Doubt has a negative connotation; it is often associated with fear or dread. However, the origin of the word in Latin (dubitare) does not carry the same ominous weight. Dubitare meant to question, hesitate, or to consider the choice between two things. It wasn't until the early 13th century that doubt began to indicate fear. I believe we have hindered...

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Often when we think about healing from trauma we think about how daunting the journey may be.  We may even choose to put off directly addressing our trauma because the challenge may feel too great.  Whether we choose to engage in the formal process of psychotherapy, there are many ways we can begin to heal; strategies we can implement now and strategies that may offer immediate relief.  While this list is not exhaustive, it is an invitation to think about immediate choices we can make to positively change the way we see ourselves, our relationships, and the world:

1.  Get Support

The first step in making changes is to stop keeping secrets. There is power in secrets and once secrets begin to be opened, changes can occur. Tell a trusted friend, a trusted family member, or a counselor/therapist.

2. Identify others who can empathize with your experience.

There is comfort in sharing our experiences and feelings with others who “know”.  There are trauma survivor groups all over the country and many, run like 12-step recovery programs, are free of charge. Many agencies in Chicago offer survivor groups, and Live Oak is the only agency in Chicago—and in the midwest, offering groups specifically for gay male survivors of childhood sexual abuse.

3. Take care of your body.

For many of us, trauma involves some loss of control over our bodies, so many of us who are survivors disconnect from our bodies or do not take good care of our bodies. Eating well, getting exercise, and getting enough sleep may sound overly simple, but these are three strategies that help create balance and a sense of grounding. Feeling better about our body can also lead to better self-care in other areas.

4. Create something every day.

Many of the residual effects of trauma are stored in parts of the brain that cannot be accessed through “talk”.  By engaging in creative and/or expressive activities, it is possible to process (or metabolize) parts of the trauma without having to speak about it. Drawing, painting, photography, playing an instrument, and dance are just some examples of creative/expressive activities that help process trauma and also help get us back in touch with the body.

5. Connect with nature.

One of the effects of trauma can be a disconnection with the world and the larger community of living things. By getting back in touch with life’s cycles, it’s possible to feel a greater connection to other people and the world at large. Place plants where they can be seen regularly. Take walks by lakes, oceans, mountains, valleys—anything that allows reconnection with the larger world. If possible, have an animal or pet as part of daily life. Caring for and receiving unconditional love from an animal can be a powerfully healing experience, and can be a precursor to more rewarding relationships with other people.

6. Connect with some power greater than the self.

Trauma may leave us questioning the existence of God (“if there was a God, how could s/he let this happen to me?”), so it is often helpful to incorporate some type of spiritual practice into daily life. This does not need to be organized religion. It may be lighting a candle each day, reciting a personal prayer, creating daily rituals, or connecting with a more organized religious community that provides support and healing.

7. Do soothing things.

Because trauma often causes us to be in a constant state of alert and/or perceived threat, engaging in activities that reduce this higher level of arousal can be immensely helpful. Meditation, yoga, Tai Chi, breathwork, massage or other activities that lower levels of arousal can help in feeling more grounded, more connected to the body, and more connected to feelings in a manageable way.

8. Volunteer.

The act of helping others and feeling worthwhile is a significant antidote to self-loathing, low self-esteem and feelings of inferiority that frequently are the result of trauma. Finding ways to find purpose once again and to feel valued by others in some way helps to create structure in our lives and provides a foundation from which to re-build self-esteem.

9. Allow feelings to be felt as they arise.

Many of us who have survived trauma may have learned that emotion is scary and when feelings come up, they are to be pushed down. If we allow ourselves to  feel the feelings as they come up, we are less likely to engage in acting out or destructive behaviors to mask them. It may be helpful to engage in creative/expressive activities when feelings arise, so that they can be processed and released. Sometimes keeping a journal is also helpful as it allows feelings and thoughts to be recorded on paper and not stored in the head or body of the survivor.

10. If possible, access a therapist or counselor who is trained in working with survivors of trauma.

There are unique issues that arise for us as survivors and it’s important that if therapy is an option or choice, that the therapist chosen has special expertise and sensitivity to these issues.  If necessary, it’s important to ask if the therapist chosen has reduced rates or negotiable fees.  Also we shouldn't  be afraid to ask about special training in working with the trauma(s) with which we are dealing.  It's our right to know the background, experience, and training of professionals we invite into our lives for support.   These ten strategies are not meant to serve as a prescription for healing from trauma, but they are an invitation to experiment with healing now, safely, and immediately.  There may never be a "right" time to heal, but we can begin thoughtfully, in small ways, on a daily basis.  

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Defining Trauma

Historically, there has been controversy over what constitutes “trauma”.  Mental health definitions have changed over time, but most explanations still discuss exposure to an event (or witnessing an event) that threatens our physical or emotional integrity—where there is horror, fear, and/or the possibility of death.

While many definitions are useful in providing a clinical understanding of trauma, they don’t capture the subjective nature of our traumas and the possibility that trauma manifests differently for different people at different times of life.  These definitions also don’t fully recognize the possibility of trauma occurring outside the context of a diagnosis of Post-Traumatic Stress Disorder.

I’d like to invite us to conceptualize trauma more broadly and not be constrained by a clinical definition for diagnostic purposes.  It is important to note that many definitions of trauma exist. Experimenting with the definition I’m about to propose in no way implies it is the only definition or the best definition.  More so, it is a definition that allows us to look at the subjective nature of traumatic experience and consider the various ways that trauma may influence our development as humans.  With that in mind, I propose the following definition of trauma:

Trauma is an event, action, or condition that damages, disrupts, distorts, destroys or changes in some fundamental way, how we see ourselves, our relationships, and or our world.   These changes manifest consciously and unconsciously, implicitly and explicitly, and frequently involve changes in thoughts, emotions, our five senses, and how we experience our bodies.    Trauma may result in post-traumatic stress and/or post-traumatic growth.

One way to experiment with the relevance of this definition is to choose an event that you have identified as traumatic in your life.  On a scale of 1-10 with ten being most traumatic and 1 being least traumatic, explore choosing an event that is somewhere around a 4 or 5.  In doing this exercise, many people report that they automatically choose, or to go, an event that is a 10.  If this is you, just notice you have chosen a charged event and be gentle with yourself as you apply this definition.

Once you have fully imagined the event, action, or condition of the trauma, read the definition out loud and notice the extent to which the experience you have identified resonates with the definition I am postulating. How does the trauma you’ve chosen impact how you see yourself, your relationships, or your view of the world?  How have your thoughts and feelings been influenced?  Your senses?  Where do you hold your feelings or tensions in your body?  How does the trauma impact the way you walk, hold your body, sit, or feel constrained in your movement?

Feel free to modify the definition based on your personal experiences.  More than anything, I hope you will be able to understand the subjective nature of trauma and the many ways it alters how you have been moving forward in your life subsequent to a traumatic experience, keeping in mind that trauma creates stress as well as an opportunity for growth.   

What if my trauma is “not as bad as”, or “worse than” someone else’s?

All of us use the word trauma for describing difficult or painful experiences in our lives or in the lives of those we love.  Sometimes we struggle with whether what we have experienced is “as bad as” what others have experienced.  Other times, we struggle with the idea that what we experienced is “far worse than” what others have experienced.  Often, either comparison leaves us questioning our own experience and the extent to which we can “claim” it as traumatic.  We may also feel more isolated when we compare our experience to others’.

As a social worker who is also a therapist, when I think about my own experiences of trauma and the experiences of trauma of those with whom I’ve worked, what I’ve found is that most of us:

  • feel ambivalent, scared, nervous, anxious, or angry about dealing with our trauma

  • feel like therapy is supposed to “fix everything”

  • feel like therapy won’t “fix anything”

  • think that what happened to us may not be as “bad” as what happened to others

  • think that what happened to us may be “worse” than what happened to others

  • want to say everything as soon as possible

  • want to say nothing for as long as you can

I hope that knowing that all of us may, at some point in our lives, believe one or more of the statements above, may help us consider that we are not alone. Others may feel the way we have in the past or the way we do now. Though when we talk about trauma, it is imperative that we speak the same language.  It’s important that we have agreed upon terminology that allows us to have conversation, to gently challenge ourselves and one another, and to grow from these challenges.

When all is said and done, trauma is trauma, and as a result, we—all of us—are changed.  

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It is virtually impossible to understand trauma without understanding the extent to which it resides within our multiple, complex, and shifting identities.  The same traumatic experience will be understood and metabolized differently when experienced at age 3 than at age 30, differently for men than for women and differently for parents than for non-parents.  Not only does trauma impact us differently based on the identity within which it is experienced, it is understood uniquely based on how our multiple identities intersect, overlap, and influence one another.

Multiple Identities 

Congruent versus Incongruent Identities

Our identities have qualitative similarities and differences.  For instance, some of our identities feel more congruent with one another, while others seem to be more incongruent.  A mother who also holds an identity of perpetrator may experience a dissonance between these identities (i.e. mothers are not supposed to be perpetrators).  And while fathers are also not “supposed to be perpetrators”, there is a greater cultural familiarity holding identities of father and perpetrator simultaneously.  The extent to which our identities feel congruent influences how we understand ourselves and perhaps come to accept ourselves.  Those of us with multiple, incongruent identities may have more difficulty feeling integrated and whole, since our identities feel more dissonant and incompatible.

Visible versus Invisible Identities

There are some identities which are visible, simply by looking at or observing someone.  We can generally tell if someone is a man or woman (though of course there are exceptions).  We can tell if someone is a child or an adult, and we can usually tell if someone is of African or Asian descent.  Other identities are not as easily to discern with the naked eye.  For instance, we cannot identify a survivor of sexual abuse simply by his/her appearance.  Similarly, we cannot tell if someone is lesbian or gay by their appearance, nor can we determine someone’s religious status simply by looking at them.  There are behavioral cues that many of us may give which help others discern one or more of our identities, but many invisible identities cannot be determined without additional information from the individual.

In terms of trauma, this increases the likelihood of exposure to insidious types of trauma.  For instance, we may be more likely to make heterosexist statements and homophobic comments if we are not aware that some of the people with whom we are interacting identify as lesbian, gay, or bisexual.  The “invisible” identity often requires some form of disclosure to others and when one or more invisible identities are coupled with one or more invisible traumas, greater fragmentation and isolation is possible.

Temporal Identities

Most of our identities have a temporal nature; that is to say that they are more or less salient at different times in our lives.  Our identity as a son may be greater when we are younger, less during our early adulthood, and then as we are called upon to care for aging parents, the “son” identity may become more powerful once again.  Our identity as female may also wax and wane over our lifespan depending upon developmental events we experience, including puberty, marriage, pregnancy, parenthood, and menopause.  Similarly, some identities last for a discrete period of time.  We are students for a finite number of years and then this may not be a formal identity we hold.

It is important to consider the extent to which trauma resides in temporal identities and may re-emerge as identities shift due to the passage of time.  The traumatic loss of a parent during childhood doesn’t “end” as much as it returns again and again over our lifespan, having different meanings when we are a child, then when we reach adolescence, and then again as an adult.  This is often the case with many traumas---that they return again and again to be metabolized over and over based upon our current life space.

Relational Identities

Some of our identities only exist in the context of a relationship with someone else.  Examples of these types of identities include:  husband, wife, brother, sister, father, mother, aunt, uncle, etc.  Each identity, by its very nature, implies a connection with another human being.  Relational identities have potential to complicate the processing of trauma when the survivor or perpetrator are somehow “related”.  Trauma within the context of these relationships may feel incongruent and therefore make it more difficult to discuss, metabolize, and release.

Inside versus Outside an Identity aka Identity and Subjectivity

As we come to understand our multiple identities, we learn that the experience of an identity is extremely subjective.  Even the same identity can be understand differently when looking out from within the identity compared to looking in from outside the identity.  For instance, a white gay man may experience himself as powerless and ashamed because he is gay.  An African American man may see the white gay man as powerfully privileged.   Another example of such a discrepancy exists with religious groups.  For instance, Jewish Zionists may see themselves as survivors of horrible oppression while Palestinians see these same individuals as perpetrators of horrendous violence.

Geography and Identity

While our objective identity may not change as we move from place to place, the way we experience our identity and the way others experience us may be influenced by the geographic location in which we reside.  For instance, a woman who identifies as Muslim and resides in a primarily Muslim country may experience herself and may be experienced by others very differently than in a predominantly Judeo-Christian country.  Even within the United States, geography influences identity.  An African American man may experience himself very differently in a traditionally conservative, southern, rural town than he would in a racially diverse larger city.  His identity may also be experienced differently by others “outside” himself.

Trauma and Identity 

While we have been discussing how identity and trauma relate, the subjective nature of trauma coupled with the subjective nature of identity can significantly complicate our understanding of ourselves and our experiences.

When one identity nests within one or more other identities, trauma may infiltrate all parts of identity, influenced by the way each identity is experienced.  Similarly, when one trauma nests within one or more other traumas, our multiple identities may be influenced by and expressed through our understanding of the trauma.  We cannot understand another’s experience of trauma without understanding how identity is experienced on multiple levels and, we cannot understand another’s experience of identity without understanding how trauma is experienced on multiple levels.

The complex and intersecting nature of trauma and identity is dynamic, lifelong, sometimes invisible, often relational, and almost always subjective.

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I will be answering this question in a short video that will be available soon at http://projectpsychotherapy.blogspot.com.  My thoughts here are a version of what I plan to say less formally in the video.

Psychotherapy helps by offering a unique place in which to tell your story and to develop a healing conversation that relieves the distresses and increases the pleasures of living.  There are three parts to the process:  safety, exploration, and action.

We start with a safe and confidential space—and that is something we create together.  We agree to meet regularly and our work is confidential.  Every topic is welcome; our goal is to learn, to experience, and to understand.  You set the agenda and you set the pace, I learn about your life from you, and we work together to nurture a welcoming curiosity about everything you experience—painful or pleasant, harmful or healing.  We want to create a safe relationship—remembering that safety and comfort are not the same.  This is our context for change.  Psychotherapy helps in the long run because we create this context and work outward from there.

Inside this safe and confidential space, we explore your experience—past and present—and we test plans and goals for the future.  Together we can challenge familiar patterns of feeling and behavior and explore new possibilities—figuring out how you have kept yourself safe in the past and exploring new ways of being safe and effective in the future.  This can be scary, and even painful—but we can do the work because we have built a safe place in which to meet, to talk, to feel, to explore.

Our work will open new ways to act and to live in your everyday life.  Because we often have overly narrow conceptions of what is possible in our lives, our work is designed to break out of those limits and to envision and then to practice a richer and more satisfying life.  Things done and said in therapy will find their way into your daily life—and the therapeutic relationship will serve as a touchstone while you are testing new ways of living.  We start small—with our relationship, and we build outwards—always using the space we have created together as a place to return to for reflection and revision.

Our relationship is what makes the difference—not because I am wise, but because the safe and confidential space, and the openness and safety of our conversations, helps you gain access to the full range of your own abilities.

There are two questions I am often asked:  How is this different from talking to a trusted friend?  How will I know when I am finished with therapy?

Our relationship is intimate like a friendship, but it is one-sided; it is focused on you, and you don’t have to take care of me.  It is also more structured than a friendship—we have a purpose—to help you—and we pursue that purpose apart from the pressures of daily living.  In addition, my training allows me to apply to your life knowledge of the life cycle, and of the common features of distress and recovery, in ways that can be helpful.  Knowledge like that matters but it is not sufficient—we need our relationship to apply it.

You will know you are finished when our conversations have become a part of you, that is, when the things we experience and talk about together become things you do on your own.

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