PLEASE NOTE: normally I encourage you to dip in and out of this blog. On this page there are a number of links to other parts of my blog. Please follow each link (and others!) if you are researching helpful treatment for trauma-related symptoms.
You are taking an important step and I want to use my own influence to ensure this research is done with great care. The findings of researchers and practitioners I mention on this page are well worth consulting.
Elvin Semrad was Bessel van der Kolk’s mentor as he trained in psychiatry in the States. In his book, The Body Keeps The Score (2014), van der Kolk quotes his mentor saying:
“The greatest sources of our suffering are the lies we tell ourselves“, going on to say that people never get better without knowing what they know and feel what they feel. The Body Scan is a safe experiment to help me explore what I know and feel what I feel.
To explain more, Semrad’s reference to “lies” was not a criticism of his patients. He was referring to specific post-trauma responses; to an apparent paradox in trauma work. Some people who experienced trauma were able to initiate strong emotions and, in turn, those reactions appear to block other feelings – the pain connected to the event at the time, or shortly after.
It’s as though there is value, for some, in reproducing strong emotions. Blocking our pain that way can become the lesser of two evils. The theory was that the recall of events – and the associated strong emotions – released morphine-like substances manufactured in the brain. These provided some relief and become a ‘preferred’ strategy.
Therapy is helpful in finding alternative strategies to uncontrolled ‘revisiting’ of trauma. That is particularly so where the blocked ‘pain’ is more psychological, e.g. when deep shame and guilt lie behind our survival after any trauma.
An example from van der Kolk’s text might help. Dogs knowingly traumatised in experiments by Martin Seligman (and others) failed to escape from their cages when the doors were opened. It emerged that those dogs secreted excess amounts of stress hormones, such as adrenaline and cortisol, long after the danger had passed. This kept them ‘frozen’ in their cages and oblivious to the available escape route.
What we now know is that the body thrives only on release of short bursts of those morphine-like hormones when the threat is present. The longer term damage created by persistent release of them is not good for our health – a series of rather large defeats can be easily overlooked. The logic is that the response worked in the short term, so that’s OK. In fact, the level of hormones needs to lessen steadily after any event if our system is to return to equilibrium.
In time, it was possible to show that one indicator of trauma is the persistent retention of stress hormones. Later it emerged that one way to achieve change – to dissipate those hormones – was to act. To break the immobility show by Seligman’s dogs, required drastic action: to “repeatedly drag them [the dogs] out of their cages so they could physically experience how they could get away“. A good therapist will not do this …. but s/he can direct your efforts to the relevant safe experiments.
The value of ‘safe experiments’ encouraged by therapists has emerged from decades-old observations. It pays to act, to get out, and to do something. Even so, I still repeat the need to design experiments with professional support as action is not all.
Another reason for using professional support is that safe experiments cannot be guaranteed to produce small victories. Indeed, treating trauma by small safe experiments may – unintentionally, or not – generate potentially large defeats. These defeats will arise because we take unskilled actions when we try something different. How long did it take you to ride a two wheel bike?
So, there is much about treatment for trauma that is not common-sense. Professional support can help identify and articulate those “lies” we might tell ourselves. That does not mean you need the best qualified, ‘top’ doctor. You need some-one who can give you confidence that you will find a way to do something a bit different. That said, suitably qualified people, with additional training in trauma management should be recruited. Please research carefully when choosing some-one to work with.
For my part, I begin to negotiate an end to therapy as and when it is evident that the other person has ‘got’ the insight into their pain and can give voice to it. Therapy can move towards closure once the significance of any pain is appreciated, and a ‘proper’ place is found for it in our body and in our matrix memory.
Looking pain in the eye is particularly difficult when we feel guilt and shame.