As I was looking at the posts from the
previous months, I realized that even though they have been covering important
healing issues, they felt very random. The main framework, the bigger picture
was left out. So, this post looks at the forest not the trees of healing.
I often hear from my clients that they
want to be over their ordeal NOW or even better LAST WEEK, MONTH OR YEAR. My
heart goes out to them and all other survivors struggling in this very moment,
as I understand this desire very well. Who would like to spend another second
suffering from anxiety, depression, panic attacks, feeling suicidal or stuck in
the nightmares or horrible memories of what happened? Clearly, no one.
From my perspective, here is the biggest
challenge of a sudden trauma, such as an assault, a military attack, an
earthquake, a murder or a sudden death of someone close. It kicks us out of our
normal ordinary comfortable life and destroys all the paths back to it. We
cannot go back no matter how much we want to or how hard we try. But we
continue to carry with us a memory of how it was before. We desperately want to
recreate it. We do not understand that it is as if a nuclear bomb was dropped
on our house and we need to leave that place behind and move to the new grounds.
Now, chronic traumas, such as childhood abuse, domestic violence, living in a
criminal environment have somewhat different major challenge. We get so
accustomed to living in the war zone, that we either forget or do not know that
it is not like this everywhere, that there are safe places and caring people
outside of the fence. We do not believe that a better life is possible, if we
dare to leave the current situation. Whether we suffered from a sudden or
chronic trauma or both, there are several general tendencies that are
associated with healing from the aftermath.
Many people ask me and themselves why it
takes such a long time to heal from something that took few seconds, minutes,
hours or something that is so far in the past. My understanding is that it is
very easy to destroy something and much more difficult to create, grow, and
heal. A production of a human being takes nine months in the mother’s womb,
multiple years of caregivers taking care of him/her, loving and teaching, before a person can be
self-sufficient and stand on his/her own. How much does it take to destroy this
precious life? Often, just few seconds. Another less horrid example is getting
injured while going through some kind of athletic training. Again, takes just a
moment. A second ago you were strong capable athlete and now you are lying on
the ground screaming from the pain of a broken ankle. It will take months of
careful treatment and rehab to heal it and more months to get back in the
pre-injury shape. SO, here is the first important fact of
healing. It takes time.
When we get a small physical injury, like
a paper cut, it can heal on its own with minimal effort on our part. When an
injury is more serious, such as a bullet wound, it requires much more attention
and effort in order to be remedied. We have to clean the wound, medicate it,
bandage it and so forth on the regular basis. It is very similar but more
complex, when it comes to a psychological wound. We need to tend to it in order
for it to heal. But tending to it is painful and the wound is not visible, so
the temptation to avoid dealing with it is often very strong. We often pretend
that it is not there, while it continues to fester. Alternative of
acknowledging it, looking at it, talking about it is so frightening. But the
wound will not heal unless paid attention to. The second important fact of healing is: it takes effort.
Traumatic events stand out of the realm of
the ordinary human experiences. Those are things that should not be happening
in the normal human life or things that happen once in a lifetime. As a result,
we are not equipped to deal with them. We simply do not have knowledge, skills
and tools necessary to patch those wounds. No one is prepared. It is not our
fault. However, now that we have been injured, it is our responsibility to
learn those new skills. We need to figure out how to re-create a sense of
safety to continue functioning. We need to learn who and how we can trust. We
have to develop an ability to take extra-good care of ourselves. We have got to
learn how to cope with anxiety, depression, desire to self-harm, nightmares and
other things we might have never experienced before. Many of us also have to
put together a new picture of the world, because often the old one was blown up
in pieces by the traumatic events. The third important fact of healing: new knowledge and skills have to
be obtained.
There are many tasks in life that we can
accomplish self-sufficiently on our own. Healing from trauma is not one of
them. We need help and support from others in order to heal. For many people,
who have experienced interpersonal traumas of abuse and betrayal by other
humans, seeking support is very tough. How do we know that those in helping
role will not take advantage of us or betray us? How can we rely on someone,
when we survived only because we relied on ourselves and our strengths? How can
we overcome shame and embarrassment of telling another human being of what
happened and how we coped? How can we trust them to not reject us after they
learn what we have been through? Those and others are complicated questions.
Many survivors struggle with them for years. Some make decisions to avoid
relationships all together. Others
stumble through and get hurt over and over again. If you cannot fathom asking
another human being for support, I suggest starting with individual therapy and
developing supportive relationship with your therapist. The fourth important fact of healing: we need
support of other humans to heal and move forward.
The process of healing also has its own
rhythm and structure. Years of clinical experience and research suggest that
there are certain stages that trauma therapy has to go through. In general, the
process is described as having three stages: (1) stabilization stage includes
learning new skills, coping with current issues and symptoms effectively,
developing a sense of normalcy and safety; (2) reprocessing trauma stage is
about reconstructing traumatic experience or processing it, as well as mourning
losses associated with it; (3) integration stage includes assimilating new
experiences and perspectives, such as new picture of trauma and new perspective
on the world; it also includes internal integration of different parts of self
that were and were not affected by the events. This framework can be applied to
the effective healing process. In addition, timing is an important
consideration too. Many of my clients have experienced feeling stuck and
frustrated for month only to experience sudden insight one day. Many are also
familiar with the experience of taking a step forward only to take two steps
back. All of those experiences are normal and a part of healing. Sometimes
survivors try to push through and expedite the process of healing. It can be
facilitated but only so much. Like a plant has to be a seed and a sprout before
it becomes a full-grown plant, so the process of healing has to unravel. It is
important to know and respect this gradual growth. The fifth important fact of healing is that the process has its own
rhythm, timing, and structure that have to be respected.
Finally, we also have to respect our own
internal rhythm of coming to terms with what happened. Our psyches are complex
and adjusting to the injury takes a number of different steps. Many people go
through the following stages: (1) initial shock and feeling numb or
overwhelmed; (2) denial that trauma was a big deal or that it had any impact,
trying to persuade self and others that they are coping well or are over it;
(3) anger often comes next brining in focus realization that they were wronged
and that what happened was extremely unfair; folks may also just be angry and
irritable at others around them and at the small life stresses without
realizing the underlying cause; (4) profound sadness and depression is the
stage that is associated with realization of how much was lost; the most
difficult realization of all is associated with the loss of parts of self and ability to enjoy life; (5) finally, acceptance
sets in; with it comes a deeper level of understanding about what happened and that old reality is gone forever; survivors
may not like this fact at all but they don’t fight against it anymore. Most
folks go through these stages multiple times, back and forth, feeling
completely done and accepting, only to find themselves in the throws of anger
or denial again. It is a normal process. It feels painful but there is nothing
wrong with the process itself. It often helps survivors to understand the
dynamics and not blame themselves for the “slow progress” or “relapse”. The sixth important fact of
healing: our psyche moves back and forth and gets stuck and unstuck multiple
times as we heal.
I understand that the steps and big
picture of healing may seem overwhelming at first. It may take you reading and
reflecting on this post a number of times or digesting it in small portions.
The idea behind it is to give you hope and understanding that healing is
possible and that you have some control over the process. You can take helpful
steps, you can stay away from interfering with it too much. You can heal!
To summarize, the bigger
picture of the healing from any trauma includes the following aspects:
1. Plenty of time
2. Survivor’s effort
3. Obtaining new knowledge and skills
4. Support of other humans
5. Respect for the rhythm, timing,
and structure of the healing process
6. Acceptance of the cyclical nature
of healing and being stuck at times
I am
interested in your comments and questions. The best of luck on your journey!
