is also investing in relationships where there is reciprocity, where your presence is not used to establish someone else’s status, and where there is room for repair when something goes wrong.

Understanding the pattern gives you more choice. You can see when you are being pulled into a hierarchy that diminishes you. You can track how your body responds and what it needs in that moment. And you can decide where your time and energy go, based on what actually supports stability and respect in your daily life.

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Complex PTSD as Sensitization to Cues of Danger

Posted on April 24, 2026 by Shay Seaborne, CPTSD

People sometimes wonder why I react so easily. Why a tone shift, pause, or subtle power move can instantly affect my body. They want to know why I notice things others miss and why my system seems to live so close to the edge. Complex PTSD makes sense when understood as sensitization to cues of danger.

I did not become this way because I am weak or fail to “let go.” My nervous system learned hypervigilance from environments where harm was real, repeated, and often wrapped in authority, expertise, or supposed care. It learned that danger did not always look dramatic. Sometimes it seemed polite, wore a white coat, or arrived as dismissal, control, silence, or being overridden while being told it was for my own good.

When danger is ongoing and relational, the nervous system adapts. It detects tone changes, shifts in hierarchy, that autonomy is about to be taken, or needs will be ignored. This is not fearfulness, but accuracy shaped by experience.

From an Interpersonal Neurobiology (IPNB) perspective, Complex PTSD is not a disorder of thinking or a failure to be rational. It happens when a human nervous system has spent too long in conditions that demand constant vigilance. The system becomes sensitized. It starts to respond to cues that resemble past threat because, historically, missing those cues came at a serious cost.

This is why telling someone with complex PTSD that they are safe does not help. Safety is not a concept or decision. It is a lived, repeated experience. My body does not respond to reassurance, but conditions. Does this environment reduce hierarchy or reinforce it? Do I have choice, or am I being managed? Is repair possible, or will harm be denied? Are signals consistent or unpredictable?

Healthcare professionals and family blamed me for my responses. They said I was anxious, thinking the wrong thoughts, focused on the wrong things, needed to forgive, or just needed to take up yoga. They ignored and bypassed the real issue. My nervous system was doing exactly what it had been trained to do: scan, prepare, protect, and react. The problem was not my sensitivity, but that my environment demanded that I take the hits and act like nothing was wrong.

Complex PTSD arises when a sensitized system does not receive enough sustained relief to recalibrate. Healing does not emerge from desensitizing people through exposure or teaching them to tolerate more. It requires reducing the load: fewer threats, less coercion, reduced hierarchy, and more predictability, dignity, and support.

As those conditions change, the nervous system changes. Not because it is convinced, but because it learns through experience that vigilance is no longer required at the same intensity.

This is why I focus on Interpersonal Neurobiology (IPNB). It supports the truth of what happened to us. It explains our responses without shaming. It makes clear that recovery is not an individual failure or success story. It emerges when sufficient safety and connection exist for the nervous system to recognize that the environment no longer requires hypervigilance.

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Why I Quit Therapy

Posted on April 22, 2026 by Shay Seaborne, CPTSD
Over 6.5 years, I was traumatized by 13 therapists. Even the intake, first session, and attempt to explain my history put my nervous system back into the same defensive state. In session, I frequently encountered misattunement that prompted their disbelief, dismissal, minimization, and attempts to pathologize and gaslight me. The hospital’s psychologist twice blew off my concerns about intensifying suicidal ideations from Lexapro. I ended up in the hospital. A different psychologist tried to convince me I shouldn’t be upset that medical abuse destroyed everything I had worked to build because, “at least, you had it for a while.” His colleague insisted that I needed to take on starting a food co-op, though I was flattened and barely functioning. An intern at a rape crisis center asked if I had a will to live, right after I told her how I had been fighting for my life for years. A Somatic Experiencing psychologist broke down crying and admitted she didn’t “have the bandwidth” for my somatic experience. The more I tried to find a therapist who would help and not harm, the higher my stress levels rose.
 
I stepped back and looked at it through a Relational Neuroscience lens. The basic principle is simple. Human regulation depends heavily on the relational environment. When the people around you repeatedly misattune, dismiss, or overpower your autonomy, the body learns that those environments are unsafe. Continuing to expose yourself to the same type of environment keeps the nervous system in protection mode.
 
When an environment repeatedly triggers threat responses, distance can be one of the most stabilizing steps a person can take while they rebuild safety elsewhere. I decided to stop going to therapy because even the stress of searching for a therapist was causing harm. Instead, I focused on applying Relational Neuroscience principles in my daily life. A big part of that was choosing to avoid relationships that were likely to destabilize me. In my experience, therapists were very likely to do that.
 
I focused on building regulation through safer relationships, predictable routines, and people who could meet me with basic respect and attunement. Initially, these had to be with healthcare practitioners because they had become my primary social contact. The trauma of repeated medical abuse and neglect had severed my numerous prior connections and destroyed my sense of safety. I needed authentic care, so I worked to build a team of practitioners who intentionally participate in my recovery. With their support, my body began to settle. By shaping my relational environment more carefully, I was able to regain enough sense of safety to start building new relationships outside of medicine.
 
Life is much better now.
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When the Boss Plays Mind Games: A Case Study in Blame, Power, and Gaslighting

Posted on April 20, 2026 by Shay Seaborne, CPTSD

About 15 years ago, I left one of only two jobs I ever had that offered a living wage and benefits. I didn’t choose to leave. My boss had a political agenda, and I became a target.

I was the office manager for a Fairfax County, Virginia, district supervisor. My position required work that others could not or would not do — such as serving as the interface between the office and the county IT team — and I consistently delivered results. Despite that, the supervisor fired me so he could hire the relative of a political supporter. I knew when I accepted the job offer that employment was “at the pleasure of the supervisor,” which meant he could send me on my way at any time, for any reason. I didn’t have an issue with why he terminated me, but how. It showed his true character when he justified his decision by making me the problem. 

Instead of saying something like, “I owe a political favor, so I need to give your job to someone else. I’ll put in a good word for you at another county office,” he targeted me in a degrading and threatening way. This was apparently to make himself feel better about putting a single mother in such a bad position in the aftermath of the Great Recession. 

The man ignored his chief of staff’s advice and turned what was supposed to be my positive annual review into a forty-minute fusillade of criticisms. These included retroactive rules, improvised grievances, and even blaming me for his marital problems. All the while, his chief of staff, sitting at the opposite end of the table, repeatedly signaled, “stop.” When our boss finally paused and noticed the time, he became angry that he was late for his next meeting. That was my fault, too. The upshot was that my employment would terminate in 4 months. I left the office shell-shocked.

When the new employee arrived, I was relegated to a desk in the back of the conference room, borrowed from the Department of Sanitation. After years of serving in the front office, I was banished to a punishment space.

I did not speak about this in my social circles at the time. The environment included people connected to politics, and the risk of being labeled a problem or a tattler was high. Sharing the truth would likely have jeopardized future opportunities in that and the adjacent county, or any in the political system. The relational context created a high probability that disclosure would trigger social and professional consequences, not resolution or justice.

The pattern of abuse extended beyond one individual. The supervisor’s actions signaled that performance and effort offered no protection. Anyone entering the same system would encounter similar risks because the environment rewarded loyalty to connections above all. 

Despite the supervisor’s ill treatment, the staff gave me an extraordinary farewell. It showed me that they cared, and that pushed back against his abuse. They organized a party, pooled money to purchase a very generous gift certificate to a high-quality garden nursery, a carefully chosen potted azalea, and two bottles of expensive champagne. Most sipped politely and returned to work, but the staffer who received my position insisted we share the rest. In that tiny alcove, we laughed, cried, and hugged.

Although my boss never said another word about it, failed to thank me for my service, and was absent on the day of termination, the former district supervisor met with me. Dana apologized for his successor’s behavior, acknowledging that the office had tried to help him be a better human in the role.

From a Relational Neuroscience perspective, someone who behaves like my former boss—displacing blame, vilifying a competent employee to justify unethical decisions, and avoiding accountability—likely operates from a pattern rather than a one-time lapse. Patterns like these often reflect deeply ingrained relational strategies shaped by past experiences, power dynamics, and nervous system regulation. Recognition of this pattern is important. It is not the individuals subjected to these dynamics who are at fault, but the system itself and the way power is exercised within it.

I am now speaking about this experience because the immediate personal risk no longer exists, and because telling the truth of my lived experience is the only justice I have known. The goal is to highlight the recurring patterns and the structure of domination within this system. Observing the pattern allows others who were subjected to similar treatment to recognize that the behavior reflects the system, not personal failure.

Helping others see these patterns serves a function of accountability. It shifts attention from self-blame to understanding how relational and structural dynamics operate. The pattern includes arbitrary enforcement of authority, prioritization of personal networks, and systematic marginalization of those who demonstrate competence or independence. Observing and describing these dynamics contributes to clarity about risk and reduces the likelihood that people will internalize responsibility for personalized systemic harm.

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Can Trauma Survivors Recover Even Without Access to Professional Help?

Posted on April 17, 2026 by Shay Seaborne, CPTSD

According to a 2021 study, “most states have fewer than 40% of the mental health professionals needed” and “more than half (51%) of counties in the United States have no practicing psychiatrists.” Even where mental illness industry practitioners exist, many cannot afford the cost. “A traditional 60-minute therapy session can range from $100 to $200 [and]…A patient with major depression can spend an average of $10,836 a year on treatment.” Increasingly, therapists are leaving insurance networks (“because they face a mountain of hurdles from insurers to get reimbursed),” further reducing accessibility.

Even when proximity and cost are not issues, it can be very challenging to find a therapist who is truly trauma proficient. “Trauma-Informed Care” has become hardly more than a buzzword, and even therapists with special training or designations like “Trauma-Focused,” are uninformed about the neurobiology of trauma and recovery, which means that, despite their best intentions, they will cause harm.

Fortunately, the field of Interpersonal Neurobiology (also called Relational Neuroscience) shows us that trauma survivors can recover by focusing on building strong, supportive relationships and environments that foster safety and connection. 

Community and Social Support: IPNB emphasizes the importance of healthy, attuned relationships in healing trauma. Survivors can seek out supportive communities or peer groups where they can share their experiences and receive empathy and understanding. These relationships can help rewire the brain by providing new, positive relational experiences that counteract the isolation and fear often caused by trauma.

Interpersonal Regulation: Survivors can engage in relationships where co-regulation is possible. This means spending time with people who can offer a calm and stable presence, helping the survivor’s nervous system to stabilize and regulate. This form of relational safety is crucial for healing.

Self-Education: Learning about the nervous system and how trauma affects it can empower survivors to develop self-regulation strategies. Techniques like mindful breathing, grounding exercises, and body-based practices (e.g., yoga, tai chi) can help manage symptoms and promote nervous system balance, which can support symptom relief.

Creative Expression: Engaging in creative activities such as art, writing, music, or dance allows survivors to express emotions that may be difficult to verbalize. This form of expression can facilitate emotional release and foster a sense of agency and empowerment.

Nature and Environment: Spending time in nature and creating a safe, soothing environment can support healing. Nature exposure has been shown to reduce stress and help the nervous system return to a state of balance.

Peer Support Networks: Forming or joining peer-led support groups where survivors can connect with others who have similar experiences can be extremely therapeutic. These groups can provide validation, reduce feelings of isolation, and offer practical strategies for coping.

Mind-Body Practices: Practices like meditation, breathwork, Imogen Ragone’s BodyIntelligence and mindful movement help connect the body and mind, promoting a sense of safety and presence. These practices can aid in re-establishing a sense of control and internal calm.

Advocacy and Activism: Engaging in advocacy or activism related to trauma and mental health can give survivors a sense of purpose and empowerment, helping them transform their pain into a force for positive change.

By focusing on these relational, community-based, and self-directed approaches, trauma survivors can work toward recovery and resilience independent of the mental illness industry.

DISCLAIMER: This is not medical, psychological, or legal advice. The contents of this site represent Shay Seaborne, CPTSD’s lived experience, and understanding of the neurobiology of trauma through study and experiences. For medical, psychological, or legal advice, seek a qualified practitioner.

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Secrecy and Stability: The Super Enablers at My Father’s Memorial

Posted on April 15, 2026 by Shay Seaborne, CPTSD

At my father’s memorial in 2019, the family dynamics were easy to see. Most people did not want to talk to me. They showed it through distance, short answers, or simply not engaging. My sister’s behavior was openly hostile. Her daughter was manipulative.

Three other people approached me in a completely different way. Two of them were my cousins’ wives. The third was a cousin’s daughter, my second cousin. They were upbeat, friendly, and attentive. They went out of their way to engage me in conversation when most of the room was avoiding me. At the time, it felt strange. Something about the interaction did not match the larger social atmosphere in the room. Later, the pattern became clearer.

In families that carry a legacy of abuse, some people play the role of enablers. They minimize, ignore, or redirect attention away from the abuse. A smaller group operates more actively. I call them super enablers. In systems language, they function as secondary enablers or system-maintaining allies. They engage directly with the person who has spoken about the abuse. They are often the ones who approach the survivor first. Their behavior appears supportive on the surface, but it serves a stabilizing function for the family system.

The pattern works through relational management. When someone in a family signals the reality of abuse, the social field becomes unstable. People feel threatened because disclosure of the open family secret can expose long-standing dynamics and redistribute responsibility. Some family members withdraw. Others move toward the person who has spoken. The super enablers create friendly interaction that keeps the survivor occupied. Conversation becomes light, chatty, and pleasant. The interaction regulates the moment. It reduces the likelihood that the survivor will confront abusers or speak directly about the abuse in that setting.

This is not always deliberate. People regulate themselves and each other through social behavior. When maintaining family cohesion depends on silence about abuse, certain roles develop. The super enablers become the ones who manage proximity to the survivor. Their friendliness stabilizes the environment and protects the larger structure of relationships. The system remains intact because the underlying issue never reaches open discussion.

The difference becomes visible when someone interacts without that system-protective role. At the memorial, the only person who spoke with me in a direct and grounded way was another second cousin, who had talked with me about the family dynamics over time. That interaction did not revolve around smoothing over the atmosphere. It allowed the reality of the situation to be acknowledged.

Many people who speak about family abuse recognize this pattern immediately. Some relatives avoid them completely. Others approach with intense friendliness that does not include acknowledgment of what has been said. The friendliness functions as social management. It keeps conversation in safe territory and maintains the existing hierarchy and loyalties.

Spotting super enablers requires watching patterns across situations. Notice who approaches quickly when others withdraw. Notice who keeps interaction upbeat while steering away from the subject that destabilizes the family. Notice who maintains close engagement with the survivor while continuing to protect the people responsible for harm. Those patterns reveal how the family system organizes itself around secrecy and stability.

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Cues of Safety: Why Connection is Non-Negotiable in Healthcare

Posted on April 15, 2026 by Shay Seaborne, CPTSD

Cues of safety are signals we give each other that tell our nervous systems we are safe with one another. When we feel pro-social and safe enough to be authentic and truly connect, we naturally give off these cues, which include how we smile, our tone of voice, how fast we talk, what we discuss, and where we focus our attention.

We generally know these things intuitively. For most people with a typical brain and a normal family experience, we learn these cues through lived experience starting in childhood. These signals are vital information coming into our body about what another person’s intention is and whether they are safe for us.

The Essential Role of Connection

Safety is not only the absence of threat, but the presence of connection. This presence is critical because the lack of connection is what makes space for othering, discounting, and contempt and cruelty. We simply do not have the capacity to be cruel or contemptuous toward someone to whom we feel connected. When we receive these signs of safety, we can be pretty sure it is safe to relax, be authentic, express our emotions, be vulnerable, and have meaningful and deep conversations.

Empathy in the Context of Chronic Conditions

I have been examining this concept closely through the lens of being a patient with chronic conditions. For me, understanding that empathy is not optional—it is something I must have—has been vital. My nervous system has been begging for this. The core issue often comes down to this: not enough empathy, and too much cruelty and contempt.

Because of this, finding providers who can genuinely offer empathy is especially important to me.

The Healing Connection

I will never forget the day I met one of my pain specialists. When he entered the room, it was like the sunshine came in; there were so many cues of safety. I immediately felt comfortable and that I could trust him, and I still do, over three years later. He is wonderful; he pays such attention to what is going on with me and responds to it out of goodness.

The Detached Provider

In stark contrast, his boss, who owns the practice, does not offer cues of safety, but danger. When I saw him for a consult about a potential procedure, things went so badly that I decided I could never even let him touch a hangnail. He expressed only a highly fake cognitive empathy. That attempt seemed to be a strain for him, as his body moved into a strange, jerking contortion. He even tried to rip me off by upping the price of the procedure by 50% after he had already given the line item costs. He saw me as an object—a billing code, something to go in his pocket—which is very different from the doctor I work with and care about.

Subsequently, I saw a new provider, a functional neurologist at a “Brain Center.” He supposedly understands how the brain works and what we need for healing from PTSD. Unfortunately, there were no cues of safety from him or his staff. Everything was cold and clinical, focused on the protocol. Nobody even said my name once during the entire visit, which lasted about an hour. That experience convinced me not to go back. Even if I found the treatments themselves helpful, being in that kind of environment would not be adverse to my healing.

I am grateful that I understand this: connection is a must, especially with your healthcare provider. If they cannot provide that—if they cannot function well enough themselves to safely connect—I do not need them to be in my life, and they certainly cannot help to move my health forward, only cause more harm.

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Outsourcing to Angels: Faith as Deferral Instead of Action

Posted on April 13, 2026 by Shay Seaborne, CPTSD

Recently,  I met someone who told me that the political turmoil of today is okay according to the angels. They say it’s just cleaning out the bad stuff. She also said that angels don’t work on our timeline, so we can’t predict what will happen. We should trust the angels. I found this fascinating from a Relational Neuroscience perspective, of course.

It was easy to recognize this was her way of making uncertainty feel tolerable by placing control and meaning outside of human systems. It removes the need to recognize cause and effect in real time. That can feel stabilizing in the moment because it replaces unpredictability with a fixed narrative.

But it also bypasses observable reality. Political turmoil has direct, material effects on people’s safety, access to resources, and exposure to harm. When those are framed as part of a distant or unknowable plan, it interrupts the process of accurately registering what is happening. That means it’s impossible to respond appropriately or effectively.

From a nervous system standpoint, regulation depends on pattern recognition that is grounded in what can be seen, tracked, and acted on. Predictability comes from being able to say: this is happening, this is who is affected, this is what increases or reduces risk. If that layer is replaced with “trust the angels” and “we can’t know the timeline,” then there is no stable feedback loop. There is no way to orient, prepare, or adjust behavior based on conditions.

The angel idea also shifts responsibility. If harm is reframed as “cleaning out the bad,” then the focus moves away from the people and systems producing that harm. That weakens collective response. It reduces pressure on institutions and actors who make decisions that affect others.

We can see the difference in how each viewpoint organizes behavior. One approach leads to observation, documentation, boundary setting, and coordinated action with others who see the same patterns. The other leads to waiting, deferring, and tolerating conditions without intervening.

I choose to stay anchored in what is observable and what changes outcomes. That keeps my orientation tied to reality rather than to a system that asks me to suspend it. This focus gives me options for choices that support human well-being instead of blinding me to them and leading me into complacency or helplessness.

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