Trauma
Life is filled with a multitude of experiences; some joyful, loving and positive, some scary, terrifying and overwhelming, with many in between. How we navigate through various life experiences depends largely on factors like the circumstances of our upbringing, our genetic makeup, our temperament, and the nature of our attachments to our caregivers. No matter what our individual circumstances, I believe that we all emerge from our childhoods with some positive strengths and competencies (even if they are hidden), coping mechanisms, as well as with some scars and wounding. I don’t think it’s possible to be alive and not experience moments of the pain, heartbreak and hardship that go with being human. No one is immune to life’s challenges. Ultimately, I believe that we are capable of healing the wounding of our past, and by doing so, we are free to emerge more alive and connected to the fullness of who we truly are, and who we were always meant to be.
Defining Trauma
Trauma can be difficult to define because what feels traumatic to one person may not feel traumatic to another. We live in a culture that tells us we should just ‘get over it’ and do it quickly. This can feel shaming and harsh. We need to be kind to each other and realize that what may not be traumatic for me, may, in fact, be traumatic for you. We need to respect each person’s definition of trauma and when someone says he/she is traumatized, it’s important to believe that. We don’t measure trauma by objective means; it is each person’s relationship to the event or events that trigger a traumatic reaction based on a multitude of factors. Feeling traumatized is not something that someone chooses on purpose. Most people, given the choice, would choose not to feel traumatized.
There are experiences that most everyone would agree could be defined as traumatic. Examples include things like living through a natural disaster (hurricanes, floods, and earthquakes), being involved in a major accident, like car/plane crashes, surviving a mass shooting, or deploying to a war zone where violent death is witnessed and/or there is a constant threat of death. Most certainly, people involved in these kinds of traumatic experiences will be impacted in some way. How much and how deeply they are impacted is where the variables come in.
Other kinds of traumatic experiences, more relational in nature, also impact us deeply. In fact, it is usually relational traumas, committed by the very people with whom we entrust our well-being, that have the potential to wound us the most. If we are hurt and unprotected, in childhood, by the people who are supposed to love us the most, we are left with an unimaginable amount of struggle from which to make sense of the world, and future relationships. Examples of relational traumas may include things like, growing up with neglectful parent(s), being physically/sexually abused, having few friends, feeling unloved, being constantly criticized, being left alone for long periods of time, going without basic needs, watching parents argue/yell, going through a family separation/divorce, growing up around people using alcohol/drugs, losing a loved one, being abandoned, either physically and/or emotionally, etc.
We are exposed to a wide variety of experiences as we grow up. If the majority of those experiences are with family members who love and care for us, who generally attend to our basic needs and leave us feeling connected to and cared about, when challenges come our way, we have strengths, both internal and external, from which to meet those challenges. If, however, the majority of our experiences are filled with chaotic and traumatic interactions, constituting invasion, abandonment, criticism, threat, betrayal, and/or overwhelm, then, out of necessity, we operate on sheer survival instinct just to survive. We do whatever we have to do in order to survive.
This process is mostly unconscious. It is purely based on a need to survive and the decisions and impulses we have are not coming from a conscious place. As we call on that survival instinct over and over, it becomes encoded in our brains as the way to relate to the world around us. We are usually not consciously aware that we have been so deeply impacted by the events of our early life. As we grow into adulthood, we may not realize the deep impact of these early experiences, but can sense that there may be a problem, usually as a result of having problematic relationships.
We may begin to recognize patterns in relationships that seem hard to break. We may realize that our lives are not working as well as we would like. We may run into the same kinds of challenges over and over and not fully understand that our early coping strategies are outdated and may be contributing in a negative way to the way we relate in our current relationships.
Traumatic Reactions
If your daily life is being interrupted by reactions stemming from the past or you are feeling overwhelmed or stuck in old behavior that is not healthy or no longer serves you, this may be an indication that you are in a traumatic reaction. It’s really important to know that whatever your reaction to a particular circumstance or incident, you and your body are doing the best you can to navigate that material. If you are feeling overwhelmed or unable to function as a result, there is no shame in this. It is your nervous system letting you know that you are in need of assistance in order to navigate the treacherous waters of trauma. We can assume that someone is feeling traumatized when he/she has trouble separating out the traumatic event(s) from the past from more current, present reality.
Someone who is feeling traumatized is not able to act from the full spectrum of resources and choices available and may be stuck in a survival pattern learned long ago. Usually these old survival mechanisms spring to life when we are triggered in a way that reminds us of an earlier time. In therapy, when we are able to explore these reactions in a safe way, we can usually see that they come from younger parts of ourselves that had the job of surviving earlier challenges. These patterns are now often outdated, and may not be the best responses in current life. In therapy, we are able to track and identify what happens when this pattern gets activated, begin to bring conscious awareness and mindfulness of how it ‘lives’ inside of you, and begin to explore and experiment, in the safety of the therapeutic environment, with making new, more empowered choices, all in the context of a caring presence moment to moment.
We aren’t entirely sure why one person may be overwhelmed by a particular situation and another person isn’t, but it is most likely due to a combination of genetics, developmental factors, quality of attachments to caregivers, duration of trauma (single incident, ongoing, long-term) and age of onset.
For instance, early childhood traumatic experiences have the potential to profoundly impact children in many ways since they are still growing and developing essential strengths and coping mechanisms. If trauma interrupts normal development, this can put a person at an early deficit in terms of being able to tolerate and successfully negotiate some of life’s problems and challenges. The good news is that these early wounds can be healed.
Because traumatic experiences are highly subjective, I focus on understanding what you have experienced and the impact that has on your self-concept (core beliefs), your current relationships and your present day to day life. Many people have experienced traumatic experiences, either in childhood or more current times, and continue to function well in daily life. If there is positive social support and a way to process the traumatic experiences soon thereafter, sometimes that is enough to help the material become integrated and not develop into further symptomology, such as PTSD.
But often, traumatic experiences are not processed and are left unintegrated and when this happens the unprocessed traumatic experiences can take on a life of their own. People can become dysregulated, hyper-aroused (hypervigilant, anxious, restless, overwhelmed), hypo-aroused (feeling shut down, dissociated, depressed, paralyzed), focused on avoiding the traumatic material, or alternatively becoming overwhelmed by the material or memories which can show up as flashbacks. It is at these times that the trauma has become unmanageable and extra support is needed.
Trauma Treatment
Because everyone is different, there is no one size fits all method of treating trauma. We do know that good trauma therapy follows well established guidelines that have been identified over the years.
Trauma treatment has experienced an incredible evolution over the past 25 years. Gone are the days when we focus purely on recreating the traumatic experience aiming for a full cathartic release of emotions. That way of working, common in the 80s and 90s, proved to cause more overwhelm and dysregulation, and in some cases, re-traumatization. It was a hard lesson for clinicians to learn.
Beginning with Freud, the ‘talking cure’ was thought to be the way to heal traumatic experiences. We now know that simply talking about one’s experiences, while helpful, is not enough to bring full resolution to a traumatic reaction. Neither is cathartic release. With breakthroughs in the field of neuroscience and somatic processing (bringing mindfulness to what is occurring in the body in the present moment), clinicians now have a much better understanding of how trauma is stored in the body and effective ways to work through it. To fully process traumatic experiences, we need to access the entire spectrum of how experiences are organized and encoded within us. Effective trauma treatment crosses all realms of human experience, including cognitions (thoughts and beliefs), somatic (sensations and impulses felt in the body), emotions, and spiritual.
Effective trauma treatment consists of 3 basic stages
Stage One
Stage One centers on establishing safety (internal and external), stabilization of symptoms, and resource development. Before trauma processing can begin, proper preparation is needed. This includes getting a full psycho-social history, identifying external/internal resources, competencies, and strengths. The length of this stage differs depending on the particular circumstances of each person. We work to develop essential internal resources that may be needed during the processing of traumatic material. I am also focused on getting to know you, attuning to you, developing rapport, building trust and establishing a feeling of safety between us. The therapeutic relationship we develop will offer opportunities to provide the corrective emotional experiences that will help heal the past wounding from others.
Stage Two
Stage Two focuses on processing traumatic reactions/problematic somatic sensations/memories/experiences. Usually, in this stage, I use EMDR, combined with attention to somatic processing and the relational attachment between us, to help bring the unintegrated material to resolution. I focus on cognition, body sensations, feelings/emotion and beliefs in order to address healing across the entire spectrum of how we organize experience as it lives in us.
This stage involves using the resources we have strengthened and developed in Stage One to assist in processing the material to completion. We will know that the processing is successful when the ‘charge’ (emotional, physical) reaction is brought down to a neutral place when the stressor or trauma is evoked through thinking/talking about it. In some cases, this can happen quickly, and in some cases, this takes repeated sessions, as new layers of the trauma need to be addressed. I also use my training in Sensorimotor Psychotherapy and Hakomi Psychotherapy to help the body process the trauma somatically, because, afterall, trauma is held in the body. And finally, I use Attachment Theory to help repair the relational piece, often using the relationship between myself and my clients as a platform from which real healing can occur. This may involve me saying healing and gentle phrases to you as you make eye contact with me. Trauma often happens in the context of relationship, and the healing of it must include a relational repair.
Stage Three
Stage Three aims to work with integrating the newly developed perspective and integration of new self-concepts and strengths. More current day to day concerns are addressed and problems are re-examined from the new perspective of having healed the past, old hurts. It is this stage where transformation is apparent as the old patterns are discarded in favor of new choices and new potentials. We focus on your dreams and goals for a future that is now filled with infinite possibility.