So many of us have experienced trauma — physically and/or emotionally, a one-time event or repeated incidents, firsthand or secondhand experience…and in many combinations and accumulations thereof.  Some would say that life is a series of traumatic occurrences, beginning with birth itself.  But what actually constitutes trauma?

The experience of a traumatic event and the onslaught of emotions in its wake have been called, “a rupture with the past”; life begins to be viewed in terms of an idealized ‘before trauma’ period and the turmoil that follows.  Survivors’ beliefs are challenged;  assumptions regarding personal identity and a global sense of benevolence and safety are shattered.  There’s a tendency toward feelings of helplessness and hopelessness, perception of danger lurking in every corner,  and a lack of attachments or sense of future. The unconscious mind not only can’t let go of the trauma; it believes, independent of one’s conscious thought, that the trauma is still occurring, right here and right now.

In the one-time, often cataclysmic event, such as the tsunami of southern Asia in December 2004 or the earthquake in Haiti just 10 days ago, these feelings are obvious, expected, understood — and, with time and the support of loved ones, and perhaps some assistance, survivors can move beyond the experience.  For the types of trauma that occur over time and multiple events — abuse of any kind, including neglect, raging, or abandonment; mass starvation or epidemics; life in a war zone or high crime area, or that of the child soldier, or the gang member — these feelings are often more profound, always more entrenched, and typically less understood.

There’s another type of traumatization that’s less frequently acknowledged: the secondhand, or vicarious, version, such as in the child who is witness to a sibling’s abuse, the children of an abused parent, the humanitarian worker who repeatedly comes to the aid of those who have experienced extreme trauma, and even the psychologist or other health care provider who specializes in trauma care.  Just as in secondhand smoke, the vicarious effects of trauma can be insidious.

Many people are familiar with psychologist Abraham Maslow’s “Hierarchy of Need”, which indicates in what order our most basic needs must be met; a sense of safety and security is at the very foundation, just above physiological needs such as food, water, and breathing.  Trauma of either type, or — most challenging of all — in combination and cumulative, represents the destruction of one’s sense of safety and security, and without this foundation, all other aspects of life become secondary.  It is hugely difficult to experience a sense of joy, or of loving and being loved, or of trust and developing attachments, when one’s sense of safety is absent.

The good news is: a feeling of security and higher levels of functioning can be restored.  In most cases, particularly in repetitive or combined forms of trauma, the assistance of a psychologist who specializes in this area is necessary.  One doesn’t have to discuss and surely is not meant to re-experience the trauma itself; while discussion in the form of a therapeutic method called “narrative reprocessing” can be useful, the possibility of re-traumatization must be carefully avoided. The feelings associated with trauma and the sense of its immediacy must first be contained, to reintroduce the experience of safety.  Following this, a step-by-step process is needed to reduce and ultimately resolve negative emotions and behaviors that have developed as a result of the trauma, and to renew feelings of control, hopefulness, and meaning.

There are many types of trauma therapies, including “power therapies” such as EMDR; a treatment approach unique to and optimal for each individual can be determined by a psychologist with knowledge of and experience in this area.  Integrative psychotherapy not only allows for a combination of therapeutic methods; it also includes somatic therapies to help reintegrate a full experience of the physical body when safety has been restored and the timing is appropriate.

Like the shaman, the psychologist can help one to search for those “lost parts of the soul”, and to return them to where they belong.

Despite the devastation that trauma wields, a rediscovery of hope, joy, and well-being — of balance — can be achieved.

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