15 Feb Trauma is everywhere. How to SPOT it in yourself and others, and how to FIX it
Navigating life's traumas through bad cancer and COVID-19
What is happening to me?
I am lying flat in the passenger seat of my car, being driven down La Cienega Blvd right after my latest radiation treatment. I am letting out primal screams as I am reliving the earlier moments in the machine. High-energy particle beams spinning around my body and shooting at me, while I am immobilized in a position that causes me excruciating pain. I cannot move. I am in agony but trapped in this contraption. My heart rate goes up. I break out in cold sweat. It is terrifying. And the terror repeats, day after day, same time, in a relentless pattern of planned prison torture, like having your nails pulled out, or your tongue snipped daily.
In a rare moment out of the mental fog, it occurs to me to question: What is happening to me? Why am I having this reaction? After all, it is not my first time in pain! But this is different. I feel like my entire body is in violent shock, is revolting against it. Why?
I ponder this question for a few days. What is happening to me? Until providence, doing what it does, throws the answer right in my lap, courtesy of my dear, dear friend, Maria Diaz. In the form of a book called: “The body keeps the score. Brain, mind, and body in the healing of trauma”, by Dr. Bessel Van Der Kolk, a world-renowned trauma researcher, with a celebrated career establishing trauma centers at Harvard and elsewhere.
A massively jumbled box of puzzle pieces
By the time I am through the book, It feels like I opened one of those 1000-piece puzzle boxes, shook the fragments of my life loose, and then tossed everything into the air. And when they landed on my floor, they formed the image perfectly, every piece in its place, and I can see the big picture of my life:
It turns out, what I experienced was a classic major traumatic event: Being in pain and prohibited from protecting myself.
It also becomes evident, that this is not my first. A number of previous traumas now take shape in my head – their time, place, and content for the first time circumscribed with dramatic clarity. I am amazed that I had never put it all together before. But I got answers now and they are important enough to share.
Let me explain.
The imprint of trauma is everywhere.
We have been led to believe that trauma is rare, it is this unusual phenomenon, isolated to war veterans and rape victims. Not by a long shot. Think of this:
- Have you ever felt unsafe, always on alert, hyper-vigilant? My therapist used to tell me that I was catastrophizing constantly, but to me, it did feel like catastrophe was just around every corner.
- Have you ever wondered why you were floating through life, without a good grasp of who you are? I remember confiding to a friend once that “I never had any anchors in my life”. You don’t feel connected to your body, or to your experiences. You move robotically.
- Do you feel numb emotionally? A long time ago, I was asked to come up with a list of emotions, and I couldn’t even name 10 of them.
- Is it hard to feel real affection for others? Do you wonder about people who show empathy for others? Or maybe you have too much empathy for others, but it does not occur to you to feel the same for yourself. I know this one well.
- Maybe life seems to not have a purpose, a driving force, everything seems rather pointless?
- Do you keep repeating the same patterns? Do you feel rigid in your mind, stuck in your pattern of living with no on-ramp to more joy? Are you finding it hard to let your imagination go and imagine a better future?
These feelings, it turns out are the imprint of trauma. It seems to be everywhere.
Trauma may be one-time, or the long drip, drip, drip, of constant powerlessness.
Yes, war crimes and sexual abuse. But also: Being ignored, neglected in your needs as a baby or child; being left hungry, dirty, and alone in your crib with no one to hear your cries or help you out of your pain; not allowed, or invited to express yourself, or to make your own choices – or being shut down when you do; feeling unseen; witnessing violence in your family and being unable to do anything about it; being sent away from home – to a distant aunt, or to boarding school – too early; abruptly losing someone you love deeply; feeling guilty for something you did and being unable to fix it; even being thrown into a pandemic with no control of your life (yes, traumatic!). The list is long. Trauma happens in families, maybe even entire cultures that stifle us. It can be caused by disaster, or by common, everyday helplessness.
At its core, trauma is caused by our loss of agency.
This is the practical definition of trauma: Being in a position of need, and unable to help yourself. Being immobilized, not allowed to act to defend yourself. Losing control of your life. Losing agency.
Trauma is life-changing because it reprograms the brain and the body.
Neuroscience has now developed a mountain of evidence through fMRI imaging, and it tells the story of exactly what happens. Oversimplified, it goes like this:
When we are put in a position of risk, we have three ways to respond – each corresponding to a part of the human brain. We first try the top, conscious, complex, social brain, and reach out to others, through our facial muscles and voice. If no one responds, we turn to the next level down: the limbic brain that manages our emotions: the sympathetic nervous system takes over, with massive amounts of stress hormones to prepare our body for fight or flight. If we can’t fight or flee, we get agitated, panicked, angry, and that can become a chronic condition of anxious living. But if we are trapped, and the intensity of the pain is intolerable, the last resort is the ancient, reptilian brain that manages our life support. It literally puts us on life support. We collapse and disengage. In this mode we lose ourselves. And I mean, we literally lose the neural connection between our brain, and our viscera, where all the senses of the body are communicated. See, the brain’s job is just to get us to survive, not to be happy. Really, this is a feature, not a bug!
Brain scans show that in this state, key parts of the brain that control our sense of self get disconnected!
These start at the medial prefrontal cortex, above our eyes, and run along the midline of our head towards the back. They hold our self-awareness. Fundamentally, we lose our connection with our body, we lose ourselves. We become phantoms to ourselves, and we see others as phantoms too. We disconnect and dissociate. We cannot engage emotionally, or fire our imagination, because our brain biology has now changed. Entire parts of it have gone offline.
As a result, we cannot integrate our experiences, learn from them, and build our life story, because what happened to us, how it felt in our body, and in our emotional brain, is not meaningfully recorded. The brain structures (e.g. insula) that combine events and experiences into a coherent story in memory, are not engaged, so we lose the narrative of our life and its direction and meaning. Traumatized people live in the past, not the present, because they can’t bridge these gaps in their history, and so keep repeating the same old patterns. Learning cannot happen without integration of new input.
Too often, we will try to fix the problem by attaching to someone who will let us practice our self-protection mechanisms again (and again) until we get to feeling safe again. We keep reenacting the previous trauma – abandonment, trust betrayal, terror – hoping to master the skills. That cannot work, because usually that person is attracted to us for similar reasons of needing to heal their own pain. We end up codependent.
Finally, the language expression area of the brain, Broca’s area, also goes offline. We have difficulty finding words to express our feelings. We become mute. Reading this, I suddenly remember being told that when I first went to school, I did not open my mouth to speak for a whole six months. Talk about trauma. So much makes sense to me now.
Trauma can be healed, and we are learning how.
And yet, as foreboding as this sounds, in this newfound knowledge, there is finally hope! Thanks to the plasticity of our brains (the ability to constantly rewire itself based on new experiences), trauma can be repaired. This is the good news:
Repair means rebuilding these connections between mind and body, our brain and our viscera. They can be reactivated in 2 overlapping, non-medicinal ways.
One, by working on the conscious mind. The key is to detect, name, and record our physical and emotional sensations– until it becomes automatic again for us to notice ourselves.
- Talking and writing help, because language expression mimics an action that was previously denied to us, and can dissipate trapped stress hormones.
- Meditation and yoga, of course, directly train the mind in body consciousness.
Second, we can reprogram the reptilian brain, by accessing the autonomic nervous system through movement, touch, and breathing. Many of the so-called alternative therapy techniques turn out to be the most effective methods of putting the Self back together:
- Emerging somatic therapy methods, like EMDR, Instant emotional release (both of which I have found dramatically effective, and much, much quicker than traditional talk therapy), Internal Family Systems Therapy and more.
- Any expressive, tactile, or rhythmic movement of the body – massage, dance, song, qigong, tai-chi, acupuncture, social games, free play, theater
- Combination techniques, like the Tomatis method, and others
As it turns out, my treatment experience was a classic pain-and-powerlessness-induced trauma. But my extreme response to this one was magnified by all my previous instances of being unable to escape the pain. Trauma compounds, unfortunately, because brain wiring intensifies the more an experience repeats. On the other hand, it can also heal, if trauma is followed by positive supportive experiences, that restore our capacity to recognize and honor our feelings, to successfully protect ourselves against suffocating or violent people or cultures.
And this is the most significant message to me. Trauma may be vastly more pervasive than we realize, and so many of us need to put the puzzle pieces of our life back together. But we now have the techniques to heal.