Back From the Brink: A Family Guide to Overcoming Traumatic Stress, by Don R. Catherall, Ph.D.
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6

 

GUIDELINES FOR LOVED

ONES

Talking/Listening/Relating to the

Trauma Survivor

 

At this point, those of you who are involved with a loved one who is a trauma survivor may be feeling pretty helpless your­selves. You may be feeling pulled between joining your loved one in his isolation or abandoning him and going on with your life. You may be resentful and have lost patience with him. You may even have disengaged and broken the connec­tion between you because it's just too difficult to stay tuned in. If you've broken the connection with someone you love, this chapter will provide you with guidelines for reconnect­ing. And if you've hung in there with a frustrating connec­tion, this chapter will help you deal with many of the obstacles that you're facing. The central issue in improving your connection is communication.

 

Talking to the Trauma Survivor

 

It should be clear by now that I consider it important for trauma survivors to talk. I don't know what your trauma­tized loved one needs to talk about; each survivor is different. Most survivors need to talk about their traumatic experi­ences, but not all. So your first goal may be to convince her that you want to hear what she has to say, and that you want to understand what it's like to be in her shoes.

 

Your Decision to Talk

 

If she perceives that you're less than sincere about want­ing to talk, she may not talk in a way that will be truly helpful to her. Thus, the first obstacle for you, the listener, to con­tend with is whether you really do want to know what your loved one's traumatic experience was like. Before you go any further, you need to examine whether you are indeed pre­pared to experience vicariously the awful emotions and de­tails of your loved one's traumatization. If you're uncertain but think you want to try, go ahead‑but proceed cautiously. Trauma survivors are extremely sensitive to how much oth­ers actually want to relate to their feelings and put them­selves in their place.

 

If your self‑exploration reveals that you aren't prepared to relate to your loved one's feelings, you must make some decisions. You might want to enter psychotherapy yourself in order to get some support for this task. Or you may be able to find a support group in your community, composed of other people who are dealing with similar issues. Family members can help enormously. But whatever route you choose, don't expect perfection, and don't expect to feel totally able to deal with your loved one's traumatization‑that's unrealistic. You are not going to be able to come along and magically cure your loved one. What's more likely to happen is that you and your traumatized loved one are going to explore her feelings together. The decision I'm asking you to make is not whether you think you can handle it all, but whether you're willing to hang in there and try to understand and relate to some very disturbing thoughts and feelings.

 

But what if you are too depressed yourself? What if you're so angry at your loved one that you can hardly talk openly with him? What if you've had too much emotional turmoil in your own life, and you just don't have any more tolerance? What can you do? To begin with, this is not an all-­or‑nothing decision. If you can't do it yourself, you can work at making it happen with someone else. But don't be too quick to decide that you're not up to this task. You may not feel ready to leap into the deep end of the pool, but with some guidance you may be ready to inch into the shallow end. It's been my experience that you and your loved one will be able to deal with things better than either of you ever imagined.

 

His Decision to Talk

 

If you've come to terms with your reluctance to delve, you must prepare for your talk. Your decision to enter your loved one's world of traumatized emotions will not be a one­time event. It's a decision that you must reexamine and re­make repeatedly as you actually encounter those feelings. It may seem easy to sit here and read about those emotions and believe that you can tolerate them with minimal effort, but it's a different affair to actually experience them directly. It's no accident that so many traumatized people devote their energies to staying away from the emotions associated with the event. It's one thing to talk about the enormous anxiety associated with a near‑death experience‑it's another to live it.

 

Now that you've decided to talk about it and know that you'll have to continue to monitor your own reactions, you must open communication with your loved one. He needs to be aware that you want to talk with him about his experi­ence, and he needs to have the opportunity to make a deci­sion to do so himself. If he decides that he doesn't want to discuss it, your goal will change. You must convince him of the benefit of opening up and sharing what he's experienced and is continuing to experience. You must explore his fears about talking. Perhaps he's already tried and found it to be unproductive or even destructive. He may have already expe­rienced the pain of trying to talk and feeling the other person distance from him whenever he approached the traumatic emotions.

 

More likely than not, however, he'll agree to talk. This doesn't mean he's decided to let you in‑only that he's agreed to talk to you about his traumatic experience. Re­member that most trauma survivors are adept at talking about their traumatic experience without feeling any of the emotions. They can employ their emotional numbing and even discuss the event rather easily without actually feeling anything. So if your loved one is like this, agreeing to talk only means that you're going to have some access to his ex­perience; the real work is still ahead. Other trauma survivors cannot numb out their emotions so easily. For these people, agreeing to talk can actually constitute a decision to let you in. If you've been let in, tread carefully. Bear in mind that your loved one is struggling to control overwhelming emo­tions.

 

The Discussion

 

Once it's accepted that you and your loved one are going to talk about his trauma and what it's done to him, you can do some things to facilitate the discussion. Here are some guidelines to help you establish the right kind of atmosphere so that your loved one feels safe and so that the two (or more) of you are as comfortable as possible.

 

1. Establish the Setting

 

It's important to set the scene. Make sure you have suffi­cient time and a place that is free of distractions and inter­ruptions. You've made it clear to your loved one that you're serious about wanting to talk, so don't contradict that mes­sage by choosing a setting that doesn't easily permit serious discussion. We're often tempted to bring up difficult topics at casual moments, when the other person is engaged in an activity such as washing the dishes or driving the car. This can be a way of trying to lighten the atmosphere and avoid the anxiety of facing a difficult topic head‑on. But I recom­mend that you find a time and place that has no distractions and allows face‑to‑face conversation, to support your conten­tion that you really want to talk.

 

2. Ask Questions

 

A primary goal of your discussions is for you, the listener, to learn what it was like for your loved one to expe­rience her trauma, and what it's been like for her to live with it since. You want to find out what it feels like to be her and to have lived through what she's lived through. That means you're not there to tell her what it's been like; you're there for her to tell you. She's not there to get advice, and it's probably better not to offer it unless she asks for it. Be care­ful not to lecture, and don't reassure her that the worst is over with (maybe it's not) or tell her that she shouldn't focus on the past. Your comments should be directed toward clari­fying your understanding of what she's telling you. Beyond that, you should probably only say enough to keep her talk­ing and to demonstrate that you're following her words care­fully.

 

3. "1 Know Just How You Feel. "

 

No, you don't. If you try to say that you do, you'll only discredit your assertion that you want to find out how she feels. Instead, don't be afraid to acknowledge your igno­rance! She knows that you don't know, and the most impor­tant thing to her is your sincere desire to understand what it has felt like for her to go through her trauma. If she doesn't pick up a feeling of sincere desire, she won't be able to open up with you. If you don't understand something, let her know. Make it your mutual goal to develop understanding. Your lack of common experience may lead you to push her to provide you with new examples, new metaphors, for what she's experiencing. This can result in her developing a stronger grasp of her own experience, as well as greater un­derstanding in you.

 

For example, you might say something like: "Look, I know that I haven't been through anything that compares with what you went through. But I really want to know what it was like. I want to know what it's like for you to live with it now. Teach me. Help me understand. I'll listen to anything you have to say about it. I'm interested in anything that you think is relevant. Bear with me—I can learn. And I will, with your help!"

 

On the other hand, don't be afraid to offer her a compa­rable experience of your own as part of your effort to under­stand. The boyfriend of a woman who's been raped, for example, might recall being burglarized and his feeling of discomfort at someone having access to his most private pos­sessions. He could describe this experience as a means of seeking common ground for understanding what her experi­ence was like for her. You may fear that you will minimize her experience by comparing it with something more trivial, but I believe you shouldn't hold back. Sharing an even partly comparable experience is a step in the direction of under­standing. The danger is that she might misinterpret your tell­ing the story as an assumption on your part that you already understand, rather than an attempt to move toward better understanding.

 

To prevent that, the boyfriend might say something like: "I know this must sound trivial in comparison to what you went through, but my house was burglarized once. I felt this sickening feeling, not over what was taken as much as just the thought of some stranger going through my stuff. I'm sure what I felt doesn't begin to come close to what it was like to be raped. But I'm trying to understand what it must have been like for you, and I thought it might be a similar kind of thing. Am I even in the ballpark?"

 

It's imperative that you make clear that you know you do not understand, but that you're searching for a common ex­perience to give yourself a sense of what she's feeling. Most traumatized people are actually not put off when others try to relate to their trauma by comparing it with more trivial experiences—as long as those others are not simply making a token effort at understanding or assuming they understand when they don't. There's an initial disappointment when a survivor discovers that even loved ones don't understand, but I believe that it can be overcome if you persevere and don't let the survivor fall back into her old pattern of not talking.

 

4. Come to Grips with the Emotions

 

The primary reason your loved one hasn't already talked through the trauma is that the emotions associated with it are overwhelming. Even approaching them fills him with anxiety and dread. In order to make any headway in examin­ing them, he needs to feel not only that you are with him but that you yourself can tolerate and handle the emotions he's stirring up. Remember, he's used to having people steer him away from those feelings and distance themselves from him when he begins to experience them. If you continue to stay linked by concentrating on what he's communicating, then he's likely to go more deeply into his unexplored feelings.

 

The primary obstacle to maintaining your link with him is your own natural reluctance to experience overwhelming emotions. None of us is immune to this, and at times we're more than reluctant. Some of us just can't do it at all until we overcome emotional blocks within ourselves. Since part of what you're trying to do is to help your loved one overcome an emotional block, you must stay tuned to your feelings as he talks about things that are disturbing. You must pull your­self back if you notice yourself shying away from your task of listening.

 

When you find yourself shying away from the task of listening, you are probably experiencing a feeling that is hard to tolerate. There's a good chance that this is also a feeling that is hard for your loved one to deal with. Hence, figuring out what you are reacting to may give you some insight into what your loved one is trying to avoid.

 

If you're having difficulty maintaining your end of the emotional experience, try doing the following after your dis­cussion:

 

·        Write down a list of the major feelings that you understand your loved one to be experiencing. Go over the list with someone else who knows what your loved one is going through. (That might be the trauma survivor himself.)

 

·        Ask whether your list of his feelings is complete. If you've left out some significant feeling, it is likely to be a feeling that you aren't comfortable experi­encing yourself and therefore have difficulty even perceiving when someone else is feeling it. It's likely to be rage, guilt, grief, or intense helpless­ness. Think about it: How often do you let yourself express that particular feeling?

 

·        If your list is complete, you may not have a partic­ular feeling that you've blocked. But for each feel­ing on the list, ask yourself how much you let yourself experience it.

 

·        Think about how you felt when your loved one expressed each of those feelings. Were there par­ticular points where you lost your concentration or distanced yourself from the feelings?

 

·        Once you've identified your own emotional blocks, you can make a decision to overcome them. But even before you overcome them, your knowledge of them can help you become a better listener since you know what your blind spots are. Be on the lookout, and watch for those points in the conversation.

 

·        You may have to let your loved one know that you have difficulty with certain feelings. This way he'll understand that the problem is not with him or what he's saying.

 

·        Dealing with your own emotional blocks usually means uncovering feelings that you have buried. That requires you to talk to someone yourself! (It may or may not be the trauma survivor.)

 

·        If you have no one with whom you can talk, or if you find that your blocks seem impenetrable, find a psychotherapist. You may do so individually, or you may want to see a family or couples therapist with your traumatized loved one. But take it one step at a time; you don't have to settle all these things ahead of time.

 

5. Talk About the Feelings as Separate Experiences

 

What is it like to feel terror, rage, extreme grief? As these overwhelming emotions are identified, they need to be ex­amined from every possible angle. Distinct physical sensa­tions are associated with every emotion, and each person's physical experience of their emotions is different. Stop and think for a moment about what it's like to feel fear. Some people sweat, others feel "butterflies" take flight in their stomachs. Then there are those whose temples throb in fright, and others whose voices suddenly go up an octave. Yet all of these physical reactions are ways of feeling the same emotion.

 

Every emotion involves not only physical reactions but specific thoughts and visual images. These too are different for each person. Since you want to learn what your loved one's exact experiences were and are, ask her to convey what it's like for her to experience the emotions she's identifying. You may ask not only "What was it like to be shot at?" but "What is it like to feel fear?" or "How do you know when you're afraid?" or "What happens when you're scared like that?" These questions focus on the feeling—independent of the particular experience.

 

For example, you might say something like: "That sounds so frightening, I would have been scared to death. I don't think I've ever been that scared. What's it like to feel that scared? Were you aware of how scared you were right then, or did it catch up with you later? When I get scared, I feel it in my stomach. Where do you feel it? How do you know that you're afraid?" or "You said you were enraged. What did that feel like? Does your body feel a certain way when you get that angry? What thoughts go through your mind when you're in a rage like that? What sensations go through your body? Does it scare you to feel that intensely angry?"

 

6. Learn When to Back Off

 

I've encouraged you to help your loved one to delve into his traumatic emotions. This is a terrifying experience for him, and it may be for you as well. Now I must reverse my­self and remind you that the reason he has buried these emo­tions in the first place is because they are overwhelming. That means that reexperiencing them can overburden his psychic capacity to function. He's likely to feel like he can't tolerate it if he's pushed too far or gets too carried away with his emotional reexperience of the trauma.

 

You must be prepared to help him back away if he feels he's gone too far. I recommend that you make your loved one your partner in evaluating whether he feels he's getting in over his head. If you think he's feeling overwhelmed and not talking about it, ask him. But if you find yourself asking fre­quently, it may be a sign that you're not reading him well or that you're expressing your own fear of his intense emotions.

 

Your goal is to help your loved one feel that he has some choice about how much he will let himself experience those frightening feelings. He needs to know that you're encourag­ing him to express them but that you will back off if he needs you to do so. You might say something like: "I want you to talk to me about these things, but I understand that some­times it's too much and you feel you can't talk about it. If I'm pushing too much and you have to slow down, tell me. Let me know if you feel you're getting in too deep. I believe we can go further than you may think, but I'll back off if you let me know that you need to stop. I don't think we have to leave anything untalked about, but I certainly don't feel that it all has to be done today. If you feel too overwhelmed, we can come back to it later."

 

If the two of you agree that he's gone far enough and you wish to help him stop for now, you can do so by switching from feeling questions to thinking questions. You can bring him back to the here and now by focusing on the actual dis­cussion you're engaged in. This reduces the intensity of your loved one's memories without leaving them altogether. It also gives you the opportunity to continue if the two of you feel up to it.

 

To turn the conversation from feeling to thinking, you might ask questions such as these: "I can see that you're getting really upset. Was it anything that I said? How would you prefer I ask something like that? Do you think we were pushing too hard, or did you just get surprised by some for­gotten feeling? Is this what happened the other times you tried to talk about the trauma? Do you want to take a break here?"

 

If your loved one does enter the realm of feeling that he has worked to avoid, he will feel overwhelmed. He may expe­rience intense feelings of fear, sadness, anger, guilt, or other emotions. He may sob uncontrollably—the scary part is the uncontrollable aspect. He may think he's having a break­down when he's seized by the intensity of these feelings, but he's not having a mental breakdown. He's only experiencing a depth of feeling that is so intense that it has a life of its own. It won't last forever—in fact, it will last a few hours at most and often only for a few minutes.

 

After this kind of emotional experience (called an abre­action), your loved one will probably feel drained. He may feel a lightness, as if he's finally relinquished a great burden. He may feel vulnerable for days afterward. You should not let him feel forgotten during that period. Check in often, and make sure he's doing all right.

 

7. What Meaning Has Your Loved One Given the

Traumatization?

 

Human beings cope with existence in a manner that is different from other forms of life. We think. We deal with life's events by creating meaning. One of the primary ill ef­fects of traumatization is that the meaning we have created for our life is thrown askew. We lose our sense of certainty about ourselves. We come to doubt many of the things we believed before. Even our core beliefs—such as the purpose of life—can become meaningless. In its worst forms, trauma­tization can destroy the meaning of life! And without some kind of meaning, it's nearly impossible to go on.

 

An important part of the process of talking with your loved one is to help her straighten out this meaning dilemma. This can sound overwhelming when you consider the scope of your task. Most of us are not philosophers or theologians, and we don't really know what our own answers to such weighty questions are. But stop and think for a moment. The fact is that every one of us has found our own answers to these questions. The meaning you create for your personal life is expressed in your notions about who you are, what kind of person you are, and what kind of person you want to be.

 

You can help your loved one find her own answers to these questions. It's not as difficult as it sounds. Remember, she had answers before she was traumatized. Her objective is not to create meaning from scratch but to reconnect with the meanings she had, then make adjustments in those old answers that allow her to understand the changes she's been through. How can you help her make sense of those changes? Ultimately, she'll come up with the new answers herself, but she needs a forum—a sounding board—as the opportunity for her to examine herself and consider the changes she's undergone.

 

PTSD experts have identified basic questions that the trauma survivor must answer in order to make sense of it all. The following five questions, based on Dr. Charles Figley's model, provide a foundation for the process of reestablishing meaning in the survivor's life.

 

1. The survivor needs to consider what happened and to be able to make some sense of why it hap­pened. He does this by talking to you about it. Ev­eryone seeks to understand why terrible things happen.

 

2. The survivor must consider why it happened to him. He may have an explanation for why events occur as they do, but why did this one happen to him and not someone else? Why were some people hurt more than others? Why did something worse happen to someone else than to him?

 

3. Why did he behave as he did at the time? Trauma survivors are the ultimate Monday‑morning quarterbacks. They review their actions over and over, pondering why they did this instead of that.

 

4. How has he changed as a result of the trauma­tization? He must look at himself, at what he was and at what he's become. You can help him take an objective appraisal of himself; your perspective can be invaluable.

 

5. The last question is similar to the third. Every trauma survivor thinks about what he will do if it happens again. He may not talk about it, but he thinks about it. It's another way he is trying to mas­ter the experience, so that next time he will be pre­pared.

 

These questions can provide a framework for you and your loved one to probe into the meanings of the traumatiza­tion. They aren't the whole agenda of your discussions, but they are issues that are likely to emerge if you're talking with her about her traumatization.

 

It's also important to talk with her about the losses she's experienced. Many survivors can't let go of their preoccupa­tion with their trauma until they've mourned their losses. It's sometimes hardest to mourn the intangible losses—such as her innocence, her faith, or her sense of security—because it's hard to identify those losses. You can help her recognize the many things she's lost by talking about the loss of both tangibles and intangibles. Here are some other questions you might ask over the course of your discussions:

 

·        How do you explain what happened?

 

·        How do you think this experience has changed you?

 

·        Where was your life headed before the trauma? Where is it headed now?

 

·        Have you changed your attitudes and beliefs? What kind of world do you feel this is? How is that different from the way you used to perceive the world?

 

·        What kinds of changes have taken place in your core beliefs, such as your beliefs about God, good and evil, justice, how the world works, right and wrong, what we should do with criminals, who deserves the breaks, and your purpose in life?

 

Contending with the Trauma Survivor's

Symptoms

 

Talking with your loved one about his traumatization is even more difficult when he has symptoms. Many symptoms serve to keep him and you away from the emotionally loaded things that he should talk about. Sometimes the challenge for you is to hang in there and relate to him despite his symptoms. Many family members give up on trying to talk when their loved one is likely to get drunk, go into a rage, or with­draw from them. You must find a way to stay connected to your loved one despite his symptoms.

 

Here are some of the symptoms that you'll likely encoun­ter.

 

Emotional Numbing

 

The most common symptom you'll encounter is emo­tional numbing. It's a tricky symptom because you're not al­ways aware that it's going on. It can allow your loved one to discuss the trauma in such unemotional tones that she may be able to convince both you and herself that there's no un­derlying emotional issue that needs to be talked about.

 

Though I'm calling numbing a symptom here, as you'll recall, it's actually a coping mechanism. It allows her to function in a survival situation in which she might otherwise be paralyzed by intense emotions. But numbing becomes less a coping mechanism and more of a symptom as time goes by and she continues to bottle up any experience of intense emotion—or unloads all the emotion under one disguise, such as rage.

 

If your loved one shows little or no feeling about some part of her traumatization, don't assume that her feelings about it are resolved. You may have to try to get her to talk with you about it dozens of times before she finally begins to overcome her emotional blocks. You may be approaching the subject from many different directions or from the same di­rection, but as long as she continues to show emotional numbing all has not been said.

 

The hardest work for you may be dealing with the emo­tional numbing that you encounter in other areas of your relationship with your loved one. Numbing can be very diffi­cult to tolerate when your spouse appears insensitive to your children or yourself. Trauma survivors who are entrenched in emotional numbing often seem cold, self‑centered, cynical, and distant. They may make painful jokes about subjects that are not funny to you.

 

People who are exposed to high levels of human tragedy—emergency room workers, paramedics, policemen, fire­men—often resort to morbid humor as a means of coping with tragedy. Among professionals who have devoted their lives to dealing with others' tragedies, this humor isn't an indication that they don't care; it's a way of numbing the pain so that they can continue to be around tragedy. Simi­larly, your loved one's cavalier attitude does not mean that she doesn't care. She's employing her emotional numbing because the feelings the situation evokes in her are too close to her feelings from the trauma. You need to understand that her caring is there; it's only that it's buried beneath a placid surface.

 

Elizabeth, the nurse in Vietnam who saw hundreds of young men die in her care, developed a stony exterior that revealed little emotion. She never cried and had a cynical attitude that her husband found exasperating. She almost never laughed with real humor. Instead, her laughter was a comment on the dismal nature of the world around her.

 

Only after years of therapy could she begin to show some of the enormous pain she felt about seeing so much death and human misery. She didn't know how to share these feel­ings with her husband. She viewed his concern about the little details of daily living as evidence that he was a superfi­cial person and could never understand the depth of her pain. But as she began to share tiny bits of her painful experi­ences with him, she was surprised to discover that he was interested and supported her in her healing rituals, such as her pilgrimages to the veterans' memorial in Washington. The more she let him see the feelings underneath her stony exterior, the more understanding he became. She began to see that he had only seemed shallow because she had hidden her feelings and given him nothing to respond to that pro­voked emotions.

 

Difficulties with Closeness

 

All trauma survivors manifest difficulty with closeness. It's less severe for some, but it's agonizingly difficult for most. What can you do about it? How can you get past this problem in order to accomplish the task of talking? There are no simple answers to these questions. This difficulty with closeness is one of the very last symptoms to go in the heal­ing process. In the meantime, the trauma survivor may see you as an intruder, an outsider, someone who is not wanted but is unfortunately needed. It's a lousy situation for you.

 

It helps to understand the origin of his difficulty with closeness. He sees an attachment as a potential place where he can get hurt, so he shies away easily. And he no longer knows himself. He's become a stranger to himself. This inter­feres with getting close to you or anyone. Put yourself in your loved one's shoes. It's hard to know who you love if you don't know who you are. You find yourself questioning your feel­ings, uncertain about how deep they go or whether they're even valid.

 

If a survivor was emotionally involved with someone be­fore the trauma, he may feel that he was another person when he developed that relationship. He may not feel that he has much in common now with who he was, and perhaps he doesn't love the same kind of person. He may fear that he's not capable of loving anyone anymore, and he's fearful of losing anyone that he does love. But as he begins to feel more like himself again, many of those questions subside.

 

Rage Attacks

 

It is disconcerting, to say the least, to be the object of your loved one's rage when you're clearly working so much harder than anyone else to understand and support him. But trauma survivors—as well as people in general—often can't tolerate behavior in their loved ones that doesn't bother them in strangers. No one can get to you as much as the people who are important to you. You expect your loved ones to know how you wish to be treated, and when they fail you, you experience great disappointment. For many trauma sur­vivors, that disappointment quickly leads to rage.

 

How can you deal with your loved one's rage attacks?

 

·        First of all, don't provoke him. Remember that he's struggling to control his temper, despite ap­pearances to the contrary.

 

·        If he's becoming enraged, don't argue with him. Bring the discussion to a halt without trying to make your point one last time. Let him have the last word.

 

·        Don't get defensive. Make an effort to listen and understand, even if you're not being listened to yourself.

 

·        Try not to put him in a no‑win situation. Leave him an out, a way to save face.

 

·        If you do something that makes him feel helpless, he'll be closer to losing control. Try to help him feel some control. For example, let him decide what he would like to do now.

 

·        If he starts to escalate, back off and stay away until he's calmed himself down. Remain calm yourself.

 

·        Don't try to calm him down by talking to him like a child.

 

If your husband is a combat veteran, take this advice seriously. If he's subject to rage attacks, the worse thing you can do would be to fight back. I'm not advocating that you give in. I'm simply saying that you should "break contact" until he's in a better frame of mind. He's probably afraid of becoming violent himself. It will frighten him even more if he feels that you don't take seriously the possibility of his losing control. And if he gets scared, he's more likely to lose control. He'll be reassured if he knows that you respect the dan­ger of provoking him and know when to break contact.

 

Nelson, a Vietnam combat veteran, had the ghastly expe­rience of firing a machine gun into a hut that turned out to contain women and children. He was haunted by memories of this experience. After the war, he married and had chil­dren of his own. He thought he had put his war experience behind him, but when his children reached the age near that of those he had killed, he found it impossible to be close to them. He began to think more about that one afternoon in Vietnam—everything reminded him of it. He became in­creasingly distant from his family, sitting in front of the tele­vision for hours, speaking to no one.

 

When his wife tried to approach him to find out what was wrong, he'd get angry and insist she leave him alone. Several times she persisted, and he blew up—punching holes in the walls of their home, throwing things, and speeding off in his car. He would go to a bar and drink until he was so inebriated that he could return home without fear of blowing up again. What his wife didn't understand was that he left because of his fear of hurting her or the children. He was using the television and the alcohol to drown his painful memories and to stay away from the current reminders—his wife and children.

 

Social Withdrawal

 

Your loved one's withdrawal from the rest of society re­flects her feeling about herself as different, and this is the area where she feels most changed by the trauma. It's painful to be around other people because that difference seems so much more apparent. She feels that she no longer belongs, that she's no longer part of the group, that she's an outsider. It's a very disheartening feeling, and she can keep it to a minimum by avoiding other people as much as possible.

 

Many activities can lead to an even greater sense of iso­lation on the part of the trauma survivor. For example, it's hard to be around ordinary people having fun because she's keenly aware that her life doesn't feel anything like fun. Depressed people have a hard time being around others who are obviously enjoying themselves, and of course, many trauma survivors are significantly depressed. It can be particularly difficult to be around a group of people enjoying something that she especially used to love. For instance, going to a softball game with her old team could be very difficult for a woman who used to really enjoy playing softball. Being there could heighten her awareness of how much she's changed and how she's no longer the same fun‑loving person she used to be. Thus, she learns to avoid social situations in order to protect herself from feeling painfully different.

 

Another social scene that's particularly difficult for many trauma survivors is being around people who are caught up in something that the survivor regards as trivial. The survivor carries her tragedy around inside her head, and when she sees others intensely involved in something that appears unimportant to her, she's acutely aware of the disparity between her internal tragedy and the seemingly superficial concerns of others. She's apt to respond with anger, cynicism, or depression.

 

Consider what this is like for her. Suppose you've just left a room where a loved one is dying, and you encounter someone who's upset because her favorite soap opera has been preempted by a special news broadcast. You're not likely to have much sympathy for that person. If you live this way daily—always feeling as if you had just left a dying loved one—and you seem to continually encounter people upset over trivial things, you're quite likely to find yourself becoming angry and cynical. Your feelings of being different from others will increase, and you'll probably become more depressed. You'll stop caring about whether you're involved with others, not only because it's painful to feel so different but because you come to regard others as superficial and not worth the bother.

 

George and Frances are the parents of a little boy who was sexually molested by his teacher at preschool. The molestations were accompanied by physical threats. The entire family was traumatized by the experience, which took place over an extended period of time. For several months after­ward, friends were understanding and interested, and the couple continued a variety of social contacts. But as time passed, they began to see less and less of their old friends. They felt that their friends were uncomfortable in their pres­ence, and they found their friends' interests to be shallow compared to their ordeal. Their child was in therapy, and as the treatment progressed, new horrors were revealed. George and Frances talked less and less about it with the old friends and more with each other and with a network of new friends who had lived through similar events. As they found it increasingly painful to be around the old friends, their so­cial lives made a permanent shift.

 

The issue of social alienation has a great impact on the loved ones of trauma survivors. As the survivor becomes more alienated, you feel a direct pull to become less involved yourself. If you pursue your own social activities with other people, you find that it increases the distance between you and your loved one. If you stay home with him, however, you become depressed and resentful, and he feels guilty. Eventu­ally you fight. In either case, you come to feel more and more of that sense of being different yourself.

 

So what can you do? To begin with, respect the depth of his feeling of being different. Don't attempt to persuade or force him to enter into activities that will unnecessarily re­mind him of that difference. On the other hand, don't let him resign from the human race either. You can play a very im­portant role in getting him out and involved. But you must carefully choose activities that he can tolerate as you slowly build toward more interactive pursuits. Some things to avoid include:

 

·        large groups of strangers with whom he must in­teract (like a party with your co‑workers);

 

·        many of his old friends at once (rather than a few at a time, gradually);

 

·        social activities in which he used to be highly in­volved and now shuns;

 

·        activities that require high levels of audience par­ticipation (like playing charades); and

 

·        activities for which he's not prepared (like sur­prise parties).

 

Instead, start with activities that are relatively unde­manding. Go to the movies, out to dinner, or on a walk to­gether. Go to public places together. See friends in small groups in which conversation can easily take place. When you're with special friends, help create an atmosphere in which feelings can be discussed. Don't let the conversation become overly superficial or tensely evasive of the trauma. People generally care and would like to be able to discuss it, but they often don't know whether to bring it up. Your loved one may be hesitant to talk about it as well. It's usually better if you don't talk about it for him; rather, encourage him to talk for himself. Support him when such conversations take place. Sit close to him. You're both still learning how to talk about these kinds of things—when to push on and when to back off. It's all right if he relies on your presence for a bit while he learns to talk with others about the difficult topics.

 

These are some of the things that you can do to help an adult who's been traumatized. In the next chapter, we'll dis­cuss some of the special considerations involved when the trauma survivor is a child.