Human responses to trauma, the symptoms, the diagnosis, the neuroscience, the varied treatments and the possibility of chronic mental ill health if treatment is not effective, make working with trauma daunting to the young practitioner. The more we complexify it, the more family, friends, communities and workplaces step back from ordinary human healing connection and defer to experts.
I like to emphasise human resilience, and come from the belief that human beings are actually pretty good at healing, if we keep it simple and ordinary and link it to an established process. Sir William Osler said “I suture the wound, but God heals it” (whatever your God may be)
We get good at trusting that if we cut ourselves or break a bone it will heal, but in our culture we are not so good at learning to trust that our emotional wounds will also heal. If you break your leg, you put a plaster on and it heals, but we aren’t so good at knowing what the plaster is for an emotional wound, and tend to let these wounds get poked, adding to the pain and slowing the healing.
I like to tell clients who have suffered trauma that people get over trauma the way a woman gets over childbirth. The experience is often pretty intense and commonly medicalised and a bit frightening. But then theres a baby to distract you from your own experience and then there are visitors with joyful smiles who want to listen to you share your experience, so you get to retell it in a different emotion, and lay it down again in your memory with a softer, safer emotion. And you retell it many times to many visitors until the emotion becomes bland. By the time the baby is about 6 weeks old you start to think, “That wasn’t so bad, I could definitely do that again.”
Some years ago I was in the immediate vicinity in the moments following an armed robbery. The shop senior was assaulted and I was presented with her immediately following the event. She was in a state of distress, almost howling in a possessed way. The person with her was noticeably distressed at her distress.
I just sat with her…I think I asked a question and cracked a joke about our small town, how that kind of thing doesn’t happen here. She stopped wailing and looked curiously at my calm demeanour and began to speak of what had happened. She kept saying she felt like such a twit. She was the senior and SHE fell apart, everyone else was fine. I pointed out that they were fine because she was dealing with it so they didn’t need to. She kept saying she felt like such a twit. She was OK as it was happening, gave him the money after being shoved around, and then when he left she fell apart. I said… “you see that in war…the captain gets blown up by a mine, goes on to secure the situation, make sure everyone that he is responsible for is ok, and then looks down to discover his leg’s been blown off.” She looked at me in a certain steady way, there was a moment of silence as she was making connections, and then she said… “I’ve got to get back”, and spoke about the shop junior, implying her responsibilities.
I reminded her how it can feel to be jetlagged. You arrive somewhere and it’s as if your experience has to catch up with you. All the emotional responses that were appropriate during the robbery were put on hold and then happened all at once afterwards. I presupposed she’d now caught up with herself. I mentioned the thing she did in not taking him seriously at first resulting in getting pushed around as an opportunity to learn, but she stopped me and said that it seemed like minutes but was probably only seconds, she thought he was joking and laughed at him, he shoved her, and then she reacted appropriately. She was convincing me!
Then she started saying “what a twit” a few times and I realised she wasn’t speaking about herself anymore so I said “him?”…and she said “Yes!!” and ranted about what an idiot he was, how he wasn’t even wearing a balaclava. She said with certainty that she would recognise him again, that she knew what he looked like. Then she said again that she had to get back. The whole conversation had taken little more than five minutes. She stood up confidently and said to me…I feel like hugging you…who are you again? I laughed and told her my name, and felt very sure she’d recognise me again!
She dropped back an hour and a half later to tell everyone they were back in business and the police had left. She looked very much back in the driver’s seat of her experience.
The next morning I was told by someone who had checked on her that she was teary, and hadn’t slept the previous night. They were worried and thought I should know. It seemed important not to respond straight away, so I worked until lunchtime and went down to discover a very calm, confident woman, who had told the story to dozens of customers who had heard and wanted to find out what had happened. She told me she hadn’t slept. I said I would be worried if she had. That I didn’t know any normal human beings who would have slept well after such a day. I said I expected her to sleep poorly again, and maybe even for a few more nights, perhaps as many as 5 nights, but by the 6th night I expected her to be sleeping more normally. She agreed and said that after a few hours she had decided to watch a movie, and then she got a little sleep. I congratulated her and revised my estimate of her sleeplessness to 3 or 4 nights. She went on to tell me the “twit of a man” went on to the next suburb and did the same thing there. That shop assistant was sent home and wasn’t doing too well. She told me with authority how wrong it was that she was sent home. And talked in detail as if to teach me the appropriate management of such a person! I then made the observation to her that she had a lot to offer in assisting everyone else involved.
Dissociation is a very normal and very human response to a traumatic event and allows us to function in that event. In reflecting on what is useful in reconnecting an individual, either immediately or years later, it seems a process of associating them, and focussing them, while allowing the emotion to settle, or by attaching a more useful emotion or body experience to the traumatic event.
I have also noticed that people with no training often respond very usefully to someone in distress. The people who put their own responses aside are usually humanly helpful. I remember a story of a small boy who was saved from near drowning by his 8 year old brother who had a vague idea of CPR. Some acronyms are useful. I wonder if mind body resuscitation (MBR) might bring a more useful focus to trauma management, and help to redress the fear and paralysis that “PTSD” brings.
It can be so simply satisfying to observe and be part of another’s reconnecting. I would say that MBR involves;
D-Disconnecting from your own upset in order to be useful to the other.
S-Sitting with and being present and allowing the other to be present.
M-Marrying the emotional response to the events and allowing them to settle.
4-forgetting unhelpful acronyms.