Trauma Outpaces our Ability to Adapt: It is the Source of Our Suffering

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Trauma is not some bizarre thing that happens to us and mysteriously sends everything off kilter. It is a violent extension of the routine processes of the brain, as we write our “plays of consciousness” through the limbic system. All throughout life, trauma defines the negative elements of our environment. Just as responsiveness is the source of healing in the world, trauma is the agent of harm and damage. Trauma consists of abuse: sadism and cruelty; and deprivation: the cold absence of loving which generates the absence of the possibility of tender attachments. Trauma is an assault so extreme that it overrides and rewrites our otherwise healthy play of consciousness. It outpaces our flexibility to adapt, and writes a dark new play in its place.

The ways that trauma affects us is consonant with how consciousness is formed in the first place. Consciousness is written as a drama in the theater of the brain. It is written as our temperament digests our environment. Our pertinent emotional environment may be a loving responsiveness or it may be traumatic – full of sadism, and emotional deprivation. The ‘play’ consists of a representational world with a cast of characters who relate together by feeling, scenarios, as well as plots, set designs, and landscape. Keep in mind that the plays of consciousness are illusions of our brains taken to be real.

Here’s how consciousness writes its plays: The limbic system, in the context of traumatic abuse, maps our emotional experience as sadistic aggression filled with attack, humiliation, and endless war. Consequently the activated internal scenario is one of continuous internal fighting between personas. It is mapped through the limbic pathways of serotonin, cortisol, and adrenaline. In the context of loving responsiveness it would be mapped through gentle oxytocin pathways. The mapping of our nurture reflects our actual experience of parental care. [See – “The Nature-Nurture Question – Nurture”]. Our parental experience is then digested by our genetic temperament. The four elements of temperament are shown in the ‘nature’ post [See – “The Nature-Nurture Question – Nature”.] The more sado-masochistic trauma, the more damage to our plays which prefigure psychiatric symptoms later in life.

Trauma damages us during our formative years in childhood, and affects us for the rest of our lives. Sexual abuse, physical abuse, emotional abuse, extreme violence, and the absence of warmth, tenderness and caring that ought to be a safe harbor for our attachments. Violations such as these, generate extreme forms of damage. Once our character forms, we live out its invisible scenarios for the rest of our lives.

One person subject to sadistic attacks will generate one set of symptoms, while someone else, with a different temperament and similar abuse, will adapt with other symptoms. One person may process trauma in such a way as to generate a state of ‘depression’; Someone else may generate ‘Anxiety’; or ‘Obsessions’ or ‘Compulsions’; or ‘Phobias’, or ‘Hyperactivity’; and if the coherence of the play fragments, we may get ‘psychosis’ or ‘mania’. This all comes from the way our temperament adapts to trauma. This is the whole story. The idea of brain diseases, or brain disorders is a complete fiction. There’s no such thing. There certainly are neurological conditions like Tourette’s. But these are easily distinguished from psychiatric struggles.

As the twig is bent so grows the tree. Once our primary play is established, the rest of our experience is filtered through it. Once our original play is in place we continue writing our character. All along the way, in childhood, in adolescence, in adulthood, there can be traumas so significant that they can override and rewrite the original play. When subject to trauma later in life it can send us into much darker places.

In the course of life, traumas affect us more powerfully when we are younger. [This in no way is meant to diminish the post trauma effects of adult trauma such as wars and significant losses.] I’ve had patients where incest began at four. The play could not encompass such a violation and it fragmented into psychosis. When sexual abuse happens so early, our play foundation is far too weak to handle it. As our plays of consciousness get written over time, they solidify.

In other patients, later violations of sexual abuse did not create schizophrenia. Instead the patients utilized the extreme adaptions of dissociation and splitting. Sexual molestation generates a sexual response in the victim which is of course unacceptable to the victim. This is compounded by the sadistic attack. By dissociation the patient is able to deny and not feel the sexual response, although it is actually present. The most difficult aspect of therapy is to own and mourn this response which has been put inside the victim, but is not caused by her. While the sexual response is dissociated, she still secretly identifies with it. The secret identity of the victim is that the molestation is her fault, which of course is not at all true. She believes she is bad and shameful. She believes she is the pervert. By splitting, the victim can construct positive fantasies of the perpetrator and develop Stockholm syndrome, even believing that the perpetrator loves and cares about her. This is sadly very common. Most prostitutes, subjects of pornographic movies and pictures, and strippers are sexual abuse victims. And “John’s” take advantage of this travesty for their sexual fantasies and activities.

People’s suffering is a human story. This has been known throughout the wisdom of the ages. The delusion of the twenty-first century is that people suffer from genetic, biochemical brain diseases, an insult to the human condition. Despite the fact that it is so widely believed, it deserves be disregarded as a bad joke. We must return psychiatry to its proper place, where it is understood that the only subject of psychiatry is the human story. And that trauma is the major player in all of our psychiatric struggles. I call psychotherapy the ‘Psychotherapy of Character’. It could just as appropriately be called the ‘Psychotherapy of Trauma’.

The living of a life is the story of our character, our history. Etymologically history is derived from: ‘inquire’, ‘to know’, ‘finding out’, ‘a narrative record of past events’, ‘a historical play or drama’, ‘what happened among human beings’. It has been estimated that the number of people who have ever been born is 107,602,707,791 individuals. Putting it all together we have over 107 billion unique ‘his stories’ (and ‘her stories’). Every snow flake is different, but we are all snowflakes. Character is destiny. What can help ameliorate the pain of trauma and alter our destinies?

All responses to trauma are problematic adaptations. In the formative years it is seems just intrinsic, an invisible part of our character. As we get older trauma can become more dissociated. The treatment for trauma is mourning. Psychotherapy is all about mourning the traumas of our life. A therapist must have his own therapy to attend to the traumatic pain in his own life so it doesn’t interfere with his wherewithal to be responsive as a therapist. A therapist is neither superior or inferior in relation to his patient. Patients are not ‘sick’. Psychotherapy is the difficult and complicated process of respectful mourning in the context of emotional trust and listening to the story. The major thing that differentiates a therapist is his willingness to sit with pain that most people with any common sense would tend to flee from.

Mourning a loss or a death is the opposite process from mourning post traumatic events. Both are traumas. When a man mourns the death of his wife, the issue is for the husband to relinquish his old deeply held play in which he has a life of attachment to his wife. His marriage play continues to live on the deeply held limbic mappings of consciousness. He has to mourn to accept the new play where she is no more. Mourning her death is the process by which the older play of his wife will cease to be has activated play.

When his wife dies, despite the fact that the he knows cognitively that she has died, the process of mourning will allow him to inhabit the new play, that she is gone. Elisabeth Kubler-Ross’s five stages of grief– Denial, bargaining, anger, sadness, and acceptance –accurately describe the processes involved in relinquishing the old play to accept and inhabit the new one. [These five stages is just a shorthand, mourning is a far more complicated process than this.] There is an emptiness that always remains, as the pain of loss can never completely heal. At best by grieving our loss we can allow it to live on and be enshrined as a loving memory where it belongs. Once an attachment forms it can never be undone. It enters our world as a monument to the living. All loss leaves scars. [See – “Mourning – death, loss, trauma, and psychotherapy. It is the universal agent for recovery and change.”]

With post traumatic events, a powerful and violent new play is written and gains ascendancy over the old plays. The purpose of the mourning process is to digest and relinquish the new play to allow for a more loving one to become re-established or newly written. When incredible trauma happens in war, the newly written play becomes the operative emotional reality. As a result of the power of the illusions of consciousness, we think we are believing what we see, but in fact we are actually seeing what we believe. The flashbacks, the paranoia, the distorted reality, and the nightmares all reflect the newly written play in our brain. In war, the trauma writes a new play of sadistic violence and loss, which overrides regular life plays. This then becomes the new reality which gets played out and believed over and over again. To recover from post trauma, one must mourn and digest the new trauma to return to the original play. This too is never perfect. In this case the individual must face, digest and mourn the violence, loss, rage, fear, and pain of what happened in an extraordinary situation. This process is extremely difficult. A therapist must be responsive to the hazards. The pain always feels worse before it gets better, and the patient must be safe. Sometimes, the pain is too powerful and can only be approached with great care to not become too overwhelming. A responsive therapist does not have to be a soldier to understand. He has to be open. It is often useful to have others with similar experience to be together with in group settings.

For the sake of brevity I won’t go into the traumas generated from physical, sexual, and emotional abuse . They operate in a similar way as war trauma. With ongoing violations of abuse, the established plays of consciousness get overridden and rewritten by the limbic system in the brain. The process of mourning is to redigest the experience in such a way as to separate oneself from the sadistic aggression that has been put into the victim, always in the context of one’s temperament. The processes of psychotherapy allows one to dismantle the old abusive play and write a new play in the context of trust and responsiveness to live a life of greater authenticity and the capacity for love.

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

22 COMMENTS

  1. Dr. Berezin, I really enjoy how you explain ‘plays of consciousness’ as how we project our reality. I enjoy being able to perceive my ‘storylines’ apart from who I am as a person/spirit/energy. Certainly makes me feel as though I am in the driver’s seat, rather than being controlled by external factors. At least, that is the goal of my personal growth, along with, as you say, increasing my capacity to love. I do feel that is ever-relevant to creating positive change as well as our own inner peace and well-being.

    What occurred to me as I read your article is how we, as a humanity, have been collectively traumatized, at least this would be my play at present, how I am interpreting what I observe and feel as I interact with the world. It seems to be so common now–daily, in fact–to read about heinous, violent, unthinkable acts causing trauma to multiple people at once. It’s really out of control, in my estimation. “Flashbacks, paranoia, distorted reality, the nightmares…” seems to describe the world at this point.

    I don’t see how we can any longer separate from each other when it comes to life trauma. We’ve all been duped, one way or another, to believe such negative things about ourselves and to fear our own thought and emotions, dissociation has become the standard for survival.

    Not sure what my point is, here, other to make this observation. Perhaps there is a process to go through together, as a collective. Yet, we keep each other at a distance now, from suspicion–direct result of betrayal trauma, which is epidemic. Seems there would be a new play written here.

    Thanks for your very interesting and though-provoking work.

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      • Hello Dr. Berezin,

        I love this post; one of my all-time favorites. My questions, comments and some nitpicking are as follows.

        (1) Not all trauma is malicious — e.g., parental death suffered by a young child — and I assume that you do not mean to suggest otherwise. Also, what about evidence that trauma can be transmitted to future generations through altered gene expression?
        (2) I believe it is important to emphasize that trauma is broader than abuse; it can also mean the lack of healthy and warm nurturing from a parent who is stressed, overwhelmed and out of tune with the child, no? The focus on abuse makes people defensive (“I was not an abuser”) and more likely to discount the importance of early childhood development and nurturing.
        (3) Not all trauma is interpersonal. Trauma can also be physical and the most obvious example is the effect of psychiatric drugs (the effect of the drugs themselves, in addition to the emotional or interpersonal trauma of being violated through coercive drugging), and psychiatric drug withdrawal. Conditions such as dissociation and psychosis are common symptoms of drug withdrawal.. Aside from extreme states, why is it that interventions such as diet (e.g., a diet to eliminate Candida) can be so effective in alleviating brain fog (probably a better term to use than ADHD)? Why is it that things like fish oil and vitamin D are helpful, possibly by making people more resilient and better able to withstand the trauma that life and people inevitably bring?
        (4) What do you say to those who maintain that talk therapy is not the recommended first-line treatment for traumatized people and who advocate body-based interventions such as EMDR, at least initially?
        (5) One of your sentences does not read right to me; i.e., “Sexual abuse, physical abuse, emotional abuse, extreme violence, and the absence of warmth, tenderness and caring ought to be a safe harbor for our attachments.” Did you mean to say that it is the warmth, tenderness, etc. and absence of sexual abuse, physical abuse, etc. that ought to be a safe harbor for attachments?

        You sound like an amazing therapist and I wish that great therapy were more readily available. What gives me pause and where I disagree is the notion of “this is it, the whole story, the whole truth; this is all there is.”

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        • Thank you GetItRight,
          I agree with most of what you said. As far as number (1) is concerned. I agree and I go to great lenghts in my book to spell that out. I was using as much shorthand as I can in a blog. I think people have gone overboard with the return to LeMarkian anti-Darwin transmission to subsequent generations. In fact in my opinion such ideas are rather weak with not a lot of evidence. (2) I include emotional neglect as co-equal to abuse.It is major and has such import regarding attachment. (3) I agree. (4) I’m not all impressed with EMDR. In all honesty, I think it is a silly fad. As far as I’m concerned it’s all about mourning. That isn’t to say that feelings are and memories aren’t located in the body. They are. I find that they are accessible by paying attention to them. It was a typo, and I meant to say what you wrote, “that ought to be a safe harbor for attachments?”. As far as your last point, I’ve been impressed that it is all encompassed in the human story.

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        • Thank you GetitRight for asking these questions. As a parent of a young adult who experiences extreme states called ‘psychosis’ I don’t identify with being a perpetrator of ‘sadism’ nor do I identify any member of our household with being ‘sadistic’ Although I find the author’s views consistent with my own views about the origins of ‘psychosis’ (trauma), there are a number of traumatic events that can happen in early childhood that have nothing to do with sexual or physical abuse. In Joanna Greenberg’s book “I Never Promised You a Rose Garden” I remember that her therapist determined the source of Joanna’s trauma was being temporarily left in the care of a nanny for several months (and for much of that time confined to a crib) as a result of a medical crisis involving another family member.

          If I had some advice to give to therapists who do not yet know their patients well, refrain from judging the family until you can get a clear, balanced picture of that person’s childhood experiences. Second, screen your patient for recent psychiatric harm and abuse; ask your patient, have you ever been jumped by multiple people and forcibly injected with a needle containing Haldol or Thorazine? Have you ever been restrained with five point restraints? Have you ever been forcibly made to live in an institution because you were considered to be a danger to yourself or others or did you ever try to run away from a psychiatric institution or foster home, only to be returned, in handcuffs by a police officer? Have you ever served time in jail or prison for a non violent crime? Have you ever been secluded, stripped naked, or forced to sit for 24 hours in a small cell without windows with no access to a bathroom? Have you ever had to endure horrific side effects, including incontinence, due to being forced to take mind numbing medications? Have you ever been warehoused for months, even years with people in deep states of emotional distress, all of whom were being drugged to the point of being disabled? Can anyone who purports to treat patients in ‘psychosis’ really be that obtuse as to the profound and lasting effects that such ‘treatment’ has on people who are already experiencing grief, loss, and trauma?

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          • Madmom

            After spending three months as a “guest” and working for the past five years in the state hospital where I was held, I’ve come to believe that the staff who do such things to people don’t really care about how this affects people. They don’t give it a second thought. They are the “experts” about how people need to be “treated” and by golly they’re going to make sure that the “treatment” happens. Very few of them have even tried to put themselves in the place of the person that they’re “treating”. I would love to make them spend a couple of days and nights on a locked unit and see how they end up liking the “treatment”.

            I think a few people do know how this affects people but they don’t say anything because then they’d have to admit that they participate in harm and re-traumatization. I think that this is why so many staff go nuclear on you when you suggest that such treatment is harmful. They can’t allow themselves to know and admit anything.

            For the most part though I don’t think staff see what they’re doing as harmful in any way. If you don’t comply and behave and cooperate, which is what staff ultimately want the “patients” to do, you will suffer the consequences. Won’t take your “meds”, well then we’ll put you in a physical hold, pull down your pants, and give you a shot, right there in the hallway of the unit. Want to run up and down the hall causing commotion, well, we’ll put you in a physical hold, drag you to the seclusion room, and strap you into the restraint chair, which looks very similar to an electric chair. And you will stay strapped in that damned chair until you comply and behave. Won’t bow down and follow orders, well, then you will stay in the “hospital” until you decide to comply, no matter how long that may take. After all, Medicare is paying for your stay so what does another month or two matter if we have to keep you that long until you knuckle and bow down to the “experts”.

            I watch this take place each and every day. I’m allowed to voice complaints about such “treatment” because I’m the peer worker and it’s expected of me to do so. But does anything come of my complaints? Nada, nothing changes and they go on doing exactly as they please.

            I think of your daughter often because I for one know exactly what she goes through on a daily basis. It’s awful, it’s inhumane, it’s unethical and immoral. But it’s “good treatment” based on the “evidenced based practices” of the wonderful medical model.

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          • I am with you on this, Madmom. All abuse involves trauma, but not all trauma involves abuse. This distinction bears repeating to underscore that injury to the psyche need not involve sadism or malicious abuse. I believe that most parents are not monsters or sadists, want to do right by their children, and will welcome and benefit from better understanding of the importance of good nurturing and bonding, especially if they themselves are products of dysfunctional upbringing and/or are raising a child who is more sensitive than resilient. Predisposition is the other factor to consider (yes, I know the idea that some people may be more vulnerable to breaking is not universally popular on MIA). I myself believe that some people are more sensitive and others are more resilient and that, to me, means simply that the more sensitive child (the orchid child) may need much more in the way of nurture and support than the more resilient (dandelion) child. I would not like to see a replay of Bettelheim’s indictment of the “refrigerator mother” based on nothing more than the child’s condition. I consider the Bettelheim saga with autism to be one of psychiatry’s many embarrassments, with an enduring bad legacy: the backlash led many parents to seek support at NAMI, with disastrous consequences, and made the focus on early childhood development and the importance of nurture irrelevant, if not downright controversial.

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          • Madmom, what a sweeping and yet precise description of systemic trauma perpetrated by the psychiatric community on those it seeks to serve. That this goes on without a hint of malice (“this is for your own good”) and with the imprimatur of society and the medical establishment multiplies the traumatic impact of the ‘interventions’ exponentially. Sadly, the truth so evident in your reply will be too easily ignored by practitioners.

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    • Alex, I have to agree and to tell you how refreshing it is to hear someone else recognize the collective trauma of human society – and the very collective, truly epidemic burdens it has foisted upon us, even before we are old enough to escape or manage it.

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  2. Thanks for trying Dr B. I sense that you are still holding trauma at a great distance with your lexicon and that for whatever reason putting trauma out onto a grand scale. More of an intellectual exercise than philosophical and poetic reverie on this most important topic.
    So glad you addressed it. However, as a person more than just aware of trauma. I want to take issue with your emphasis on trauma on a grand scale.
    Sometimes the scale is very small. A phone conversation, the look in someone’s eyes, the sound and tenor of a voice. Still plays out the same. My guess is those in concentration camps or any type of involuntary imprisonment would say sometimes its the minuscule traumas that can hurt the most.
    Then there also is the cycle of trauma that we all finds are self in these days. The invisible traumas – those small ones- affect how everyday interactions take place. The husband comeing home from a a bad day at work yelling at his wife, kicking the dog, unable to go out and play with his children after dinner. That scenario is taking place over and over and over again in our society. The stressors on folks continue to rise unabated and that negative energy no matter how hard one tries still ripples across our intimate and external worlds.
    The worse part is with the uptake of stressors the ability to talk about anger, fear, anxiety is effectively being squashed. If you are Joe Biden you are graciously allowed to talk about your moments of grief. If you one of the rest. Shut up – your sick – we don’t want to hear you – holding our ears now and will be calling the police.
    Until we all are able to acknowledge the role of trauma in our lives and talk in a real human way about emotions which result from chronic and acute trauma we will be in trouble as a society. I am glad folks are beginning to speak out, books written, ect. I just hope it will all come to at the very least a society that is not afraid of caring.

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  3. What about the ‘trauma’ that a very sensitive soul can feel when hearing about atrocities committed on others. I have heard of stories of people going into psychosis after being involved in humanitarian work and then coming home to see how little people care about those far away. I know my loved one used to talk about how ‘symptoms’ first appeared after a beloved teacher graphically described how children were treated in certain work environments. We live in a very cruel world and I believe sensitive developing souls can suffer very deeply when their faith in humanity is shattered -even if trauma hasn’t happened directly to their own person.

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    • I personally think of these kinds of exposures to traumatic information as traumas themselves; kind of in the vein of a woman hearing of atrocities that have happened to people of the same gender, which is psychologically damaging even if she, herself, hasn’t had traumatic experiences of gender-based violence at that point. Instead of gender, though, I think each of us are affected by the knowledge of how others are treated, on the basis of our common ground as beings of emotion and comprehension. Children are naturally distressed when they see violence against non-human animals, which is another “3rd party” exposure to cruelty. This is just an opinion, but I also think that it’s in our evolutionary nature as humans to psychologically start out with (and seek out) the maximum sensitivity we can manage. After all, our power doesn’t seem to be in class, venom, or night vision, but rather with flexibility of adaptation. Sensitivity lends itself to learning and adaptation, in environments that are suitable, or traumatic, or some blend of features of both. In other words, it may not be a feature of psychological sensitivity that a person is so affected by what happens to others. It may just seem exceptional because of how widespread the adaptation of disassociating, becoming dismissive, or otherwise avoiding the material (emotional & otherwise) has become, which creates an illusory norm in society that we should not be affected by hearing these things.

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  4. Dr. Berezin, I largely agree with your perspective. And was wondering if you have any advise for a mother whose child was sexually abused, outside the home, several times at the age of 3 1/2 – 4. I was psychiatricly defamed and tortured to cover this up, but did escape, however due to this I no longer trust either the psychological or psychiatric, or even really the mainstream medical field. But out of necessity I am trying recreate a mutually respectful relationship with the latter industry.

    Nonetheless, my child did deal with sadistic people. He largely recovered by eigth grade, at least he surprised his school district by going from remedial reading in first grade, to getting 100% on his state standardized tests in eighth grade. He ended up graduating from his private high school as valedictorian, despite his father’s unexpected passing just prior to his junior year in high school. So my son is a survivor and doing well, but he definately is a guarded young man.

    I’ve dealt with this sadistic experience by discussing and being open about the crime with my child, but justice was never served. My ex-religion, whose been covering this up for the past 10 years, has opted to become an openly child abuse covering up religion instead.

    https://books.google.com/books?id=xI01AlxH1uAC&pg=PA15&lpg=PA15&dq=jesus+and+the+culture+wars&source=bl&ots=Uy84nIlakS&sig=oM3PLiGb5CfoLh2hbU1B1YzUVng&hl=en&sa=X&ved=0CC8Q6AEwBWoVChMIwP2ZwdqAyAIVggiSCh1NvQga

    Have I dealt with this sadistic situation as best a mother can? My son has put this crime elsewhere in his mind, so finding a lawyer to sue has yet to be an option. I’d be grateful for your input.

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  5. Dear Mr Berezin,

    I am contemplating whether a *false* allegation of sexual abuse of a child can be traumatic for the alleged individual. And I contemplate whether such trauma would be enlarged when some MD, who had not even personally investigated the case, would publish on-line his frivolous opinion that the falsely alleged abuser is actually an ‘incestuous molester’.

    What would you make of it, if that MD would publicly assume that the alleged ‘victim’ is right, in spite of multiple thorough investigations that proved her wrong? What if he based his factless, frivolous opinion on his standing ‘as a psychiatrist’ and on the general notion that ‘victims’ need love and understanding?

    What would you make of the integrity of such MD? What would you make of his allegiance to the Hippocrates oath? In the light of his likely enlarging of some innocent person’s trauma?

    I am curious to hear your professional take on all this.

    Sincerely,
    Hannes Minkema

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  6. Dr. B just laid out the whole truth with no apologies. Made my morning, as heavy as the material is.

    I agree that psychiatry and its “theories” are as valid as a bad joke and should be treated as such. It always sounded funny to me that my brain was the culprit of my disengagement from abusive environments and people!

    Nurture is too powerful in the human brain & mind to be considered second in relevance to the still-unmapped science of neurochemistry. Large bodies of research on the subject at large seem to be floating at large distance between each other, (or being kept at that distance) because the meeting of these varieties of knowledge would reconcile quite a bit of the “unknown” of “mental illness.”

    Thank you for laying it out succinctly and accurately.

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