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"Understanding Trauma" V ~ How We Reenact Trauma

4/9/2014

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This is Part V and final part of a series to help survivors and loved ones better understand how the body and mind react to traumatic events.  If interested, it is better to start with Part I.  
  
These magical substances called endorphins are a part of normal, everyday functioning, but they are especially important during times of stress. If  we
look at evolution, this makes sense. Not only do endorphins calm anxieties, improve our mood, and decrease aggression, but they also are great 
analgesics since they are related to morphine and heroin. Therefore, in times of stress, they provide pain relief so they are not disabled by injuries that would prevent us from escaping the danger.  If people are only exposed to rare episodes of overwhelming stress, then they are less likely to show alterations in this biochemical system. Far more problematic are the people exposed to repeated experiences prolonged stress. These people, often children, are exposed to repeatedly high levels circulating endorphins.  One hypothesis is that people can become “addicted” to their own internal endorphins.  As a result, they only feel calm when they are under stress and feel fearful, irritable and hyper-aroused when the stress is relieved.  This is much like someone who is withdrawing from heroin and has been called “addiction to trauma.” 
 
If this cycle is in place, then it helps us to understand many of the perplexing symptoms that have been incomprehensible without this information. Stress‐addicted children will be those children in the classroom who cannot tolerate a calm atmosphere but must keep antagonizing everyone else until the stress level is high enough for them to achieve some degree of internal equilibrium. 
Violence is exciting and stressful and repeated violent acting‐out, gang
 behavior, fighting, bullying, and many forms of criminal activity  have the additional side effect of producing high levels of stress in people who have grown addicted to such risk‐ taking behavior.

This also helps to explain self‐mutilation in its many forms ‐ these children and adults have learned that inflicting harm on the body will induce the release of endorphins that will provide some comfort, at least temporarily. These are children, who as adults, are unable to trust or be comforted by other people ‐ in fact other people have been the fundamental source of the stress.  Instead, they must fall back on whatever resources they can muster within themselves, resources that they can control, to achieve any kind of equilibrium. 
 
 As adults, under stress, people who have been brutalized as children may
again resort to behaviors that help induce some kind of alteration in
the opioid system.  These behaviors can include self‐mutilation, risk taking behavior, compulsive sexuality, involvement in violent activity, bingeing and purging, and of course, drug addiction. 
 
 This recognition of  the importance of addiction to trauma implies that
intervention strategies must focus on helping people to “detox” from this
 behavioral form of addiction by providing environments that insist on the
 establishment and maintenance of safety. Physiological stability cannot be achieved as long as the person is on an emotional roller coaster of stimulus and response. 
 
 Even more ominous for repeatedly traumatized people is their pronounced
tendency to use highly abnormal and dangerous relationships as their
normative idea of what relationships are supposed to be. Trauma bonding is a relationship based on terror and the twisting of normal  attachment behavior into something perverse and cruel.

People who are terrorized, whether as adult victims of torture, or domestic violence or child victims of family abuse, experience their abuser as being in total control of life and death. The perpetrator is the source of the pain and terror, but he/she is also the source of relief from that pain. He/she is the source of threat but he/she is also the source of hope.  Jayce Dugard and Elizabeth Smart are prime examples of this.
 
This means that people who have been traumatized need to learn to create
 relationships that are not based on terror and the abuse of power, even though abusive power feels normal and right. In such cases, people often
need direct relationship coaching and the direct experience of engaging in
relationships that are not abusive and do not permit abusive and punitive
behavior. 
 
It has long been recognized that “history repeats itself,” but never before have we so clearly understood why history does so. People who have been 
traumatized cannot heal themselves alone. It is one of the tragedies of human existence.   That which begins as life‐saving coping skills, ends up delivering us into the hands of compulsive repetition.  We are destined to reenact what we cannot remember.  Freud called it the repetition compulsion and he said, “He reproduces it not as a memory but as an action; he repeats it,
without, of  course, knowing that he is repeating... He cannot escape from this compulsion to repeat; and in the end we understand that this is his way of remembering.”  
 
It has become clear that the very nature of traumatic information
processing determines the reenactment behavior. We must assume that as human beings, we are meant to function at our maximum level of integration and that any barrier to this integration will produce some innate compensatory mechanism that allows us to overcome it. Splitting traumatic memories and feelings off into nonverbal images and sensations is life‐saving in the short‐term, but prevents full integration in the long‐term.  
  
Based on what we know about the split between verbal and nonverbal thought, the most useful way of understanding traumatic reenactment may be through the language of drama. Shakespeare told us that the whole world is our stage, and with behavioral reenactments we see this in  action.
We reenact our past everywhere – at home, at school, at the workplace, 
on the playground, in the streets. We cue each other to play roles in our own 
personal dramas, secretly hoping that someone will give us a different script, a different outcome to the drama, depending on how damaging our experiences have been. The cure is in the disease. 
 
The only way that the nonverbal brain can “speak” is through behavior, since
it has no words. If we look at reenactment behavior we can see that traumatized people are trying to repeatedly “tell their story” in very overt, or highly disguised ways. If only we could still interpret nonverbal messages, perhaps we could respond more adequately to this “call for help.” For healing to occur, we must give words and meaning to our overwhelming experiences. In “Macbeth,” Shakespeare urges us to “Give sorrow words; the grief that does not speak whispers the o’er fraught heart and bids it break.” But we cannot find the words by ourselves.  That is the whole point ‐ the traumatized person is cut off from language,  deprived of the power of words, trapped in "speechless terror."  
 
We need the help, the words, the signals, of caring others, but to get their 
 attention we must  find some way to signal them about our distress in a 
 language that has no words. This is the language of behavior, the language of 
 the mime, of the stage. It is the language of symptoms, of pathology, of deviant behavior in all its forms. Unfortunately, we have largely lost the capacity for nonverbal interpretation, and so most of these “cries for help” fall on deaf ears. 
 
Instead, we judge, condemn, exclude and alienate the person who is behaving in an asocial, self‐destructive, or antisocial way without hearing the meaning in the message. To counter these long standing habits, we need to develop systems of compassionate regard, translate the nonverbal message into a verbal  understanding that can be shared, while still insisting on healthy change and behavior that is socialized, responsible, and nonviolent.  
 
 Creating Sanctuary refers to the process involved in creating safe environments  that promote healing and sustain human growth, learning, and health.   One fundamental attribute of Creating Sanctuary is changing the
presenting question with which we verbally or implicitly confront another human being whose behavior we do not understand from “What’s wrong with you?” to “What’s happened to you?” Changing our position vis‐à‐vis other
people in a way radically shifts our perspective on ourselves and others,
moving us toward a position of compassion and understanding and away from blame and criticism. 
 
When people receive understanding from others, it enables them to  begin their way down the long road of understanding – and changing – themselves.   As  Ronnie Janoff‐Bulman has shown, the experience of trauma shatters ‐ often  irrevocably - some very basic assumptions about our world, our relationship to others, and our basic sense of identity and place in the world.   A sense of  meaning and purpose for being alive are shaken. Making sense out of violence, transcending its effects, and transforming the energy of violence into something powerfully good for oneself and the community describes what Judith Herman has called “a survivor mission.”   
It is often a mission that encompasses the remainder of one’s life. Confrontation with the spiritual, philosophical, and/or religious context – and conflicts – of human experience is impossible to avoid if recovery is to be
assured.
 
Please visit my blog soon for my next post to see how Cognitive Processing Therapy (CPT) addresses and relieves the multifaceted, traumatized person with PTSD by helping them find and put words to their trauma and
subsequently process it and move forward.
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    I am a Licensed Clinical Social Worker with a strong spiritual foundation providing counseling in the Tallahassee, Florida area.  My areas of interest include grief and loss, depression and anxiety, women's emotional health, trauma related issues such as PTSD, family substance abuse issues, domestic violence and family counseling including couples counseling, children and adolescent behavioral issues and parenting. Giving back is very rewarding with the growth and satisfaction of each client. It is my passion and my honor to serve others. 
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