Book: Trauma And Recovery – The aftermath of violence – from domestic abuse to political terror

I feel this is an excellent book for those tasked with social programming or anyone seriously struggling with life’s challenges. Society will benefit from reading Judith Herman’s book which includes these chapters; Traumatic Disorders (A Forgotten History, Terror, Disconection, Captivity, Child Abuse, A New Diagnosis), and Stages of Recovery (A Healing Relationship, Safety, Remembrance and Mourning, Reconnection, Commonality). Click here to learn more or read some excerpts below or here to read an excellent review of the book.

Studies of children, in fact, offer some of the clearest examples of traumatic memory. Among 20 children with documented histories of early trauma, the psychiatrist Lenore Terr found that none of the children could give a verbal description of the events that had occurred before they were two and one-half years old. Nonetheless, these experiences were indelibly encoded in memory. Eighteen of the 20 children showed evidence of traumatic memory in their behaviour and their play. They had specific fears related to the traumatic events, and they were able to reenact these events in their play with extraordinary accuracy. For example, a child who had been sexually molested by a babysitter in the first two years of life could not, at age five, remember or name the babysitter. Furthermore, he denied any knowledge or memory of being abused. But in his play he enacted scenes that exactly replicated a pornographic movie made by the baby sitter.

The offers had been rescued first, even though they were already relatively safe in lifeboats, while the enlisted men hanging onto the raft were passed over, and some of them drowned as they awaited rescue. Though Kardiner accepted this procedure as part of the normal military order, the patient was horrified at the realization that he was expendable to his own people. The rescuers’ disregard for this man’s life was more traumatic to him than were the enemy attack, the physical pain of submersion in the cold water, the terror of death, and the loss of the other men who shared his ordeal. The indifference of the rescuers destroyed his faith in his community. In the aftermath of this event, the patient exhibited not only classic post-traumatic symptoms but also evidence of pathological grief, disrupted relationships, and chronic depression: “He had, in fact, a profound reaction to violence of any kind and could not see others being injured, hurt, or threatened…. [However] he claimed that he felt like suddenly striking people and that he had become very pugnacious toward his family. He remarked, “I wish I were dead, I make everybody around me suffer.”19

In fighting men, the sense of safety is invested in the small combat group. Clinging together under prolonged conditions of danger, the combat group develops a shared fantasy that their mutual loyalty and devotion can protect them from harm. They come to fear separation from one another more than they fear death. Military psychiatrist in the Second World War discovered that separating soldiers from their units greatly compounded the trauma of combat exposure. The psychiatrist Herbert Spiegel describes his strategy for preserving attachment and restoring the sense of basic safety among solders at the front: “We knew once a solder was separated from his unit he was lost. So if someone was getting tremulous, I would give him the chance to spend the night in the kitchen area, because it was a little bit behind, a little bit protected, but it was still our unit. The cooks were there, and I would tell them to rest, even give them some medication for sleep, and that was like my rehab unit. Because the traumatic neurosis doesn’t occur right away. In the initial stage it’s just confusion and despair. The that immediate period afterwards, if that environment encourages and supports the person, you can avoid the worst of it. 49

If, by contrast, the survivor is lucky enough to have supportive family, lovers, or friends, their care and protection can have a strong healing influence. Burges and Holmstrom, in their follow-up study of rape survivors, reported that the length of time required for recovery was related to the quality of the person’s intimate relationships. Women who had a stable intimate relationship with a partner tended to recover faster than those who did not.51 Similarly, another study found that the rape survivors who were least symptomatic on follow-up were those who reported the greatest experience of intimate, loving relationships with men. 52

Once a sense of basic safety has been reestablished, the survivor needs the help of others in rebuilding a positive view of the self. The regulation of intimacy and aggression, disrupted by the trauma, must be restored. This requires that others show some tolerance for the survivor’s fluctuating need for closeness and distance, and some respect for her attempts to reestablish autonomy and self-control. It does not require that others tolerate uncontrolled outbursts of aggression, such tolerance is in fact counterproductive, since it ultimately increases the survivor’s burden of guilt and shame. Rather, the restoration of a sense of personal worth requires the same kind of respect for autonomy that fostered the original development of self-esteem in the first years of life.

The worst fear of any traumatized person is that the moment of horror will recur, and this fear is realized in victims of chronic abuse. Not surprisingly, the repetition of trauma amplifies all the hyperarousal symptoms of post-traumatic stress disorder. Chronically traumatized people are continually hypervigilant, anxious, and agitated. The psychiatrist Elaine Hilberman describes the state of constant dread experienced by battered women “Events even remotely connected with violence – sirens, thunder, a door slamming – elicited intense fear. There was chronic apprehension of imminent doom, of something terible always about to happen. Any symbolic or actual sign of potential danger resulted in increased activity,, agitation, packing, screaming and crying. The women remained vigilant, unable to relax or to sleep. Nightmares were universal, with undisguised themes of violence and danger.”52

Prolonged captivity disrupts all human relationships and amplifies the dialectic of trauma. The survivor oscillates between intense attachment and terrified withdrawal. She approaches all relationships as though questions of life and death are at stake. She may cling desperately to a person whom she perceives as a rescuer, flee suddenly from a person she suspects to be a perpetrator or accomplice, show great loyalty and devotion as a person she perceives as an ally, and heap wrath and scorn on a person who appears to be a complacent bystander. The roles she assigns to others may change suddenly, as the result of small lapses or disappointments, for no internal representation of another person is any longer secure. Once again, there is no room for mistakes. Over time, as most people fail the survivor’s exacting tests of trustworthiness, she tends to withdraw from relationships. The isolation of the survivor thus persists even after she is free.

Adaptation to this climate of constant danger requires a state of constant alertness. Children in an abusive environment develop extraordinary abilities to scan for warning signs of attack. They become minutely attuned to their abusers’ inner states. They learn to recognize subtle changes in facial expression, voice, and body language as signals of anger, sexual arousal, intoxication, or dissociation. This nonverbal communication becomes highly automatic and occurs for the most part outside of conscious awareness. Child victims learn to respond without being able to name of identify the danger signals that evoked their alarm. In one extreme example, the psychiatrist Richard Kluft observed three children who had learned to dissociate on cue when their mother became violent.8

When abused children note signs of danger, they attempt to protect themselves either by avoiding or by placating the abuser. Runaway attempts are common, often beginning by age seven or eight. many survivors remember literally hiding for long periods of time, and they associate their only feelings of safety with particular hiding places rather than with people. Others describe their efforts to become as inconspicuous as possible and to avoid attracting atttention to themselves by freezing in place, crouching, rolling up in a ball, or keeping their face expressionless. Thus, while in a constant state of autonomic byperarousal, they must also be quiet and immobile, avoiding any physical display of their inner agitation. the result is peculiar, seething state of “frozen watchfulness” noted in abused children.`9

If avoidance fails, then children attempt to appease their abusers by demonstrations of automatic obedience. The arbitrary enforcement of rules, combined with the constant fear of death or serious harm, produces a paradoxical result. On the one hand, it convinces children of their utter helplessness and the futility of resistance. Many develop the belief that their abusers have absolute or even supernatural powers, can read their thoughts, and can control their lives entirely. On the other hand, it motivates children to prove their loyalty and compliance. These children double and redouble their efforts to gain control of the situation in the only way that seems possible by, “trying to be good.”

Feelings of rage and murderous revenge fantasies are normal responses to abusive treatment. Like abused adults, abused children are often rageful and sometimes aggressive. They often lack verbal and social skills for resolving conflict, and they approach problems with the expectation of hostile attack.17 The abused child’s predictable difficulties in modulating anger further strengthen her conviction of inner badness. Each hostile encounter convinces her that she is indeed a hateful person. If as is common, she tends to displace her anger far from its dangerous source and to discharge it unfairly on those who did not provoke it, her self-condemnation is aggravated still further.

This malignant sense of inner badness is often camouflaged by the abused child’s persistent attempts to be good. In the effort to placage her abusers, the child victim often becomes a superb performer. She attempts to do whatever is required of her. She may become an empathic caretaker for her parents, an efficient housekeeper, an academic achiever, a model of social conformity. She brings to all these tasks a perfectionist zeal, driven by the desperate need to find favor in her parents’ eyes. In adult life, this prematurely forced competence may lead to considerable occupational success. None of her achievements in the world redound to her credit; however, for she usually perceives her performing self as inauthentic and false. Rather, the appreciation of others imply confirms her conviction that no one can truly know her and that, if her secret and true self were recognized, she would be shunned and reviled.

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