Trauma and therapy
"Trauma is an affliction of the powerless."
(Herman, 1992)
A brief introduction to Trauma Therapy. Traumatic events occur far more often than perhaps recognised and probably affect just as many women, men and children as those that suffer in war or catastrophic disaster; equally such experiences are very personal and can often be difficult to share.
The symptoms of trauma are the result of a biological hard-drive common to all humans, indeed to all animals, you may have heard of Fight, Flight or Freeze? This is our automatic built-in reaction to any event that, in the case of Fight or Flight, gives us an immediate explosion of energy to save ourselves from any threat to life or limb. This inbuilt survival mechanism can be a life saver; if a speeding car or a drunken raging somebody with a knife comes towards you, it makes perfect sense to protect yourself as quickly as possible without having to think “now, what shall I do?” Someone trained in martial arts may have different automatic reactions to someone who has not but regardless, most of us wouldn’t hang about. However, what happens when we are faced with some nameless horror that cannot be escaped or fought, that we have no preparation for? Then we may freeze; helpless in the face of overwhelming fear, we can become rigid, unable to move, think or feel. Sometimes referred to as being like “a rabbit caught in the headlights”, this is an automatic psycho-physical reaction outside of our cognitive control. A complete sensory overload.
However, we are far more complex than rabbits; we have brains that are about 135 times larger with more neurons than there are stars in the universe operating at about 450 mph with sensory and nervous systems that are constantly relaying information back and forth around the whole body. And most of that information processing happens without our even being aware of it. Yet sometimes our senses can pick up information which triggers something perhaps older, something perhaps forgotten or locked away because it hurts too much to remember. For instance, perhaps the trigger is no longer a speeding car but an old Ford Escort driving past or perhaps just the smell of alcohol on somebody’s breath that causes those same frightened or angry feelings. Such triggers can cause severe anxiety or depression and even a desperate need to end the apparent cause of our suffering – and this is where Trauma Therapy can help.
Safety is fundamental in Trauma Therapy; it doesn’t help anyone to be re-traumatised by trying to face memories which have been locked away for a purpose. The path to recovery has to be taken cautiously, everyone is unique and how they have dealt with past trauma will be different. Initially, and throughout therapy, CBT and Mindfulness form a key role in helping people to understand what is happening to them and to control and manage the difficulties they are suffering from in the short term. Understanding how Stress and Trauma affect Mind, Brain and Body is not difficult and is an important part of therapy for both Clients and Therapists. Mindfulness also brings with it awareness of how your body reacts to triggers and how you can learn to recognise and manage those physical feelings better so that they no longer overwhelm the system.
EMDR – Eye Movement Desensitisation and Reprocessing – is the often the next most useful step. EMDR was developed by Francine Shapiro and is acknowledged by most leading authorities as one of the most effective approaches in helping relieve the symptoms of trauma. (World Health Organisation, NHS & others) It is believed that EMDR works on a psycho-neurological level and is similar to how Rapid Eye Movements (REMs) during dreams help the brain to sift and sort information from past and present. Our brains are constantly comparing new sensory information with old stuff, checking for inconsistences, for information that doesn’t fit with what is known or comfortable. Reoccurring dreams and nightmares, for example, are often about events or situations that have been caught in a logjam of frightening information that won’t clear. EMDR has helped clear many such nightmares as well as the original traumatic memories that may have continued to disturb and distress Mind, Brain and Body for sometimes many years after the causative event/s.
The following is a list of possible symptoms and difficulties suffered by survivors of traumatic events; some can be caused by other mental, physical, pharmaceutical or psychosocial difficulties. Constant stress at work and home can often create some of the problems below and can even echo the symptoms of serious trauma. As such, your GP should always be your first port of call if you suffer from any of these without understanding their cause, and probably even if you do. However, suffering several or more, even mild or moderate ones, can often indicate the effects of Major or Minor Trauma somewhere in the past.
Thoughts about self-harm
There are many ways we might harm or damage ourselves, perhaps through accident or carelessness, perhaps through smoking or drinking too much or perhaps just working or playing too hard.
The pressures of living and coping can sometimes prevent us from seeing or acknowledging the harm that we are doing to ourselves and those around us. For some, it might be a gradual or even sudden moment of realisation that provides the impetus for change, the motivation to do something about it. The trigger may be a health-scare or a growing relationship problem, it may be from comments by friends or relatives; whichever it is, it is often enough for us to do something about it. However, while our behaviour may have been harmful, it is not self-harm.
Self-harm involves far more intentional action; often called deliberate self-injury, self-harm involves cutting, burning, scalding, hitting, purging, poisoning and many more. The word deliberate is often used but, just for a moment, I’d like to consider one of the word’s definitions; to consider thoughtfully and carefully. How does that fit with someone who feels so overwhelmed by what is going on in their mind or in their life that their only way to cope with it is to cause themselves real pain and risk serious harm?
What is most important here is understanding that self-harm makes sense in that it can help someone manage those thoughts and feelings that have escalated to a level that cannot be controlled by any other means at that moment in time.
There are many theories about why people self-harm yet it has to be acknowledged, people have been doing it in one form or another for thousands of years for a great variety of personal, cultural or spiritual reasons. Self-harm always has a reason and it is not often about wishing to die; more often than not it is about staying alive, about feeling alive. While accidental and intentional suicide is at an increased risk among many people who self-harm, there are also many who have self-harmed for years and have kept themselves safe, often keeping their self-harm a secret because of what they may have heard or experienced from the attitudes of both the general public and from those professionals who are meant to be there to help them;
”Over and over again, the young people we heard from told us that their experiences of asking for help often made their situation worse. Many of them have met with ridicule or hostility from the professionals they have turned to.” - Camelot Foundation & Mental Health Foundation, the truth about self-harm, 2006
However, recognition of the damage that the wrong approach has done in the past, and can still do in the present, along with far more research and a better understanding of the causes and thinking behind self-harm, is now hopefully creating more helpful and caring responses by health professionals. More importantly, it is about helping those who self-harm to challenge the inappropriate actions – or reactions – of professionals who lack a full understanding of self-harm.
While I have both the training and experience to hopefully provide effective therapeutic help for people who self-harm, this is also about helping people to manage their self-harming behaviour more safely before perhaps finding a way to end the need.
As such, a useful starting point may be to look up The National Self-harm Network who provide detailed information and advice for individuals, families and professionals.
Thoughts about anger
"Anyone can become angry -- that is easy. But to be angry with the right person,to the right degree,at the right time,for the right purpose,and in the right way -- this is not easy."
Aristotle (384 BC – 322 BC)
Everyone has the right to be angry, it’s part of the human condition; indeed, it's an integral part of how we deal with fear and injustice, of how we protect ourselves and our loved ones, a part of our survival.
It becomes a problem when it is the only way someone has of dealing with life’s problems and relationships; when it is the only way someone has of coping or dealing with whatever cards life happens to deal that day.
No-one can be happy or content when they are angry. Counselling is a way of helping to find where that anger belongs, working through it and closing an open wound that otherwise may always hurt.
