When is it trauma?
So many of us have brushed aside the notion of being traumatized because our self-image, our self-talk, our reliable defensive stance in life don’t allow us to reflect inside. “It was my fault. I shouldn’t have been dressed that way. Maybe then they wouldn’t have followed me outta that bar and beaten me up…” is what I heard one new client referred by the Victim Witness Assistance Program tell me when speaking about their most recent hate crime.
My client didn’t consider themself a victim, and they were proud of that. I respected their personal experience of the beating, and I knew their take on it was protective for them. My understanding of their beating (which I didn’t share with them at intake) was that they had likely dissociated from the vulnerable feelings and sensations that were a part of the beating in that dark parking lot. While this client presented a more obvious story of trauma that therapy could, and would resolve, other traumas are less obvious…yet just as devastating to the mind-body psyche.
Interestingly, conscious awareness at the time of traumatic experience is not a prerequisite for people to [subconsciously] register experience as traumatic. At clinical intake, the psychotherapist may hear, “My childhood? Mine was just great. Wonderful parents! Funny thing though…I don’t remember anything specific about it now that you ask.” Only many sessions later may the therapist begin to discover the client’s abusive/neglectful childhood if there is one. This kind of dissociative process happens automatically as a built-in survival mechanism attendant to the human condition. Why? -----because we are built to cordon off that which we cannot metabolize consciously. And kids are especially susceptible to dissociating when life gets to be too taxing for their burgeoning personal psychology in the midst of abuse and/or repeated experiences of emotional neglect.
My client who had been beaten up did not begin to consciously register their trauma until they sensed it was safe enough with me to explore this possibility within a paced, therapeutically shared internal journey. Resolution of trauma came quite slowly. After careful clinical interviewing, it became apparent to me that this client had Dissociative Identity Disorder (DID), and we worked through a serious history of early trauma extending up to the present at age 21 years. Their trauma healing process took a handful of years altogether in therapy with me.
When does the trauma response cease to be triggered?
Skilled therapeutic intervention is key to resolving trauma, and fortunately there is not just one method or modality to accomplish resolution of traumatic experiences! At the heart of mental/emotional trauma resolution is therapeutic memory reconsolidation as articulated by Bruce Ecker’s (2018) methodology literature review. Healed trauma cannot be re-triggered. It’s permanently gone. Erasure of memory’s traumatic aspects connected to the declarative (aka, factual) and episodic recall is complete. This is fantastic news!
At present, there are ten different therapy modalities that have the backing of published scientific research explaining therapeutic memory reconsolidation. Check the list out here. These distinct therapies provide a framework for established best practices in the field of trauma psychology. The International Society for the Study of Trauma and Dissociation (ISST-D) has treatment guidelines for adults which can be found here, and for child treatment of trauma, the guidelines can be viewed here. Working within these guidelines leaves ample room for applying the various treatment modalities alluded to above. FYI, please look them up!
To be frank with you, in my early years of treating Complex PTSD and DID, I hardly knew how to recognize what the heart of the matter was with these clients! I definitely contributed to the well-known statistic of DID clients being in therapy for an average of seven years before being given an accurate diagnosis of DID. Fortunately, I found ISST-D via one of my mentors, and my confidence in working with traumatized clients has blossomed over the years. I now utilize the treatment modality of EMDR as a framework with nearly all of my clients, and it requires a specialized, advanced application with traumatized persons. If you are a client needing trauma-informed care, or if you are a psychotherapist treating trauma, aren’t we so fortunate as seekers and deliverers of therapy at the current time when trauma truly can be healed! Please share this blog with anyone you know who may benefit.
Ecker, B. (2018). Clinical translation of memory reconsolidation research: Therapeutic methodology for transformational change by erasing implicit emotional learnings driving symptom production. International Journal of Neuropsychotherapy, 6(1), 1–92. doi: 10.12744/ijnpt.2018.0001-0092