Back From the Brink: A Family Guide to Overcoming Traumatic Stress, by Don R. Catherall, Ph.D.
Table of Contents | Introduction | Afterword
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9
REPAIRING
THE DAMAGE
TO
THE SENSE OF SELF
In Chapter 2, we saw that traumatized people inevitably sustain damage to their basic sense of self. This damage is reflected in their inability to function effectively at work and in relationships, and in their difficulty maintaining a sense of harmony and emotional balance. All these areas influence and are in turn influenced by‑self‑esteem.
When you have good self‑esteem, you not only
think well of yourself, you have confidence in your entire environment,
including how you fit into it. But when your sense of self has been damaged by
traumatization, you lose the feeling of fitting in and belonging. You become
at odds with your environment and question your place in it. The damage to your
sense of self is aggravated by being around people who don't acknowledge the
emotional shock with which you're struggling.
You need someone with whom you can talk and process
the trauma, since many traumas are just too much to reexperience and examine
alone. Recovery requires both finding the appropriate relationships and being
able to use them. And using relationships in this therapeutic fashion requires
trust in yourself as well as the other person. We don't know exactly how
processing emotional trauma in a trust relationship rebuilds a damaged sense of
self, but we can see the results. You may have no close relationships, or you
may be unable to take advantage of those you do have. But there are things you
can do to improve your ability to enter into a close relationship.
In order for trust to develop, you must have
confidence both in yourself and in the other person. The only way your
confidence in yourself can grow is for you to build your self-esteem and learn
to control your anger and defensiveness. Then you must take the risk of letting
someone matter enough to have an influence on you.
Self‑esteem is not a static thing—it’s a
dynamic process that lives and breathes, ebbs and flows according to how a
person's life is going. Whether you realize it or not, you have a great
capacity to influence your own self‑esteem; you can either strengthen or
damage it. If you listen to your inner voice, you may find that you say things
to yourself that interfere with your self‑esteem. You may put yourself
down and call yourself names—“Boy, am I stupid"—or you may maintain
unrealistic expectations and standards for yourself, such as "I should
always be on top of every situation."
How can you change these patterns? Learn to replace
your negative self‑talk with positive self‑talk—“I handled that
pretty well"—and make your standards and goals realistic, based on accurate views of yourself. Recognize your
limitations, and work with them instead of fighting them. Don't chide yourself
for having limitations; rather, congratulate yourself for knowing how to live
with them. Most of all, listen to what you're saying to yourself. Are you being
hard on yourself? If so, that's where you want to substitute more encouraging
comments.
Changing your self‑talk can go a long way
toward improving your self‑esteem. But in itself it's not enough. You
must also change how you behave. The source of your selfesteem is yourself, so
you're the one who can make you feel good about yourself. And you're the judge
of what you really need to do in order to accomplish this.
So the thing you need to do is to identify and
change the things that make you feel bad about yourself. Once you have
identified something that you don't like about yourself, examine the
conditions where you tend to do it. At what critical point in the events
leading up to it do you normally decide to
do it? If you feel bad about your tendency to procrastinate, for example, and
put off doing the difficult things and do the easy things first, that critical
decision point occurs when you are deciding what to do with your time. In order
to change, you have to decide to do the difficult things first. Then the whole
process is altered. Once you isolate that critical decision point, you can
change the bad habit and improve your self‑esteem.
Working on a goal
is the best way to put your self-discipline into gear. If you're a
workaholic, your goal may be to spend more time pursuing leisure activities. If
you're not working enough, your goal may be to take on new projects. If you
feel your life is stagnating, your goal may be to develop new interests. If
your life is overwhelming, your goal may be to prioritize your time and set
limits. But wherever you start, the purpose of setting a goal is to make your
life better. It gives you a sense of direction‑something concrete to work
on, and something concrete to point to and feel good about.
Here are some suggestions
for how you can go about altering your life in a positive fashion:
·
Step
back and take an overview. Is there something you are not doing that you probably should be doing? Or are you doing
something that you probably should not be doing?
·
What
are your bad habits? Are any of those habits truly interfering with your being
what you would like to be?
·
Where
would you prefer to be at this point in your life? Is there a central project
(such as starting an exercise program, going to school, or stopping drinking)
that would lead in that direction?
·
Think
about setting some goals. Make a list of all the goals you'd like to
accomplish. Consider which of those goals would allow you to overcome your
disappointment in yourself. Number those goals according to their priority.
·
Don't
overwhelm yourself by trying to achieve all your goals at once. Focus on one,
maybe two. Pick one that's important‑it doesn't have to be the highest on
your list. Rather, it should be one that you feel you have a chance of
accomplishing.
·
Now
break your goal down into steps. Write down every aspect of achieving that
goal. Make a realistic plan for achieving the goal, including isolating and
changing that central decision‑making point.
·
Show
your plan to your loved ones. Get their support for achieving your goal. And
talk to them as you pursue your goal; keep them informed.
·
When
you've accomplished your goal, give yourself a reward. Don't let it go
unnoticed‑take some time to feel good about what you've done.
·
Then
go back to your list and decide what's next.
Some problems with self‑esteem are deep‑seated;
solving them requires more than these simple steps can provide. But even with
deep‑seated problems, these steps bring some improvement. And the better
your self‑esteem becomes, the more you'll be able to pursue the other
aspect of repairing your damaged sense of self‑engaging in trust relationships.
In every important relationship in your life, you have a choice—you can be vulnerable, or you can be defensive. If you're vulnerable, you let the other person (and yourself) know what your feelings are—particularly weak, frightened feelings. But if you're defensive, you hide those vulnerable feelings. You blame the other person whenever there's a conflict. You get angry instead of hurt. Your focus is on how the other person is behaving, what he or she is doing to you and making you feel. You don't acknowledge your own part in the conflicts or in maintaining the distance between you.
If you're defensive, your relationship is
perpetually less than satisfying. You always feel that there should be more,
that there's something wrong. It doesn't restore you—it drains you. If you're
vulnerable, however, you can get hurt, perhaps very badly. If you've been hurt
much in the past, you're likely to shy away from being vulnerable now. If you
were traumatized and others responded poorly, a second traumatization
occurred—to your relationships and to your social sense of yourself. You can
heal your relational trauma and redevelop trust in others only by being
vulnerable, by taking the risk of getting hurt. If you start out from a
defensive position, you don't really know what the other person is capable of
because you haven't given him a chance.
Helen and Rich had been happily married for
seventeen years when Rich discovered that Helen had been having affairs off
and on for the past twelve years. He was devastated by his discovery, and his
world disintegrated. Everything he thought he knew and trusted was thrown into
doubt. Helen, for her part, seemed relieved to finally be able to tell him the
truth. Over the years, she had built a wall of lies between them, starting with
small lies and snowballing into a mountain of lies. Indeed, her philandering
was probably increased by the lies, because the more lies she placed between
herself and her husband, the more distant she felt from him. Now she was
relieved to no longer have to work at juggling the many falsehoods.
Once the truth came out, her affairs stopped. Helen
and Rich entered marital therapy and worked on rebuilding their trust
relationship. But the biggest hurdle for Rich was to risk trusting his wife
once more. That would have meant exposing himself to the possibility of getting
badly hurt again. So he remained defensive to protect himself. He constantly
criticized and argued with Helen, finding something wrong in everything she
said and did.
Both of them thought that he was critical and
argumentative because he was still angry over the philandering. But I don't
think that was the primary reason. Rich was protecting himself from getting
hurt again. He remained defensive by constantly being on the offense and
focusing on Helen rather than his own vulnerable feelings.
If you want to overcome your defensiveness, it helps
to be able to recognize the ways you maintain it. Here are some common ways
people avoid becoming vulnerable in a relationship:
·
Fault finding. Since everyone is human,
you'll seldom be disappointed in your search for the other person's faults.
You'll feel justified in maintaining your attitude that no one is the right
person to trust.
·
Constant conflict. As long as you're fighting,
it's impossible to stop being defensive. So if you're afraid to reveal your
vulnerable feelings, you can start a fight. That will keep you from having to
reveal a vulnerable feeling.
·
Grievance collecting. In order to keep conflict
alive and avoid resolving anything, you can collect grievances. One sin always
reminds you of other sins, so you can maintain ready access to the anger you
need to hang in there and stay defensive. No transgression is ever forgiven.
·
Withdrawal. If you don't feel up to
constant conflict, you can just withdraw‑physically or emotionally‑in
order to keep a distance from the other person and thereby protect your more
vulnerable feelings.
·
Investing in things. If it's difficult to
withdraw emotionally and be unfeeling around others, you can disguise your
withdrawal by investing yourself in things instead of people. You can expend
your energy working or playing to a degree that cuts others out of your life.
·
Being superficial. If you must spend time with
others but you're afraid to be vulnerable and you don't want conflict, you can
always just be terribly superficial. Talk about anything except how you feel and what's going on between the two of you.
Sports and the weather are acceptable as elevator conversation, but they tend
to run a little dry when that's all you have to say to someone important to
you.
·
Avoiding the here and now. The most vulnerable feelings
are the ones you're actually feeling as you talk about them. It's easier to
talk about feelings in the past tense or as if they occurred in some other time
and place.
And
here are some things you can do to make the shift from being defensive to being
more vulnerable:
·
Make
“I” statements. When you and your loved one are talking about the hot topics,
don't start each sentence with “you”. Talk about yourself rather than focusing
on your partner.
·
Express
your feelings. Focus inside yourself and determine what you're feeling. Then
listen to what you say. Are you really expressing feelings (like sadness, loneliness,
longing, and fear), or are you expressing thoughts preceded by the words I feel?
·
Don't
give in to your angry feelings. You're angry because of something‑find
that thing and express it. Has your loved one said or done something that
left you feeling unloved, hurt, sad, or cut off from her?
·
When
you express that feeling, don't blame your loved one because you feel that way.
Chances are that your loved one touched on a vulnerable feeling that was
already there and simply brought it to life. Help her know where your
vulnerabilities are so that she can tread more carefully.
·
Stay
in the "here and now." Don't let your discussion range into all the
past ways you've been hurt by each other. That will likely be too much and
bring back your defensiveness.
·
If
you feel overwhelmed and need to withdraw, state your need directly. Own it as your need, not as something you have to
do because she's so difficult.
Rage is another barrier to getting close to others.
I don't list it as one of the ways we stay defensive and avoid vulnerability
because I don't think it is that kind of mechanism. Anger certainly feeds
defensiveness, but rage is more than anger—it is anger out of control. It may
frighten the angry person as much as it frightens his target. It feels as if it
has a life of its own. Rage generally accompanies a damaged sense of self and
is a frequent symptom of traumatization, particularly when there's a
relational trauma. While not all trauma survivors have attacks of rage, most
either do or feel the rage inside and fear losing control of it. In general,
men give vent to their rage more than women.
There are at least two types of rage that trauma
survivors experience. One results from the feeling of helplessness produced by
the initial trauma. That feeling of helplessness is intolerable, and you'll do
anything to change it. When you're enraged, you don't feel helpless. Instead,
you suddenly feel powerful and in control.
The second type of rage is an aspect of the
relational trauma—it is part of a survivor's reaction when there is a breakdown
in his relationship with his social world. In some invisible way, we're all
connected to a personal community of people, and when this connection is
healthy, we weather life's disruptions. It is communities of people who survive, form cultures, and thrive. The
relational trauma occurs when you lose your sense of being connected to the
people around you. It can feel as if the group has released their hold of you
and left you on your own. Your rage is at the group for not caring enough to
hold on to you when you need it.
Normally people can feel connected even through conventional casual contacts like elevator talk. You can also feel connected through mediums such as reading, watching television, or listening to music. But if you have been traumatized and suffered a break with your social world, you've lost that ability to feel easily connected. Now you need a special trusting connection to help you repair your damaged sense of self. You need a more intense, responsive contact than elevator talk.
In order to reestablish your sense of being
connected, you must control your rage and enter into a trust relationship. To
understand your rage better it helps to compare it with the tantrums of
children. Those tantrums don't just appear out of nowhere—they’re usually a
response to something, such as stress, tiredness, or unconnectedness. After a
period of dissatisfaction and little episodes of control battles with the
adult, the child blows up. Afterward, the child can't be approached for a
while; she's sad and wants to be left alone. Eventually, she's ready to resume
normal activities. Adults understand that her tantrum is over when she makes an
effort to reconnect.
Adults go through something similar when they experience
a rage attack. The episode usually begins with a period of dissatisfaction or
irritation; sometimes you may be feeling very good, only to have some
disappointment or frustration plunge you backward. When you blow up, you
temporarily sever your feeling of connectedness to your loved one. As a result,
her arguments have no effect upon you, which is very perplexing for her because
she can't understand how your caring for her could suddenly just cease. After
the rage attack, you feel sad and find it difficult to reconnect. But the
feeling that you do want to reconnect is a sign that your rage is gone.
If you live with someone and find yourself getting
enraged with her, despite your wish to control your temper, it can help if
both of you understand what's setting you off. It also helps to know the stages
of your rage. After a fight, if your loved one tries to reconnect before your
rage has run its course, it can easily reactivate the fight.
Reconnecting is very difficult for some couples.
They cool down from a conflict—and become ready to reconnect—at different
rates. The one who's ready to reconnect first often restimulates the fight by
trying to reconnect too soon and not respecting the fact that the other isn't
ready yet. Then the first one gets angry all over again, and the cycle
continues.
Mark and Annette were traumatized when Mark developed
cancer. The illness virtually exhausted their financial resources, but they
managed to recover. Now Mark's illness is in remission, but they live with the
constant stress of knowing it can return. The bout with cancer had a great
impact on their relationship. They got much closer for a while, then began
having frequent arguments. Mark would become enraged and often threaten to leave.
Annette was terribly hurt by the threats and the other things he would say when
he lost his temper.
Both of them would get angry during the fights, but
Annette would always cool down more quickly and approach Mark to be friends
again. But this would lead to another flareup. Mark would make some reference
to the point of contention, and Annette would try to restate what she'd said in
a more acceptable and understandable way. He would interpret this as a refusal
to let it go, which made him even more defensive, and on it would go.
Their fights often centered on Mark's concerns about
his health. Annette felt he needed to stop talking so much about it, and she
communicated this indirectly by changing the subject, by disagreeing with him
about minor aspects of what he was saying, or by minimizing what he was saying.
("Oh, Mark, thousands of people have had that symptom and nothing was
wrong.") This made Mark feel she didn't care. But when she learned to say directly that she didn't want to talk
about it, things improved—though not before they went through an initial period
of increased tension. Mark had to learn to express his feeling that Annette
didn't care—instead of just threatening to leave her—and he had to get a handle
on his blowups.
Mark worked on his tendency to blow up in couples
therapy with Annette. He learned that he was approaching her with expectations
of understanding and support. When he felt he didn't get that understanding and
support, he would feel crushed with helplessness and disappointment. Then he'd
swing quickly from expecting understanding from her to expecting the worst from
her.
Once his trust collapsed, he would protect his
vulnerable feelings of disappointment by going on the offensive and getting
angry and making threats. In therapy, however, he learned to hold back on the
threats and not do the kinds of things that would escalate the argument. Most
important, he learned to express his disappointment and feelings of
helplessness instead of blowing up.
And Annette was able to respond to these feelings with the understanding he
wanted.
If you have rage attacks,
here are some things you can do:
1. Start by reminding yourself that you really do want to maintain your connection, even though you may lose track of it in the middle of conflicts. Make a rule that you'll overcome your reluctance to reconnect and try to keep your connection with your loved one, even when you're angry.
2. Learn to recognize when you're in that preliminary
state of feeling dissatisfied, short‑tempered, or grumpy. Once you
recognize it, let your loved one know that you're in a bad mood and need to be
left alone.
3. Learn to calm yourself during the key period when
the situation usually escalates into a blowup. Use breathing exercises,
meditation, exercise, or whatever soothing activities you've found.
4. Slow down. Look for the sadness, the helplessness,
the loneliness (the vulnerable feelings) and learn to express those.
5. If you do blow up, try to bring more control to
the things you do and say while you're enraged. Part of you knows that you will
regret these things later. Listen to that part of yourself.
6. If you're enraged, say what you're angry about, then leave it
alone.
7. You may need to get away from your loved one for
a period of time in order to calm yourself down. If so, let her know that you
are not abandoning her but just need some solitude to calm down.
8. Learn to recognize your own oblique feelings of
wanting to reconnect. It's fear that prevents you from acting on those
feelings. Learn to reach out.
Improvement begins with a decrease in the frequency of rage episodes, not with a
decrease in their intensity. They may occur less often, but they can be just as
intense as ever. So don't let the intensity of an occasional rage attack make
you think you're not making progress. They can be stopped, but it takes time.
Be patient and work at controlling your rage.
The Overall Picture of Recovery
Successful recovery is reflected in the
reestablishment of your sense of connection and belonging to the social world
around you. As I indicated in Chapter 4, a traumatized person tends to
withdraw from society in levels and return in reverse order, usually starting
with intimate relations and moving outward.
Recovery from both the initial and relational
traumas involves utilizing a trust relationship with another person or persons.
It's easier to reexperience and examine the initial trauma when you feel
connected to someone who cares and understands. Only in an intimate
relationship can your sense of self and of connection be fully restored.
You can do things to make it easier for you to
engage in a trust relationship. You can work directly on your self‑esteem,
which, ironically, contributes to your ability to trust others. You can make
efforts to overcome your particular ways of remaining defensive and avoiding
vulnerability. And you can work to understand and control your feelings of
rage, which may be expressed or hidden
under the surface.
Several other things can aid the process of recovery
while you work things out in your trust relationships. If you have physical
symptoms that are getting in the way, deal with them directly rather than just
waiting for them to disappear as a result of processing the trauma.
And there are other things you can do to facilitate
your healing process. The next chapter is about a different way of approaching
the processing and letting go of the trauma. It's about taking advantage of the
power of healing rituals.