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.
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. If you are curious about online counseling or in-person counseling, connect with us here.
Or if you live outside of California or Florida, please consider enrolling in the waitlist for the Relational Trauma Recovery School – or my signature online course, Hard Families, Good Boundaries, designed to support you in healing your adverse early beginnings and create a beautiful adulthood for yourself, no matter where you started out in life.
And until next time, please take very good care of yourself. You’re so worth it.
Warmly, Annie
Additional articles of mine that you may find helpful to explore:
- All The Little Fragments: Understanding Complex Relational Trauma
- Little Girl Blue: What if you were a child robbed of your childhood?
- Dispelling The Myth of Child Abuse.
- How To Recover From Growing Up With A Narcissistic Parent.
- The playing field wasn’t level to begin with: On childhood trauma and the fruitless comparison game.
http://tara-miller.com/emdr-trauma-treatment/
https://traumaqueenblog.com/emdr-dangers-and-negative-side-effects/
https://www.myptsd.com/threads/terrible-effects-after-second-emdr-session.71587/
Annie, asking this question with curiosity and respect. Have you looked into the Negatives of EDMR?
Hi Shauna,
Thank you for your comments and for sharing your questions and concerns about EMDR.
Like with any other form of therapy, some individuals may have a negative experience with the modality due to a variety of factors: the clinician’s training (or lack thereof), adherence to laws and ethics of the field (or lack thereof), the client’s preparedness for such work (or lack thereof), to name but a few variables. I don’t want to dismiss the experience of individuals who had negative experiences with EMDR, but at the same time I do know that a wide variety of research studies (international treatment guidelines, meta-analyses, randomized clinical trials, nonrandomized studies, etc) have been implemented using various treatment aspects and protocols as their focus since EMDR Therapy’s initial development by Francine Shapiro, PhD. You can find a wonderful library of research articles here: https://emdria.omeka.net/
EMDR’s effectiveness based on nearly 30 years worth of research and study suggests it to be one of the most effective trauma treatments we know of today (in fact, it’s even endorsed by the WHO).
Given this, I chose to train in the modality (and will continue training and pursuing my certification in it next year) because I truly do believe it’s a wonderful tool.
I hope this feels helpful in understanding my thinking.
Warmly, Annie
All of your comments on complex trauma, and all of the experts you cite, are in line with my thinking as I express in therapy how the effects of my parents’ abuse still effects me many years later; these ideas and experts are not as well known or understood, just as your comments suggest, and I am very grateful to hear your thoughts on these points on diagnosing and treating Complex PTSD. I lived in San Francisco from the 70s to 1999, then moved here to Quebec with my French Canadian wife who I met in San Fran, returned to school to do a grad degree in literature and criticism, and my interest in psychoanalytic theories brought me to a post-grad program training to be a therapist, which I left in the third year – my west coast approach of being gently frank about my own trauma history, and the source of my counter-transferences, I felt the need to be transparent about, which sadly inspired a hostile response; something that would not have happened in SF. But I followed van der Kolk’s advice about the trauma survivor reclaiming their voice by recounting in narrative their version of events, and wrote the memoir “Back and Forth” under the pen name David Winter – the hostile reception I received in academics compelling me to do as I had to do as a child: to give myself a modicum of protection by keeping secret my authentic self. Males have some challenges in being vulnerable, and for good reason: an internet search for “child abuse memoir male” gives many hits, but with most of them being qualfied with “sexual”, which tacitly holds the value that only a male humiliated by another, in the way a raped woman is humiliated, could possibly inspire a need to tell his story in seeking catharsis from its terrible effects; a “red-blooded” “healthy” male ought to be able to just shake off his parent’s abuse and just get over it – with the breakthrough response to this point coming from Bessell van der Kolk and other experts on Complex PTSD: no adult survivior of child abuse does, which your observations also validate. I am working again with a therapist here, and he seems quite proficient with a trauma-informed apporach. But it is good to hear from Bay Area therapists; there are days I wish I never left – but good work and thanks very much!
Thank you so much for what you have shared here. I can’t put into words how much it means to hear you share the reactions you received from those in academia. And the need to protect yourself by using a different name in writing your story. I am so often dumbfounded by how sharing even bits of my experience can be a conversation killer with those I would expect to be informed and compassionate. I wrestle with that. Am grateful for your honesty and integrity to do what you needed to do and not be shut down because of others discomfort and ignorance. Reading your words has helped me feel less alone and frightened tonight. Grateful
I’m so touched that Steve’s share helped you feel less alone, Marilyn. Your experience of sharing your story and being met with a lack of compassionate response is, unfortunately, so common for folks with complex trauma histories. I hope your past experiences don’t stop you from sharing your story with folks who can treat your vulnerability with vulnerability. You deserve that. Warmly, Annie
Hello Annie,
I’ve been a reader of your newsletter for a very long time – quite a few years now actually. But I’ve never left thought to leave a comment here on your blog.
Your newsletters throughout the years have helped contribute towards my understanding of a very traumatic childhood, as well as gaining clarity on why for so many years I responded to life in the ways that I did.
It has also helped me learn how to shape my counselling sessions so that I get the most from them. I know what words and ideas to bring to my counsellor, and in some instances I have shown her your articles on specific issues when I have been unable to speak the words myself.
I just wanted to say thank you so much for the time and dedication you clearly put into these articles – they are all so well researched and informative. I save just about all of them.
Looking forward to your next newsletter.
Kind regards,
Ami
Ami,
I can’t tell you how much your message touched me! I’m so glad to know I could play even a small part in your journey. I’m honored you read my posts and that they’ve been helpful and clarifying. And I’m so happy you could take what I talk and write about and share it with your own counselor to help deepen your work. I think that’s so smart. I know I brought articles and books and podcasts to my own therapist over the years when they helped crystallize something I wanted to work on.
Thank you so much for taking the time to write to me and for taking the time to read my posts. I really appreciate it.
Warmly, Annie
Steve, thank you so much for this wonderful, vulnerable, and courageous share. What stood out to me from reading your words is the thought, “He is so self-supporting and self-loving to be able to keep trying.” I’m so sorry your vulnerability and openness was not well-met. You deserved that. And I’m so, so glad you didn’t let that shut you down from either seeking out more help or from telling your story. And it’s so smart and self-supporting of you to have told your story under a pseudonym – that’s a creative and careful way of taking care of yourself. I’ll keep writing from down here in the Bay, and with giants in the field like Van Der Kolk, Levine, Parnell and more, I’m confident there will be a greater awareness and increased compassion for what trauma can look like and how best to treat it. Warmly, Annie
Thank you so much for enlightening me on the definition of trauma. I come from a blended family with strained relationships. Prior to reading your post, I didn’t realize that I had sustained 18 years of trauma. Although it wasn’t physical, I was CONSTANTLY afraid. My father is easily angered and would often argue with everyone in the house except me. I learned how to be a people-pleaser early in life. Your post has encouraged me to seek help from a trauma therapist here in Atlanta.
Christine, your post brought tears to my eyes! I’m so glad that my writing could help you see yourself and your story more and seek out help close to where you live. I truly hope your therapy journey is going well and I’m sending you much warmth from Berkeley. Warmly, Annie
I always appreciate how you explain complex subject matter with clarity and simplicity. Thank you for another accessible post.
Thank you so much for this wonderful feedback, Heather. I try my best to take a topic that typically gets pushed to the shadows and bring it out into the daylight so that we can all feel less alone. I appreciate your work in the world, too! Warmly, Annie
Thank you Annie for this wonderful and informative article. Very true that a majority of households are victims of trauma knowingly or unknowingly.
Thank you once again.
You’re welcome, Fayaz. I’m so glad you found the article helpful.
Every. Single. Symptom. Thank you for this.
Hi Holly,
While I wish none of us had to see ourselves in this article, I’m hopeful that, because you did, you maybe felt a little less alone and a little more validated and seen.
Sending you warmth, Annie
Articulate and informative. Thank you
I’m so glad you found the post helpful, Kathy. Thank you so much for taking the time to read it and also letting me know what you think. Warmly, Annie
I am just now addressing my own trauma from childhood. I was in/out of foster care multiple times due to instability, abuse of every kind, and neglect. After adoption I endured multiple moves due to divorces. My adoptive mom loves me dearly but stuck her head in the ground when it came to my significant problems. I learned to turn it all inward to keep everyone happy and outwardly appear okay. I completed undergrad (barely) and worked as a social worker for a long time. My job held significant responsibility that I did well at. But throughout I endured an abusive husband and became a single parent to three young children. I knew I was explosive at times and hated the way I acted. Pills were prescribed that delayed the response but the feelings persisted. I got my first dui after fleeing a bar because I was panicking. I tried aa and an intensive outpatient treatment. I was severely overwhelmed being a single mom, full time social worker, and home owner. After quitting my job and selling my house, we moved to another state. I was drinking heavily and got another dui. Please don’t think that I am a completely self centered person for doing that. Because that’s not true, I actually really care about people and I am deeply ashamed. I never wanted to work in human services again but when you have a heart to help it sticks with you. All these years, a few different counselors, and other professionals that knew me never zeroed in that my trauma needed to be addressed. All my life I’ve been fighting, fleeing and freezing and at 45 I’m just now seeing it. I unfortunately have nailed the coffin shut on my career which I am broken hearted about. I’ve been addressing my trauma and have finally found success in living sober. I went back to school and will complete a MS in criminal justice in a few weeks. No one will hire me because I am seen as a liability I suppose. I don’t know what to do now.
Hi Angie,
Thank you for sharing your vulnerability with me. I’m so glad you’re able to see your patterns now at 45 and not at 85! You have a lot of life left to live and congratulations on living sober – that’s HUGE! And further congrats on your degree. You know, you reminded me of my favorite quote (and one of the guiding principles of my work):
“She could never go back and make some of the details pretty. All she could do was move forward and make the whole beautiful.” ― Terri St. Cloud
I hope you’ll let that soak in and know that you have plenty of years and chances and opportunities left, despite your past. I’m rooting for you!
Warmly, Annie
Once again your blog provides ‘great insight’ into the life I have lived.
Thank you.
Kay, I’m so happy to hear that you can see yourself and your story in the posts I share. That’s why I write! Thank you so much for taking the time to leave a comment and for trusting me enough to read my posts. Sending you much warmth, Annie
Dear Annie,
As I sit in my home tonight at my lowest and worst, I want you to know your posts bring immense comfort to me. Thank you for writing about these emotional topics. I am suffering and know many others are too. Feeling alone, unloved, and worthless is truly the worst. I appreciate your insight and warmth.
Kelann
Kelann, I’m so touched by your message. I hope that my writing can help you feel even just a tiny bit less alone and more connected. Many people are sharing your experience. I’m sending you a big, digital hug. Warmly, Annie
I am the father of a daughter that was raped and a year later someone attempted to murder her. Both these events occurred at her University, which is also the place I am faculty. I am having trouble coping with this and what makes it more difficult is that the place I work is where she was harmed and being there is a frequent trigger. There is a lack of understanding by my supervisor and no real support. I am berated for making errors even though this occurs less frequently. I am having trouble finding support groups for people who experience this kind of secondary trauma. It even a struggle to make my supervisor understand that this is common experience for people whose kids have been harmed. Any books, articles or support groups you could point me to would be helpful.
Pete, I am so, so sorry to hear about what happened to your daughter! I can only imagine how devastated you feel, how triggered you feel by where you work, and how unsupported you feel by the administration. That’s so much to hold. I have to confess: I don’t know of any support groups off the top of my head for parents or partners of those who experienced trauma but I can ask my colleagues if they know of something. Moreover, I want to recommend a book to you which, while oriented to clinicians and practitioners in the trauma field, nonetheless has excellent advice and guidance on how to manage secondary/vicarious trauma impacts: https://amzn.to/2t9G5XJ
Again, I’m deeply sorry your daughter experienced what she did. But I’m glad to know she has a father who loves and cares about her. Not every young woman has this.
I’ll email you directly if I find any online support groups – sound good? Warmly, Annie