By Anne-Marie Suddreth
I was raised by a brilliant woman. She couldn’t play a sport to save her life, but she played piano so beautifully that by age 8 she was made backup for the church pianist. An insatiable reader from early childhood, she earned a graduate degree in English and taught at the college level for years. She was beloved by her students who frequently kept in touch long after class ended. Her coworkers gushed about her extraordinary teaching skills and gift for writing. She returned to school years later to pursue School Counseling and no one was surprised at her remarkably high grades and evaluations. As a school counselor in rural North Carolina schools, she quickly worked her way into the hearts of students and staff alike.
My mother was genuinely loved and respected. She was one of the most moral and compassionate people I’ve ever known. When she died suddenly at the age of 50 there was a larger crowd present at her memorial service than she would ever have predicted and many tears were shed. Countless people shared how special she had been in their lives.
The Great Mystery of my mother, though, was how she struggled with a pervasive and handicapped sense of being “not good enough.” She was amazing and I told her this regularly, imploringly. I would point out the evidence that she was invaluable to myself and others. Ultimately, though, she never could accept she was worthy of love and belonging. Her fundamental sense of being was fatally flawed. It created within her an isolated, pained and lonely woman. She was unable to feel the deep connection that others felt for her. It robbed her of relationships, happiness and ultimately her health.
The Past Behind the Woman
After her death, I found a treasure trove of her personal writing. One day, like a needle in a haystack, I found the missing piece. My mother had been sexually abused for many years as a child. This was a profound revelation. It was perhaps THE big key to the enigma that was my mother, but I did not yet understand the scope of what it meant.
Six years later, I was doing an internship for my Clinical Psychology program at the local community mental health center. I saw a wide range of clients and began to see a pattern of qualities which was startlingly familiar. I saw them often and in people from all walks of life. I began to understand what “trauma” meant and the myriad ways it manifested.
Post-Traumatic Stress Disorder
Trauma becomes like the elephant in the room, or “the elephant in the brain,” as I sometimes say. At the most severe end of the spectrum is Post-Traumatic Stress Disorder (PTSD). Many people are aware that this sometimes plagues veterans of war. However, PTSD is not limited to military veterans.
Anyone who has experienced or witnessed the threat of death, violence, or injury is at risk of posttraumatic stress. This includes sexual assault and abuse, estimated to affect as many as 1 in 4 women. There is no “statute of limitations,” either. An experience from years ago, even in childhood, can impact your functioning decades later as an adult.
Dr. Francine Shapiro, a prominent figure in trauma research and treatment, distinguishes between “ big T” and “little t” traumas. Big “T” traumas are what we immediately think of as traumatic: war, rape, murder, etc. Little “t” traumas are life events that cause us pain such as being harassed or outcast as a child, working with a verbally abusive boss or partner, or public humiliation. Many people are surprised to find their brains have processed those events similarly to a big Trauma. In fact, sometimes little traumas are more insidious because we tend to fail to recognize old memories as affecting us. After all, they weren’t “Traumas.” But they could be and the results involve significant pain and dysfunction.
It is possible to be affected by symptoms of post-traumatic stress without experiencing full PTSD. Symptoms vary, but they affect both the mind AND the body. Some are intrusive such as nightmares, recurrent memories of the event, and intense distress or anxiety after being exposed to a reminder of the event, called “triggering”. Sometimes the trigger is obvious; other times you just notice a sudden negative mood, such as guilt, shame, anger, fear, horror, irritability. When symptoms are intense and unpleasant, individuals tend to avoid the people, places, things, certain thoughts or feelings that may act as reminders. The problem with avoidance is that it can interfere with daily life and interpersonal relationships. The brain will not allow us to avoid them forever.
Trauma also affects thinking and concentration. Flashbacks are a state where the brain and body relive the event. Memory problems are not uncommon particularly in regard to memories of a specific event. Also, there can be episodes of ‘losing time’ in the present because of disassociation or flashbacks. One of the symptoms I see most often is the deep ingrained distorted sense of self and the world as in “I’m bad” or “It was my fault.” This leaves survivors feeling alienated or disconnected from others.
Finally, trauma can cause the body feel stuck in an “on alert” mode, where the body is always looking out for a threat. Do you startle easily or jump when you hear a loud noise? Do you have trouble sleeping? All of these are symptoms of post-traumatic stress.
How PTSD Operates
How does post-traumatic stress happen? What makes these memories seem to take over our rational mind so completely? The answer is in how the event was processed in the brain at the time it occurred.
Meet the amygdala. It is a relatively small almond-shaped structure in the brain that is key to registering and processing emotion, particularly fear. If a grizzly bear starts running toward you it is the amygdala which activates your fight, flight, or freeze response. It has saved countless lives by perceiving threat and emotion and helping us act accordingly.
When the amygdala is “overactivated” in duration or intensity, the ability to process those events appropriately is compromised. Think of a story from your life that is slightly negative and notice the lack of anxiety or discomfort. The lack of a negative response means the memory was processed appropriately. When an event is life threatening, the amygdala and its partner, the hippocampus may be so overwhelmed they cannot process and direct emotional information away from places of primal fear. Whenever the brain is reminded of that event in any way, the amygdala becomes aroused again. The original thoughts are reactivated and the body re-experiences some of the physical sensations which accompanied the event. All of this happens to varying degrees at different times, depending on the traumatic experience itself. It is extremely difficult, if not impossible, to return to your original state by an act of will alone.
Recovery and Treatment
In order to recover from trauma, both physical and psychological symptoms must be addressed. Medication cannot do this long-term. Many doctors have been taught to prescribe tranquilizers and sleep medication to calm the nervous system. It is not enough if you want to truly heal.
Anyone who is working to recover from trauma needs to know there is no quick fix. Meditation, psychotherapy, yoga, and bibliotherapy (writing therapy) have all been shown to reduce symptoms of PTSD and post-traumatic stress. But many people find that it is not enough.
One therapy modality which addresses both the physical and psychological effects of posttraumatic stress is called Eye Movement Desensitization and Reprocessing (EMDR). In essence EMDR allows for the reprocessing of those traumatic memories in such a way they no longer activate the intensity of the emotional center of the brain. For example, a train engineer was rolling down the tracks one day when a young pregnant woman jumped in front of his train and committed suicide.
For weeks he couldn’t sleep, couldn’t stop “seeing” her jump in front of the train and felt the sheer terror of the moment and could not go back to work. With some EMDR therapy, he was able to get back in the driver’s seat. He did not forget what happened, but reminders of the incident no longer shut him down physically and emotionally. He was able to return to his life and move on.
For “simpler” traumas (e.g., car accidents) in people without a previous history of significant trauma, EMDR is often a faster method of treatment. There is more processing work in cases of complex, intense, or prolonged trauma. Furthermore, EMDR may not be the end of the healing process. However, EMDR has been the key to moving on for many vets, civilians, adults of all ages and children. I’ve witnessed its power in many of my own clients. I cannot recommend it highly enough. I only wish my mother had access to this kind of work.
If you or someone you love is dealing with trauma, it is critical you understand it is not a weakness or personal flaw. It is an issue created by the neurological system in response to an intense event. If you’ve never sought help for it — please do! If you have sought help and haven’t experienced the kind of healing you desire — keep trying something new. There is always room for change and growth.