“So, Annie, what do you do for work?”

I was at a dear friend’s wedding last weekend back in New England and many people asked me this question across the several days of events.

And I’d say, “I’m a trauma therapist.”

“Oh,” they’d reply, “So you work with Veterans?”

And I’d say something like, “Well, no, not exactly. I’ve worked with active-duty military members before, but mostly I work with professionals in the Bay Area. Lawyers, doctors, tech folks, start-up founders, UC Berkeley students.”

“But didn’t you say you were a trauma therapist?”

“Yes, I am.” 

And more than a few times I’d see brows wrinkle and sense that the niche I have as a clinician and the population I work with didn’t seem to reconcile for these folks. 

And I get it. 

Most of us have a preconceived notion of what trauma is, and also a preconceived notion of who someone with a trauma history might look like. 

But because those preconceived notions tend to be limiting and somewhat unhelpful if you fall outside the scope of the notion, I wanted to write today’s post to dispel the “myth” of not only what trauma is, but also what someone with a trauma history can look like.

My hope is that, if you see yourself in either description, that you can feel validated, more curious about your experience, and perhaps more inspired to seek out help if you need or want it.

 

What is trauma?

The best definition I’ve found is this:

Trauma is the unique individual experience of an event or enduring conditions in which the individual’s ability to integrate his/her emotional experience is overwhelmed and the individual experiences (either objectively or subjectively) a threat to his/her life, bodily integrity, or that of a caregiver or family.

(Saakvitne, K. et al, 2000).

There are two parts of this definition that I want to highlight. 

First, “trauma is the unique individual experience.”

By this definition we see that psychological trauma is subjective and relative – meaning what makes something traumatic for one person may not be traumatic for another depending on what our ability to deal with it is. 

The key, though, across subjective experiences, is that it overwhelms the individual’s ability to cope with it. 

That’s what makes something traumatic.

And there’s another part of this definition that I want to draw attention to: “enduring conditions.”

Typically and historically, trauma has been thought of as an isolated and discrete event or events: a car crash, a bombing, a rape, military service. 

And certainly, all of these are examples of what could be traumatic for someone. 

But Karen Saakvitne, Ph.D., a distinguished trauma therapist and author, also nuances that trauma can be a set of enduring conditions. 

Enduring conditions are complex and protracted, meaning they take place repeatedly over time. 

For children who are powerless and who depend on their caregivers quite literally to preserve their young lives, examples of traumatic enduring conditions could be:

  • Abandonment or threat of abandonment;
  • Neglectful treatment or conditions;
  • Outright verbal, emotional, or physical abuse;
  • Witnessing domestic violence or frightened or frightening behavior from one or both parents.

So in what context might these traumatic enduring conditions occur? 

Often, unfortunately, these events can happen if you were raised by a personality-disordered, mood-disordered, or addicted parent(s) or parental figure(s).  

Being raised by a narcissistic mother or an alcoholic father (to name just two examples) can certainly set the stage for traumatic enduring conditions.

And, unfortunately, being raised by parents who struggle like this, is an all too common experience for many people in this world, including among high-functioning professionals.

 

So what does someone with a trauma history look like?

I spoke to this earlier in the post’s introduction but there’s often a myth and misconception about what someone with a trauma history can look like. 

Variations of this myth include the assumption that someone with a trauma history has to be a military veteran or someone who’s lived through a major and terrible external event.

Or, sometimes, there’s a belief that someone with a trauma history is low functioning or gravely impaired with their everyday life. 

This particular belief is the one that I think wrinkles brows the most when I tell people what I do for work and who I work with. 

It’s hard for some to believe that you have a complex and extensive trauma history and be, in some ways, quite high functioning. 

But you can absolutely be professionally and financially high achieving and still have a trauma history and trauma symptoms.

You can be a corporate lawyer, a CEO, a start-up founder, a family physician, a brilliant graduate student.

You can own your own San Francisco condo, be married, have kids, manage employees, and have multiple Ivy-League degrees under your belt.

You can have traveled the world, pitched VC’s for funding, have memberships to your city’s best social clubs, and, on paper, have it “all together.”

And you can still have a trauma history and have it still impact you in myriad ways.

Being outwardly high-functioning and needing trauma recovery work are not mutually exclusive things.

It’s just that, sometimes, recognition of one’s own trauma history (based on what someone believes to be considered “traumatic”) gets missed, and trauma-history symptoms either get (adaptively or maladaptively) managed or compensated for until those coping mechanisms stop working quite so well. 

And so, when we define trauma and who someone with a trauma history looks like so narrowly, folks may miss out on seeing the truth of their personal history, causing them to dismiss the severity of what they’ve lived through and the significant impact of their symptoms, adding to their resistance to seek out help. 

 

So how do I know if I have a trauma history? 

The manifestations of and constellations of trauma symptoms are as varied, complex and unique as the individuals who endure the trauma.

Moreover, those with trauma histories may not have memories, but rather only sensations that seem unrelated to any source of trauma.

As psychologist and author Mary R. Harvey, Ph.D. so insightfully states:

“Trauma survivors have symptoms instead of memories.”

(Harvey, M.R. J Trauma Stress (1996) 9: 3. https://doi.org/10.1007/BF02116830)

So, unfortunately, there’s no one-size-fits-all definition to see yourself in. 

But, there are symptoms and signals you can be curious about that may help you reflect on whether or not you come from a trauma history.

Common signals and symptoms of trauma may include:

  • Depression and/or anxiety (including generalized anxiety);
  • Irritability and being very short-tempered;
  • Loss of interest in things that used to bring you pleasure, or in life itself;
  • Numbing through substances and behaviors;
  • Trouble concentrating;
  • Insomnia and challenges sleeping (including nightmares);
  • Feeling emotionally flooded and overwhelmed easily;
  • An inability to visualize a future (let alone a positive future);
  • Hopelessness and despair;
  • Shame, a sense that you’re worthless;
  • Few or no memories, feeling like your childhood is a fog or a big blank;
  • Hypervigilance and mistrust;
  • Body symptoms such as aches, pains, headaches;
  • Substance abuse and eating disorders;
  • Self-harming or destructive behaviors;
  • Feeling like you have no true self, like you don’t know who you really are.

(Adapted from Janina Fisher, Ph.D.’s psychoeducational flipchart.)

 

So what’s the treatment for trauma if I do have a trauma history?

If you identify with having a trauma history, particularly of the complex and relational kind (trauma rooted in painful enduring conditions), there are many options for getting and receiving help. 

Trauma therapy is still relatively in its infancy – though we have nearly 40 years of second-wave work thanks to giants of the field like Judith Herman, MD, Pat Ogden, Ph.D., Bessel Van der Kolk, MD, and Peter Levine, Ph.D. (among others) – and research is providing us with more information and additional trauma treatment interventions as the years progress.

For now, though, the two most effective tools for relational trauma recovery work that we have are psychotherapy and EMDR therapy.

Psychotherapy – particularly with a trauma-informed licensed mental health professional – is a wonderful treatment tool, particularly for those who experienced trauma in the context of an early relationship and who, for their recovery, may need reparative relationship experiences.

There’s also a growing body of research that EMDR therapy – one of the two evidence-based modalities that the World Health Organization recognizes as efficacious for treating PTSD – is a wonderful tool to complement talk therapy in the treatment of complex relational trauma.

Side note: I’m currently completing my EMDR training now and will be rolling this out in December 2019 as a service I offer in addition to my trauma-informed talk therapy services. So what this means is that you can work with me as your primary therapist for trauma treatment recovery work and also receive EMDR or, if you’re already working with an established therapist here in the Bay Area but would like to experience EMDR as an adjunctive treatment to your work with that person, we can partner together, too. If you’d like to stay in the loop about the launch of my EMDR services, please sign up here.

Regardless of whether you work with me or another licensed mental health professional, what I want to say is this:

Trauma is not just something that happens in single, isolated and terrible events. 

Trauma can be something that arises from recurring, painful relational experiences early in life. 

AND, you can be high-functioning and still come from a trauma background. 

Your life can look amazing on paper and you can still be suffering. 

Those two things are not mutually exclusive. 

What’s important, though, is that you don’t dismiss your personal history or circumstances as unworthy of being deemed “traumatic” because of “how good you had it or how good your life looks now.” 

Trauma is indiscriminate in who and how it impacts.

If you see yourself in, what I hope I provided as slightly wider definitions of what trauma is and who and how this might impact someone, I hope that you will honor your experience and reach out for support if you need it.

You’re so worth it.

Warmly, Annie

 

Additional articles of mine that you may find helpful to explore:

 

Medical Disclaimer

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