A colleague, Jackie, recently told me about an experience she had had with an attorney. This colleague does quite a bit of family therapy and has a long history of having been involved in families that are usually quite dysfunctional. “Dysfunctional” is not one of my favorite words, but it means that the adults in the family were not mature: not mature emotionally and hence not mature socially. Jackie said that she indicated that there had been a good deal of trauma in the family, particularly with the father in the family. The lawyer who was litigating the case, which had to do with custody and care of the children, asked Jackie “how much training she had had in trauma.” I don’t know exactly how Jackie answered the question, but she said a most profound statement to me at that moment: “It’s all about trauma, isn’t it, Ron?” I agreed. It’s all about trauma.  To talk about trauma one is usually led to talk about post-traumatic stress disorder.

What is trauma? And what is Post-Traumatic Stress Disorder?

There is some debate about what “trauma” means, and rightly so because the word trauma has been increasingly used in the culture, not only by therapists but by many other professionals and by many people who just live ordinary lives. There is general agreement among mental health practitioners that trauma is the following:

• An unexpected negative event in a person’s life
• An event that had some kind of negative impact on the person
• An event that had a substantial amount of emotion connected with it, primarily the emotion of fear, and then secondarily of anger and sadness

Note that this definition of trauma is not the definition of Post-Traumatic Stress Disorder (PTSD) that we hear about so frequently. PTSD is a condition that includes the elements noted above plus two other elements:

• A failure to express the emotions associated with the negative event.
• We refer to these emotions as being “repressed” although importantly, there is not a conscious decision by the person to repress these emotions.
• A reaction that is one or more of the normal reactions to a negative event:
  • Fight
  • Flight
  • Freeze
• There is a significant neurological (brain) change due to the trauma and the repression of emotions associated with the original negative event
• These emotions, not expressed at the time of the negative event, return to the person’s life at a later time, hours or years later.
• There are often “re-traumatizing” events that occur later in the person’s life.

Trauma and PTSD are very real and very important. Unfortunately, there are at least three errors made in regard to PTSD:

• The person fail to recognize that s/he has been traumatized and suffers PTSD
• The person actually does not suffer from PTSD but finds the “diagnosis” a kind of justification for some kind of self-damaging behavior
• The genuine PTSD or false PTSD causes social damage.
  • Damage from genuine PTSD comes because the real PTSD continues to affect the individual’s social life.
  • Damage from the artificial PTSD comes as the person artificially blames his/her past alleged trauma for harmful social behavior.

So the situation of trauma and PTSD is murky because of these complexities. Here, I will focus on genuine trauma and the PTSD that results from it. Anything can be traumatic. Any trauma can lead to PTSD. Furthermore, different people deal differently with the traumas in their lives. Something that is traumatic to one person is not necessarily traumatic to another person.

Examples of traumas

We normally think of traumas and PTSD in the realm of war trauma and sexual trauma. Specifically, people who have suffered trauma while in a theater of war very often suffer PTSD (while most soldiers do not suffer PTSD). People who have suffered genuine sexual abuse very often suffer PTSD (almost all sexual abuse victims do suffer PTSD). I will discuss these issues momentarily, but I have seen traumas and resulting PTSD from at least the following traumas:

• A child was traumatized in utero for some reason including
  • A chemical damage, such as the mother taking damaging drugs
  • A hormonal imbalance due to mother’s biology
  • A fetus in utero damaged by the emotional imbalance of mother or the emotional disturbance of the parents
  • A long-term painful pregnancy
  • A difficult birth, e.g. an extended time of labor
  • The child was not planned
  • The child was not wanted
• Early infancy difficulties:’
  • Birth is traumatic. Freud talked about “birth trauma.” Think about it: the fetus doesn’t need to eat, breathe, or eliminate, much less talk or walk. Then, rather suddenly, s/he has to breathe, taking in air into the lungs that have never had air before.
  • Feeding difficulties
  • Sleeping difficulties
  • Emotional disturbance in the family
  • Change of geography of the family
  • The addition of another child to the family within the first year or two, which requires the parents to limit the time they can spend with the older child
• Toddler years difficulties:
  • Neglect
  • Abuse
  • Indulgence
  • Shame
  • All of above
• Childhood
  • All of the foregoing toddler difficulties
  • Bullying at school
  • Academic challenges at school due to some form of learning disability
  • Physical/medical difficulties that restrict the child’s activity
  • Some kind of social rejection
  • Difficult teacher
  • Difficult adult (relative, significant person in the family)
• Adolescence
  • All of above
  • Alcohol or drug use
  • Failure to identify a vocational direction
  • Social relationships that lead to some form of antisocial activity
• Adulthood
  • All of above
  • Any adult trauma, such as a loss of person, place, or thing as well as separations and changes in jobs, geography, loved ones, and friendships.
  • There may also be traumas associated with parenting and other responsibilities that come along with adulthood.
  • There are also what Freud called “repetitive compulsions,” namely traumas that are created by individuals in a vain attempt to resolve early childhood traumas; e.g. marrying an abusive or neglectful individual hoping to have the early trauma magically resolved.
• Intergenerational trauma
  • This is a bit hard to understand, but there is clearly trauma that occurred to our relatives that trickled down to us in the form of emotional or cognitive images of danger.
  • More interesting yet is the more recent finding that traumas that occurred to our great grandparents or earlier actually changed their DNA structure, and hence affected generations to come. The Black community seemingly still suffers from slavery, possibly both culturally and biologically.

Now, let’s look at what can be done about old traumas and PTSD:

Resolving traumas and PTSD

Importantly, all traumas are resolved, however difficult that may be to believe. There is strong evidence that it is not necessary to continue to suffer PTSD if a traumatized individual is able to find resolution to the original trauma(s). What does “resolution” mean? It means “completing the emotional process that was stunted when the original trauma occurred. Simply put, it means finding, feeling, and “finishing” the emotions that occurred…but were repressed…when the individual was traumatized. I have written about “finishing unfinished emotions” in previous blogs, but in a nutshell, it means feeling the original fear, anger, and sadness that are always associated with any trauma, particularly fear, which is our most basic emotion, one that keeps us alive. Finishing fear is most difficult because the brain gets in the way of finishing fear. You might check out my previous blog on finishing fear, noting that anxiety in any form (worry, panic, nervousness, or fear itself) is very resilient to change because of our most primitive brain function: stay alive at any cost, including the cost of staying anxious.

Anxiety, fear, worry, and the like are all forms of PTSD and can be felt and finished, e.g.:

• Generational trauma, like slavery
• War or sexual traumas
• Social traumas
• Physical/medical traumas
• Loss of any kind

If you find a competent therapist to help you “finish” the traumas in your life and be free…yes completely free…of anxiety, you will need to face each and every trauma and loss you have had in your life where you did not allow yourself (or were not allowed) to feel the feelings of fear, sadness, anger, and sadness. If you do this, you will discover that sadness replaces both fear and anger (as Deb and I wrote in our earlier book and unpacked further in our recent book). So you must be prepared to feel more sadness, possibly a great deal of sadness when you start facing, feeling, and finishing the fear that caused your anxiety. Sadness always ends…if you allow it to run its course. Fear and anxiety do not naturally end; they just cause physical and social difficulties.

Many other things occur when you are no longer anxious, like increased confidence, increased humility, and decreased concern about yourself, and increased commitment to do something for the world with all the energy you now have at your disposal. Furthermore, when you are not thinking about and worrying about yourself, what might happen to you, and what people might think of you.

Yes, it is all about trauma, but more importantly, it is all about love: love of things, love of people, and love of ideas. More importantly, love of yourself, which always leads to self-confidence, humility and graciousness