Tuesday, July 26, 2016

When it's hard to take

There are some things in this life which are just hard to take. A really simple way to tap on this is to say as you go through the pointsI find it hard to take this … in” or use whatever words feel right for you. Living a healthy life is all about good digestion both physically and psychologically. And at the risk of sounding like a broken record, it’s why I like Ivor Browne’s definition of trauma: unexperienced experience. It’s not frightening, stigmatising, complicated or marginalising. It’s just beautifully simple and inclusive because I’d bet we can ALL identify with it. It also defines trauma as an experience, not an event. A crucially important distinction that gives weight and credibility to the individual’s experience.

Developmental trauma can be especially difficult to overcome. We are social animals and we suffer tremendously when we don’t have at least one person on whom we can depend. Love is not optional, it is essential for our physical and mental wellbeing at every stage of our life, but particularly so when we are infants. Babies who are securely attached have a solid foundation and if they are traumatised later in life, can usually get through it with the help of family and friends. They have learned that they are fundamentally okay, lovable and acceptable and that anything that happens is not because they’re innately bad or unworthy.

Tuesday, July 05, 2016

Here but not present

You might wonder what dissociation has to do with trauma. Both terms can seem scary and stigmatising until we learn what they mean and how many of us have experienced them (all of us?). One of the simplest definitions of trauma is ‘unexperienced experience’, by Irish psychiatrist Ivor Browne. What I really like about this definition, besides its simplicity, is it explains how trauma comes about.

It is dissociation, both psychological and somatic, which prevents an experience from being experienced, and consequently, integrated. Dissociation is a mental and physical process that results in a lack of connection and integration between thoughts, emotions, memories and our sense of identity.  We can experience a traumatic event and not develop trauma. Trauma only develops when we persistently dissociate. And while dissociation is a brilliant short term defence strategy for survival, long term, it can cause havoc with our mental and physical health.

Nijenhuis, E. R. S. and van der Hart, O. (2011). Dissociation in trauma: A new definition and comparison with previous formulations, Journal of Trauma & Dissociation 12(4): 416-445.

Sometimes we dissociate just before or during an upsetting experience (peritraumatic dissociation), but afterwards we find the resources; e.g. solid childhood foundation, supportive network of family and friends etc, to help us digest and move through the difficult experience. When we’re continually overwhelmed however, it can be very difficult to process painful experiences and this is particularly true of children. If a child suffers from continuous abuse and neglect and has no one to turn to on top of the abuse—what is termed betrayal trauma—they are very prone to dissociating because it really is the only relief they can find in horrible circumstances. A good example of this is author Carolyn Spring who developed Dissociative Identity Disorder (DID) after suffering horrific continuous ritual abuse during her childhood.

The degree to which we dissociate is the degree to which we have been hurt and that is subjective. Trauma cannot be defined objectively. Of course there are horrific experiences that some people go through, but when it comes to trauma, or more precisely showing the signs of being traumatised, comparisons are odious. All they do is minimise or maximise someone’s pain instead of taking each individual’s experience seriously.

Most people know that amnesia, derealisation and depersonalisation are examples of dissociative behaviour but did you know that flashbacks and intrusive emotions and sensations etc., are also dissociative behaviours? The former are termed negative symptoms as they denote a loss of some kind (hypoarousal) and the latter are called positive as they intermittently intrude on the self and other parts (hyperarousal).

We tend to think of dissociation as something that remains hidden, in the shadows, and therefore something to be feared. We also tend to think of it as a purely psychological or mental process, however, the freeze response (or tonic immobility) is an example of physical or somatic dissociation. It is the reason that rape victims often can’t move or call out for help. They are physically paralysed with fright and shock. This is often mistakenly perceived as being compliant, or not putting up a fight and as a result, many perpetrators are not bought to justice.

In Karla McLaren’s book, The Language of Emotions, she talks of panic and terror as being signs that we’re ready to move into phase three of trauma healing (the final phase). Could flashbacks and intrusions, that often go along with terror, be an attempt of the dissociated parts to integrate and to experience what hasn’t been fully experienced? is this why they're termed positive dissociative symptoms? I think knowledge is power and when we know what’s happening to us has a reason, it brings some relief, or even a lot of relief. I think unresolved trauma is one of the greatest health issues that we all face, as stress is responsible for over 80% of physical diseases.