Trauma has shut down their inner compass and robbed them of the imagination they need to create something better.
If you mistake someone’s solution for a problem to be eliminated, not only are they likely to fail treatment, as often happens in addiction programs, but other problems may emerge.
If you do something to a patient that you would not do to your friends or children, consider whether you are unwittingly replicating a trauma from the patient’s past.
If the people whom you naturally turn to for care and protection terrify or reject you, you learn to shut down and to ignore what you feel.22.
DSM largely lacks what in the world of science is known as “reliability” – the ability to produce consistent, replicable results. In other words, it lacks scientific validity.
The challenge is not so much learning to accept the terrible things that have happened but learning how to gain mastery over one’s internal sensations and emotions.
It is hard enough for observers to bear witness to pain. Is it any wonder, then, that the traumatized individuals themselves cannot tolerate remembering it and that they often resort to using drugs, alcohol, or self-mutilation to block out their unbearable knowledge? Tom.
We deliberately tried to collect just isolated fragments of their experience – particular images, sounds, and feelings – rather than the entire story, because that is how trauma is experienced.
Images and physical sensations may deluge patients at this point, and the therapist must be familiar with ways to stem torrents of sensation and emotion to prevent them from becoming retraumatized by accessing the past.
The greater the doubt, the greater the awakening; the smaller the doubt, the smaller the awakening. No doubt, no awakening. – C.-C. Chang, The Practice of Zen.
Social support is a biological necessity, not an option, and this reality should be the backbone of all prevention and treatment. Recognizing the profound effects of trauma and deprivation on child development need not lead to blaming parents. We can assume that parents do the best they can, but all parents need help to nurture their kids. Nearly every industrialized nation, with the exception of the United States, recognizes this and provides some form of guaranteed support to families.
Therapy won’t work as long as people keep being pulled back into the past.
We can hope to solve the problems of these children only if we correctly define what is going on with them and do more than developing new drugs to control them or trying to find “the” gene that is responsible for their “disease.” The challenge is to find ways to help them lead productive lives and, in so doing, save hundreds of millions of dollars of taxpayers’ money. That process starts with facing the facts.
Pat Ogden and Peter Levine have each developed powerful body-based therapies, sensorimotor psychotherapy29 and somatic experiencing.
We now know that more than half the people who seek psychiatric care have been assaulted, abandoned, neglected, or even raped as children, or have witnessed violence in their families.
And yet after thirty years and millions upon millions of dollars’ worth of research, we have failed to find consistent genetic patterns for schizophrenia – or for any other psychiatric illness, for that matter.2 Some of my colleagues have also worked hard to discover genetic factors that predispose people to develop traumatic stress.3 That quest continues, but so far it has failed to yield any solid answers.4.
As my friend Ed Tronick taught me a long time ago, the brain is a cultural organ – experience shapes the brain.
The stress hormones of traumatized people, in contrast, take much longer to return to baseline and spike quickly and disproportionately in response to mildly stressful stimuli.
Lacking a filter, they are on constant sensory overload. In order to cope, they try to shut themselves down and develop tunnel vision and hyperfocus. If they can’t shut down naturally, they may enlist drugs or alcohol to block out the world. The tragedy is that the price of closing down includes filtering out sources of pleasure and joy, as well.
After a while most people with PTSD don’t spend a great deal of time or effort on dealing with the past – their problem is simply making it through the day. Even traumatized patients who are making real contributions in teaching, business, medicine, or the arts and who are successfully raising their children expend a lot more energy on the everyday tasks of living than do ordinary mortals.