Sunday, April 18, 2010
What constitutes trauma? It many be different for all of us but the core feelings are the same. Fear, anger, withdrawal, confusion, intimidation are all emotional elements of those who have survived a traumatic situation. Working through it can be a lifelong process and it involves many types of coping skills to deal with it effectively. I am not speaking about physical trauma but rather psychological trauma though one can certainly lead to the other.
Many years ago emotional trauma brought up the feeling of shame. It was hidden away by families and never spoken about, fearing the stigma of having survived trauma would cast a disgraceful light on the victim. The 'we do not air our dirty laundry' syndrome. Blocking out the incident was the only means of treatment but, of course, this did not solve the problem. Learning to withdraw or disassociate from the memory of the event was encouraged but this merely suppressed intense negative feelings, rendering the victim to live a wounded life. Never being able to escape the multitude of emotions associated with surviving trauma. And when those feelings are ignored, they eventually re-emerge in the form of self-destructive behaviors.
This was especially the case with soldiers who had experienced the horror of war. So overwhelming were the experiences causing death and severe injury, the mind could not comprehend the magnitude of the situation at the time. Long after the event, if not processed, a triggering (reminde event caused them to live the memory of the trauma over and over again and believing that it was happening again. Never being able to obtain peace. Thus, Post Traumatic Stress Disorder (PTSD) became a diagnostic psychological impairment in the psychiatric world and a new way of approaching treatment came to light.
We do use our survival skills to get through the trauma (though it may not seem like we do at the time) to ensure self preservation. It is the aftermath that creates the severe difficulties in our thinking and behaving. As I have said, repression is usually the first condition noticed. We use this as a defense mechanism in which to deal with the event but this usually cannot last forever. At some point, when the sufferer cannot function well in the day to day living situations of society, the issue must be gently addressed. Associated with repression, reoccurring nightmares, panic attacks, anxiety, addiction and depression can consume one's life. The decision to address the traumatic event is a major breakthrough and only then can the intricate work can start to occur. It is not a decision that is easily reached. With the guidance of a qualified mental health professional, the victim discovers that they are really a survivor. This change in thinking sets the stage for the rest of the work. It is important to address the details of trauma in a safe environment. A therapist can pace the amount of information revealed and will recognize when the survivor is become overwhelmed. In some cases, it is a delicate balance but the therapist usually takes his/her cue from the client with the hope that, in time, the entire event can be processed.
I usually discourage those sitting alone at a computer to relive the details of their trauma as they can become devastated by the disclosure and there is no safety net in which to fall. I understand the human need to allow others in but emotional safety must be considered. A therapist will remind an overwhelmed client that the trauma is not happening in that moment. The trauma was done in the past and that the client is not in any immediate danger. This is very grounding for the client as they realize that they are, indeed, talking about the past without the danger of re-occurrence. The goal of therapy is not to eradicate the trauma from the clients psyche but rather to make the memories more manageable; no longer paralyzing them or destroying their quality of life. Discussing the event on a regular basis assists in reducing the emotional power that the client initially feels their trauma has over them. In support groups, talking to others who have experienced trauma and discussing the feelings that they all share can be very therapeutic in showing the client that they are not alone. Once the event no longer rules over the life of the survivor, they are free to experience the positive aspects of their lives. We all want the best possible life and learning healthy coping skills to deal with past traumatic events can be life saving.
Remember to be kind to yourself during this process. You did not ask for this. We are all fragile human beings, sometimes feeling alone with our past so processing it takes love and patience. No one wants to live in fear. We want to live in the sunshine, reclaiming our lives and relationships. It is never a requirement that past traumatic events must rule over our lives indefinitely. We learn to be the ruler over the after effects of our crisis situations. We can live with the knowledge that our trauma is behind us and we can have exactly the kind of life that we want. It is all possible.
National Center for PTSD: http://www.ptsd.va.gov/