Q: We’ve all heard the word trauma and have probably used it ourselves, though perhaps incorrectly. What is trauma as you define it?
A: Although we use the word trauma to refer to all sorts of difficult experiences, it’s not generally trauma when we’re humiliated or discouraged or simply deeply hurt by something. In trauma, our resources are overwhelmed, and on some level, there is fear for our survival. Some events are more universally traumatizing than others. These include rape, assault, war, natural disasters, something like a plane accident or car accident where you fear for your life. A number of experts in the field of trauma now suggest that we not get too wed in our definition of trauma to particular stressors but look at trauma as the response of the bodymind system to any stressor. So just as we define an allergy by the body’s response to something, trauma is our response to feeling overwhelmed. It may be one of these “big T” traumas (as one author calls them), or it might be something smaller that totally undoes you.
Q: With this definition of trauma related to one’s response, what are some of the responses or “signs” of trauma.
A: There are many signs or “footprints” of trauma, and I have a whole chapter of them. One quite obvious clue is having large gaps in your memory, not remembering significant periods of your life for example. Another is having disturbing images intruding into your waking or dreaming life. Having big emotional reactions to things and not understanding why is yet another footprint or “track” left by trauma.
I use some characters from the Wizard of Oz— the Lion, Tin Man, and Scarecrow—to describe three other patterns. Just as the Lion was too scared to stay present, when we’re triggered by something threatening, we find some way to split—although I’m talking about psychologically and without knowing that we are doing it. We call it dissociation when we separate from our experience so we don’t feel the full impact. There are many ways that this might feel; one is like you’re not really here in your body. Scarecrow lost his brains, and when trauma survivors get in an activated state, the survival part of our brain takes over and the thinking brain essentially goes offline. We can’t think clearly in those moments. Tin Man lost his heart, his ability to feel, and this is similar to the common defense of numbing.
I can’t go through the entire list, but let me just add that people who’ve been traumatized tend to feel different, defective, and alone. It’s quite a load to carry.
Q: You are a therapist, but you’re also writing as a trauma survivor. Would you tell us a little about what happened to you?
A: I was a victim of incest throughout my childhood. In retrospect, I imagine that some of these symptoms of trauma were present throughout my life, but they certainly weren’t recognized. The incest was completely repressed until I was almost 40. Many of the symptoms I describe were showing up then, and did for many years after this, until I fully worked through this extensive trauma.
Q: We’ve all heard of PTSD. What does it mean to have PTSD?
A: There are specific criteria to be met to be diagnosed with PTSD, so let me talk about it more as an overview. First, PTSD is like still being caught by trauma, because you’re still reacting to it. It’s still in your system, and you re-experiencing it in some ways (perhaps through dreams or flashbacks). I say, “It’s a shock to your system that keeps jolting you.” Then, to cope with this, you try to distance yourself, either by numbing out or avoiding anything that could remind you of the trauma. Third, despite your trying your best to stay out of it, you feel activated, and your nervous system is in a state of hyperarousal, so you feel irritable, hypervigilant, overreactive, have difficulty sleeping, and so on.
These follow a traumatic stressor. For most, they follow immediately after the event, but for some they don’t surface until years or decades later.
Q: PTSD isn’t the only trauma disorder. What else can happen?
A: There are many different ways trauma affects long-term mental health. These can occur alone or in combination, often in combination with PTSD. These include depression, addictions, anxiety disorders like obsessive-compulsive patterns and panic attacks, and dissociative disorders, like what we used to like multiple personality.
There are also a number of physical ailments that often accompany trauma, such as chronic fatigue, fibromyalgia, multiple chemical sensitivities, and chronic pain.
Trauma changes your physiology, your sense of self, and your sense of the world in profound ways.
Q: Yet not everyone is so thoroughly harmed or harmed to the same degree.
A: Right. And there are understandable reasons for this. Let me give just two examples.
First, understanding that the essence of trauma is being helpless and ineffective in the face of an overwhelming danger, if someone can take any kind of empowered action during an event (such as a kidnapping or a flood), that person will fare better than the person who can do nothing.
Second, trauma that is caused by another person, especially one you know or depend upon, has worse impacts generally than impersonal trauma like a flood or fire.
So there are significant differences in what happened to us, in our resources at that time, in the response of people in our environment afterward, in how much trauma we’ve experienced….there are many factors, so it would be better if we could step out of comparison and blame, because we’re each dealing with a unique set of circumstances.
Q: You say in your book that “time doesn’t heal” when it comes to recovering from trauma. Why not?
A: Because trauma stays in the body and the nervous system. Again it’s that shock that keeps jolting you. There is evidence that without healing interventions, we tend to get worse over time. It is thought that the nervous system continues to become more and more sensitized, so an even larger number of stimuli spark your trauma responses.
Q: You say several times that traumatic memories are not like other memories. How are they different?
A: They are much more vivid, and instead of being in the present looking back at something, it is like being back in it. They are also more fragmented in my experience. They come in bits and pieces, almost like different tracks that make up a movie. There’s the visual track, the feelings in the body, sounds and smells, emotions and thoughts.
Q: You describe a number of trauma therapies and ways that these are different from earlier ways of working with trauma. There is even a suggestion that some of these earlier ways can be harmful. How is the field of trauma therapy changing?
A: We’re moving away from “talk about it.” Because when you talk about trauma, you often stay glued to it. The body remembers in a way that is all too real, and we end up going through the same emergency reactions in the body, “traumatizing” the person all over again. The newer therapies approach trauma in a more careful and calibrated way.
Q: You have two chapters on self-help tools. Why are these important?
A: Even if you’ve got a great therapist or team of helpers, you’re going to need to manage your trauma symptoms other times (like the middle of the night). Also you will want to create strong, supportive habits and structures in your life that will help make you less “tippy.” So I have a chapter of tools for dealing with trauma activation and memories and a chapter of “tools for living” which help us create a more balanced life, which itself is a counterbalance to the instability created by unresolved trauma.
Q: Do you ever really heal from trauma?
A: Yes. You can. It’s not exactly wiping the slate clean, (you’ll always have this history), but we can free ourselves of most if not all the symptoms of trauma, manage the few that are left, and finally move on. There may be ways we feel more fragile because of what we’ve been through, but there are also ways that we feel stronger because of it.
Q: What do you think is important for people who suffer from trauma-related conditions to know?
A: Several things. First, it’s not your fault. You are not suffering because of some inadequacy in you. Second, healing is possible, although in most cases it will take a lot of work. Third, you don’t have to do it alone. You’ll need self-care tools that you apply on your own, but in most cases, you’ll need a number of helpers. In the book, I talk about how to select the best helpers for you.