How Do Counselors Define Trauma? The Answer May Surprise You
Each heart know its own bitterness, who can share its joy. – Proverbs 14:10
In counseling people for the past 22 years, I have never ceased to be amazed at hearing a client’s tragic story only to be accompanied by the phrase, “Other people have had much worse happen to them.”
In other words, my story is not really worth the time and attention of being heard and supported because somewhere out there, someone else has had it worse. The above proverb tells a different truth, “Your story is the worst because it happened to you.”
Trauma can be defined as a deeply distressing or disturbing emotional experience which may be associated with physical shock (dictionary.com). It translates literally from a Greek meaning “wound.”
Why do some people endure traumatic experiences and show no long-term effects while others seem to never recover?
This article will consider some emotional and spiritual considerations related to healing from trauma, as well as how to define trauma.
After the Vietnam war, the diagnostic label “Post Traumatic Stress Syndrome” (PTSD) was identified by mental health professionals in this country. Prior wars had terms like “battle fatigue,” but there was something different about Vietnam where this syndrome was identified.
When I studied the effects of violent rape in graduate school, my professor taught that people who had endured a single sexual assault trauma who had at least a single relationship for support tended to heal without symptoms within a year of an attack.
People without support not only tended to not heal but became vulnerable to more assaults than the average person. I have wondered if this aspect of surviving a rape related to the Vietnam soldiers’ experience coming back from war. They had endured traumatic experiences, but unlike other wars came home to a country who was largely unsupportive of their efforts. In other words, they got no societal support.
Some of the symptoms that accompany PTSD include flashbacks of the trauma through triggers, emotional numbness, and increased emotional arousal. These symptoms suggest that when a healing process does not occur, an aspect of the person remains bound to the traumatic event and its consequences. For some, the foundation of their personality is bound up in trauma.
In her seminal book, “Cognitive Behavioral Treatment of Borderline Personality Disorder (BPD),” Marsha Linehan theorizes that BPD might be better named “Traumatic Stress Syndrome.” Linehan’s research found that people with BPD tended to grow up in traumatizing environments where they were emotionally invalidated and prevented from grieving.
The result is the foundation of the BPD personality wired for emotional reactivity and behavioral extremes. Looking at trauma in these debilitating conditions can teach us a lot about the importance of healing from trauma in the many ways it shows up in life.
In my experience, when a person undergoes traumatic experience(s) and does not get the support they need at the time, they must later embrace four areas of healing to overcome the enduring symptoms that result. People move through healing at different paces and have different challenges.
For example, individuals who experience multiple traumas when they are very young with no support may heal in successive stages over a time frame that they can handle (rather than all at once). When it comes to trauma, time does not heal all things.
The healing process must be engaged in several different areas for freedom to occur. These distinct areas are embracing truth, abreaction, modifying the belief system, and learning new relational skills. Below I will try to paint a picture of what moving through each stage looks like and some of the challenges that exist for each.
Embracing truth as it relates to trauma is difficult for several reasons. Firstly, children are egocentric and dependent on their adult environment to make sense of their experiences. Due to the limited ability to think abstractly, a child tends to think of things in black and white terms.
When it comes to trauma and a lack of support, children are often vulnerable to personalizing the cause of the trauma as being “their fault”. Sometimes that means that an adult has told them as much or perhaps the vacuum of explanation causes a child to make their own meaning with a child’s understanding.
For example, an 8-year-old child smelling alcohol on their parent’s breath before a car accident killing their sibling may later tell themselves, “That wouldn’t have happened if I said something.” They are using an adult perspective to manage an out-of-control experience and absorbing the blame inappropriately.
Not only is that not an accurate assessment of the cause of the accident, but they are also giving adult powers and responsibilities to a child. Thus, the untruth leaves the person feeling responsible for something they had no control over.
Denial and repression are common psychological defenses people use to mitigate feeling overwhelmed and shocked by trauma. Magical thinking seems like an irrational response to trauma until one understands how effective it is in shutting down overwhelming feelings and grief. Having a fantasy of control over a traumatic situation can relieve tension in the short term.
In the above example, the adult who “didn’t stop” their drunken parent from driving at 8 years old may blame themselves into adulthood, but they effectively keep themselves from feeling the soul burning feelings of grief and powerlessness in losing their sibling and almost dying.
Another example that comes to mind is that of a client who, when asked about her rape, told me “I am mad that I was so weak that I let it affect me.” This client was angry at her own vulnerability. The problem was that because of this belief she was now unable to solve problems where vulnerability was actually needed.
We had to slowly trace problems in her present life that this belief was blocking solutions. She was mad at her roommate but was afraid to tell her. Her symptoms were not being able to drive on the freeway without having a fear of swerving out of control. She would add 3 hours to her commute every night to drive side streets home until she could accept the truth of her story and give herself permission to be vulnerable
Helping people reconstruct their story as it was (not how they wish it was) must be done carefully. Behind the false narratives are floods of grief, anger and other emotions that person does not feel like they can handle. In fact, sometimes the story is too traumatic unfolding it too quickly can overwhelm the person. I have seen people become psychotic from facing their truth too quickly without sufficient time and preparation.
Abreaction is a psychoanalytical term used to describe the expression and release of previously repressed emotion. The human brain house structures that transmit and process a person’s response to an emotion evoking event. Those emotions then orient a person on how to cope with a particular situation. Feelings associated with memories are stored in the brain, with similar feeling events being stored together, so when like events occur the person knows how to deal with them.
When it comes to repressing emotions associated with a traumatic event, the person never processed them, and as a result, they don’t have an adaptive way of coping with new events that evoke similar feelings. The failure to process their emotions, in effect, keeps them stuck in trauma. When a person undergoes trauma accompanying the injury (physical, emotional, spiritual) the person suffers loss.
Different traumas create different kinds of loss. For example, sexual abuse may create a loss of trust. A near death experience may injure the need for safety. Emotionally critical or disengaged parents may injure a child’s sense of worth. All of these traumas must be mourned in order for the person to move through the injury toward restoration.
I am not sure why God has ordained grief as a process that human beings must go through. Books in the Bible like Lamentations, Job and Psalms all illustrate people (or whole nations) grieving losses in the hope of restoration. Maybe God sets it up that way so we won’t hold on to anything in this world too tightly in place of him, but I am not certain on this point.
From a counseling standpoint, I have observed parts of a person’s relational self become frozen until they tap into the emotional energy of unprocessed grief. Grief, in my mind, is like the fiber of our emotional diet. Without it, we don’t move through traumas.
In counseling, there are relational aids that assist in unblocking grief. Postive regard and maintaining the attitude that “this person handled this situation better that I would” help me reflect respect for their strength in enduring the trauma. Not being quick to present a “silver lining” way of looking at when a person starts to share their sadness is another important behavior in facilitating grief.
Being with a person in grief is more of a mindset than a behavior. Try to sit with a person who is grieving and strive to feel what they feel. This is the most difficult part of assisting with trauma because we end up absorbing some of the person’s pain.
There are dozens of therapies and tools that can aid in healing trauma. As long as they facilitate a safe, supportive expression of grief, the person will have the opportunity to heal. Moving through grief leads to the next stage where the person can learn to adopt new beliefs and new ways of coping with previously injured parts of themselves.
New Beliefs/New Skills
Once a trauma survivor can embrace truth and mourn their losses, they are ready for new beliefs and skills. Professional counseling has numerous therapy approaches that support ways of modifying maladaptive beliefs and learning new ways of doing things.
For example, a Psychoanalytic way of looking at a childhood wound might be asking the person to look at a picture of themselves as a child and ask “what do you think he/she needed at the time the abuse occurred that they didn’t get?”
Similarly, a Cognitive Behavioral approach might ask the therapy client, “How might a person that deserves to be valued a protected react in this situation?”
The important thing in therapy is that the trauma survivor has the opportunity to learn new adaptive ways of viewing themselves and learn new coping skills to heal. Depending on the nature, length and available support, how quickly trauma is dealt with must be considered.
Too much too soon can leave a person overwhelmed and cause other problems. My recommendation to therapy seekers is to do research on a prospective therapist to ensure they have the training and experience to help.
From a Christian perspective, I think this is the best time for a person to embrace God’s promises and Gospel teachings. The Bible is full of passages that direct a person how to think about themselves, how to handle situations, and how to adapt to difficult times. Getting help from a therapist who supports Christian beliefs can be key in bringing spirituality into the healing process.
In my experience, trauma survivors often want to skip to his stage of healing while neglecting the other two. This is understandable, because who wants to revisit their worst memories and feelings associated with them? The work of healing can be long and painful, with the need to take many breaks as the mountain of healing is climbed.
Healing cannot be rushed and it is important to take time to reflect on progress made along the way. Having a guide along for the journey in the form of a therapist can make a big difference.
The goal is to embrace the journey with the understanding that we will get significant healing and restoration in this life, but ultimate healing only in the life to come. There is no heaven on earth and our task is to strive for ultimate restoration in God’s salvation plan.
“Grief”, Courtesy of Luis Galvez, Unsplash.com, CC0 License; “Tears”, Courtesy of Kat J, Unsplash.com, CC0 License; “Sunken Tree”, Courtesy of Michael Held, Unsplash.com, CC0 License; “No Trespassing”, Courtesy of Isaac Quick, Unsplash.com, CC0 License