The ORDINARY RESPONSE TO ATROCITIES is to banish them from consciousness. Certain violations of the social compact are too terrible to utter aloud: this is the meaning of the word unspeakable. Atrocities, however, refuse to be buried. Equally as powerful as the desire to deny atrocities is the conviction that denial does not work. Folk wisdom is filled with ghosts who refuse to rest in their graves until their stories are told. Murder will out. Remembering and telling the truth about terrible events are prerequisites both for the restoration of the social order and for the healing of individual victims. The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma. People who have survived atrocities often tell their stories in a highly emotional, contradictory, and fragmented manner that undermines their credibility and thereby serves the twin imperatives of truth-telling and secrecy. When the truth is finally recognized, survivors can begin their recovery. But far too often secrecy prevails, and the story of the traumatic event surfaces not as a verbal narrative but as a symptom. The psychological distress symptoms of traumatized people simultaneously call attention to the existence of an unspeakable secret and deflect attention from it. This is most apparent in the way traumatized people alternate between feeling numb and reliving the event. The dialectic of trauma gives rise to complicated, sometimes uncanny alterations of consciousness, which George Orwell, one of the committed truth-tellers of our century, called "doublethink," and which mental health professionals, searching for calm, precise language, call "dissociation." It results in protean, dramatic, and often bizarre symptoms of hysteria which Freud recognized a century ago as disguised communications about sexual abuse in childhood. . . .
Even in times of trauma, we try to maintain a sense of normality until we no longer can. That, my friends, is called surviving. Not healing. We never become whole again ... we are survivors. If you are here today... you are a survivor. But those of us who have made it thru hell and are still standing? We bare a different name: warriors.
The blade sings to me. Faintly, so soft against my ears, its voice calms my worries and tells me that one touch will take it all away. It tells me that I just need to slide a long horizontal cut, and make a clean slice. It tells me the words that I have been begging to hear: this will make it ok.
In response to threat and injury, animals, including humans, execute biologically based, non-conscious action patterns that prepare them to meet the threat and defend themselves. The very structure of trauma, including activation, dissociation and freezing are based on the evolution of survival behaviors. When threatened or injured, all animals draw from a "library" of possible responses. We orient, dodge, duck, stiffen, brace, retract, fight, flee, freeze, collapse, etc. All of these coordinated responses are somatically based- they are things that the body does to protect and defend itself. It is when these orienting and defending responses are overwhelmed that we see trauma. The bodies of traumatized people portray "snapshots" of their unsuccessful attempts to defend themselves in the face of threat and injury. Trauma is a highly activated incomplete biological response to threat, frozen in time. For example, when we prepare to fight or to flee, muscles throughout our entire body are tensed in specific patterns of high energy readiness. When we are unable to complete the appropriate actions, we fail to discharge the tremendous energy generated by our survival preparations. This energy becomes fixed in specific patterns of neuromuscular readiness. The person then stays in a state of acute and then chronic arousal and dysfunction in the central nervous system. Traumatized people are not suffering from a disease in the normal sense of the word- they have become stuck in an aroused state. It is difficult if not impossible to function normally under these circumstances.
Some people's lives seem to flow in a narrative; mine had many stops and starts. That's what trauma does. It interrupts the plot. You can't process it because it doesn't fit with what came before or what comes afterwards.
Traumatic events, by definition, overwhelm our ability to cope. When the mind becomes flooded with emotion, a circuit breaker is thrown that allows us to survive the experience fairly intact, that is, without becoming psychotic or frying out one of the brain centers. The cost of this blown circuit is emotion frozen within the body. In other words, we often unconsciously stop feeling our trauma partway into it, like a movie that is still going after the sound has been turned off. We cannot heal until we move fully through that trauma, including all the feelings of the event.
Dissociation is the common response of children to repetitive, overwhelming trauma and holds the untenable knowledge out of awareness. The losses and the emotions engendered by the assaults on soul and body cannot, however be held indefinitely. In the absence of effective restorative experiences, the reactions to trauma will find expression. As the child gets older, he will turn the rage in upon himself or act it out on others, else it all will turn into madness.
we are threatened with suffering from three directions: from our body, which is doomed to decay..., from the external world which may rage against us with overwhelming and merciless force of destruction, and finally from our relations with other men... This last source is perhaps more painful to use than any other. (p77)
It is as though some old part of yourself wakes up in you, terrified, useless in the life you have, its skills and habits destructive but intact, and what is left of the present you, the person you have become, wilts and shrivels in sadness or despair: the person you have become is only a thin shell over this other, more electric and endangered self. The strongest, the least digested parts of your experience can rise up and put you back where you were when they occurred; all the rest of you stands back and weeps.
Combat and rape, the public and private forms of organized social violence, are primarily experiences of adolescent and early adult life. The United States Army enlists young men at seventeen; the average age of the Vietnam combat soldier was nineteen. In many other countries boys are conscripted for military service while barely in their teens. Similarly, the period of highest risk for rape is in late adolescence. Half of all victims are aged twenty or younger at the time they are raped; three-quarters are between the ages of thirteen and twenty-six. The period of greatest psychological vulnerability is also in reality the period of greatest traumatic exposure, for both young men and young women. Rape and combat might thus be considered complementary social rites of initiation into the coercive violence at the foundation of adult society. They are the paradigmatic forms of trauma for women and men.
Here, from her ashes you lay. A broken girl so lost in despondency that you know that even if she does find her way out of this labyrinth in hell, that she will never see, feel, taste, or touch life the same again.
Unlike simple stress, trauma changes your view of your life and yourself. It shatters your most basic assumptions about yourself and your world — Life is good, I’m safe, People are kind, I can trust others, The future is likely to be good — and replaces them with feelings like The world is dangerous, I can’t win, I can’t trust other people, or There’s no hope.
Fear and anxiety affect decision making in the direction of more caution and risk aversion... Traumatized individuals pay more attention to cues of threat than other experiences, and they interpret ambiguous stimuli and situations as threatening (Eyesenck, 1992), leading to more fear-driven decisions. In people with a dissociative disorder, certain parts are compelled to focus on the perception of danger. Living in trauma-time, these dissociative parts immediately perceive the present as being "just like" the past and "emergency" emotions such as fear, rage, or terror are immediately evoked, which compel impulsive decisions to engage in defensive behaviors (freeze, flight, fight, or collapse). When parts of you are triggered, more rational and grounded parts may be overwhelmed and unable to make effective decisions.
Changes in Relationship with others: It is especially hard to trust other people if you have been repeatedly abused, abandoned or betrayed as a child. Mistrust makes it very difficult to make friends, and to be able to distinguish between good and bad intentions in other people. Some parts do not seem to trust anyone, while other parts may be so vulnerable and needy that they do not pay attention to clues that perhaps a person is not trustworthy. Some parts like to be close to others or feel a desperate need to be close and taken care of, while other parts fear being close or actively dislike people. Some parts are afraid of being in relationships while others are afraid of being rejected or criticized. This naturally sets up major internal as well as relational conflicts.
The inability to get something out of your head is a signal that shouts, Don’t forget to deal with this! As long as you experience fear or pain with a memory or flashback, there is a lie attached that needs to be confronted. In each healing step, there is a truth to be gathered and a lie to discard.
Even in times of trauma, we try to maintain a sense of normality until we no longer can. That, my friends, is called surviving. Not healing. We never become whole again ... we are survivors. If you are here today... you are a survivor. But those of us who have made it through hell and are still standing? We bare a different name: warriors.
So, what role does memory play in the understanding and treatment of trauma? There is a form of implicit memory that is profoundly unconscious and forms the basis for the imprint trauma leaves on the body/mind. The type of memory utilized in learning most physical activities (walking, riding a bike, skiing, etc.) is a form of implicit memory called procedural memory. Procedural or "body memories" are learned sequences of coordinated "motor acts" chained together into meaningful actions. You may not remember explicitly how and when you learned them, but, at the appropriate moment, they are (implicitly) "recalled" and mobilized (acted out) simultaneously. These memories (action patterns) are formed and orchestrated largely by involuntary structures in the cerebellum and basal ganglia. When a person is exposed to overwhelming stress, threat or injury, they develop a procedural memory. Trauma occurs when these implicit procedures are not neutralized. The failure to restore homeostasis is at the basis for the maladaptive and debilitating symptoms of trauma.
As a civilian, I know nothing about combat, the Marine Corps experience or modern man's struggle adjusting to peace after war. I only know what's been shared with me; confidences I would never betray, nor use as details in a novel.
This book is a memoir - not of specific life events, but of the processes of dissociation, and of re-enlivening emotions that are shameful to admit or even to feel. It is an account of the altered states that trauma induces, which make it possible to survive a life-threatening event but impair the capacity to feel fear, and worse still, impair the ability to love. (292)
The power we discover inside ourselves as we survive a life-threatening experience can be utilized equally well outside of crisis, too. I am, in every moment, capable of mustering the strength to survive again—or of tapping that strength in other good, productive, healthy ways.
Somatic Symptoms: People with Complex PTSD often have medical unexplained physical symptoms such as abdominal pains, headaches, joint and muscle pain, stomach problems, and elimination problems. These people are sometimes most unfortunately mislabeled as hypochondriacs or as exaggerating their physical problems. But these problems are real, even though they may not be related to a specific physical diagnosis. Some dissociative parts are stuck in the past experiences that involved pain may intrude such that a person experiences unexplained pain or other physical symptoms. And more generally, chronic stress affects the body in all kinds of ways, just as it does the mind. In fact, the mind and body cannot be separated. Unfortunately, the connection between current physical symptoms and past traumatizing events is not always so clear to either the individual or the physician, at least for a while. At the same time we know that people who have suffered from serious medical, problems. It is therefore very important that you have physical problems checked out, to make sure you do not have a problem from which you need medical help.
The brave men and women, who serve their country and as a result, live constantly with the war inside them, exist in a world of chaos. But the turmoil they experience isn’t who they are; the PTSD invades their minds and bodies.
Alterations in regulation of affect (emotion) and impulse: Almost all people who are seriously traumatized have problems in tolerating and regulating their emotions and surges or impulses. However, those with complex PTSD and dissociative disorders tend to have more difficulties than those with PTSD because disruptions in early development have inhibited their ability to regulate themselves. The fact that you have a dissociative organization of your personality makes you highly vulnerable to rapid and unexpected changes in emotions and sudden impulses. Various parts of the personality intrude on each other either through passive influence or switching when your under stress, resulting in dysregulation. Merely having an emotion, such as anger, may evoke other parts of you to feel fear or shame, and to engage in impulsive behaviors to stop avoid the feelings.
We are Craiglockhart's success stories. Look at us. We don't remember, we don't feel, we don't think - at least beyond the confines of what's needed to do the job. By any proper civilized standard (but what does that mean now?) we are objects of horror. But our nerves are completely steady. And we are still alive.
Complex PTSD consists of of six symptom clusters, which also have been described in terms of dissociation of personality. Of course, people who receive this diagnosis often also suffer from other problems as well, and as noted earlier, diagnostic categories may overlap significantly. The symptom clusters are as follows: Alterations in Regulation of Affect ( Emotion ) and Impulses Changes in Relationship with others Somatic Symptoms Changes in Meaning Changes in the perception of Self Changes in Attention and Consciousness
Changes in Meaning: Finally, chronically traumatized people lose faith that good things can happen and people can be kind and trustworthy. They feel hopeless, often believing that the future will be as bad as the past, or that they will not live long enough to experience a good future. People who have a dissociative disorder may have different meanings in various dissociative parts. Some parts may be relatively balanced in their worldview, others may be despairing, believing the world to be a completely negative, dangerous place, while other parts might maintain an unrealistic optimistic outlook on life
One of the paradoxical and transformative aspects of implicit traumatic memory is that once it is accessed in a resourced way (through the felt sense), it, by its very nature, changes. Out of the shattered fragments of her deeply injured psyche, Jody discovered and nurtured a nascent, emergent self. From the ashes of the frantically activated, hypervigilant, frozen, traumatized girl of twenty-five years ago, Jody began to reorient to a new, less threatening world. Gradually she shaped into a more fluid, resilient, woman, coming to terms with the felt capacity to fiercely defend herself when necessary, and to surrender in quiet ecstasy.
Survivors are damaged to different degrees by their experiences. This does not depend on what happened physically. A Survivor who has been raped will not necessarily be more damaged than a Survivor who has been touched. The degree of damage depend on the degree of traumatic sexualization, stigmatization, betrayal and powerlessness, the child has experienced. This in turn depends on a number of factors such as: * who the abuser was; * how many abusers were involved; * if the abuser was same-sex or opposite sex; * what took place; * what was said; * how long the abuse went on for; * How the child felt and how she interpreted what was happening; * if the child was otherwise happy and supported; * how other people reacted to the disclosure or discovery of the abuse; * how old the child was