Doc’s Corner

Holiday Celebration Dichotomy

We are currently in the midst of the “Holiday Season”. Thanksgiving is a wonderful time to reflect on our many blessings in life and enjoy good food with friends and family. This is also a time of much emotional conflict for many. While some of us enjoy the festivities and celebrations, others feel estranged and lonely. Our community has just experienced extreme trauma from the Borderline shooting experience and then the devastating fires. Rather than feeling like celebrating, many feel great loss and loneliness. Each of us handles tragedy differently depending on our “life story”, the circumstances along our path of life.  

As we learned all too well in Thousand Oaks, one does not have be a combat soldier, or visit a refugee camp in Syria or the Congo to encounter trauma. Trauma happens to us, to our friends, to our families, and to our neighbors. Research by the Centers for Disease Control and Prevention has shown that one in five Americans was sexually molested as a child; one in four was beaten by a parent to the point of a mark being left on their body; and one in three couples engages in physical violence. A quarter of us grew up with alcoholic relatives, and one out of eight witnessed their mother being beaten or hit.Some have experienced horrific acts of violence or witnessed it up close.

As human beings we belong to an extremely resilient species. Since time immemorial we have rebounded from our relentless wars, countless disasters (both natural and man-made), and the violence and betrayal in our own lives. But traumatic experiences do leave traces, whether on a large scale (on our histories and cultures) or close to home, on our families, with dark secrets being imperceptibly passed down through generations. They also leave traces on our minds and emotions, on our capacity for joy and intimacy, and even on our biology and immune systems.

Trauma affects not only those who are directly exposed to it, but also those around them. Soldiers returning home from combat may frighten their families with their rages and emotional absence. The wives of men who suffer from PTSD tend to become depressed, and the children of depressed mothers are at risk of growing up insecure and anxious. Having been exposed to family violence as a child often makes it difficult to establish stable, trusting relationships as an adult.

Trauma, by definition, is unbearable and intolerable. Most rape victims, combat soldiers, and children who have been molested become so upset when they think about what they experienced that they try to push it out of their minds, trying to act as if nothing happened, and move on. It takes tremendous energy to keep functioning while carrying the memory of terror, and the shame of utter weakness and vulnerability.

While we all want to move beyond trauma, the part of our brain that is devoted to ensuring our survival (deep below our rational brain) is not very good at denial. Long after a traumatic experience is over, it may be reactivated at the slightest hint of danger and mobilize disturbed brain circuits and secrete massive amounts of stress hormones. This precipitates unpleasant emotions intense physical sensations, and impulsive and aggressive actions. It also leaves traces on our minds and emotions, on our capacity for joy and intimacy, and even on our biology and immune systems. These posttraumatic reactions feel incomprehensible and overwhelming. Feeling “out of control”, survivors of trauma often begin to fear that they are damaged to the core and beyond redemption.

Recent studies are helping us to understand how overwhelming experiences affect our innermost sensations and our relationship to our physical reality—the core of who we are. We have learned that trauma is not just an event that took place sometime in the past; it is also the imprint left by that experience on mind, brain, and body. This imprint has ongoing consequences for how the human organism manages to survive in the present.

Trauma results in a fundamental reorganization of the way mind and brain manage perceptions. It changes not only how we think and what we think about, but also our very capacity to think. We have discovered that helping victims of trauma find the words to describe what has happened to them is profoundly meaningful, but usually it is not enough. The act of telling the story doesn’t necessarily alter the automatic physical and hormonal responses of bodies that remain hyper vigilant, prepared to be assaulted or violated at any time. For real change to take place, the body needs to learn that the danger has passed and to live in the reality of the present. Our search to understand trauma has led us to think differently not only about the structure of the mind but also about the processes by which it heals.

Being able to feel safe with other people is probably the single most important aspect of mental health: safe connections are fundamental to meaningful and satisfying lives. If you are a victim of trauma or struggling to help someone who is, I suggest reading, Bessel van der Kolk, M.D. “The Body Keeps the Score.”

As we continue to celebrate the holidays, it is good to remind ourselves that some of us are hurting, feel alienated, not understood and very alone. Be sensitive to their “story” and offer support with a desire to understand and come along side.

Happy holidays!

 

Paul R. Block, MD, FACP, FCCP

 

Includes Excerpts From: Bessel van der Kolk, M.D. “The Body Keeps the Score.”


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