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“Trauma is when your reality is not seen or known.”
Bessel van der Kolk
The Many Faces of Trauma
Trauma occurs when circumstances overwhelm our capacity to cope, disabling a return to pre-trauma functioning. Instead, we get locked in an existence of impending threat, hyperarousal, and tension that wreak havoc on our health and daily lives. Trauma not only leaves us feeling broken and helpless, but also physically alters the brain and gets stored in our bodies. If you are stuck in this destabilizing state, take solace in knowing you are not alone and that evidence-based therapies prove effective.1 The first step is discerning whether trauma may be the source of your distress. Common varieties include:
- Being Harmed: Experiencing or witnessing harm inflicted by another (e.g., cruelty, humiliation), an accident, death, illness, or natural disaster can put us in a state of shock that swiftly throws our sense of safety off balance. We may keep dwelling on it, have nightmares, be haunted emotionally, and feel like we can never trust anyone again. Depersonalization (feeling detached from yourself/an outside observer) and derealization (distortions of perception/dream-like sensations) are common dissociative coping strategies. Violence, medical mistreatment, and negative sexual encounters fall into this category.
- Early Attachment Wounds: Children who lack physical and/or emotional safety (feeling nurtured, valued) due to abusive, neglectful, or unavailable parents can develop a pervasive sense of insecurity in the world. As adults, our “inner child” will keep striving for love and nurturance not provided by parental attachment figures so that we can feel safe. This inadvertent seeking of “reparenting” form another can result in repeated dysfunctional relational patterns.
- Unremitting Stress: Living in fear of losing basic needs (safety, shelter, food, healthcare) or a loved one keeps us in a scarcity mode of survival. Examples include “walking on eggshells” to stay safe in a relationship, managing a serious illness, or caring for a terminally or chronically ill family member.
- Collective Trauma: Shared suffering has widespread societal effects, such as increased rates of depression and suicide in the wake of a pandemic2,3 or the intergenerational pains of ongoing systemic oppression. Exploitation of vulnerable others (due to status, gender, race, etc.) leaves people with a pervasive sense of helplessness and heeds a quote by Meer Atkinson “… unsustainable gardens of grandeur have grown on the blood and bone of subjugated women, children, slaves, invaded and colonised peoples…..”
If you are suffering from trauma, be compassionate with yourself. Honor your body’s inner intelligence, which ensures your survival in an acute crisis (to flee, fight, or freeze). Although your body and mind remain in this state of threat, you are highly adaptable and can recalibrate to feel a sense of safety and empowerment again, even if your trauma resulted in (or is the result of) permanent physical harm.
Working with a therapist can lessen trauma’s grip over you mentally and physically. It is of utmost importance to first build a foundation of trust, safety, and inner resources with your therapist to avoid re-traumatization. Once established, integration (rather than avoidance/ repression) of painful memories can allow for healing. Turning towards the pain may make it initially feel worse, but can free you from the loop of emotions, thoughts, and attempts to cope that keep you trapped. Robert Frost’s sentiment applies here: “The only way out is through.”
References
- 1. Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258-258. doi:10.3389/fnbeh.2018.00258
- 2. Banerjee et al. (2020). The dual pandemic’ of suicide and COVID-19: A biopsychosocial narrative of risks and prevention. Psychiatry Research, 113577-113577. doi:10.1016/j.psychres.2020.113577
- 3. Steardo, J., Luca, Steardo, L., & Verkhratsky, A. (2020). Psychiatric face of COVID-19. Translational Psychiatry, 10(1), 261-261. doi:10.1038/s41398-020-00949-5
