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Book Review-Healing Trauma: Attachment, Mind, Body and Brain

Edited volumes are quite literally a collection of semi-random chapters written by different authors.  The results can be good, bad, or both.  Healing Trauma: Attachment, Mind, Body, and Brain has both good and bad.  It’s an attempt from 2003 to pull together the best of what we knew; in some ways, what we knew then is just as relevant today.  In a few cases, the material and perspectives didn’t age well.  Overall, it’s a good place to get perspective on a vexing problem.

Differentiation and Integration

Navigating the world isn’t always easy.  We’ve got to learn how things are different from one another – and how they’re the same.  These twin processes of our brain are constantly helping us to see better.  Sometimes, as in the case of stigma, it has negative consequences (see Stigma), but much like we’ve learned about altruism, these functions have evolutionary value.  (See Supercooperators and Does Altruism Exist?)

The assertion of Healing Trauma’s editors is that trauma blocks the integration process.  Individuals can see how they’re different, but not how they’re the same as others.  They can see that the trauma was different from their ordinary world but are blocked from integrating that experience with the rest of their lives.  The result is the fragmented, implicit memories that are at the heart of problems with trauma and sometimes develop into post-traumatic stress disorder (PTSD).  (See Trauma and Memory for more.)

Put Out the Fire

Brain Structure

Perhaps one of the most challenging aspects of reviewing older materials is the balance between accepting the reality that different regions of the brain have differentiated functions and rejecting the broad, sweeping statements about the hemispheres of the brain and their function.  The historical perspective of neurobiology was that the left and right hemispheres of the brain had distinct and different purposes.  Our understanding today is more nuanced.

It’s true there are two hemispheres, and they’re connected.  The right hemisphere even develops before the left.  However, often, people overstate both the differences and what can be determined as left or right hemisphere.

As I’ve mentioned in my review of Transforming the Living Legacy of Trauma, we realize today that our thinking is much more distributed and integrated than previously thought.  In fact, therapies like EMDR are theorized to enhance integration between the two hemispheres, thereby relieving distress.

History Is Not Destiny

The power of processing trauma is that, by better processing it, you can change your future.  It’s possible to disable or render inert behavioral habits that lock people into repeating patterns.  While it seems obvious that your history doesn’t set your destiny, when it comes to trauma, many authors seem intent on believing that once you’ve experienced trauma, you are damaged goods.  They ignore the fact that all organisms need stress, challenge, and setbacks.  (See Antifragile and Why Zebras Don’t Get Ulcers.)

More importantly, the estimates are that 80-90% of people will experience a traumatic event in their lifetime.  Effectively, we’ll all be injured by traumatic events – and we’ll all need to figure out how to process those events.

Rather than viewing trauma from the perspective of its unchangeability, we should recognize that the impacts of the trauma are inherently changeable.  The way that we view the traumatic event and how we choose to respond is under our control.

Attachment

Attachment theory has a big impact on the way that we process trauma.  The more secure our attachment, the more likely we are to integrate the memories and develop adaptive styles of coping.  (See Attached.)  What are the factors that are most likely to influence our attachment style?  Obviously, given the roots of the study, they’re our parents’ ability to meet our needs and to not respond negatively to our needs.

What this really means is that the more integrated our parents’ narratives are, the more likely they’ll be to respond positively to our needs as a child.  Those parents who have a coherent autobiographical story integrate their “parent-ness” into who they are, and they choose parent-like behaviors.

The Difference Between Thoughts and Feelings

In How Emotions Are Made, Lisa Feldman Barrett sought to expose the cognitive processes that underlie our emotions.  She explains how our thoughts fuse with our bodily sensations in ways that form emotions.  How we feel about someone or something has as much to do with indigestion or illness as attraction.

Neuroscientists have not been able to find some clear, defining line between what constitutes a thought and what is an emotion.  While they’re differentiated, it may be possible that thoughts are not all that different from emotions after all.

Storytelling and Press Secretaries

We’re constantly writing and rewriting our autobiographies in our heads.  We’re moving from a set of disjointed experiences and stringing a narrative between them.  Sometimes, we can articulate the narrative – and other times, we can’t.  Either way, we’re constantly writing our stories.  Once we passed our second birthday, we began speaking in stories, and the most important one is ours.

Some of what we see as our story is just a rationalization for what we decided without conscious intervention.  Jonathan Haidt explains that the rider in his elephant-rider-path model is a press secretary.  (See The Righteous Mind.)  The press secretary’s job is to make sense of what has already been decided.  Similarly, our conscious mind often just makes up stories to fill in the gaps in what we’ve already decided or done.  (See Incognito.)

Tolerating Trauma

The general strategy for helping to relieve the negative impacts of a traumatic event is to make processing the event easier, safer, and more tolerable.  It isn’t that the event can be made fear- or anxiety-free, but rather that it is possible to reduce the degree to which recalling an event induces fear or anxiety.  It’s important to realize that this isn’t unique to trauma.  In Find Your Courage, it was rightfully asserted that courage isn’t the absence of fear but a decision to move forward in the presence of fear.  The lower the fear or greater the conviction, the greater the chances we’ll see something we call courage.

Fear is at the heart of Richard Lazarus’ work, Emotion and Adaption.  In it, he explains that fear is an evaluation of the impacts and probabilities of an event – mitigated by our coping capacity.  We can encourage better evaluation of the factors of fear so that they can be reduced.

Rick Snyder in The Psychology of Hope explains that hope too is a cognitive process and that when you increase someone’s sense that they know how to solve a problem it gets bigger.  The other component of hope is willpower.  As explained in Willpower, we can increase our capacity for willpower.  Antifragile points to increasing capacity with appropriate challenging exposures.

In Why We Do What We Do, Edward Deci speaks of our intrinsic motivation and the need for us to feel autonomy.  In the language of Compelled to Control, we want to believe that we control ourselves.  The more we believe that we’re in control of our lives, the more intrinsic motivation we’ll have.  The ability to control one’s destiny is also a factor in preventing burnout.  (See our Extinguish Burnout site.)

In short, we can change the factors that make someone fearful or anxious about remembering a traumatic event.  Through this remembering we can continue to lower the fear and anxiety of the traumatic event until it can be successfully processed – and therefore no longer a traumatic event impacting now.

The Disorganization of Nomads

Most mammals return to a home base when frightened.  There’s a den or hutch somewhere that they return to for protection.  However, humans are different: we seek out protectors rather than places.  This may be a side effect of our initial nomadic life, where there wasn’t a singular place we could feel safety.  Instead, we had to adapt to seeking others for our protection.  This becomes problematic when the protector is the one who is making us feel threatened.  Our instinct to protect ourselves leads us away and towards the person at the same time.

Taking a step back, we find that anxiously attached adults have experienced what they believe to be abandonment.  Therefore, they seek to keep people they’re connected to closer.  Avoidantly attached individuals avoid close personal connections, because they believe they can only be harmed by a close relationship – in short, they’ve experienced some situations where they’ve sought protection, and the protector made them fearful.  For instance, they come crying to a mother or father, and the parent responds with, “That’s nothing – stop crying, or I’ll give you something to cry about.”

The disordered attachment person alternates between anxiety and avoidance seemingly without reason.  They can’t decide whether they need to be close to people – or whether close relationships only cause them pain.  So, when our nomadic parents don’t have the capacity to respond in consistently supportive ways, we’re at risk for some insecure attachment style (anxious, avoidant, or disordered).

Don’t Blame the Parents

It’s natural, particularly in today’s age, to blame the parents for the challenges that children face.  After all, if the parents were fully available to their child, wouldn’t they be securely attached?  As Judith Rich Harris points out in No Two Alike and The Nurture Assumption, it may not be that simple.  It can be that the parents did meet all the needs of the child – from their perspective.  The child may or may not agree, and that may not be the parent’s fault.

Additionally, a tendency to blame the parents ignores the problem of math.  Once parents have more than two children, it’s not literally possible to meet every child’s needs all the time.  Even with fewer children, the demands of life to make money, go grocery shopping, and generally “do life” can interfere with the ability to meet a child’s needs at every moment.  Parents who are struggling at the edge of poverty are particularly challenged, as they must strive to simply provide food and shelter.  The additional emotional needs of children may be beyond their capacity.

Holding Back the Trauma

“I’m still in love with the illusion of this life.”  Rarely is it articulated this well.  People recognize that they need to move forward to change their world and “bring things to a head” but refuse to do so.  They know their marriage isn’t what it should be, and they need to change it or, more likely, get a divorce; but they know that the divorce itself will be traumatic, and they’d like to avoid that, if possible.

It’s easy enough to claim that “it’s not that bad” or believe that magic will happen, and things will get better.  Rarely do people choose to walk into the possibility of trauma despite the awareness that the degree and severity will be lower if it’s confronted directly.  Or they believe they’re incapable of surviving the trauma if they trigger it.  They believe the divorce might break them.

Some of the traumas we need to deal with are the ones that we ourselves initiate – or at least initiate the timing of.  Continuing to believe the illusion that there’s a way to avoid the trauma generally makes things worse, not better.

Get Well or Stay Married

Sometimes, individuals are faced with a trauma-inducing and -reinforcing relationship that was that way from the start.  One of the parties wants to get better, but the other doesn’t want to change.  They believe that their drinking buddies are more important than a healthier lifestyle.  It’s in these situations that one of the partners is faced with the reality that they can either get well or stay married.  They can’t do both.

There’s no doubt that the first stop should be to try to convince your partner to try the change.  Attempts to create desire in the other person must be tried.  There should be ample – but not too much – time to shift thinking.  However, if the partner is unwilling or unable to make the change, then sometimes it will be necessary to get well and accept the trauma of the loss of marriage.  Once you’ve made this tragic decision, you can move forward towards Healing Trauma.

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