Last week I introduced you to three people and their stories with the idea in mind of understanding trauma a little better — and what to do about it.
The common element in trauma is that a person is shocked and overwhelmed by a great loss.
That feeling of shock is important. It means that the new event can’t easily be integrated into one’s expectations of what is “normal.”
For example, a picture of “normal” would not include a terrorist running into a store and killing people. A traumatized person might replay that scene over and over in his mind, unable to comprehend such a thing. Replaying the tape does not make the event easier to accept or to understand.
A well-known therapist, Bessel van der Kolk, tells the story of this trauma repetition in the case of a Vietnam veteran who lit up a cigarette one night during his period of fighting the Viet Cong.
The cigarette gave away his and his buddies’ location and the enemy fired, killing one man. As van der Kolk tells it, “From 1969 to 1986, on the exact anniversary of the death, to the hour and minute, he yearly committed ‘armed robbery’ by putting a finger in his pocket and staging a ‘holdup,’ in order to provoke gunfire from the police. The compulsive re-enactment ceased when he came to understand its meaning.”
Replaying or a sense of reliving an incomprehensible and disturbing event is one symptom of trauma. Others include
- poor sleep
- fear
- avoidance of being in a certain location or with specific people
- flashbacks
- extreme preoccupation
- blocking out the memory of the traumatic event
- emotional numbing (for example, even good food tastes flat)
As the stories last week illustrated, trauma can result from “ordinary” things that are shocking because they are unexpected.
Lilly, for example, was hit by an angry father. How rare is that? Unfortunately not rare enough. We could think of it as “ordinary” but because Lilly never knew when her father would erupt — and she never knew if she would make it to the safety of her closet — the experience was overwhelming to her.
Because this left Lilly always on edge, she was, indeed, a trauma victim.
Traumatized people can be disturbed by memories for years and decades without resolution.
Discussing the event with friends or in therapy generally doesn’t make the memory or the bad dream go away.
What is needed is a way to accept the happening and integrate it into the rest of life; although it can never become “normal,” it has to become “part of” one’s life experience.
How can this be accomplished?
The key ingredient necessary to live a healthy life after trauma is to once again be able to feel safe. In Lilly’s case, you could be a bit too logical and say that she should feel safe most of the time since she is not with her father.
However, as you know from your high school studies of Pavlov’s dogs there is a process of conditioning in which elements of the frightening situation generalize to other contexts.
For that reason, Lilly might be afraid of all men, or perhaps only men with the same build or the same accent or the same hair color as her father.
One of the most beautiful ways for her to heal might be from the gentle and patient love that her husband gives her.
If she expects him to react as her father did — and her husband instead is kind and loving — then the expectation of a bad reaction will fade (or as the behaviorists say, it will extinguish).
Marital therapy to guide a spouse in reacting with wisdom and understanding can help greatly. However, Lilly might still require individual treatment for her trauma.
Oddly enough, Joe from our story last week, suffered the same exact lack of feeling safe from women as Lilly did from men.
In fact, the more kind and loving the woman, the more unsafe Joe would feel: He had developed a firm belief that if you love a woman, she will leave. He built some sturdy walls around himself.
I also described Aaron, who was terrified of changes. Lilly, Joe, and Aaron would benefit from a gentle therapy that engages the imagination in positive and empowering ways, especially if it could help these people create new meaning from their awful experiences.
Hypnosis is just such a therapeutic tool.
Let’s peek in on therapy with Joe. Apparently, Joe doesn’t remember his mother’s funeral. He consciously blocked out thoughts of her as they were just too painful.
When asked about good times earlier in his life, he can’t seem to recall those either.
With Joe’s permission, the therapist walked him through a progressive relaxation of his body, coached him to take slow, deep breaths, and suggested he go into himself to capture what was bright, beautiful, and meaningful about his mother. He could do this with or without conscious awareness, whichever felt more right to him.
A highly permissive form of hypnosis like this puts the process in the client’s hands, or to be more accurate, in the client’s imagination.
His thoughts are what he wants them to be. Why would a process like this help when Joe has already stated that he did not want to recall his mother?
The answer is that as painful as it is to remember a loved one who has died, that memory also has in it a sense of warmth and closeness. The pain is there precisely because it is linked to the closeness. The pain is because of the loss but closeness feels good.
Joe knows this. That is why he came to therapy in the first place. And the beauty of this approach is that Joe can finish the session without having remembered his mother if that is how he really wants it.
Instead, tears streaming down his cheeks, Joe opened his eyes and said, “My mom was President of the PTA when I was in grade school. I remember!” He had a bright smile on his face. “She was a real doer. A real giver. She loved children. That’s why this was so much of a shock.”
His voice trailed off as his thoughts stretched back in time. But he got up resolutely and thanked the therapist. A week later, the therapist got a call from Joe. He had set up a memorial fund. It would memorialize his mother and pay for books for children and adolescents.
As you can see, the therapist only set the stage for Joe to find his own solutions within the creativity of his unconscious. While it did involve pain, it also brought him the warmth he had missed all these years.