Life after Trauma

Trauma and Recovery - a Book Review

Traumatic events are extraordinary, not because they occur rarely, but rather because they overwhelm the ordinary human adaptations to life.

Judith Lewis Herman 

   

Distressed woman (photo: Alex Thompson, flickr creative commons)

  Judith Lewis Herman's book, Trauma and Recovery, is a landmark book. I don't use this term lightly. A woman who calls herself SwedishJewfish has written a lengthy review of Trauma and Recovery on The Daily Kos, describing it as a "life-changing" book. I definitely agree.  I first picked up Trauma and Recovery several years after I'd been diagnosed with PTSD. I'm not sure how I had overlooked it before, but I think it was because I wasn't ready to read something theoretical yet. I was too caught up in my own head. The genius of Herman's book is that it operates on so many levels. The book is not only a history of the study of trauma and recovery, as the title suggests, it also deals with many topics that few have written about in quite the same way. I'll go through the book's sections below - hopefully briefly. If you're interested, you should get your hands on a copy because Herman's book is so filled with insights into trauma that it is impossible to share them all in a brief review. 

Introduction

In most books, you can skip the introduction. However, I suggest that you read Herman's introduction. It's brief and clear about why we should be interested in trauma. Herman argues that, "Remembering and telling the truth about terrible events are prerequisites both for the restoration of the social order and for the healing of individual victims." (p. 1) She then goes on to describe the conflict that is at the heart of Post-Traumatic Stress Disorder: "the conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma." And that's just on page one! 

A Forgotten History

Memorial to those soldiers who were executed in World War I for shell-shock (combat trauma) (photo: flickr creative commons)

 

In the first section of the book, Herman discusses the history of the treatment of trauma. She begins with Freud and shows how he suppressed the evidence that sexual abuse was more widespread in the well-to-do population of Vienna than anyone suspected. Controversy is still raging on this subject, so I'll leave it to you to decide who's right. Right or wrong about Freud, Herman raises many important points about the study of trauma. She argues that it has been hard for psychologists to get "respect" for studying something that most people would rather deny. "To study psychological trauma," Herman says, "means bearing witness to horrible events." (p. 7) 

The next section of the book, discusses the work of W.H.R. Rivers with shell-shocked soldiers in World War I. I've written about this work at length on an earlier post and Man Booker Award winning author, Pat Barker, has written about it in Regeneration. Barker's book - part of a trilogy on the subject - beautifully evokes the shift from punishing combat trauma to treating it humanely. That wasn't necessarily because people became more empathetic, Herman suggests, but simply because there were so many shell-shocked men in World War I, that if they had all been executed - as many were - there would have been no one left to fight the war. 

Next, Herman goes on to discuss the treatment of combat trauma in the Vietnam War, when PTSD first came into usage as an official diagnosis. As Vietnam Vets returned home, they increased awareness of this issue and, in the 1970s, the Women's Movement took up the issue of rape and what they called "the rape trauma syndrome."  It's amazing to realize today that it was only in 1971 that the first rape crisis center was opened in the United States. Before that, women kept quiet or were silenced about sexual violence, unless - and this is a big unless - the perpetrator came from a group that was discriminated against by society, eg. African-American men in the U.S. 

Describing PTSD

In this section of the book, Herman does a splendid job of describing the hallmark symptoms of PTSD.

• Hyperarousal
• Intrusion
• Constriction
• Disconnection - with family and community

Unfortunately, I don't have room here to share her many insights. 

A New Diagnosis

Herman makes a strong case for a new diagnosis: complex PTSD and outlines why she believes that people who have experienced repeated/chronic PTSD, particularly at a young age, will need different treatments and approaches to recovery. 

 

Man crying at the Vietnam War Memorial (flickr creative commons)

Stages of Recovery

As important as the first part of Herman's book is, the part that glued me to the page was the stages that trauma survivors must pass through in order to successfully recover from PTSD. (Caveat: to recover doesn't mean that people who have experienced significant trauma will return to their pre-trauma state. It means, rather, that the survivor will be able to reconnect with others both on the individual level and on the community level.) 

Safety

The first, and most important stage, is that the survivor must be safe. Some survivors, tragically, cannot leave unsafe conditions and may not have the luxury of a safe recovery. Most people, however, can begin to understand that the trauma is over and they are safe now. First, comes physical safety, then the establishment of a "safe" therapeutic relationship. Both facilitate healing.

Remembrance and Mourning

Beatrice Mauwa, Survivor of Sexual Violence in the Congo, telling her story (The Advocacy Project, flickr creative commons)

This is a very difficult, although vital, stage for recovery. It may be a long stage, if my own experience is any indication. Much depends upon how many traumas you've experienced and whether or not others are receptive to hearing about them. Telling your story of trauma in this stage is essential. Ideally, you can do this through a combination of therapy and writing, voicing your story to a wider audience. Be aware, however, that this story is not something most people want to hear, so choose your audience carefully. This is what sets Herman's book above many others on trauma; she recognizes the essential role that the community and the political climate have on trauma survivors' ability to recover. 

Reconnection with (Ordinary) Life

Women protest violence against prostitutes and others, Columbia, 2009 (The Advocacy Project, flickr creative commons)

The first person the survivor must come to trust is the self. Indeed, it is only recently that I have come to trust myself in ways I hadn't done since the initial traumas in my life occurred. Herman urges survivors to connect with a larger community and become involved in action to expose or end the trauma of others. This can only be done, however, when the survivor is strong enough. This step, however, can be a powerful one. Herman suggests that survivors can, "transform the meaning of their personal tragedy by making it the basis for social action. While there is no way to compensate for an atrocity, there is a way to transcend it, by making it a gift to others" (p. 207). Herman has more to say about the connection between trauma survivors and communities. However, I've run out of both space and energy. In the final analysis, Herman's book is not just informative, it's courageous. Herman is not afraid to speak out about the so-called "unspeakable" and to bring traumas that are hidden out into the open. It's only there, Herman suggests, that true healing can occur. 

 And what about Judith Herman the person? She was born in 1942 and grew up in New York City. She's a medical doctor and a professor of psychiatry. Those of you interested in Herman and her work will enjoy the lengthy interview below. It gets off to a bit of a slow start, but stick with it or fast forward to about minute 12. Herman shares wonderful stories about her work with trauma survivors and insight into how trauma is connected to our larger society. 

 

Finally, a video by Solomon Burke. Herman worked in the Civil Rights movement and much of her work has been motivated by a sense of justice. I think she would like this song; it makes me think of her.

 

Why is it important for trauma survivors to speak out?

Our lives begin to end the day we become silent about things that matter.

Martin Luther King, Jr. 

 

I Can't Hear Your Pain

"I need to minimize my exposure to your pain," a friend told me recently, while we were discussing some of the traumatic events we've both experienced in our lives. Sadly, this isn't the first time I've heard those words. Another friend told me that "it makes her stomach hurt," to hear about my past experiences. The friend who I met for coffee last week, happens to be the father of the daughter I relinquished for adoption: aka my ex. The original intention of our reunion was to discuss and heal from the experiences of the past. Now, he's decided that he doesn't have room in his life for me anymore and he doesn't want to hear anymore about my grief. What he had to say hurt, but I had seen it coming for a long time and I wasn't surprised. 

The Loneliness of Trauma

Processing trauma can get very lonely at times. Therapist Dr. Kathleen Young refers to this as trauma stigma and her take on what silencing can mean to trauma survivors is worth reading.  I am a trauma survivor with complex PTSD and complicated grief recovering from and processing multiple traumas that took place over 20 years of my life - ages 17 to 37. That doesn't mean that I talk about trauma all the time. Far from it. I would get exhausted. However, there are times when I want to share how I'm feeling with friends, family and - in the case of my ex and my husband - those who have gone through traumatic experiences with me. I  have several wonderful friends who are not afraid of my pain. They can let me feel what I feel and be who I am. This is not a small gift. Others - even people I love - behave as if trauma is contagious and the less said about it the better. I like to give them the benefit of the doubt and think that they can't really understand what it means to be silenced. Sometimes, however, this is no longer possible. It is not healthy to be silenced. The problem isn't that I MUST always speak about my pain. The problem is that the traumas I experienced are a part of me and, even though I am working on healing, the pain may never be entirely gone. And so, I have to limit my exposure to people who want to silence me. 

Speaking Up

My ex followed up our talk with a hurtful email that said, amongst other things, that being reunited with our daughter should make up for any trauma that I experienced in the past and that he wasn't interested in holding my hand while I continued to grieve. If it were only that simple. My relationship with my daughter is a tenuous thing and she hasn't spoken to me in over a year, while my ex sees her and talks to her regularly. Both my ex and my daughter imply that "if only you would change and let go of the past everything would be great." That might be true. But it is hard for me to believe. Telling people that "if only you change, I'll love you," rarely seems to work, at least in my experience. My therapist has often told me not to disown that part of myself that experienced the trauma. I also know that if I tried to silence that part of me, not only wouldn't it work, but I would have to erase a large part of myself and I can't do that. It reminds me of the hikers we met along the West Coast Trail on Vancouver Island. There was a large dead seal near where they had pitched their tent They had simply thrown some dirt over the seal and moved their tent 20 feet. Both black bears and mountain lions frequent that stretch of the trail and neither animal would be the least bit fooled by dirt. Trying to cover up trauma and grief can be that way: only the person burying it thinks it's hidden.  To get back to my ex, I responded to his email with one of my own. Amongst other things, I said that "I am tired of your anger and your inability to accept me for who I am."  And that's what it comes down to: acceptance or silencing. I have silenced myself for many years and now that I am learning to speak out, I can't stop. I have a voice and I need to use it. That doesn't mean I have to speak out at inappropriate times and places. All I know is that I don't want to be silenced again. And after I sent the email, I felt a burden lift from my heart. Below, Dr. Maya Angelou reads her poem "And Still I Rise," Her poem evokes the beautiful resiliency of the human spirit under difficult circumstances. It is a poem that resonates with me. 

 

 

Has anyone ever silenced you when you were sharing your feelings about past traumas or your grief? What did you do?

This is the first in a series of posts on trauma within communities and why trauma survivors need to speak out in order to heal.  

Kindness - offering the gift of kindness to ourselves

 Before you know kindness as the deepest thing inside, 

You must know sorrow as the other deepest thing . . . 

Then it is only kindness that makes sense anymore,

Only kindness that ties your shoes and sends you out into the day . . . 

                                                Naomi Shihab Nye

 

                    Grandmother and grandchild (Michael J. Foley photo, flickr)

Today, I went Christmas shopping. I also mailed out a box of candy to the daughter who isn't speaking to me. That made me feel both "sorrowed and glad," as a line from one of the songs we did in last week's concert goes. Sorrowed because I imagined the candy going into silence. Glad because, even though my daughter isn't speaking to me, she has not asked me to quit writing. After mailing the candy, shopping began. Christmas shopping is never my favorite thing and so I tried to be kind to myself. Generally, I am a kind person. I don't say that in a bragging sort of way, it's just that after going through trauma and grief, I understand that the world isn't always kind and so we have to be kind to each other and enjoy kindness when we encounter it. I don't have to remind myself about this - especially as I get older - this understanding is there like the air I breathe. 

Sadly, people who have experienced more than their share of sorrow or trauma, aren't always kind to themselves. I'm not sure why. In my case, part of it is self-blame for things that have happened in my life, even though they were not things I caused. Also, the aftermath of some kinds of trauma creates shame and even self-hatred. However, each year I succeed in being a little kinder to myself. Therapy and singing helps with that. So does visualizing kindness. As often as I can, I imagine myself being as kind to myself as a mother (0r grandmother) would be too their (grand) child. I imagine being tender with myself and it helps. Kindness is powerful. It may seem like a small thing compared to the large sorrows, worries and even traumas and tragedies that overtake us in our daily lives. But, really, it is one of the strongest things in the world. Poet Naomi Shihab Nye recognizes the power of kindness, which she describes so beautifully in her poem, "Kindness". Kim Rosen, poet and author of Saved By a Poem, reads Nye's poem, below. 

 

 

This is one of my favorite poems and the more I read it, the more I wonder whose kindness the poem is talking about. Lately, I've been thinking that Nye is talking about the voice we carry around in our heads that we can either use to speak to ourselves with kindness or to judge ourselves harshly. And, more and more, I turn to myself with kindness because I need kindness, like a tree needs water.

Everyone needs kindness, but those of us who are processing grief and trauma need it more than others. Recently, I read a book about sexual violence during the Rwandan genocide, called The Men
Who Killed Me. It sounds like a grim book, and in many ways it is, yet throughout the book many of the survivors who share their stories experienced moments of kindness during the genocide, however rare those moments were.  One young woman, for example, was rescued by an old woman who found her barely alive and gave her the food and water she needed to stay alive. "Compassion filled her heart at that moment," the woman said of her rescuer fifteen years later. None of these survivors forgot the kindnesses that kept them alive during the genocide. We are all in need of kindness during the holidays and, this kindness must begin in our own hearts. It is too important to leave to the kindness of strangers, as wonderful as that may be, or even to the kindness of family and friends.  The Tutsi women of Rwanda had to rely on others - and there is no harm in that - but cultivating self-kindness is an essential part of kindness. How to Be Kind to Yourself by Juliet du Preez, is an excellent post that does an wonderful job of describing self-kindness. 

Meanwhile, how was I kind to myself today?  

• I did not go to a mall (which I hate) and only went into stores that I enjoy.
• I made sure to stop shopping and eat a good lunch.
• I quit looking for vintage tea towels for my sister after going to 3 different places AND I forgave myself for only finding 2 not particularly exciting ones.
• I allowed myself to buy a book at a used book store simply because I loved the title, A Walnut Sapling on Masih's Grave and Other Stories by Iranian Women.
• I came home while I still had enough energy to notice  - and enjoy - the full moon rising in the clear winter sky.

                      (photo by Mark Blasingame, flickr)


How do you take time for self-kindness during this hectic, and often difficult, time of the year?