“Turn your wounds into wisdom.”
– Oprah Winfrey
Trauma & Emotional Wounds:
Do you relate to the following?
- Do you often feel ‘triggered’ and in emotional distress that is showing up as acute anxiety or a depressed and defeated mood?
- Are you carrying emotional weight with core negative beliefs about yourself (eg; self-talk messages that say, “I’m not good enough” or “There must be something wrong with me”)
- Are you struggling with self-sabotaging patterns linked to perfectionism and control that keep you stuck?
- Does your life feel unmanageable and out of control like being on an emotional roller coaster even though you are sober?
- Do you find yourself recreating unhealthy patterns in relationship that seem to be connected to family-of-origin issues?
The inner prison of unresolved trauma can often feel like a ‘war zone’ in your mind and heart. If you are struggling in your recovery from substance abuse related to emotional pain, you may be ready to take your recovery to the next level by resolving trauma. Pursuing this work where the inner landscape is healed, allows you to navigate challenges in different ways and transform your outer circumstances.
I specialize in working with women in recovery who have experienced emotional abuse and neglect from childhood that leaves scars on one’s heart. This can show up in high functioning families where there is covert shame and fear-based messages that propel one to search for external validation, approval, acceptance, and love.
A core legacy of trauma is mental health symptoms and emotional flashbacks. Emotional flashbacks are described as sudden and often prolonged regressions to painful feeling states experienced in childhood. They are not attached to any specific memory narrative. Each time a child is shamed, she is also emotionally abandoned.
Identity formation is impacted with childhood trauma as the defense of compartmentalization emerges. There is also interference with the ability to self-regulate one’s emotions at the psychophysiological level and compensatory survival coping strategies surface in response. This can take the form of self-medicating with substances as a way to numb, increase hypervigilance, self-soothe, combat depression, or facilitate dissociating.
Perfectionism and control are common survival coping strategies. Perfectionism may be viewed as an attempt to gain the approval and validation that was not in adequate supply in one’s family of origin. Control is often aimed at trying to achieve an emotional sense of safety and security.
Another common effect of emotional abuse and neglect in childhood is the development of an ‘inner critic’ or an internalized ‘task master’. When a child is consistently abandoned, her developing superego “assumes totalitarian control of her psyche and carcinogenically morphs into a toxic inner critic” (Peter Walker’s article on Managing Abandonment Depression in Complex PTSD).
Doing the work in trauma therapy affords the possibility of restoring emotional wellbeing, discovering a newfound freedom and wholeness one may have not thought possible.
What is Trauma?
The word ‘trauma’ comes from the Greek word for “wound”. In the world of psychology, trauma refers to an emotional injury or wound. It’s helpful to think about physical wounds when trying to understand emotional traumas. Wounds come in different shapes and sizes. They affect each individual in different ways. Inattention to the proper treatment of a physical wound can complicate the healing process or lead to infection. The same is true for emotional wounds.
There are different types of traumas and it can be a single event or a series of events in which the trauma is prolonged and repeated. Some examples of traumatic events that may overwhelm one’s usual coping strategies include the following: serious illness or injury, partner violence/abuse, loss of a child, military combat or natural disasters.
Developmental or relational/attachment trauma refers to experiences in childhood that significantly impact a child’s development and functioning. Children are rendered ‘captive’ by their condition of dependency and thus the trauma is often repeated and prolonged affecting the developmental trajectory of the child.
Some types of this trauma include the following: physical abuse, sexual abuse, emotional/mental abuse, emotional deprivation/neglect (to include emotional abandonment), physical neglect, witness to domestic violence, a parent who has an alcohol or drug problem, and abandonment or the loss of a parent.
This type of trauma is a type of Complex Trauma or C-PTSD (Complex Post-Traumatic Stress Disorder). The effects of trauma often result in mental health symptoms and struggles with deep emotional pain. As trauma affects the central nervous system there is what is called ‘dysregulation’ and this manifests in hyperarousal and hypoarousal symptoms.
Hyperarousal symptoms are the following: emotional overwhelm, panic, anxiety, impulsivity, hypervigilance, feeling unsafe, reactivity, anger/rage, and racing thoughts.
Hypoarousal symptoms are the following: feeling numb, depression, lack of energy, disconnection, shut down, dissociation, and ‘not there.
The ‘Resliency Zone’ refers to a bandwidth where one is able to be integrated in body, mind, and spirit and deal effectively with stressors that come up in daily life. The individual with a trauma history, however, is often ‘triggered’ and this bumps her out of the Resiliency Zone and into a state of dysregulation. One can bounce between these states which can feel like an emotional roller coaster. This is called the ‘biphasic response to trauma’. It is an oscillation between hyperarousal and hypoarousal symptoms.
As written by Judith Herman, MD in her book, Trauma & Recovery, “This dialect of opposing psychological states is perhaps the most characteristic feature of post-traumatic syndromes. Since neither the intrusive or the numbing symptoms allow for integration of the traumatic event, the alternation between the two extreme states might be understood as an attempt to find satisfactory balance between the two. But balance is precisely what the traumatized person lacks”.
The key types of symptoms according to the DSM-5 Manual (specifies criteria for mental health disorders) are in the following four categories:
- Avoiding specific locations, sights, situations and sounds that serve as reminders of the event
- Anxiety, depression, numbness, or guilt
- Intrusive thoughts, nightmares or flashbacks (includes ‘emotional flashbacks’)
- Anger, irritability, and hypervigilance
- Aggressive, reckless behavior, including self-harm
- Sleep disturbances
Negative Mood and Cognitive Symptoms:
- Loss of interest in activities that were once considered enjoyable
- Difficulty remembering details of the distressing event
- Change in habits or behavior since the trauma
The Effects of Trauma:
As noted above, there are often complex biopsychosocial-spiritual effects of trauma. Symptoms, as opposed to narrative memory, is often the ‘living legacy’ of trauma. This is because traumatic memories and experiences tend to be encoded as bodily and emotional states rather than narrative. Some of the symptoms or affective states of trauma may involve anxiety, anger/rage, emotional overwhelm, numbing, irritability, depression, shame, self-loathing, substance abuse, eating disorders, flashbacks (to include ‘emotional flashbacks’) and self-injury behaviors.
Here I will highlight five common effects of trauma:
- Mood Dysregulation
- Development of Survival Skills
- Core Negative Beliefs about oneself (falsehoods that trauma often promotes)
- Development of a ‘False Self’
- Repetition Compulsion (often shows up in adult relationships)
Mood Dysregulation: As mentioned earlier there is an experience of being ‘triggered’ and an oscillation between a hyperaroused versus a hypoaroused state with little time being in a regulated state (calm but alert and integrated state – the ‘Resiliency Zone’). The triggering most often results in intense affective states with a high level of emotional distress.
As noted by Tian Dayton, PhD in her book, The ACOA Trauma Syndrome, “We all have an emotional set point”, a default setting that represents our personal “norm”. It’s a set point that we can continually return to as our set point of emotional balance and equilibrium out of which our thinking, feeling, and behavior grows. Trauma disrupts that delicate balance. It upsets the equilibrium and can cause us to lose our ability to return easily to our emotional set point because it’s been disrupted too deeply and too often”.
Development of Survival Skills: Children who grow up in families where there was not a consistent sense of emotional safety (mirroring, validation, and acceptance), nurturing, and protection often develop coping survival strategies to navigate in such a system. There are different ways that these survival skills have been delineated.
In Adult Children of Alcoholics & Dysfunctional Families (ACA) there is a Laundry List of 14 Traits. Three of these include “We have stuffed our feelings from traumatic childhoods and have lost the ability to feel or express feeling because it hurts so much”, “We become approval seekers and lost our identity in the process” and “We have an overdeveloped sense of responsibility and it is easier for us to be concerned with others…” (pg 5 in ACA Redbook).
In the Internal Family Systems Model (IFS) it asserts that we all have various parts to oneself but in the face of trauma some of these parts take on ‘extreme roles’. The survival skills in this model are understood as protector parts. Protectors are parts that manage our interactions with the world and defend against underlying pain and unhealed trauma.
These protective parts fall into two categories: Manager parts and Firefighter parts. A Manager is a proactive protector part that prevents re-wounding and does not allow one to be overwhelmed emotionally. Managers can take the form of perfectionism, control, or a taskmaster part. A Firefighter is a reactive protector part that comes in and puts out the ‘fire’ of emotional pain when it is activated. This can take the form of substance abuse, overeating, or other addictive behaviors. Both have the intention to protect the wounded and vulnerable part that holds the unprocessed emotional pain. As there is healing of the wounded parts (exiled parts) in therapy the protectors can take on more balanced roles.
Core Negative Beliefs: Another difficult effect of trauma is that it so often promotes falsehoods about oneself. In the IFS model these are called ‘burdens’. These may take the form of “I am worthless” or “If I’m not perfect, then I am a failure”, “I am unlovable”, “I am a disappointment”, or “I am never enough”.
The weight of these core negative beliefs is linked to shame. Shame says, ‘there is something wrong with me”. As children when bad things happen or there are consistent unmet emotional needs, the child in her egocentric mind interprets herself to be the cause of things. This can take the form of believing that if I can be good enough or perform perfectly then I will get what I need or feel loved. Some of the trauma-related beliefs revolve around four areas: responsibility, safety, choice, and value.
Responsibility: I am to blame; I should have done something; I should have known better
Safety: I cannot trust anyone; I am not safe; I cannot show my emotions
Choice: I have no options; I have to be perfect or please everyone; I am trapped
Value: I’m not good enough; I am damaged; I am worthless/inadequate
Healing involves an ‘unburdening’ process where these falsehoods are released and one is able to move away from a shame-based identity and into her value and worth. A new internal self-view is built.
Development of a False-Self: A False Self can be understood as a protective part of oneself that took on relating to oneself and others in a way that prevents further rejection or injury. When we learn as children that who we are does not get us what we need, we learn to adapt to survive. This may begin as a pattern of hiding one’s true feelings or authentic self in favor of developing a self that is acceptable to the parent(s) or family unit. The False Self is primarily constructed in the face of family dysfunction. It resurrects to meet the needs of the parent(s) to try and make the system work. Sometimes it manifests in roles like the family hero, the scapegoat, the lost child, or the mascot.
As written in the book, Drama of The Gifted Child by Alice Miller, “Accommodation to the parental needs often (but not always) lead to the “as-if personality” (Winnicott described as the “False Self”). This person develops in such a way that she reveals only what is expected of her, and fuses so completely with what she reveals, one could hardly have guessed how much more there is to her, behind this “masked view of herself”.
Repetition Compulsion: Moreover, another effect of trauma tends to be what is termed a repetition compulsion. When there have been childhood emotional wounds what often emerges is cycles of reenactment. As written in The ACOA Trauma Syndrome by Tian Dayton, PhD “Repetition compulsion is a psychological phenomenon in which we repeat the emotional, psychological, and behavioral aspects of a traumatic event over and over again without awareness, recreating the pain from yesterday in relationships and circumstances of today”.
There is often an unconscious hope attached to this that there will be a different outcome. It’s like continuing to seek out individuals who are emotionally unavailable with that hidden hope that one will get what was and is needed. This is an attempt to repair the original wounding through these adult relationships; to have a different outcome than that of one’s childhood. Becoming more conscious of these patterns can lead to change.
The Healing & Recovery Process for Trauma Resolution:
Part of the recovery and healing process involves integration and balance. It also involves regulating a dysregulated nervous system and expanding what is termed the ‘Resiliency Zone’. Identification of and coping with ‘triggers’ is a part of the therapeutic work.
The trauma trigger brings about emotional distress, bodily changes, and symptom reactions. Most often the trauma reactions come about in relation to either internal or external triggers but initially it may be difficult to link it to a trigger until there is increased self-awareness. This is another step in the healing process. Identifying the triggers and adopting healthy coping strategies to re-regulate one’s emotions and nervous system are a part of the trauma resolution process.
Some of the work also includes building a new internal self-view to heal a shame-based identity. Shame merges externals with one’s identity where one’s sense of worth can be highly associated with performance or achievement in a perfectionistic way.
Another aspect of my approach to healing trauma involves beginning to work with the parts of oneself that surfaced to protect the more vulnerable and wounded parts. While these emerged to help you survive and defend against the emotional pain, these strategies are often what is keeping you stuck and blocked from creating the life you want. These strategies are no longer serving you.
We work to understand these protective parts and their roles in order to release the ways these are making problems for you in your life today. The outcome of this is more harmony in your inner system with an awakening to emotional well-being and inner freedom that allows you to flourish. You then have the freedom to pursue your heart’s dreams without encumberment.
In this process, I also integrate expressive arts therapy as a way to help one externalize the feelings and gain increased self-awareness as a catalyst for making these desired changes. Individuals need no previous arts experience as it’s about the process not the product. Using creative arts in therapy allows for new emotional vantage points, to express that which is difficult to verbalize in words, and it can give distance to a situation through a different lens. Creativity as a life force is accessible to us all.
Both Internal Family Systems (IFS) and Expressive Arts Therapy (EXA) are evidenced-based treatments to address and heal trauma. I also find value in the 12 Steps of ACA (Adult Children of Alcoholics and Dysfunctional Families) and the material in the Red Book. It provides a good description of the ‘problem’ and a ‘solution’ along with tools for healing childhood trauma.