The excellent article interviewing Shlomo Schor in January’s issue, “Understanding Trauma and PTSD in Laymen’s Terms,” was an informative overview. Now I will attempt to give some general and anecdotal ways in which trauma therapy and the path to healing play out and to suggest caveats to prospective clients.
I am a licensed counselor who has been in practice for 25 years, with specific trauma training for the past six. I have met people who endured physical violence and other abuse, which, while no doubt horrific and distressing, did not traumatize them. I’ve known others who went through a more common experience, nowadays, like divorce of their parents when they were vulnerable children, who remain traumatized as adults.
So a working definition of trauma is not the actual event but, rather, the symptoms of stress, anxiety, PTSD, and somatic illness that one is experiencing. Of course, each person’s temperament and physical, emotional, and environmental sensitivities are also factors in their own suffering.
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A word I’ve come to use to describe a traumatic reaction to life circumstances is “insidious.” It reminds me of one of those whack-a-mole inflatable toys. People may think they have been stabilized after trauma by becoming physically active and rebuilding strength, yet they find their sleep fragmented and their digestive system malfunctioning. Or they may think they have addressed the situation head-on by discussing it, yet their “fuse” is short, and they are jumpy and easily irritated. The point is that trauma affecting one’s life foundation needs to be addressed at all levels of being.
A trauma therapy expert I studied with said that, currently, it can take multiple practitioners to diagnose a person’s state of trauma, particularly if the precipitating incident(s) occurred years ago. Dissociation is a major defense, which helps people to seemingly survive earlier trauma. Unfortunately, it lops off full emotional and cognitive functioning in the process. A person who can only navigate life within a rigid framework has probably shut down from trauma.
A goal of trauma therapy, beyond getting the person stabilized during an immediate crisis, is restoring the ability to utilize all of one’s resources. Situations that formerly were triggers to reliving the trauma are now managed by regulating one’s response and connecting with an inner self that feels grounded and centered.
A self-defined “medical intuitive,” Carolyn Myss, who has written several books about healing, says that if someone ruminates 40 percent of the time about the past and is anxious 30 percent of the time about the future, that person has only 30 percent of their energy available to live and respond to what’s happening now. Thus, one can become imprisoned in his or her own consciousness.
The trauma therapist needs to be well versed in modalities that not only address a person’s visible presentation but also interact in a less direct way with a person’s fear center – the fight-flight-freeze survival mechanism – and teach modes of self-regulation. Non-verbal therapies like art, music, and dance seem primed for this as trauma is truly an experience beyond words. While movies show people having epiphanies on mountaintops, the skilled trauma therapist must take time to create a safe, almost hallowed space. Quick, magical cures may be tempting, but they are shallow. As the precipitating traumatic incident(s) has often occurred in the proverbial blink of an eye – a few seconds or minutes – the therapy must become the antithesis of this as the client is slowly and expertly guided toward admitting and processing intense emotion.
The traumatized client is seeking a new foundation, an internal locus of control that is reliable, efficient, moral, and productive. Often, I sense a person’s fragmented pieces floating around, and I feel that my task is to offer a space and tools with which to reconnect them. Other times, I realize that the person has some gaps in development, and this traumatic experience affords him or her the first possibility of creating a workable life foundation.
The client’s vulnerability is a delicate challenge for a responsible therapist. Unfortunately, some therapists are so enamored with their own recovery from trauma that they feel they have “the answer” and proceed to engineer control over the client’s psyche. Buyer beware. If you feel you are being controlled and offered a solution that requires adopting someone else’s way of being, then get out. This may be the first act in assertively standing up for yourself.
The other side of this slippery slope is the belief that one’s trauma is so intractable that no one can ever fully understand or be helpful. Frozen fears keep people from engaging with any therapist, and thus the cycle of therapy shopping begins. If it’s hard to start the process, you might try bringing someone you trust to your first appointment to get a better sense of what this therapist is really like. I offer an option for prospective clients to come in to meet and greet and see the office space, then to take time to decide whether to return for treatment.
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Different modalities strike a resonance in different people. A currently popular method, EMDR, has shown effectiveness for specific traumatic incidents, like being physically or sexually assaulted. Developmental trauma is harder to pin down, as there were likely many issues in the client’s earlier experience of trying to create healthy attachment to a parent. There may have been overbearing or distant parenting or some alternation between the two, so the growing child never knew what to expect. While the relationship between client and trauma therapist is always important, it is particularly vital in trying to repair an attachment wound. The therapist becomes the object for the client to play out his/her learned attachment style while the therapist uses this interaction to create a healthier relationship. It is imperative that the therapist not have her own agenda or be controlling in any way.
Generational trauma is experienced in families or groups of people. We know that children and even grandchildren of Holocaust survivors can continue to live out the fear and anxiety of their forbearers. Since they did not have the direct oppression, their triggers may be more mysterious, surprising even them. Clients come in with symptoms but no sense of when the distress began: “This is just the way things are in my family,” they’ll say. Clients who have experienced physical or sexual abuse within family networks where this is prevalent may have the same sense of being caught in a hopeless web. This is tricky territory because often people do not want to totally separate from their families yet need to negotiate a different way of relating.
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Besides entering a therapist’s office, there are things a person can do on his or her own to begin to find balance and a greater sense of well-being. I call these “healing resources,” which are activities or practices that are free or low cost, readily available, and do not require special conditions or the presence of another person to pursue. Some examples might be a visit to a park, caring for plants, interacting with animals, engaging with music or art, and developing healthy life routines. These activities may be how a person initially deals with trauma, and they can go hand-in-hand with psychotherapy.
While there is no set time frame for effective trauma therapy, one should not expect the wound to be forgotten. Still, it comes to occupy a less central place in one’s thinking and feeling. Most people do not return to being just the way they were beforehand, but there is often a positive shift. A person who finds productive ways to process trauma may use this new-found awareness to advocate for others in challenging life situations. Someone not having to always focus on managing their symptoms may now free energy for creative or recreational pursuits.
Human resilience is astounding, and I encourage anyone suffering from acute or chronic trauma to engage with the best, most trusted therapist as a partner in the journey to a greater self for the rest of his or her life.
Joyce Wolpert can be reached at jbdance8@yahoo.com.
