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THE PHENOMENOLOGY OF COMPLEX TRAUMA

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THE PHENOMENOLOGY OF COMPLEX TRAUMA

 

This paper deals with the phenomenology of trauma, using information from leaders in the field of trauma work and integrating the experience of trauma that I have experienced.  Judith Lewis Herman describes what complex trauma is and how to work with it.  Bessel van der Kolk works with the physiological aspects of trauma.  Jennifer Freyd has written about betrayal trauma and why children of abuse forget what was done to them.  Robert Stolorow describes emotional dwelling, a way to sit with a client who is dealing with deep trauma.  Andrew Feldmar is an existential phenomenologist who has been working with trauma victims for more than forty years.  Each brings a different but complementary way of looking at the phenomena of trauma and of working with survivors.  I look at a number of the issues that trauma victims deal with, including forgetting and remembering, shame, suicide, and cutting,  anxiety and language.

 

 

 

 

 

Elie Wiesel, the Night Trilogy

You claim you love me but you keep suffering.  You say you love me in the present,

but you’re still living in the past.  You tell me you love me but you refuse to forget…

the truth is that I am nothing to you.  I don’t count.  What counts is the past.  Not ours; yours.  I try to make you happy: an image strikes your memory and it is all over.

You are no longer there.  The image is stronger than I.  You think I don’t know?

You think your silence is capable of hiding the hell you carry within you?

Effects of Trauma

Post-Traumatic Stress keeps harming the victim, years or decades after the traumatic event(s) occurred.  Trauma interferes not only with the victims but also with everyone who loves them.  To be unable to create or maintain healthy relationships or to stay in the present moment can destroy any possibility of intimacy and love.

In the Comprehensive Textbook of Psychiatry, it states that the common denominator of psychological trauma is a feeling of “intense fear, helplessness, loss of control and threat of annihilation.”  (Herman 1996 p.104).  Trauma becomes encoded in the unconscious and in the body of the victim and it breaks out in flashbacks in daytime and nightmares during sleep.  These memories are neither linear nor verbal.  They are alive and are in the present.  Instead of narrative, they come in fragments, like shards of glass—sharp, with no context, splinters of horror that seem to make no sense, but that cannot be stopped.  According to Herman, Complex Post Traumatic Stress is caused by “a history of subjection to totalitarian control over a prolonged period (months to years.)”  This includes hostages, prisoners of war, concentration camp survivors, and religious cults, survivors of domestic abuse and childhood physical and sexual abuse (1996 p.3).

Freud said that “the essence of repression lies simply in the function of rejecting and keeping something out of consciousness.” (Freyd. p. 15).  Repression is a way to block the retrieval of memories that are too traumatic and painful to remember—they are beyond words.  What cannot be put in words cannot be remembered.

Dissociation is a way that persons disconnect from the here and now, because it is too traumatic to be present to what is happening, so they disconnect from their bodies and their surroundings.  In my case, dissociation became a way of life.    Whenever I encountered a very stressful situation, I would dissociate.  I didn’t realize what was happening to me.  I used to think I was very forgetful.  I created ways to cover myself when this happened so that I could hold a job and take care of myself.  Since I began working with my current therapist, I rarely dissociate anymore, but it still happens when I am under a lot of stress.

Depersonalization may happen where you feel like you are not in your body.  Derealization may occur in which nothing feels real.  My understanding of dissociation is that it happens at the time of the event.  Repression happens afterward.

As with many trauma survivors, my memories were buried for many years.  When I was thirty-eight years old I was riding on a bus from San Francisco to Petaluma, CA when I began having horrifying visions of blood and bodies.  This made no sense.  I felt panicky and trapped on the bus and I began to feel very afraid.  My chest felt so tight that I found myself bending over in my seat.  My breathing was fast and shallow.  The fear and panic stayed with me after I got home and I was afraid to go to sleep.  I was confused because I had no idea what was happening.  I felt like I was unraveling; my mind was unable to process or understand what was going on.  My body was tense and my hyper-vigilance became so intense that every sound and movement startled me.  I was living in a state of terror without knowing what was terrifying me.  I realized that I needed help and I needed it now.  I got out the San Francisco phone book and looked for someone I could talk to.  I found a young woman named Metece Riccio.  At that time, I thought that all my problems came from a mother whose presence I could not bear and whose touch made my skin crawl.  Metece was younger than me and I didn’t have great expectations for therapy but she was all that I could afford.  I met with her weekly for a while.  She was helpful as I got away from an abusive husband, who then stalked me for a year, moved to a cheap apartment in San Francisco and started a new job.  I never really believed that she cared about me until the 4th of July about two years into my therapy. Metece had given me her phone number to call if I ever was in crisis and I never called her until that day.  I was suicidal.  She came into San Francisco and met with me for about four hours and she said that she was not going to charge me, she was just there to help.  That was a turning point in our relationship.  From then on, I began to trust her.  I began to believe that she cared and that it was not just about the money.  She was kind and patient and she never suggested that I had been abused but was there to listen and support me.  During my therapy, the flashbacks continued and memories began to come of abuse by my mother.

According to the DSM-5, “Dissociative Amnesia is an inability to recall important personal information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetfulness.” (p.298)  Jennifer Freyd, the author of   Betrayal Trauma, wrote that those persons whose perpetrators were closest to them in relationship, such as a parent or a caregiver, are far more likely to forget the trauma.

Prior to experiencing flashbacks, I had thought that I was mentally ill.  For my whole life, I had been dealing with anxiety, depression, suicide attempts, and self-mutilation.  I am still dealing with anxiety and flashbacks at age 71.  The only difference is that I deal with the flashbacks much better than when they first happened.  The immediate response is just as traumatic, but my recovery time is shortened.  I know the pattern and I am aware that the feelings and emotions that are triggered will pass.  As more and more of the shards have shown themselves, I have been able to piece them together and get pictures of the abuse that was done to me.

Forgetting and Remembering

There is a process that happens to me sometimes prior to experiencing a new abuse memory.  I experience an unsettled feeling, a  sense of disquiet and unease.  I can feel afraid or sad for no obvious reason.  It can take hours or days, and then something unbidden arises in me.  It can be a missing piece of a memory or a new one. I may experience shock or grief, followed by extreme exhaustion.  I can’t think straight and I isolate.  I busy my mind with trivial matters—television shows and computer solitaire—nothing I have to think too much about but something to keep me from thinking or feeling the anxiety that is a constant in my life.

Sometimes the memory comes like a bolt of lightning.  It is an immediate, intense, knock-me-to-my-knees picture or feeling, and may be without any context.  It is as if my unconscious is only giving me small bits of memory at a time because the immensity of the trauma was too much for me to deal with all at once.

After being in therapy for four years, dealing with memories of abuse by my mother, I had begun to have some flashes of memories with my father.  I had very few memories of my father.  He had seemed insignificant, a Casper Milquetoast.  This surprised and confused me.  The memories seemed unreal and I doubted myself.  I must be making this up.

It couldn’t possibly be true.  How could I forget something so devastating?   I must be mentally ill or delusional.      But I was getting flashes of him and uneasy, feelings that made no sense.  About this time, I came across this poem in the book, The Courage to Heal, ( Bass & Davis p. 15)

What My Father Told Me

By Dorianne Laux

 

Always I have done what was asked.

Melmac dishes stacked on rag towels.

The slack of a vacuum cleaner cord

wound round my hand.  Laundry

hung on a line.

There is so much to do always ,and I do it.

The iron resting in its frame, hot

in the shallow pan of summer

as the basins of his hands push

aside the book I am reading.

I do as I am told, hold his penis

like a garden hose, in this bedroom,

in that bathroom. over the toilet

or my bare stomach.

 

I do the chores, pull the weeds out back,

finger stink-bug husks, snail carcasses,

pile dead grass in black bags.  At night

his feet are safe on their pads, light

on the wall-to-wall as he takes

the hallway to my room.

His voice, the hiss of lawn sprinklers,

wet hush of sweat in his hollows,

the mucus still damp

in the corners of my eyes as I wake.

 

Summer ends.  Schoolwork doesn’t suit me.

My fingers unaccustomed to the slimness

of a pen, the delicate touch it takes

to uncoil the mind.

History.  A dateline pinned to the wall.

Beneath each president’s face, a quotation.

Pictures of buffalo and wheat fields,

a wagon train circled for the night,

my hand raised to ask the question,

Where did the children sleep?

 

As I began reading it, I started feeling dizzy and off balance.  My stomach was roiling and I thought I would throw up.  My body started shaking.  I tried to stop reading it but I couldn’t.  I suddenly knew.  There was something horrible about my father that I needed to remember.  I just had no idea of how much.  I was the good, obedient girl whose daytime life was filled with school, chores, and church.  The mention of the different rooms and the different ways in which the father came to her was too familiar.  My brain felt like it was in a haze and I couldn’t form complete sentences in my mind.  A heavy dread filled my chest and I was bent over with the weight of it.  This was the beginning of my remembering.

Trust

It is very difficult for a traumatized client to reveal who she is.  Trust is a major issue for those who have experienced complex trauma.  Being able to feel safe around others is vital to creating a healthy, meaningful life. Herman writes that “wounded soldiers and raped women cry for their mothers or for God.  When this cry is not answered, the sense of basic trust is shattered.” (1992 p. 52).  Herman also writes that repeated childhood trauma forms and deforms the personality (1992 p. 96). Children who cannot trust their caregivers, develop ways to survive that are both creative and destructive.

Because betrayal is often a huge part of the trauma, it is extremely difficult for a client to trust anyone enough to create a healing connection between them.  Judith Lewis Herman says that the first step in healing trauma is establishing a sense of safety, security, and trust.  She also states that it takes as long as it takes (1992. p. 155)  A healing relationship cannot be established until the client trusts that the therapist will not judge or betray her.

Physical Issues/Body

The importance of telling the story allows the victim to take a memory that has been frozen in time and integrate it into the victim’s life.  Herman says, “A narrative that does not include traumatic imagery, and bodily sensations is barren and incomplete.” (1992. p. 177).  The healing does not come from just speaking the words.  As the survivors tell their stories, they include bodily sensations to the ability that they can, and the therapist is there to be a witness and an ally of the clients.

In our philosophy, the phenomenology of the moment is a language rich with information.  “The body is the purest, most primal tool… we have for communicating. As Roland Barthes wrote, “ What language conceals is said through my body.  My body is a stubborn child; my language is a very civilized adult.” (Ringstrom, p.27)  We need to learn to use our observation skills when words fail us.

Gadamer asks, how we can understand the person in front of us.  There are some experiences for which there are no words when language fails to provide a way to connect with another person.   This is where the phenomenology of the moment can speak to the therapist.  To sit with someone, even in silence can be powerful and revealing.

It is extremely difficult for traumatized people to feel safe and at home in their bodies.  Being able to be physically relaxed is difficult if not impossible, so learning ways to relax is important to the healing process.  Van der Kolk says, “Once you start approaching your body with curiosity rather than with fear, everything shifts.” (Herman. 2015. p. 269).  Working with traumatized people, the therapist needs to encourage the client to find ways to reconnect with their bodies, learn to relax and to inhabit them in that childlike way that they lived in them prior to the trauma.

In my last visit with my therapist, he talked to me about my “choreography.” —the way I move and the way I hold myself around others.  He stated that it is that of a young child.  It is diffident, as if I am watching to see if those around me are safe.  He said I looked hesitant, as if I expecting someone to harm me,  as if I am ready to defer to others to remain safe.  This was a surprise to me. I had not realized that I was projecting that kind of energy. Since I have returned from that visit, I have been consciously projecting a sense of confidence and strength in the way that I sit, stand and walk.  It is shifting me.   It is such a small way to change, and yet it feels so powerful.

I was driving one day recently, and realized that I had the steering wheel in a death grip and that this is how I always drove.  I decided to relax my hands.  I would catch myself tensing up again, and I would then relax my hands, again.  After a few days of this I now mostly drive with relaxed hands.  Interestingly enough, I then began to notice the tension in my jaw.  I am now working to release the tension I hold there.  It is as if I am waking up to the tension in my body and I am feeling sensations that I had been too numb to before.  This feels important, as if I am embarking on a whole new way of healing. This is something I can teach others to do.  Self-awareness, knowing our bodies and subtly shifting them is a pathway to connecting with our power.

Other suggestions that can help the client reconnect with their bodies are having them do anything that deals with rhythm and repetition.  This could be dancing, drumming, yoga, or tai chi.  Something that was particularly helpful to me was taking a self-defense class called Model Mugging.  In this course, there are men who are heavily padded and the women get to practice full force fighting.  Instead of panicking if they are attacked, they learn to look for an opening and then fight back.  Writing and art are other ways in which the body can be involved in the healing of trauma.

Shame/Suicide/Cutting

At seventeen I attempted suicide for the first time.  I had run away from home and I was staying in a cheap hotel room on 4th and Pike St. in downtown Seattle.   Emotional pain permeated every cell of my body.   I remember the overwhelming, crushing pain I felt.  It was like a blackness that surrounded me and filled me.  I could not bear to carry the weight of it.  It was excruciating.  It was in my skin and my insides.  Like a sticky black tar, I could not rid myself of it.  It was not something that was separate from me.  It was who I was.  I could hardly lift my head and I couldn’t make eye contact.  My body felt hot and I wanted to hide, but there was no way to hide from who I was.  I felt filthy and ugly and I couldn’t make the pain go away.  I was doubled over with it,  I could barely breathe.  It wasn’t that I wanted to die.  I just wanted the pain to go away and suicide seemed the only option.  I was the pain. It was not a feeling, it was me.  I had no right to live.  I recoiled from my own body because I felt so contaminated.  I attempted suicide two other times before I was thirty.

In one of my classes, we discussed suicide.   This brought forth two revelations—the first was the overwhelming feeling that I had at the time of my suicide attempts.  I had always felt that the emotional pain was overwhelming, but I had never named it.  I realize now that it was shame.  It was not that I had no reason to live, it was that my sense of shame was more than I could bear.   The other revelation was that I had never written a suicide note.  It had never occurred to me to write one because I had no one who would have cared to read it.  Both of these revelations gave me a greater sense of compassion for my younger self and more insight into the issue of suicide.  Even though I am very open about my issues, I did not realize how much I have not allowed myself to look at or to feel my feelings.  This realization will keep me open, curious and compassionate when dealing with clients who have suicidal ideation or who have attempted suicide.

I think one of the reasons I felt so much shame was the idea that I didn’t either fight or run away.  Because I froze, I believed that it was partly my fault.  I should have done more to make them stop.  Because I allowed them to harm me, I was partially complicit.  I have since learned that fight or flight are not the only two survival options.  Freezing is a physiological response that happens when there is no possibility to either fight or escape.  The freeze response happens when a person can’t fight or escape.  When this happens, the periaqueductal gray activates the parasympathetic nervous system.  The muscles, gaze, and breath may tighten and freeze.  The freeze affects the heart rate, respiratory rate, metabolism, and endorphins. causing the victim to shut down.  This is not a conscious choice. A victim does not choose to not fight. The victim may experience no pain and may not be aware of her surroundings.   This bodily reaction happens prior to conscious thought.  It is not the act of a coward or of someone who allows the abuse.  It is a primitive human response to danger.

I was in my twenties when I first started cutting on myself.  I thought I was the only one in the world who did it.  Before I would cut, I would feel almost catatonic.  My body would be heavy and I could barely move.  I remember sitting in a chair, feeling like I was so deep inside of my body and separate from it that I couldn’t feel anything.  I was looking out of eyes that felt like dead eyes, pebble eyes—nothing in or out of them, devoid of feeling.  I just wanted to feel something, anything.  I got a razor and began making small cuts on my arm and thigh and watching them bleed.  For some reason, it gave me a sense of release and relief.  I don’t know if it was the distraction of the physical pain or if it was a way to punish myself, but for a time after cutting, I felt relief.  The next day I would feel incredible shame.  I would wear long-sleeved clothing to hide the cuts.  I remember the first time I saw cutting discussed on a talk show and I was shocked to find out that others have done the same thing.  Years later, I worked with a teen girl who had cut on herself.  By revealing that I had done the same, the young girl saw that I did not judge her for what she had done and I accepted her the way she was.

Herman states that survivors who self-mutilate describe dissociation, depersonalization, derealization, and anesthesia. Self-mutilation is not suicidal behavior.  She further states that self-injury relieves unbearable emotional pain   According to Herman, binging/purging, sexually acting out, risky behavior, drugs, and alcohol are all ways that survivors use to calm their emotional states (1992. p.109).  When I was younger, I was a chain smoker.  If I was not smoking a cigarette my body would feel so agitated that I could hardly stand still,  I would begin to feel edgy and the longer I went without a cigarette, my anxiety would rise.  It felt like all of my cells were vibrating and screaming, ”Danger.”   There was also a time when I drank to ease the anxiety.   I would sometimes feel a blackness come over me.  I once wrote:

The blackness slides over me

like sticky oil

 

I cannot see

 

The air is moving

I can feel it pushing against me

 

I am suffocating

 

The terror rolls through me

in waves

 

I am drowning

I am drowning

I am drowning

 

Who Sits in Front of Me

Heidegger asks the question, “Who sits in front of me?” This is a powerful question.  It is not just about the client, it is about what the therapist sees.  As a therapist, I am looking to see who sits in front of me, every time the client appears.  Who shows up at the visit is unique to each visit.  If I hold an expectation of who the person is, I am blocking myself from seeing other possibilities.

When someone is given a diagnosis, such as Bi-polar or psychotic or PTSD, for example, it is easy to see a diagnosis instead of the living, breathing person. It objectifies the client.  That is one of the reasons that existential phenomenology dislikes the use of diagnoses.  A diagnosis can be a distraction that removes us from what is present, now, between us, in this moment.  Part of the work with trauma survivors is to help them to lose their identification with a label and to help them open up to new possibilities.

Understanding

Gadamer writes a lot about understanding the Other as if that is possible.

We can study a culture and get an understanding of what behavior is considered appropriate at a given time in a given way.  We can learn basic facts about the Other, but we can never truly understand the Other because the Other is infinitely Other.  I love the idea that therapy is not knowledge of our clients, but responsibility for them.  To say that you understand someone is tantamount to colonization.  When I see someone, when I try to understand someone, it is always through my own lens—through my own beliefs and prejudices and my history. I put others into categories that I have created, even though they may transcend those categories.   I cannot step away from my beliefs, prejudices or categories any more than I can step out of my history.   What I can do is to pay attention, to reveal my views to myself and to stay aware of them.  I can be present, be a witness to their suffering, I can believe them, and I can accept them.

No one can really understand the experience of and the effect of trauma unless it is their own.  This is especially true of those who have experienced childhood trauma.  How can anyone understand the experience of being raped and beaten by a parent, relative or caregiver?   How can anyone understand what it feels like to realize that there is no one who will protect you when you are a young child?  It is impossible.

It is insulting to the client to state that you understand their experience and their pain.  I don’t believe that the goal of working with trauma is to understand, at least not with the regular definition of the word.

What we can do is to engage with the Other. We can be with the Other; we can love the Other.  We don’t have to understand the Other to love him.  Also, if the Other acts in a way that we would never act, we can be curious to know what conditions would cause him to act in this way.  What we can do is be present, be a witness to their suffering.  We can believe them, and we can accept them.

Time

For many trauma victims, there is little distinction between past and present.  Sights, smells, sounds or touch can suddenly bring the past into the present.  Kolk states that  “Body awareness also changes your sense of time.  Trauma makes you feel as if you are stuck forever in a helpless stage of horror.  Kolk also states that “when something reminds traumatized people of the past, their right brain reacts as if the traumatic event were happening in the present (p. 273).  Herman says, “The reconstruction of the trauma requires immersion in a past experience of frozen time, the descent into mourning feels like a surrender to tears that are endless”  (1992. p.195).

For people with complex trauma, the past and the present can both be experienced simultaneously in the present.  As an example, during the winter quarter, I was walking down the stairs between classes when Rachel, a classmate who was behind me on the stairs, tripped and reached out to balance herself.  Her hand landed my back as she tried to steady herself.  Suddenly I was triggered.  When I was seventeen, my parents confronted me one night about my being pregnant.  My mother was asking me who the father was, but I stood with my head bowed, and I couldn’t answer.  There were six men, including my father and a Catholic priest who had been raping me for years so I didn’t know who the father was. She called me an abomination. Then I was going downstairs to my room in the basement when my father put his hand on my back and shoved me  I stumbled and hit my head on the wall and then fell to the bottom of the stairs.  He then began kicking me in the stomach with his wingtip shoes.  I miscarried and then was ordered to clean up the blood.  Afterward, I washed out my clothing, put on my flannel nightgown and went to bed.

When this flashback happened at school, I was simultaneously in the past and in the present.  Intellectually, I knew I was at school and that the triggering had been an accident, but my body responded as if I were in the past.  I felt myself being drained of emotion.  If you have ever seen the Harry Potter movies, there is a scene in which the Dementors were sucking the very life and the soul out of Harry.  That was the image that came to mind. I felt my aliveness being sucked out of me.  I could barely stand and I couldn’t think or speak coherently. Michael Gonzales, another student, was with me and he helped me to find a place to sit down and gather myself.  Because I have lost so much in my life from my past trauma, I refused to go home.  I went to my next class and stayed, even though I could hardly concentrate.  I managed to get myself home but it took a day or two before I was myself again.

The past is not in the past when the body responds as if the trauma is happening now, and bodily responses cannot be shifted or stopped by any intellectual ideation or understanding.

For survivors who can’t move beyond the trauma, there is no future they can see or lean into.  Healthy living demands running into the future.  Survivors can’t always see the possibility of something better.  Taking chances, or throwing oneself into life, does not feel safe and fear of being unsafe cuts a person off from other possibilities.

Everydayness

The everydayness of living is a way for many trauma survivors to get through the day.  If the emotional pain is too great, survivors often live like they are at the airport waiting for a plane—killing time, doing busywork, watching TV, playing video games—anything to keep from being present to their lives.  This way of living is both an escape and a prison.  They are anesthetizing themselves against their aliveness.

I still struggle with this.  It has been more than 50 years since the abuse ended yet every evening as it gets later, my anxiety arises, and I fall into this type of escape.  I fight against presence, which is where life is.  Some days I win and some days not.  As I am getting older, I realize that I have less and less time to live fully.  I want love and passion and deep friendships.  I want to know who I am when I am stripped of my defenses and survival strategies.  Whom would I be?  How would I live?  What gifts would I bring to myself and others?

Ethics and Politics

According to my therapist, Andrew Feldmar, psychology is about two issues—ethics and politics. Ethics is about how we treat each other and politics is about how to gain and maintain our personal power.  It is not power over others, it is the power to live the way I want to live.  It is about my freedom.

For years I was afraid of having personal power because I connected the idea of power with abuse.  It has been difficult to shift this belief.  I spent most of my life avoiding any situation where I would be in a position of power.  I was afraid I would harm others so I was always a follower, not a leader.  I know now that power does not equate harm, but it is still uncomfortable for me to move into a more powerful way of being.

Anxiety

For trauma clients, both anxiety and angst can be an issue.  For those who are hyper-vigilant, anxiety and angst are normalized states of being.  Often healthy guilt is not one of their issues.  Instead, shame often accompanies their memories of trauma.  What is called survivor’s guilt is often shame for surviving or for a mistaken belief that somehow the trauma was caused by the client.

I developed a number of phobias, from an early age.  Over the years, I have worked diligently to release these phobias, mostly with success.  I had a phobia to animals—cats, dogs, birds, bugs, etc.  For the animal phobia, I forced myself to continue to walk down the street, even if I saw or heard a dog.  This was terrifying but after a couple of years, I healed it.  I had a phobia to the color yellow.  My first abuse memory of my mother happened in a kitchen with yellow curtains and a yellow chair.  It is easier to be afraid of yellow than to fear your mother when you are three years old. When I was about 60 years old I wore the color yellow for the first time.  I had a phobia to pregnant women.  When I saw one, I would feel repulsion and terror and I would hear the word “abomination.”  I am able to see them now without having a negative reaction.  I had a phobia to water—no swimming or showers.  I have learned to take showers and I avoid swimming.  What I came to realize, though, is that it is possible to heal the phobia but that does not remove or heal the underlying fear.  The phobia was simply the out-picturing of the fear that I attached to something else.  It was never the cause of the fear.

According to Bessel Van Der Kolk, there are three avenues to healing trauma:  first, talking and reconnecting with others, second, taking medications like anti-depressants and anti-anxiety medications, and third, finding a way to bodily heal the feelings of “helplessness, rage or collapse that result from trauma” (p. 47).  Talk therapy is an important part of therapy, but when a client is in the throes of trauma, the rational part of the brain shuts down and the primitive part of the brain takes over.  The client’s trauma needs to be calmed down before talk therapy can be effective.

One area in which I am observing myself differently is by paying attention to my phenomenological reactions to events and to people.  In the past, because of my history of abuse, I would often dissociate.  When I am very stressed I can still fall back into that response.  I was often unaware of what I was feeling.  For one of my classes, I had to write a reflection paper on the pre-conscious experience and I had to consciously work to remember.  I had to work hard to get myself to remember in a deep way.   I was surprised by how powerful the experience was.  For my own self-awareness, I am working on paying closer attention to my reactions and feelings,  This self-awareness will be important for me in looking for areas of transference and countertransference.

One area of growth I am working on is speaking up and being heard.  This is an issue partly because I tend to be quieter by nature, and partly because I was threatened and harmed as a child if I spoke up.  I realize that I still carry a residue of fear of others, even if in reality, I know there is no reason to feel that way.

Trauma leaves the client feeling powerless and at the mercy of others and of circumstances, making empowerment an important part of trauma therapy.  When living in a continual state of hyper-vigilance and fear, authenticity goes out the window.  Choice becomes about staying safe.  How does one live authentically when the goal is survival?  One doesn’t.  That is why the therapist works to instill a sense of sovereignty in her clients.

Language

All human life is rooted in language.  Language is how we connect, try to understand, convey information and have a way to express basic ideas and concepts.  According to Gadamer, the language of conversation is alive.  There are no rules. The meaning is enacted between two people.  It is a move to understand that needs both openness and information.  The dialogue between the two is a creative space in which something new is created.   It cannot be planned.  It is organic in its nature and arises between the two of them as they are present and open to what can show up.

Language can describe and transform, but sometimes, language is not available to the traumatized, who are unable to express in language what was done to them.

When I was about seven, I remember hiding in the hall closet, under the winter coats, and among the galoshes.  My mother found me and yanked me out.  I remember yelling at her.  I think she was blaming me for something and I was saying that it wasn’t me, that I didn’t do it.  She grabbed me by the throat and strangled me until everything went red and I passed out.  I remember waking up on my parent’s bed.  She wasn’t there and she never mentioned what happened.  I learned a lesson that day—never argue, never fight back.  If I do, I could die.

In therapy with traumatized people, it is a challenge to find a language—a similar way to describe what is often un-describable.  How does the client find a way to speak of the unspeakable?  Memories are very painful and often fragmented or partially forgotten and they don’t make sense.  They are not an easily told story with a beginning, a middle and an end.   Senator Dick Durbin stated at the Kavenaugh hearing, “A polished liar can create a seamless story. But a trauma survivor cannot be expected to remember every painful detail.”

Intimacy

I came across a quote recently, that describes intimacy in a way I had never before read.  I don’t know who the author is, but it struck me deeply:

People think that intimacy is about sex.  But intimacy is about truth.

When you realize you can tell someone your truth, when you can

show yourself to them, when you can stand in front of them and

their response is “You are safe with me” — that’s intimacy.

 

For those who have been traumatized, the experience of intimacy is affected by overwhelming feelings of need and fear.  Defenses that were created to protect a child become maladaptive when it comes to experiencing intimacy as an adult.  The intimate relationships that the abused child experiences are degrading, evil and those that labeled the child as something worthless that can be used and then discarded.

Without intimacy, there is no true connection.

I never felt safe enough to be able to reveal who I was.  I have been married twice and engaged once, and I never experienced intimacy with any of these men, or even with any female friends.  There has always been a filter.  I have weighed what I would say, looked for cues as to what the other(s) wanted to hear.  It was not until I began working with my current therapist that I have learned to trust that he is a safe person, in front of whom I can reveal myself.  I have tested him again and again and he has never made me feel uncomfortable, wrong or ashamed, no matter what I have said to him.  Now, before every session, I ask myself if there is something I don’t want to tell him, something that feels embarrassing or shameful.  I then make a list of those items and when we meet I talk about every one of them.  If I were to hide anything, that would mean that I do not trust him and he is not my safe place.

As I work with those who have been traumatized, I remember the need to please, even to please the therapist.  That is what I used to do.  I do not want my clients to be good patients.  I want them to feel safe enough to speak of anything.  I want to foster an atmosphere that allows the client to feel free, to get angry, to contradict me if necessary, to allow himself to be vulnerable enough to share his memories and his pain.

Relationships

According to Herman, “…a sense of alienation, of disconnection, pervades every relationship, from the most intimate familial bonds to the most abstract affiliations of community and religion.” (1992 p. 52)  This is why creating a healthy relationship is so important.    Feldmar states, “It is in relationship that we are wounded and it is through relationship that we heal.” He quotes Thomas Szasz as saying that if a person has no physical problem with his brain, then his issues are relational.  There is no mental illness if one is alone.  It is always between us.  (Feldmar Personal communication 2007)  The self is not alone.  It is always with others.

In an existential-phenomenological therapeutic approach, we can teach the traumatized how to have healthy relationships through the practice of presence, of dwelling and of rupture and repair.

The idea of rupture and repair was foreign to me.  In my family, in spite of all the trauma and abuse, I never once heard my parents argue.  When something was wrong, there was a silence and a coldness that would fill the house.  I wouldn’t know if there was something wrong between my parents or if they were upset with one of us children.  There would be a terrible waiting, a hoping it was not me they were upset about.  I was never exposed to any kind of healthy way to deal with problems.

In my past relationships, I never fought or had a real argument.  I would put up with or tolerate the behavior of my partner until I could not stand it anymore and then I would leave.  I did not understand that conflict is a healthy part of a relationship.  I thought that if you loved someone, you were supposed to agree with him.   Feldmar says that in relationship you should fight every day for your freedom, and that you should fight just as hard for the freedom of your partner.  Healthy relationships are not about domination and submission. (Personal communication 2007).  They are about two people who are living authentically and freely who bring their wholeness to the relationship.  This means that both are able to stand in their own power and it means that there will be conflict because conflict is how you repair the ruptures that happen when two people bring their unique desires and needs into a relationship.  Their otherness does not go away.

Losses

Most children have an expectation of love, care and safely from their parents.  That was not the case for me.  When I was in my fifties, I was present at the death of a child.  At the moment the child died, her mother was overcome by the pain and loss.  I remember watching her and having a shocking reaction to her pain.  Prior to that moment, the idea of a mother loving a child was, for me an intellectual understanding, but in that moment, I had a visceral reaction to her grief.  I felt her grief permeate my body and in that moment, I understood what mother love was.  I was stunned by it.  I never knew that anyone could love a child that much.  It was both a revelation to me and a feeling of incredible loss.  As I heard her pain and watched her as she grieved for this small child, who was only a little older than I was when my father started abusing me, I felt my heart break for the child I was, a child who never knew the love of either parent.  This was a loss that I did not even realize that I had experienced.   This past year I have been becoming aware of so much that I did not get in basic care.

Even before I had any memories of abuse, I was afraid of becoming like my mother—cold and controlling.  I determined that I would never do so.  At age 25, I went to a doctor and asked him to perform a tubal ligation on me.  He smiled patronizingly at me and told me that someday I would meet a nice man and I would want to have children.  I knew that wasn’t true.  I finally got the procedure done when I was 35.  Because of my mother’s coldness and abuse, I lost the desire for and the possibility of being a loving mother.  Even though I know I made the right choice, because I was too wounded to be a healthy parent, I mourn that loss.

I have never been in a healthy, loving relationship.  I did not have the capacity or the courage to love and I did not have the ability to accept love from anyone.  The men I picked had issues with drugs and alcohol and were as wounded as I was.  I want to love and be loved and I am afraid that at my age, it will not happen.

Dwelling

Robert Stolorow describes what he calls emotional dwelling.  He believes that instead of just empathically understanding a client’s emotional pain, the therapist should do more.   In dwelling, one “leans into the other’s emotional pain and participates in it, perhaps with aid of one’s own analogous experiences of pain.”   This approach goes beyond the I/Thou philosophy of Buber.

“When we dwell with others’ unendurable pain, their shattered emotional worlds are enabled to shine with a kind of sacredness that calls forth an understanding and caring engagement within which traumatized states can be gradually transformed into bearable painful feelings. Emotional pain and existential vulnerability that find a hospitable relational home can be seamlessly and constitutively integrated into whom one experiences oneself as being”.

Some years ago, I worked with a 16-year-old girl who used to cut on herself.  I disclosed to her that I had done the same thing when I was younger.  I had an understanding of why a person would do this.  My willingness to share this allowed her to realize that I  would not judge her for this behavior.  This revelation helped to create a sense of trust and safety between us and allowed us to create a loving, healthy relationship.

The Possibility of Change

Living an authentic life is an important goal in therapy.  When we are authentic, we are living in possibility and choice.  We are leaning forward into the future.  Living authentically is a goal for every human who wants to live his life with freedom and to be his own unique person.

What I know from personal experience is that trauma changes a person.  Who I was before the abuse began is not the person I am today.  I carry the memory of what Herman would call my “enslaved self.”  I know that I can be terrorized and enslaved.  I know that evil exists.  I know that I also became someone who harmed me.  I can look at my past behaviors—cutting on myself, attempting suicide, excessive drinking, choosing men who did not treat me well, and allowing those men to dominate me.  After I escaped from my tormentors I became my own abuser.  It has taken many years for me to stop harming myself and to forgive myself for what I did to myself.

What I also know is that finding someone who is a safe and loving person can be the catalyst for healing because love is a healing balm that soothes and comforts.  Furthermore, I know that the desire for health and wholeness must be stronger than the pain.  When the loving therapist and the desire for healing come together, anything is possible.

This poem, found in the book, The Courage to Heal, (Bass & Davis. p. 208) gave me hope, that with enough time I could change my life.  It told me that healing does not happen overnight, but that it can happen.

Autobiography in Five Short Chapters

By Portia Nelson

 

I

I walk down the street.

There is a deep hole in the sidewalk

I fall in.

I am lost … I am helpless.

It isn’t my fault.

It takes me forever to find a way out.

 

II

I walk down the same street.

There is a deep hole in the sidewalk.

I pretend I don’t see it.

I fall in again.

I can’t believe I am in the same place

but, it isn’t my fault.

It still takes a long time to get out.

 

III

I walk down the same street.

There is a deep hole in the sidewalk.

I see it is there.

I still fall in … it’s a habit.

my eyes are open

I know where I am.

It is my fault.

I get out immediately.

 

IV

I walk down the same street.

There is a deep hole in the sidewalk.

I walk around it.

 

V

I walk down another street.

 

 

I hold this possibility for myself and for my clients.  No matter what we have had to endure, we are not broken.  We can break the patterns that trauma has created and we can walk down a new street.

  Remember! This is just a sample.

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