Like grief, I view healing from trauma as an ongoing process that takes time. Some may find significant relief and improved functioning through treatment, while others may continue to experience some level of distress despite treatment efforts. Recovery is possibly more “complete” for many, but not for all. Intergenerational trauma has been a hot topic related to larger systemic issues. War and famine have been its strongest examples of epigenetic change which is another hot topic still in early stages of development.
I find it odd that someone can dismiss trauma so easily. Trauma is easily identified as coming from a kind of state one that generally occurs during a certain kinds of highly threatening experience. The traumatic experience has distinct features. It has various subjective characteristics. It also has objectively observable manifestations. Of course, it is always hard to say ‘this objective trait (e.g., a thousand yard stare, trembling, other physiological indicators of dissociation or whatever) are linked to various subjective states. But if you’re going to be skeptical about subjective states--well you are throwing everything else out as well. People’s reports of various incidents as they experience them --and live them--give credence to the idea whatever is happening is explicable. For example, people will be capable in extremely dangerous or high stress situations of performing extremely complex tasks. Their report of the experience is that it is not standard concentration or focus but altered, particularly as a memory or in memory.
We know there are physiological and even anatomical effects. Some of these may be measurable, though I cannot vouch for these studies as I don’t know if they have been disconfirmed. I suppose we could simply ignore all subjective reports of these experiences and their after effects, even though we can observe them in animals as well as humans --but why would we do this? We have 1) people’s subjective reports 2) other people’s objective observations 3) observations of this in other mammals 4) some physiological and possibly anatomical indicators of this altered state 5) a LONG history of this state as described under different names such as ‘shell shock’ in WWI. This is a LOT of evidence for something in psychiatry, where we are necessarily dealing with subjective aspects of a person. The burden of proof is on the person who denies the reality. I also forgot 6) an *extremely* high correlation between substance abuse and traumatic experience. So that’s another reason not to deny it, in case it does prove essential to dealing with this very socially and personally destructive phenomenon.
I don't understand how we are still taking a one sized fits all approach to something as complex as trauma. Some people heal through somatic work while others do not. Some people heal through talking about it while others heal through a more internal approach. Some people view extreme events as non-traumatic while others feel minor events in their bodies as trauma. Others don't connect trauma to their bodies at all. Everyone is both right and wrong, including Carr and van der Kolk. Trauma is not a universal experience.
I still can't understand how for so many people the idea of distress that is caused by external factors is so controversial. So many young people suffer because you of the intense pressures they face coupled with the imminent end of the world. It's just not complicated?!?
I think it's controversial because it leads to questions about how the larger social order is organized, and questions of inequality and economics . . . if the problem is the "self," then the "self" has to figure out how to address it. But if we're saying that all these selves are registering larger issues, then we're talking big money, and what it might take to make a social order that's more nourishing to the health of entire ecosystems.
Rebecca, I just listened to this episode on Liberation Psychology of an excellent podcast called Upstream that I think you might find interesting if you haven't already listened.
Thank you for this thoughtful piece. The talented writer Michelle Bowdler and I talked about some of these same themes in a conversation for LitHub. The more we discuss this the better.
1- I am a veterinarian and thus I see people in some of their most vulnerable moments
2- dogs are a known model for PTSD
3- I don't get to ask my patients about what happened when they land in my clinic after an abuse journey
4- The Body Keeps the Score changed my life
5- I am a non combat veteran
Body storage of trauma is real and I see it every day. I see it stripped of political context and I do not see trauma as political anyway.
When a dog comes to me with waxing and waning GI signs that no amount of belly meds helps and I put them on Prozac and teach the pet parent a relaxation protocol to do with their dog, 95% plus of my patients get better. When I regulate my nervous system in a room and teach an owner to do the same...the animal's life and symptoms improve.
If it is stupid and it works...it isn't stupid. I don't have the luxury of a patient that speaks or decades to unravel the mystery. That pet needs quality of life now. And if nervous system work and trauma healing gets us there, then I could give a flip about the larger, more theoretical conversation.
Thank you for sharing all of this -- it's really fascinating and interesting. I absolutely believe in somatics and I see some very interesting ways in which somatic practices are being augmented in more recent years with supplemental content and are very useful in the healing process. I don't think trauma is either "political" or "not political"; I think the discourse around trauma is politicized, and that's significant for folks who are seeking healing to understand.
'Is it possible to secure some amount of healing for the individual by current treatment methods, even as the ultimate sources of distress remain unchanged?" This question is most important to me, of the ones you offered, which are all very good. What does relieve suffering of the magnitude our clients experience in these times? Lots of proffered hope and tons of money spent, but how can the process of finding real relief be more targeted and less like shopping for something you've heard about but never seen?
Like grief, I view healing from trauma as an ongoing process that takes time. Some may find significant relief and improved functioning through treatment, while others may continue to experience some level of distress despite treatment efforts. Recovery is possibly more “complete” for many, but not for all. Intergenerational trauma has been a hot topic related to larger systemic issues. War and famine have been its strongest examples of epigenetic change which is another hot topic still in early stages of development.
I find it odd that someone can dismiss trauma so easily. Trauma is easily identified as coming from a kind of state one that generally occurs during a certain kinds of highly threatening experience. The traumatic experience has distinct features. It has various subjective characteristics. It also has objectively observable manifestations. Of course, it is always hard to say ‘this objective trait (e.g., a thousand yard stare, trembling, other physiological indicators of dissociation or whatever) are linked to various subjective states. But if you’re going to be skeptical about subjective states--well you are throwing everything else out as well. People’s reports of various incidents as they experience them --and live them--give credence to the idea whatever is happening is explicable. For example, people will be capable in extremely dangerous or high stress situations of performing extremely complex tasks. Their report of the experience is that it is not standard concentration or focus but altered, particularly as a memory or in memory.
We know there are physiological and even anatomical effects. Some of these may be measurable, though I cannot vouch for these studies as I don’t know if they have been disconfirmed. I suppose we could simply ignore all subjective reports of these experiences and their after effects, even though we can observe them in animals as well as humans --but why would we do this? We have 1) people’s subjective reports 2) other people’s objective observations 3) observations of this in other mammals 4) some physiological and possibly anatomical indicators of this altered state 5) a LONG history of this state as described under different names such as ‘shell shock’ in WWI. This is a LOT of evidence for something in psychiatry, where we are necessarily dealing with subjective aspects of a person. The burden of proof is on the person who denies the reality. I also forgot 6) an *extremely* high correlation between substance abuse and traumatic experience. So that’s another reason not to deny it, in case it does prove essential to dealing with this very socially and personally destructive phenomenon.
Thank you so much! I'm glad you found it useful!
I don't understand how we are still taking a one sized fits all approach to something as complex as trauma. Some people heal through somatic work while others do not. Some people heal through talking about it while others heal through a more internal approach. Some people view extreme events as non-traumatic while others feel minor events in their bodies as trauma. Others don't connect trauma to their bodies at all. Everyone is both right and wrong, including Carr and van der Kolk. Trauma is not a universal experience.
I still can't understand how for so many people the idea of distress that is caused by external factors is so controversial. So many young people suffer because you of the intense pressures they face coupled with the imminent end of the world. It's just not complicated?!?
I think it's controversial because it leads to questions about how the larger social order is organized, and questions of inequality and economics . . . if the problem is the "self," then the "self" has to figure out how to address it. But if we're saying that all these selves are registering larger issues, then we're talking big money, and what it might take to make a social order that's more nourishing to the health of entire ecosystems.
For sure. I get that on a systemic level but from individuals I just feel like this stuff should be so obvious. Maybe I'm idealistic and naive here!
Great piece!
Reminds me of the recent Times series on pain.
Inside that story about addiction, about malpractice, & about consumer ethics, are many great inquiries about pain and how we think about pain.
https://www.nytimes.com/column/the-retrievals
Thank you for this -- I'l be curious to read and think about the overlap between the two.
Such a powerful piece! 💥 Thank you. So much history and food for thought.
Rebecca, I just listened to this episode on Liberation Psychology of an excellent podcast called Upstream that I think you might find interesting if you haven't already listened.
https://open.spotify.com/episode/3giaeHOg26Nq80OyTCMAsK?si=fOntyE1mTe6uwHDk_jCBfA
Thank you so much! I'd love to check it out -- I appreciate you sharing this.
My pleasure!
Thank you for this thoughtful piece. The talented writer Michelle Bowdler and I talked about some of these same themes in a conversation for LitHub. The more we discuss this the better.
You're welcome -- I"m so glad you found it useful. I look forward to reading the LitHub piece!
A couple of thoughts on this with some precursers
1- I am a veterinarian and thus I see people in some of their most vulnerable moments
2- dogs are a known model for PTSD
3- I don't get to ask my patients about what happened when they land in my clinic after an abuse journey
4- The Body Keeps the Score changed my life
5- I am a non combat veteran
Body storage of trauma is real and I see it every day. I see it stripped of political context and I do not see trauma as political anyway.
When a dog comes to me with waxing and waning GI signs that no amount of belly meds helps and I put them on Prozac and teach the pet parent a relaxation protocol to do with their dog, 95% plus of my patients get better. When I regulate my nervous system in a room and teach an owner to do the same...the animal's life and symptoms improve.
If it is stupid and it works...it isn't stupid. I don't have the luxury of a patient that speaks or decades to unravel the mystery. That pet needs quality of life now. And if nervous system work and trauma healing gets us there, then I could give a flip about the larger, more theoretical conversation.
Thank you for sharing all of this -- it's really fascinating and interesting. I absolutely believe in somatics and I see some very interesting ways in which somatic practices are being augmented in more recent years with supplemental content and are very useful in the healing process. I don't think trauma is either "political" or "not political"; I think the discourse around trauma is politicized, and that's significant for folks who are seeking healing to understand.
'Is it possible to secure some amount of healing for the individual by current treatment methods, even as the ultimate sources of distress remain unchanged?" This question is most important to me, of the ones you offered, which are all very good. What does relieve suffering of the magnitude our clients experience in these times? Lots of proffered hope and tons of money spent, but how can the process of finding real relief be more targeted and less like shopping for something you've heard about but never seen?
Thank you very much for this -- I love the metaphor of shopping for an unseen object.
Have you ever read "Tribe" by Sebastian Junger? What do you think of his thesis about PTSD? Also, this George Carlin routine seems relevant
https://youtu.be/hSp8IyaKCs0
It's been a while since I looked at Tribe, so I'll have to circle back on that piece. I love Carlin, so I'm looking forward to watching the clip!
This sounds amazing--I know Matha's work but I didn't you all were reading this book together. I'm excited to check it out!