A guest blog by Margaret Martin, LCSW
Margaret Martin is a social worker that I have known for nearly a decade. Over that span of time we have shared many clients and I have always found her to be warm, brilliant and highly effective as a therapist. Recently Margaret posted a blog on trauma therapy which is a speciality of hers. I wanted to re-post the blog here so that my readers can learn from her expertise on this very important subject. What follows is her post:
Over the years I’ve found that there are some frequent misconceptions among clients seeking treatment for trauma. Based on outdated ideas of trauma therapy and a misunderstanding of the process, any one of the following beliefs could be enough to keep an individual from seeking treatment for trauma. So I want to challenge them here.
“I have to tell my whole story in order to heal.” Nope, not true. In fact, telling the story, especially all at once or repeatedly, can be re-traumatizing. Some approaches to trauma (most notably Prolonged Exposure Therapy) promote the belief that healing comes from the repeated re-telling of the trauma story. However, many clinicians see exposure therapy as simply creating a state of habituation or desensitization, a kind of “numbness” to the trauma, rather than true recovery or restoration. Desensitization not does not necessarily equal healing. Somatic Experiencing (SE), developed by Peter Levine, PhD, is one approach to trauma treatment that not only does not require the re-telling of the traumatic story but discourages moving in a way that might be re-traumatizing for the client. SE provides a compassionate approach, allowing clients to test the water and dip their toes in and take them out again, rather than diving into the deep end of the trauma pool.
Several years ago I moved away from using Eye Movement Desensitization Reprocessing (EMDR) as my go-to weapon in the fight against PTSD, particularly with clients with complex trauma. Although EMDR is still the best choice for some clients, I now use SE more frequently because I see it as much more gentle on the nervous system, especially for those with few coping skills or who currently function at a very limited capacity. Healing from trauma is hard work, but the process should not leave the client feeling raw, overwhelmed or exhausted. When that happens the process is moving too fast and needs to slow down. This does not mean that healing happens more slowly; it means the process is less painful.
“If I can’t remember what happened, or I’m not sure, I can’t heal.” Many people don’t remember the details of a traumatic event. Sometimes people have symptoms of PTSD and don’t know why. Others have vague, dream-like memories that frighten them, but for which they have no context. If trauma occurred before an individual was able to process the information verbally (any time prior to age 3-5) the memories are “implicit” rather than “explicit,” and typically have no language attached. Memories of early life events may also take on a more mythical form, such as being smothered or attacked by a shadow or monster, or hiding from an unknown danger. All of these are normal responses to trauma. Healing from trauma can happen whether or not the client knows “what really happened.” Many clients doubt their own stories or memories. This too, is normal, especially if the experience has been invalidated by other family members or friends. The reality is that symptoms of PTSD don’t occur without reason. Luckily we don’t have to know or fully understand the reason in order to heal.
“Therapy won’t help or it will get worse before it gets better, and I can’t handle that.” Jumping right in and pulling the scab off the wound can absolutely result in the experience of PTSD getting worse before it gets better. That’s why we don’t do it that way. We go gently, slowly, making sure that before we consider abandoning old coping skills, even those that are unhealthy, we work on healthier coping skills to put in their place. We create a safety net and anticipate what kinds of triggers or experiences might be “too much” or something the client “can’t handle.” Although there are times when even the most careful approach can feel overwhelming, I’ve found that especially with SE that is not often the case.
“I’m going to have to confront the perpetrator (if there is one) in order to heal.” In my experience this is a much less commonly held belief but one that can certainly dissuade someone from seeking treatment if they believe it. It’s also not true. In many situations confronting the perpetrator could be dangerous, either physically or emotionally, or could have other negative consequences. Unless confronting the perpetrator holds a clear benefit or gain, such as protecting others or taking legal action, clinicians specializing in trauma often discourage it. It certainly needs to be postponed until the survivor has explored his or her motivations, expectations, and all possible outcomes. Unless they’ve changed significantly, a perpetrator, and those who support and protect him or her, will continue the denial, rationalization, and thinking errors that allowed him or her to engage in the abuse in the first place. Expecting an apology or compassion is unrealistic and potentially risky.
I hope that if you or someone you love has been avoiding therapy due to fear of the process this perspective will be helpful.
Many thanks to Margaret for her words of wisdom. As always if you have benefitted from this information please click on the "like" button below to like it on Facebook, click on the Twitter button below to tweet it or click on the "Comment" button below to add a comment.
Wishing you health and happiness,
“To love without knowing how to love wounds the person we love.”
"To know how to love someone, we have to understand them. To understand, we need to listen."
A monk is not usually someone I would think to get relationship advice from. What do they know about the frustrations of mis-matched libidos, or dirty socks left for the spouse-as-maid, or stress about how to put the kids through college? I admit typically I trust relationship advice from people who have been there, done that.
But never say never is one of my favorite mottos. So I was pleasantly surprised when I read a book review of Thicht Nhat Hanh's latest book How To Love. In it Nhat Hanh states that “understanding is love’s other name” — that to love someone means to fully grasp his or her suffering. He gives this metaphor:
"If you pour a handful of salt into a cup of water, the water becomes undrinkable. But if you pour the salt into a river, people can continue to draw the water to cook, wash, and drink. The river is immense, and it has the capacity to receive, embrace, and transform. When our hearts are small, our understanding and compassion are limited, and we suffer. We can’t accept or tolerate others and their shortcomings, and we demand that they change. But when our hearts expand, these same things don’t make us suffer anymore. We have a lot of understanding and compassion and can embrace others. We accept others as they are, and then they have a chance to transform."(emphasis added)
What I find so amazing is how right-on he is about this. As someone who has been trying to help others love each other for over a decade and as a person who has been trying to learn to love my own partner better for nearly two decades this just rings so true. To truly love someone is to understand them. To understand their origins, their wounds, their scars and their pains. When you know these things it changes how you feel about their actions, often most of all their "unfortunate" actions. Some of their worst behaviors can be viewed with compassion and love. The spouse who can't seem to ever apologize is seen as the child who was never apologized TO. The partner who closes themselves off is the child who never had anyone available to share WITH. We begin to see that our partner is not so much acting against us or even in reaction to us but tilting at ghosts of windmills from their past. Fighting dragons long gone from their own childhoods. From this vantage point we can expand our capacity to love them even in their "low road" moments (as Dan Siegel would say).
I would also argue that our failure to consider our partner's past often becomes the new wound for them. When I cannot hang in their with the partner who struggles to mend the fence, or tell me that s/he loves me more often, I become a new wound in their attachment narrative. So not only do I miss an opportunity to heal an old wound that came before I ever arrived but I create a new one as well. How sad.
What can be done about this? Thicht Nhat Hanh would say "listen". Listen and this will lead to understanding. Understanding will lead to compassion. Compassion will lead to deeper, fuller and more stable love.
He points out the difference between infatuation and real love. Infatuation prevents us from knowing the other because it projects onto the other person the fantasy of who he or she can be for us. It is based on our own needs and desires rather than truly seeing who that person is. Nhat Hanh goes on to say "Often, we get crushes on others not because we truly love and understand them, but to distract ourselves from our suffering. When we learn to love and understand ourselves and have true compassion for ourselves, then we can truly love and understand another person."
He explains the idea of a two-person system (a concept I learned from Stan Tatkin) by saying "In a deep relationship, there’s no longer a boundary between you and the other person. You are her and she is you. Your suffering is her suffering. Your understanding of your own suffering helps your loved one to suffer less. Suffering and happiness are no longer individual matters. What happens to your loved one happens to you. What happens to you happens to your loved one...In true love, there’s no more separation or discrimination. His happiness is your happiness. Your suffering is his suffering. You can no longer say, “That’s your problem.”
Stan Tatkin teaches that this type of thinking promotes safety and security in the relationship because if I deeply and fully know that whatever I do impacts you, then I will take care in all of my interactions to do what is best for BOTH of us. This short-circuits many of the problems I see in relationships. Most, if not all relationship problems I see have some element of "this is what I need to do to take care of MYSELF" in it. When people can really stop thinking of themselves as totally separate from their partner the relationship goes to a whole new level.
Lest you think I am promoting co-dependency of some sort please see my earlier blog delineating healthy inter-dependency from pathological co-dependency in which there is a link to an interview with Dr. Tatkin on the subject. I am not promoting co-dependency in any way. But I do agree with Dr. Tatkin and Thicht Naht Hanh that "what happens to your loved one happens to you" and vice-versa. And I think in our narcissistically-oriented self-absorbed culture this is a message that is sorely needed. It's not all about us as individuals. It's about subjugating oneself to something larger. To the relationship. And trusting that the relationship is going to circle back and take care of you.
Wishing you deeper knowing of yourself and your partner; deeper compassion for yourself and your partner; and deeper love between you and your partner.
All the best,
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Krista Jordan, Ph.D.
Dr. Jordan has been in private practice for 20 years in Texas. She is passionate about helping people to overcome hurts and obstacles from their past to find more happiness and health in their current lives.