Diagnosing and Treating PTSD and Complex PTSD: Changing the Ways We Adapt

Ripples and bubbles on water for treating Complex PTSD blog post

An Interview with Trauma Therapist Brad Kammer – Part Two of Two

In Part One of my interview with trauma expert Brad Kammer, LMFT, currently on the faculty of the NARM Training Institute, we discussed how Brad and his colleagues distinguish between PTSD and complex PTSD. In Part Two, we explore how NARM’s NeuroAffective Relational Model addresses the impact of adverse childhood experiences and complex trauma. Brad and Dr. Laurence Heller outline the therapeutic framework of NARM in their new book, The Practical Guide for Healing Developmental Trauma: Using the NeuroAffective Relational Model to Address Adverse Childhood Experiences and Resolve Complex Trauma.

(Note: This is the second of a two-part  interview)

You are currently on the faculty of the NARM Training Institute. What does NARM stand for? What is your working definition of trauma?

NARM stands for the NeuroAffective Relational Model, which is a model designed by my long-time mentor Dr. Laurence Heller, to address the impact of adverse childhood experiences and complex trauma.  In NARM, we recognize that in most cases we cannot change the traumas we experience.  But, we can change the ways we have adapted in order to survive these traumas.

NARM’s five core needs and their associated core capacities for treating complex PTSD blog postWe use a developmental framework that describes five Adaptive Survival Styles which are ways we learned to adapt to attachment and environmental failures early in life. These styles form the blueprint for our adult personalities.  We focus on five specific developmental stages early in childhood when the Self is just being shaped, and the ways that attachment and other environmental failures impact healthy development in each of these stages (which we are learning so much about through the Adverse Childhood Experiences research).  The way that our brain and bodies adapt to these early traumas – specifically through shame – leads to various levels of often profound Self-disorganization and creates various symptoms, disorders, and syndromes.

In Part One of our interview, you identified the important differences between Post-traumatic Stress Disorder (PTSD) and Complex-PTSD. How might the treatment for each differ?

I am biased as to how I’m going to answer this question since I have been a somatic psychotherapist and trainer now for over two decades. I believe that any form of trauma healing must involve the body. Many of my colleagues have been pushing back against the more prominent “evidence-based approaches” that are usually derivatives of Cognitive Behavioral Therapy, and which demonstrate questionable long-term efficacy. Dr. Bessel van der Kolk’s book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, continues to be a best-seller ten years after it was first published. Many people intuitively, and experientially, know that talking and thinking about our issues only take us so far. To make true and lasting change, they have to shift deeper internal patterns.  This is where somatic approaches come in.

I have practiced Somatic Experiencing for over twenty years now and I find it to be the most effective model out there for PTSD.  As I continued to seek models that worked more specifically with attachment, emotional, and relational trauma, I found NARM, which I believe is the most effective model out there for treating C-PTSD.

Please tell us what you mean by a person having “agency.” Why is it a game-changer?

The simplest way to define how we use the concept of Self-Agency is to highlight the various ways that individuals organize and relate to life experiences.  Agency is a by-product of secure child development where a child progressively experiences themselves more as actors in their life than simply passive conduits for life experience.  Other models may refer to related concepts such as Self-Activation, Self-Actualization, or Self-Realization.

When a child has experienced developmental trauma, they experience everything as just happening to them. They feel helpless to change not only their external conditions but also how they feel internally. Children may grow up feeling out-of-control (i.e., lack of impulse control), reactive (i.e., affect dysregulation), fragmented (i.e., dissociative self-states), and fragile (i.e., decreased sense of resiliency).  Their lives are significantly impaired by their inner sense that they cannot self-activate, let alone change the way they feel or how they relate to the world.

NARM is grounded in an inquiry process that explores Self-Organization – how clients are organizing their internal worlds, and then relating to both their inner and outer experiences, in ways that either support connection and health or lead to disconnection and disease.

Types of Adverse Childhood Experiences for treating complex PTSD blog postFor example, your client shares a story about their experience at work last week where they were walking in the hallway and said “hello” to a colleague they were passing, and the colleague didn’t say hello back. Immediately, your client started feeling worthless, unliked, and lonely, and then started telling themselves that “I’m stupid and no one will ever like me.” They use this experience to justify why they withdraw from social interactions and experience social anxiety and depression.  However, they later found out that their colleague had just received a text from a family member of a sudden loss in their family, had been in a state of shock, and not even heard your client say hello. Your client describes shaming themselves for having such a strong reaction, saying that “I’m stupid for telling myself that I’m stupid based on this situation.”  This cycle of shaming oneself for shaming oneself can go on and on.

As we help clients begin to gain greater awareness of the unconscious and often automatic ways they are organizing their inner reality and relating to themselves and the world through self-shame, self-rejection, and self-hatred, they begin to experience more possibilities for organizing and relating to themselves differently. This is not just a cognitive process. It entails working psychobiologically to shift long-standing personality patterns that keep shame-based identifications intact.

Collective and intergenerational trauma are vast and necessary subjects worthy of discussion. Individuals can’t change their ancestry, and in many cases, individuals cannot change their marginalized status or persecution within a society. Can the NARM program help people traumatized by an unchanging trauma-inducing culture?

I know from my own personal experience, as well as years of clinical experience, that NARM does impact unresolved cultural and intergenerational trauma. We focus on how clients are relating to the “unchanging trauma-inducing culture” that they are born into and are still part of.  For many people, the concept of “post” in post-traumatic stress disorder doesn’t truly exist.  Many people are still living within and adapting to environmental failures, including sustained oppression, violence, and dislocation.  And yet despite these traumatic realities, we see individuals and communities cultivating health and well-being within.  It is inspiring to watch as people stop defining themselves by how others define them and embody their own authentic humanity.

I see our modern times, at least in the U.S., as defined by a widespread failure of empathy.  We care less and less about our impact on others.  This leads to relationships based on objectification and systems reinforcing dehumanization. The social fabric is rapidly dissolving, leaving an epidemic of loneliness and disconnection in its wake.  To counter this reaction, NARM supports the development of authentic empathy.  As we help people develop an increasing capacity to relate to themselves and others through acceptance and compassion, they begin to shift their own internal objectification and experience themselves as more fully human. This increased sense of humanity allows people to begin to shift the way they are relating to their family, community, and cultural systems.  So while it will likely take time, I do believe NARM can impact larger changes within society.

(Read Part One: Diagnosing and Treating PTSD and Complex PTSD: It’s Not About “What’s Wrong With You?”)

This post appeared in a slightly different form on Dale’s blog on Psychology Today. You can find all of Dale’s blog posts for Psychology Today at “Transcending the Past.”



Diagnosing and Treating PTSD and Complex PTSD: It’s Not About “What’s Wrong With You?”

Azalea flower with stones Photo: Solange Cabe / CC0 Public Domain for Complex PTSD blog post

An Interview with Trauma Therapist Brad Kammer – Part One of Two

I can’t remember the first time I heard the word trauma. Vietnam, the wars in Afghanistan and Iraq? When did “trauma” enter popular parlance? Was it after 9/11? I recently learned that there are now 6,000 podcasts with “trauma” in the title. Are we somehow in the midst of a trauma epidemic? Or does this reflect our growing understanding?

Trauma refers to a wound to the psyche or the body or both. We now know that not only experiencing trauma oneself but witnessing trauma or being told about a traumatic event can be traumatizing.

Brad Kammer for Complex PTSD blog postTo help us understand one of the emerging approaches to diagnosing and treating trauma, I’m delighted to introduce my guest, trauma expert Brad Kammer, LMFT, currently on the faculty of the NARM Training Institute.  NARM stands for the NeuroAffective Relational Model, a treatment model developed by Dr. Laurence Heller, Brad’s long-time mentor, to address the impact of adverse childhood experiences and complex trauma.  “In NARM, we recognize that in most cases we cannot change the traumas we experience. But, we can change the ways we have adapted in order to survive these traumas,” he explains.

Brad brings to his work a holistic approach that includes body-oriented therapies as well as a deep knowledge of attachment theory and survival styles. He and Dr. Heller recently co-authored The Practical Guide for Healing Developmental Trauma: Using the NeuroAffective Relational Model to Address Adverse Childhood Experiences and Resolve Complex Trauma. In a world reeling from destabilization, violence, hatred, and suffering, Brad Kammer and his colleagues at NARM present an opportunity for healing and hope.

This will be a two-part interview.

When many of us hear the word trauma, we think of soldiers, people caught in war zones or natural disasters, but you make a clear and valuable distinction between what you call shock trauma and relational or developmental trauma. Can you explain the difference?

It is difficult to differentiate because as humans we experience both shock and relational traumas, often at the same time.  For example, a parent who physically hurts a child will create a shock trauma reaction in response to the physical violence in the context of the relational failure of the parent not protecting or keeping their child safe from harm.

This is an extremely simplistic way to differentiate it – but in my teaching, I often use this as short-hand to distinguish between PTSD and C-PTSD: PTSD (post-traumatic stress disorder) is about the psychobiological process of fear, and C-PTSD (complex post-traumatic stress disorder) is about the psychobiological process of shame.  While there is certainly much overlap, research suggests there are different neural circuits responsible for fear than for shame.

The example I often use is you’re walking in the woods and a bear jumps out at you.  In that very moment, you’re not worrying about your relationship with the bear, you just want to survive.  So your brain will bypass the emotional, relational and cognitive centers and go straight to activating the hyperarousal centers of the brain in order to optimize your chances for physiological survival.  Mortal threats activate the fight/flight response.  This is experienced through fear.

Now imagine that the threat isn’t a bear jumping out of the words; it’s your parents, and each day of your life you feel that your sense of security in the world, and within yourself, is not welcomed or supported, but may be dismissed, undermined or attacked.  This puts you into a bind – as young children, we cannot run or fight against the people we are 100% dependent on for our survival.  While these threats may not be immediately life-threatening like the bear, we still have to find ways to survive the ongoing, persistent failures of in our development.

Humans are designed to be connected to themselves and others.  When connection to self and others becomes fraught with pain and danger, we use various strategies to disconnect from ourselves and the pain that we experience internally.  One such process involves the way we relate to ourselves through shame and self-rejection.  We internalize the failures of our early environment and personalize them as our inherent failures.  These shame-based identifications form the foundation of our personality development.

For so many people, they don’t even consider this “trauma.” I have had so many people – not just clients, but mental health and other healthcare professionals – push back that we are broadening the term trauma too much.  “This is just life” they say, or “This is just how childhood is.”  But minimizing and dismissing the effects of these failures is itself a sign of unresolved trauma.

My mentor used to say, “In a world of bent-over people, the one standing upright looks strange.”  So I push back on the notion that we use trauma too broadly. I argue that we don’t have a broad enough understanding of the impact of unresolved complex trauma.

What are some other ways in which PTSD is different from Complex PTSD?

The Adverse Childhood Experiences Pyramid shows how adverse childhood experiences are related to risk factors for disease, health, and social well-being. For Complex PTSD blog postAs the trauma field continues to evolve, we have begun to more clearly differentiate between post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (C-PTSD).  PTSD, which is sometimes called “shock trauma,” is generally caused by one-time events like accidents, assaults and natural disasters, and leads to hyper- and hypo-arousal in the nervous system that creates symptoms like intrusive images, flashbacks, hypervigilance, avoidance and dissociation.

C-PTSD is generally caused by relational and social failures, and leads to disorganization and insecurity in one’s sense of Self, as defined by the three symptom categories that include affect dysregulation, negative self-concept, and interpersonal disturbances.  Developmental trauma, a subset of C-PTSD, is generally caused by adverse childhood experiences that impact a child’s development.  NARM was created specifically to address C-PTSD, focusing on attachment and developmental trauma, but also working with larger social failures such as cultural and intergenerational trauma.

A word cloud of vocabulary related to PTSD, in the outline of a human brain.  Q / CC0 Public DomainThe trauma-informed field has been rapidly growing over the past 40 years since the first introduction of PTSD into the DSM in 1980.  While this field has made tremendous strides, our understanding of complex trauma has lagged behind.  Trauma pioneer Dr. Judith Herman suggested that PTSD doesn’t go far enough, and presented “a new diagnosis” in her 1992 book Trauma and Recovery, which she called C-PTSD.  And yet here we are in 2022 and we still don’t have an official complex (C-PTSD) or developmental trauma disorder (DTD) diagnosis in the United States.  This means that so many people are being misdiagnosed, or at the very least, are being treated for secondary issues.  What if many of the symptoms and disorders we see in our clients are driven by unresolved early trauma?  This changes the way we look at diagnostic categories and even challenges how we currently view psychopathology.

As we describe in our work, maybe it’s not about “what’s wrong with you,” but about “how have you adapted to what happened to you?”  For many of us in the trauma field, we see many “symptoms” and “disorders” as understandable reactions and adaptations to abnormal conditions and environments.  This is particularly true for children and how they have learned to adapt to persistent failures in their early lives.  These are not one-time traumas that can easily be resolved.  This is the territory of complex trauma, and it truly is very complex to understand.  It is also challenging to treat.  This is why we need comprehensive therapeutic models that understand how to identify, navigate and address this complex territory.

Part Two of our interview will be posted next month.

This post appeared in a slightly different form on Dale’s blog on Psychology Today. You can find all of Dale’s blog posts for Psychology Today at “Transcending the Past.”



Recovering from Trauma: Finding the Words That Heal

The Scream by Gerald Scarfe for Recovering from Trauma blog post

 

Several weeks ago, I received an interesting chain letter. Instead of being asked to send money to the designated recipient, I was to send a poem and forward the chain letter on to 20 people. If everyone followed through, I would receive 400 poems in the mail in short order.

I usually trash these invites, but something about this one caught my fancy, and I complied. In return, I received a variety of texts, including a Bob Dylan song, a verse from children’s book author Shel Silverstein, a poem by someone’s mother-in-law as well as poems by the illustriously immortal. The range and scope of the responses heightened my awareness of how we often turn to others—poets, rock stars—to speak to our souls, forgetting that all of us have the capacity to bear witness to our experience and unearth words that reflect back our deepest understanding of ourselves.

Dante Drinking from the River of Light by William Blake for Recovering from Trauma blog postIn his latest book, Drinking from the River of Light: The Life of Expression poet, spiritual teacher, and cancer survivor Mark Nepo credits self-expression as the rope he climbed to emerge from his struggle with cancer and return fully to life:

“I’ve come to believe that the heart of awakening is the quietly courageous act of feeling and facing what is ours to face. And I’ve discovered along the way that writing—expressing—is one of the best ways to stay awake. It doesn’t matter how ‘good’ our expressions are but that they keep us in relationship to the larger Universe we are a part of.”

You may be thinking what this has to do with you if you are not a writer or poet. Please consider this excerpt from James Baldwin’s magnificent story “Sonny’s Blues.” The character speaking is Sonny, a heroin addict and jazz pianist.

“It’s terrible sometimes, inside…that’s what’s the trouble. You walk these streets, black and funky and cold, and there’s not really a living ass to talk to, and there’s nothing shaking, and there’s no way of getting it out—that storm inside. You can’t talk it and you can’t make love with it, and when you finally try to get with it and play it, you realize nobody’s listening. So you’ve got to listen. You got to find a way to listen.”

That storm inside. Can’t talk about it. And sex won’t help. And nobody wants to listen. Sound familiar? By the end of the story, Sonny concludes that the remedy to his despair is that he has to listen to himself.

The poet Gregory Orr speaks passionately about his discovery of poetry and how it helped him survive his unbearable despair after he accidentally killed his brother. In a 2006 interview for NPR, Orr compellingly talks about how language helped him heal. “I believe in poetry as a way of surviving the emotional chaos, spiritual confusions and traumatic events that come with being alive. When I was 12 years old, I was responsible for the death of my younger brother in a hunting accident. I held the rifle that killed him. In a single moment, my world changed forever. I felt grief, terror, shame, and despair more deeply than I could ever have imagined. In the aftermath, no one in my shattered family could speak to me about my brother’s death, and their silence left me alone with all my agonizing emotions. And under those emotions, something even more terrible: a knowledge that all the easy meanings I had lived by until then had been suddenly and utterly abolished.”

Orr’s portrayal of his situation aligns with psychoanalyst and Buddhist teacher Mark Epstein’s description in The Trauma of Everyday Life of what happens during trauma: “the reassuring absolutisms (albeit mythical ones) of daily life—that children do not die, that worlds do not move, and that parents always survive—are replaced by other, more pernicious convictions: the ‘enduring, crushing meanings’ (of one’s aloneness, one’s badness, one’s taintedness, or the world’s meaninglessness).” Trauma, he writes, “forces one into an experience of the impersonal, random, and contingent nature of reality, but it forces one violently and against one’s will.” It also exposes us to our powerlessness, our helplessness. “The old absolutisms no longer reassure, and the newly revealed reality feels crushing.”

How do we cope when life as we know it breaks down and what we have counted on seem broken? How can we discover our strength and courage in facing challenging obstacles?

Here is the last stanza of the poem Gregory Orr wrote years after his brother’s accident in which he resolves his once unutterable grief and shame.

Gathering the Bones Together

By Gregory Orr

for Peter Orr

I was twelve when I killed him;
I felt my own bones wrench from my body.
Now I am twenty-seven and walk
beside this river, looking for them.
They have become a bridge
that arches toward the other shore.

Language summons a whole world into being, says Orr. His poem contains a trauma, but also stands outside and apart from the trauma. The bridge he mentions is the bridge language makes between our inner and outer worlds. As humans, we are continually seeking self-understanding, ways to know ourselves and make sense of who we are. Unlike other species that have language, humans are the only species that have metacognition, the ability to reflect on our own minds. This self-reflective capacity—Why did I do X? How did that make me feel?— is essential to making meaning of our lives.

Photo from The Miracle Worker for Recovering from Trauma blog postLanguage’s magical power is to make sense of the senseless. At the age of nineteen months, Helen Keller became blind and deaf. In her autobiography, she describes the dramatic moment when her beloved teacher Annie Sullivan helps her, at six years old, connect a physical sensation with its word.

“As the cool stream gushed over one hand she spelled into the other the word water, first slowly, then rapidly. I stood still, my whole attention fixed upon the motions of her fingers. Suddenly I felt a misty consciousness as of something forgotten–-a thrill of returning thought; and somehow the mystery of language was revealed to me. I knew then that ‘w-a-t-e-r’ meant the wonderful cool something that was flowing over my hand. That living word awakened my soul, gave it light, hope, joy, set it free! There were barriers still, it is true, but barriers that could in time be swept away.”

The writer Isak Dinesen famously said, “All sorrows can be borne if you can put them into a story or tell a story about them.” But writing from the heart isn’t just about the transformation of difficult emotions; to write from the heart is to engage with life at its fullest, in all its terror and splendor. In writing from the heart, we break our self-silencing and flex our muscles of courage to uncover our deepest truths.

Writing stories, poems, or journal entries may actually be the second necessary action required in finding our voices and uncovering our inner resources, the essence of who we are. The first action is deep listening. Hear Mark Nepo on listening:

“In many ways, writing is listening and simply taking notes. . . . Being still and listening allows us to behold what is before us. The deepest form of bearing witness is to behold another in all their innocence. This is the key to love. To listen until the noise of the world subsides. To listen until the noise of the mind subsides. To listen until the noise of our wounds subsides. To listen until we only hear the life before us.”

Miriam Greenspan in her powerfully helpful book, Healing Through the Dark Emotions: The Wisdom of Grief, Fear, and Despair, offers three skills and seven steps in alchemizing difficult emotions. Our culture, she claims, is emotion-phobic, and encourages an invincible heroic ideal while often shaming those who do not live up to societal expectations.

Greenspan offers ways to regain balance and exuberance in the face of even the darkest emotions. The author uses the acronym ABS for the three skills she believes basic to healing: A for Attending, B for Befriending, and S for Surrendering. “When we can mindfully attend to, tolerate, and surrender to the energy of the dark emotions as it flows,” Greenspan writes, “we open the heart’s doorway to the magic of emotional alchemy.” But, after describing these skills and steps in detail, she adds a caution. “The three basic skills and seven steps of the alchemy of the dark emotions are condensed distillations of a process that is ultimately mysterious. This process cannot easily be reduced to a set of skills, ideas, or biochemical events. The systemization of any emotional process gives it an aura of scientific credibility. But emotional alchemy is an art, not a science.”

What the authors mentioned have in common is a deep faith in our capacity to handle and thrive beyond even the most troubling aspects of our lives and a conviction we are inherently courageous and loving beings capable of transformation.

When we practice deep listening—and try to find the words for what we hear—we may be surprised at what we find.  What we haven’t noticed about ourselves, what lies hidden within, may come as wonderment at the ignored riches and creative forces offering their help.

This post appeared in a slightly different form on Dale’s blog on Psychology Today. You can find all of Dale’s blog posts for Psychology Today at “Transcending the Past.”



Trauma: Who is Telling Your Story?

Multiple Personality by Kamil for Trauma blog post

Have you ever been at a family gathering and someone shares a memory and, as you hear it told, you say to yourself: That’s not the way it happened! The truth is that our memory is an unreliable narrator, a literary term that describes a person telling a story who is not telling it straight. In fiction, an unreliable narrator can be a clever deceiver, as in many crime novels, an innocent lacking self-awareness, or a charming raconteur simply happy to spin entertaining tales.

The unnamed narrator in Edgar Allan Poe’s fabulously gruesome horror story, “The Tell-Tale Heart,” is mentally unstable and can’t be relied upon to give accurate information. Wuthering Heights has dual narrators, both of whom have biases about Heathcliff and company. Some unreliable narrators seem to have all their marbles, like Humbert Humbert in Nabokov’s Lolita, but when he kidnaps the precocious Lolita, we conclude he is what he says, a psychopath. In reading a book, there’s real delight in figuring out who’s lying, who’s manipulating, who’s speaking the truth—but what happens when our own psyches present us with multiple narrators, each with a different set of perceptions and interpretations of reality?

"The Tell-Tale Heart" by Virgil Finlay for Trauma blog postHow we see and react to the world is prompted by different parts of the brain. Sometimes, we act on “a gut feeling,” sometimes, we critically think through pros and cons. Both aspects of consciousness, and the spectrum of subtle and complex hues in between, are necessary for decision-making, and thus, ultimately, necessary for survival. Recent research indicates that in people who have experienced trauma and for whom survival, past or present, is an issue, the split between conflicting prompts can manifest in a split sense of self. An abused child, for instance, may exhibit paradoxical behavior, simultaneously clinging to and withdrawing from her abuser.

In her newest book, Healing the Fragmented Selves of Trauma Survivors: Overcoming Internal Self-Alienation, Dr. Janina Fisher helpfully presents a neurobiological map of early trauma’s negative effects on the communication between the right and left brain hemispheres and shows how this can lead to a lack of integration between the functions of each. This functional “splitting” can make us feel as if we have two brains, one under the direction of a traumatized part that originated in a painful experience, the other part guiding us toward normal responses to the day-to-day world.

Dr. Fisher has observed that many of her trauma clients speak of being “hijacked” by responses triggered by memories or perceived threats in the present moment. She writes:

“Characteristically, while the going on with normal life part tries to carry on (function at a job, raising the children, organizing home life even taking up meaningful personal and professional goals), other parts serving the animal defense functions of fight, flight, freeze, submit, and “cling” or attach for survival continue to be activated by trauma-related stimuli, resulting in hypervigilance and mistrust, overwhelming emotions, incapacitating depression or anxiety, self-destructive behavior, and fear or hopelessness about the future.”

Marci Gittleman, a psychologist in Madison, Wisconsin who works with trauma in her clinical practice, asserts: “Trauma often raises parts of ourselves, pushes other parts down, and separates parts of ourselves from each other. Recovery from trauma helps to welcome all of the different parts of ourselves into consciousness—even if we like some parts better than others!”

The traumatized “part” might be considered an unreliable narrator, pumping us with stress hormones that distort our awareness of reality. Trauma corrupts the telling consciousness that has been damaged by tragedy.

In a mindful approach to healing inner fragmentation and compartmentalization, we might acknowledge our multiple parts and discern who is telling the story (some research indicates that we are all multi-conscious rather than uni-conscious); acknowledge the source (traumatized child, veteran, shooter survivor); and ask if the information being given is valid.

Looking at fiction can help us understand how who tells the story shapes the narrative, and therefore shapes how we feel about what has happened. As we read, we might ask ourselves, who owns this story? How is reality being filtered through this consciousness (narrator)? Using one of the foundational stories of Western culture as an example of how meaning and interpretation vary with differing points of view, let’s look at different versions of the story in Genesis of the first human couple.

The Expulsion from Eden by Schnorr von Carolsfeld for Trauma blog postAdam’s version of the expulsion from Eden might include a description of the satanic snake, despair and betrayal over a temptress mate, his remorse and anger at being duped. Imagine Eve’s version as a woman pissed at taking the blame.

The same sequence of events narrated by the snake might emphasize Adam and Eve’s naiveté and the snake’s desire to wise-them-up by offering up a bite of fruit. Now imagine the story from a third teller, the archangel Jophiel, who led the couple out of paradise. His tale might be packed with the difficulties of being God’s messenger, his questioning of divine authority, his sympathy for the banished pair. Each version of the story would be accurate according to the experience of the teller, their truths part of a larger truth.

So, too, all aspects of the self, including the shameful and wounded parts, are worthy of having a voice; each deserves respect. Injury and self-harm occur when emotional pain is shunted into the borderlands of consciousness. To speak and to be heard, to be witnessed and bear witness is to shed the mantle of victimhood and embrace agency, dignity, and self-empowerment. These abstract words take on life and meaning when dramatized through characters in a story.

As an experiment in relating mindfully to the storm of conflicting impulses within us— with the goal of externalizing troublesome inner voices—try this:

  1. Grab a pen and notebook, or sit at your computer. Close your eyes and breathe. Center yourself in your body. Open your eyes and begin.
  2. With curiosity and playful creation as your guides, choose a specific troubling event in your life (you needn’t choose the most painful or difficult episode) and tell the story from your own point of view.
  3. To objectify the narrative, consider using your name in place of “I.”
  4. Now tell the same story from another person’s perspective, someone engaged in the situation, or a bystander, or even from an observing inanimate object like a tree. Use as much sensory data as possible: what is seen, smelled, touched, heard?
  5. Compare the stories. What differences do you notice? What has been emphasized or left out in each? Can you name the prevailing emotion in each story? What feelings come up as you read them? What have you learned?
  6. Take 15 minutes to write your responses beneath the stories.

Walt Whitman portrait for Trauma blog postThe influential and ground-breaking American poet and essayist Walt Whitman wrote:

Do I contradict myself?
Very well then I contradict myself,
(I am large, I contain multitudes.)

Elsewhere, Whitman wrote,

Stop this day and night with me and you shall
possess the origin of
all poems . . .

You shall listen to all sides and filter them
from your self.

In healing from trauma, we might take our cues from this great poet by gathering our inner tribe, including the exiles, and validating their worth.

Psychologist Gittleman offers hope:

“I think of trauma like a perfect storm—it’s random, surprising, time stops, and life becomes different after the trauma from what it was before it happened. Trauma rocks the heart, body and soul—sometimes more, sometimes less, and different for you than for me. It can be hard to feel safe, and the impact reverberates into the present and future in ways that are both known and unknown—even if we decide we are not going to let it! Our best shot as survivors, however big or small the traumas, is to own our stories, and all of the different parts, over time, when we are motivated and ready, by ourselves and with others whom we have come to trust.”

This post appeared in a slightly different form on Dale’s blog on Psychology Today. You can find all of Dale’s blog posts for Psychology Today at “Transcending the Past.”

 



Trauma’s Lingering Effects and the Creative Self

Social alienation for Trauma blogpost

 

Trauma. The word is everywhere these days. And something has happened to it. Something like what happened to the word awesome, once used to describe a profound and reverential experience, one filled with terror, dread or awe. Awesome has become a colloquialism that pops up as both a descriptor, as in, “I just bought an awesome lipstick,” or simply as an exclamation—Awesome! Trauma has also taken a step down from its original connotation. This is not a blog about language, but it’s worth noting that trauma and awe denote significantly profound human experiences and are linked in meaning. The Greek origin of trauma means damage or wound. The Greek origin of awe is áchos, or “pain.”

I’ve written about personal trauma before (see “My Childhood Trauma: What I Learned, What You Need to Know”) and revisiting that experience led me to want to investigate the wider dimensions of trauma and how its impact can extend across generations (see “The Things We Carry: What Our Ancestors Didn’t Tell Us”). Studies on trauma have increased in recent years and researchers in a variety of disciplines are uncovering new evidence of the widespread presence of trauma in at-risk populations. Global events such as war, famine, migration, immigration, fire, flood, widespread disease and terrorism ambush some of us every day. An expanded view of trauma that respects the influence of cultural and historical circumstances on individual lives helps to clarify how vulnerable we are to these larger forces.

The depth psychologist Carl Jung, in his exploration the past’s influence on an individual wrote: “Just as psychological knowledge furthers our understanding of historical material, so, conversely, historical material can throw new light on individual psychological problems.” (The Collected Works, Vol. 5)

Odin or Wotan for trauma blogpostAs early as the beginning of the last century, Jung encouraged psychotherapists not only to study a patient’s personal biography but also to learn about the traditions and cultural influences, past and present, of the patient’s environment. Today we understand that trauma can be “inherited,” passed down through the generations, as if frozen in our psyches and/or bodies, repressed for centuries. Jung believed that repressed trauma or what he called “complexes” affect not only the individual but also the collective culture. He wrote: “…they exist (the archetypes) and function and are born anew with each generation.”

In his somewhat controversial essay, “Wotan,” written in 1936, Jung attempted to understand what was happening in Germany with the rise of Hitler, and the embrace by the populace of a militaristic, jingoistic, fascist leader. As Jung saw it, the god Wotan, or Odin, was an unconscious archetype that had been a latent potential in the German people and arose as a dominant force between the world wars. In Jung’s telling, Wotan-like energy, heroic and victorious, was embraced by the defeated Germans after the First World War – in slogans similar to “Make America Great Again.” Jung wrote: “He (Wotan) is the god of storm and frenzy, the unleasher of passions and the lust of battle; moreover he is a superlative magician and an artist in illusion who is versed in all secrets of an occult nature.”

Jung was discerning a culture possessed by a demon or god, the inherited and repressed inhabitant of the psyche. Repressed archetypes or psychic complexes are consciously forgotten but linger and influence our unconscious behavior. That is, while we may not be aware of certain tendencies within us, they nonetheless may direct our lives.

Trauma is often repressed. Patricia Michan, a Jungian psychoanalyst in Mexico City and founder of the C. G. Jung Mexican Center, has written and lectured on the inherited trauma she has discovered in some of her contemporary patients. In her essay, “Reiterative Disintegration” in Confronting Cultural Trauma: Jungian Approaches to Understanding and Healing, she writes,“…my focus here is the cultural trauma resulting from the Spanish conquest of the Aztec empire by the forces of Hernán Cortés in 1521, through which the indigenous people were abused, subjugated, and plundered. The Spanish conquest left imprinted a deep cultural trauma.” Quoting the Jungian Luigi Zoja, she concludes with him that “the lacerating wounds have remained ‘petrified for centuries.’”

John Hill, a training analyst in Zurich, in his essay “Dreams Don’t Let You Forget” in the aforementioned book, advises “that we consider the devastation that can happen with trauma,” and become aware of “the vigilance that prevents the survivor from experiencing the world as a safe place, and the difficulty the traumatized person has in connecting with his or her true self.”

In working with our own psyches, we might consider the cultural, historic, as well as the personal aspects that contribute to trauma. By stepping back and evaluating whether the core wound has its origins in childhood or reaches further into the past and comes down as a legacy, we can widen our understanding of the suffering and increase the potential for reconciliation. A significant avenue of hope in healing the wounded part is in engaging our creative selves in the process of restoration and reintegration. Having a voice, speaking the unspoken, refusing to carry on the silence of generations moves us out of the place of victimhood and hungry ghosts.

Interviewed about Things We Lost in the Fire, her short story collection which is filled with both gorgeous prose and horrific horror, the Argentine writer Mariana Enriquez has said: “I think my fiction is very Argentinian. And in Argentina there’s something about bodies that is distinct. I spent my childhood in the dictatorship, and what they did with the bodies was to disappear them. This absence of the body is where my ghost stories come from…As much as I wanted to run away from that horror story, it’s in my DNA.”

In our current chaotic and frighteningly turbulent world where new traumas appear to lurk around every corner, might it not be wise to embrace preventive medicine: before trauma can lodge and incubate in our psyches, why not speak the unspoken now? Before repression chases the pain into a hiding place, let’s name what exists—paint it, dance it, sing it, write it, make a poem. There are limits to what can be accomplished through such acts, but the origins of change are mysterious.

This post appeared in a slightly different form on Dale’s blog on Psychology Today. You can find all of Dale’s blog posts for Psychology Today at “Transcending the Past.”