Residues of Childhood Trauma

To illustrate how early experiences can set the stage for life-long patterns and difficulties, I will relate the history of a client who came to see me some years ago. Shortly after WWII Paul’s father left his wife and family behind, immigrating to Canada in search of work and the resources to establish his family in this country. Paul, at one and a half, was the youngest of four children. Four years later the family came to Canada, seeing their father for the first time since his departure. As the baby, Paul had been especially close to his mother during this period, sharing her bed and being her special pet. Suddenly he was confronted with a man who was a stranger to him, replacing him in his mother’s bed and, as he experienced it, in her affections. He had the usual immigrant terrain to manage as well: starting school without benefit of the language spoken by most if not all of his classmates. Before long his busy mother had the care of two more babies to occupy her. His older brothers, closer to each other in age, would tease and pick on him, excluding him from their games. Both parents, worn with work and cares, would yell and hit him in their exasperation with any misbehaviour.

Misbehaviour became for Paul a way of expressing his frustration and unhappiness but also a vehicle for attention, especially from his mother. A pattern developed of activities designed to annoy her, an explosion of her anger, a deluge of unhappiness followed by tears, repentance, and reconciliation. 

This mode of communication was replicated in Paul’s adult life with his partners. He had come to see me originally because of the troubles in his most recent relationship. He had come to understand that he was behaving in ways that maintained a current of disturbed interaction. There was no peace or consistency with his girl friend. One of the main issues that would surface between them was his jealousy. Convinced on some level that like his mother, who had “replaced” him with his father when they came to Canada, any woman would ultimately betray and abandon him. He was hyper-sensitive to the slightest indication of friendship or regard that his partner had toward another man. By turns sullen, angry, or suspicious, Paul continually provoked his partner in ways that would lead to the familiar round of fighting, estrangement, and tearful reconciliation.

There were no simple or quick passages through this thicket of emotional reactions for Paul. An intelligent man, he was able to appreciate the underlying triggers and patterns that were being repeated with his girl friend. This in itself could not rapidly lead to changes, however. Our intellectual understanding and our emotional lives are not entirely coincident. Coming to knowledge at the intellectual level and developing an emotional connection leading to deep changes in behavior have rhythms of their own, not at all co-terminus. We are more deeply attached to our emotional responses and change them more slowly precisely because of their connections to elemental factors like pleasure and pain, fear and safety.

Wounded emotionally when young, we can grow up around that wound, developing physically, socially, and intellectually, all the while living with the unhealed pain within. It functions somewhat like a break in a bone that wasn’t properly repaired. Other systems may be functioning fairly well, but the slightest pressure on the area of the break will provoke severe pain. Growing up with an inner place of unresolved trouble one finds ways of dealing with it, ways which are particular to the nature of the injury and to the individual’s personality and circumstances. Paul dealt with his pain through anger and provocation. Physiologically and emotionally he found much to confirm him in this outlet. He had the excitement of rebelling and of rousing his mother to rage, exercising a power in the home that his youth would otherwise belie. Suffering the inevitable punishments meted out by her or his father, he could release pent-up emotions with his tears and self-pity. Abasing himself and seeking reconciliation with the loved one, his mother, he could bathe for a brief time in the warmth of her closeness and love.

The adaptations -- mental, physical, and emotional -- that we form during childhood to deal with painful experiences can be successful in the sense that they allow us to maintain a connection to the source and nature of our pain by re-enacting it in some form over and over, while still being able to move forward in other essential areas of development. As we come to maturity, however, these adaptations, by their very origin immature, hamper our quest to fulfill adult roles in a satisfying manner. Recognizing that something is not working and developing insight about the nature and origins of the behaviour that is thwarting one’s desires is but a beginning. 

On Self-Awareness and Self-Consciousness

One way of distinguishing between self-awareness and self-consciousness is to view the former as more cognitive and the latter as more emotive. As teens we tend to be highly self-conscious as we rapidly undergo brain development, have hormonal and physical changes, and move into a more expansive social canvas. With an already more or less solid beginning we can emerge from this crucible with a fair amount of confidence and social ease. For many, however, self-consciousness, painful and even debilitating, can persist into adulthood. Suffering in this way I can experience society of any complexity overwhelming. With others I am anxious; often I will imagine that they are perfectly at ease, that they see through my façade, or, that they are uninterested in me or find me boring/incompetent/unattractive. Because these feelings are so painful, I seek refuge in withdrawal from company, the development of a mask behind which I conceal myself, or possibly, the use of alcohol or drugs to literally spirit myself away.

Self-awareness, on the other hand, is a capacity to view somewhat dispassionately one’s behavior and feelings in order to more deeply understand oneself and by extension, others. It is an ability which in good circumstances, one can grow up with. It also can be developed later in an intentional fashion. What is most needed is a space in which this can occur. A therapeutic relationship is one such space, but by no means the only one where this can happen. Ideally, the therapist in a non-judgmental fashion can feed back to her client the things that she is aware of in the session. It can be as simple as to say, “You seem to be rather nervous.” If I have developed the habit of hiding my nervousness with others, I may even have hidden it from myself. Feeling so vulnerable may not coincide with the view that I want or need to have of myself. When the therapist gives me her observation, because I have sought her help and because I can sense that her words are not an accusation or a put-down, I may be able then to acknowledge to her and to myself that I am indeed nervous. Expanding within this terrain we may then jointly look more closely at what I might be afraid of in the encounter with her: criticism? an attack? humiliation? dismissal? a lack of understanding? We might also consider other milieu in which similar feelings arise. Are there similarities and/or differences in those situations? After this talk I may begin to find myself more aware of my nervousness in other places, talk with the therapist about these, and begin to understand more deeply their origins.

Any space that we carve out to be with ourselves can also facilitate greater self-awareness and knowledge, if this is indeed our intention. Meditation, for example, is a practice whereby I set aside time to be quietly with myself focusing on my breathing and allowing myself to dwell within my body within the moment. Much of our lives are spent in the midst of various stimuli from without and within. Our thoughts speed along from past to future events or concerns. Developing an ability to situate ourselves in our bodies and in the present is a valuable antidote to these consuming and distracting forces. But it is not an easy practice to acquire. Being aware of the thoughts that arise and quietly returning oneself to a focus on breathing requires constancy and determination. It is not necessarily a peaceful practice especially as one works herself into it more deeply. During my meditation I simply allow thoughts to come unbidden and rather than go along with them, leave them and return my focus to my breathe and to being in my body in that moment. Staying there, I will inevitably come face to face with thoughts and feelings about myself and perhaps of others with which I had not been connected and which I find disturbing or at least uncomfortable. Because of these experiences some people who practice meditation find themselves a coach or teacher with whom they can explore and gain perspective on these facets of their practice.

Journal writing is another venue for greater self-awareness. Julia Cameron’s workbook, The Artist’s Way, outlines a program of daily journal writing in a stream-of-consciousness manner. Her personal work and later, doing workshops with others, taught her that blocked artistic energies could be tapped as a person relinquishes some control over her output. The stream-of-consciousness technique, if regularly pursued, can open areas within that the writer has avoided often out of fear or shame. As these are revealed to the writer in this private and thus safe experiment, she can come to a greater understanding of her inner self and a greater freedom of self-expression.

Any activity that promotes a connection with the whole of one’s being can aid self-awareness, activities as simple as going for a walk by oneself, especially in an area which connects one with nature. Listening to contemplative music, watching a film with resonant issues, reading novels or non-fiction books that open unexplored but relevant vistas, or, talking with a friend whom one trusts and respects, can be helpful. Indeed all of life’s experiences invite us to deeper understanding if we can but be attuned to them without fear.

On Developing Self-Awareness

Socrates famously told his students that the unexamined life is not worth living. For most of us, vast areas of our lives are rarely examined. We dwell within the necessities of daily life and but seldom find the inner leisure and motivation to look more deeply at ourselves. People come into therapy because they are unhappy. The cause of their unhappiness may be focused specifically on one or two areas: a troubled relationship, an illness, or difficulties at work. Rather than having a specific content, their unhappiness might be experienced more as an unexplained over-all sense of malaise. Going to a medical doctor because we are ill or in pain, we seek an explanation and hopefully, a cure. Seeing a therapist, we look for a similar outcome. Like the doctor, the therapist must bring all of her knowledge and experience to play in assessing the client’s situation and formulating a direction for their work together. A general sense can emerge from the first session but the process of assessment is on-going, as the partners in the therapeutic endeavor reach deeper and deeper into the ways in which the client’s troubles are enacted and perpetuated in her daily life.

Talking about her troubles and receiving feedback can move a person closer to an awareness of dynamics in her present life which she experiences but may not be fully in touch with. This awareness can be expanded when, for example, her therapist enquires about her physical and feeling state in the session itself. For many of us reflection of that nature is quite foreign. Our consciousness is focused on the interaction itself. At another level, however, we are reacting mentally, emotionally, and physically to the person with whom we are talking. For example, though I might be speaking of a conflict with someone at work, internally whole other things can be going on. I might feel intimidated by the therapist whom, without realizing it, I have elevated to the role of an authority, someone who could judge me pejoratively. Alongside this reaction can be one of resentment for what I experience as being actually or potentially criticized and dismissed. At the same time I likely have other feelings, for example, longings to be understood and cared for at levels that have never been fully met. In my body are chronic tensions exacerbated by the intensity of this encounter with a person who so clearly is focused upon my words and feelings in a way rarely experienced. 

Exploring some of these reactions in the session can help me to be more aware of the quality of my interactions with others and thus to more deeply understand them. Especially when my inner responses to people and situations are viewed within the context of the dynamics of my formative years, I can develop an appreciation of the ways in which these dynamics have shaped my approaches to the world and to others. In itself this broadening perspective allows me a space to explore the possibilities of other ways of viewing and responding to the exigencies of life.

In my next post I will write about efforts that I can make between sessions that can further expand this “terra incognita,” the inner life which proceeds with or without my conscious awareness.

On Anxiety and Agitation

The kind of agitation that I wrote about in my last post can serve a variety of purposes in the inner economy of emotion. It is a stimulant, in the sense that it produces and is produced by increased levels of adrenalin in one’s body. This process can be helpful in situations where we need an extra bit of energy to protect ourselves or to complete a task. It can also have detrimental effects, especially if one lives in a fairly chronic, possibly unperceived state of heightened alertness. It is possible to exist in a manner comparable to that of a bird or small mammal, much of our energy focused on scanning the environment (physical and social) for any hint of threat, ready to react. Chronic stimulation of this nature depletes our bodies, however, and over time can compromise our immune systems. Moreover, it limits the scope of our lives, the capacity we have for taking risks, whether in personal relationships or in other areas. It also lessens our capacity for more deeply knowing and understanding our own selves. 

Focused as we are upon the possibility of threat, we have not the inner leisure and calm needed for self-reflection. We exist with a mentality and an emotional life not unlike that experienced by people living in a war zone. Life is lived, in a sense, within the confines of a state of emergency, with its concomitant stimulations, terrors, and despairs.

A reasonable enquiry from someone beginning to tune in to this dynamic within her body might be: how did I get this way? It’s an important question, but one that may never be fully or adequately answered. Nor is a full answer essential to change or healing. Information of this nature can be interesting, perhaps even enlightening, and can to a certain extent assist change. In and of itself, however, it cannot bring about the transformation of body and mind that is needed to liberate a sufferer from debilitating anxiety and the agitation that it produces. Early in my work with someone I ask her for a general description of the emotional climate within which she was raised. Who were the members of her family? How did they relate to one another and to her? How were conflict and anger managed within the household? In what manner was discipline maintained? Moving more and more deeply into the marrow of the client’s answers of these and other queries, over time we conduct a kind of archeological expedition through the heart and history of her background. We seek an understanding and delineation of the influences that have contributed in myriad ways to her formation and in a sense constitute the framework of the person that she is now in her present life.

Some clever person has come up with an analogy likening the world in which we develop to a fish bowl. Fish breathe in and out the water that surrounds them, drawing into their bodies whatever nutrients and pollutants it contains. From the earliest moments of our existence, certainly in the womb, we are permeated with whatever of good or ill circulates within our mother’s being. As our nervous systems develop receptivity, we are affected not only by the foods ingested by her, but also by the emotional climate in which she dwells. When that space is charged with fears – from conditions of war, extreme poverty, domestic conflict, or from irrational reactions to imagined threats – her anxiety and its hormonal concomitants are in the same manner made a formative part of our being. As very young children, before our brains have developed cognitively, we experience the same instinctive responses to threat as any mammal. Loud noises, yelling, fighting in our vicinity, the face of an enraged parent close to ours, or sustaining blows for offenses we are incapable of understanding, can trigger feelings of real terror. It is not hard to see insecurity manifested in the stance and behavior of cats or dogs that have been frightened or mistreated when young. Our responses are similar to theirs. Threatening experiences or chronic, adverse conditions lay down physiological sensitivities to similar stimuli, even expanding to fields greater than those which have caused our responses.

No one has escaped frightening or hurtful experiences in their formative years, but there is clearly a wide spectrum of the severity and persistence of these events. The extent to which we are affected relies on where we lie on that spectrum, as well as on other factors. People differ vastly in their temperamental make-ups. Some are constitutionally more able to deal with stress than others. Location in the family structure can play a role, as can many other factors such as the degree of support given by other members of the family or community. Genetics also is important: we can be more or less susceptible to mental health difficulties as our experiences intersect with any underlying predisposition to these troubles. Teasing out the threads that have woven the matrix of someone’s anxiety is not a simple task, but a perspective on various pieces can often help a person to better understand what they are dealing with and even prompt strategies for diminishing its effects.

On Listening

Reading Alain de Botton’s book, How Proust Can Change Your Life, I am aware that reflecting deeply on the ideas he is presenting can indeed change one’s life. Botton’s look at the author highlights the way in which Proust goes beyond the surface and the obvious, to a realm where to understand one must simply let go. Not an easy thing to do, to just let go, to be in the present and to allow the realities of the present in all of their simplicity and complexity to affect one. But it is exactly this skill or habit or way of being that can situate a therapist to most deeply be of assistance to her client. Theodore Reik called attention to a skill of this kind, calling it, “listening with the third ear.” To me this means “listening” with the whole of one’s being, past, present, and future, body, mind, and spirit. I think of all of us as, in a way, holograms of the whole of our existences. When we meet with others in any setting these holograms interact with one another on both superficial and profound levels. 

If I am able to some extent to be connected to the whole of the being that is myself in that moment of intersection with another, I can then most openly and meaningfully recognize and “be with,” that is, deeply “listen” to the other. The act of listening occurs on mental, emotional, and physical levels. Aware of, though not reflecting on especially, my own history, experiences, physical and emotional states, I am simultaneously receptive to, though again not necessarily reflecting upon, parallel dimensions in my client. I take in, to the extent that I am wholly present to her, all that she is communicating to me, verbally and by hundreds of unspoken messages given through gestures, tone of voice, bodily arrangement, facial expressions, eye contact, and so on. Just being in the presence of the client in a state of presence with myself, I am then able to “hear” and respond to this myriad of communications in ways that can be revealing to us both. In the things that she says to me I may be aware especially of a word or tone that expresses and conceals at the same time.

An example: A woman relates to me a series of circumstances that have caused her agitation and unhappiness in recent days. What most catches my attention as she speaks is her mounting agitation. I stop her and ask what she is aware of within herself at that moment. She pauses and acknowledges that as she is talking she is becoming more agitated. From past sessions and work we already know that the regular discourse of her family of origin involves the mutual sharing of stories of thwarted goals. Each actor in a scene recounts in escalating crescendo the horrors of recent experiences. One revelation prompts another. The agitation of one stirs that of another and a growing pool of unhappiness, indignation, and cynicism regarding the possibility of life being lived peacefully, settles about the group, pervading and maintaining the tone of their interactions. In our session my client was engaged in this familiar pattern as she gave me her recitation of unhappy circumstances. 

My interrupting and questioning her about her feeling state during the speech allowed her to move out of the environment of her family in which she had been mentally and emotionally dwelling as she spoke to me, and back into the space that she and I share when she comes to see me. Within this space she has, over time, developed sufficient security to risk letting go of some automatic defensive locations, still maintained to a certain degree with her family and others. As a way of feeling relatively safe in what seems a chaotic arena, being annoyed and indignant can work. Giving one some sense of personal power, it is certainly safer than displaying vulnerability and openness. 

As I spoke with her about the effect that her tale of the day’s or week’s misfortunes has had upon herself, and usually upon her listener, she began to calm down and to understand at another level the reasons and effects of her behavior. We went through once again a quiet exchange about the importance of letting go of minor agitations, of seeing these as a normal part of life, rather than excuses for maintaining, nurturing even, a chronic state of unhappiness and discouragement. In recognizing the pattern that she is falling into she has at her disposal a couple of simple, though not necessarily easy to acquire habits: take a few deep breathes and repeat to herself, out loud if possible, “Just let it go.”

The reader may be skeptical about the effectiveness of such a simple process, but certainly my client, over time, as she has reminded herself to use this method, is learning to calm herself and to establish an inner perspective on the relative necessity for alarm and rage about life’s ordinary difficulties.

About Fear

Some time ago I read an article about a biologist named Savolina. He looked at a study done in the 1950s by Balyav with foxes. People in the fur industry were concerned about the amount of aggressive behavior among their foxes. On their behalf Baylav looked at a feature of the foxes that he identified as “flight distance,” that is, how tame or frightened the animal was. Flight distance was measured in relation to the proximity of humans. If food was put out by someone who remained close by, individual foxes observing this, would differ in how far they would stay from the person and the food. If the person was to advance toward them, all of the foxes would run away but they would run different distances, depending upon how reactive they were to the fear of humans -- basically the fear of being captured or killed. One fox might run a half a mile, another 500 feet, and another 100 feet. When the human left, whoever was closest to the food would get there first and would eat it. This proved to be adaptive. Savolina related this behavior to the evolution of dogs from wolves in their interactions with humans. Those less frightened, would gradually be able to connect with and become a part of the human “pack” and be rewarded with food.

I considered Savolina's ideas in relation to human’s relationships to danger or perceived dangers. All sentient beings have a “hard-drive” response to danger. In mammals this is regulated by the autonomic nervous system fight-flight reactions. These reactions take over in cases of perceived danger. This is not taught behavior. Rather the reactions are “encoded” in the brain and nervous system. All mammals have these same automatic reactions. The world that we must navigate now is not the world humans lived in 100 years ago, 1000 years ago, or 100,000 years ago. In today’s world we very rarely fear being eaten by large animals or attacked by wild beasts. In some contexts we can fear being attacked by wild human beasts during war, for example, or in places where the rule of law is non-existence or perhaps in areas of our own country or city where we don’t feel safe. In those contexts we learn how to navigate: we learn a flight distance. Most of us simply stay away from places of war or areas of our cities where we feel unsafe. We have a sense of things of which to be wary by paying attention to signals that are real, not only from our bodies, but also which have been transmitted by media or by our community.

But there are many people who are over-reactive to signals of danger. They suffer anxiety or fears that are not even conscious. Discomfort is felt in various contexts – for example, social situations or ones in which a performance of some nature might be expected. Fears of this kind can take many faces and have a huge impact on a person’s daily life even though she may not have a particular consciousness of being afraid. She may have learned to distance herself from people, places or situations where she feels discomfort and does not necessarily examine or understand the sources of the discomfort. She may only be aware of a stomach upset or a shortness of breath and not recognize these feelings as bodily signals of fear. She may simply have a sense of not feeling well, a reaction which would further validate her withdrawal physically or emotionally from the context in which she feels her discomfort. More subtly, someone may adapt by living in a way that allows her to experience fewer signals of fear – either overt panic or anxiety or the unrecognized signals in the body. For example, she may not move from home or from her community. Perhaps she won’t travel abroad or even on the subway. If she does go away, she may feel a discomfort that is identified as homesickness. She goes home in order to feel better but does not understand that the real difficulty lies in her fear of unfamiliar settings and dangers that she fears may lie within them.

“Programmed” fear responses occur in situations which are not in themselves threatening. It is not, for example, particularly dangerous to travel on the bus or subway if one takes normal safety precautions. Nor is it an inherently scary thing to go out socially or communally; ordinarily people whom we meet are not going to punish or criticize or humiliate us. But fear, even an unconscious fear, that something of that kind could occur, will greatly curtail one’s ability to get around in the world. In my practice I am constantly struck with how often people present with difficulties in their lives which at bottom have their root in fear. There are tremendous elaborations resulting in physical problems, mood disorders, relationship problems, troubles with intimacy, with work, creativity, or with parenting. As I pursue different pieces that people bring, the greatest common denominators seem to be various levels of anxiety. In some, bodily reactions to threats have overwhelmed the person on a physiological level and become a kind of habit of the body – the way that Wilhelm Reich talked about the body carrying tensions to hold in threatening emotions.
With this awareness I work to discover the parameters of fear as they operate within the difficulties a person presents when she comes for therapy. Often I am aware of nervousness in her, manifested in agitated movements, a discomfort with silence, difficulty maintaining eye-contact, and the kinds of tensions that the person is obviously holding in her body.

When we come to doing relaxation, these anxieties become even more visible. In relaxation one listens deeply to the voice of another telling her muscles and nervous system and whole body to relax. In order to yield fully to these instructions, she will necessarily go closer to places of discomfort and fear that chronically lie within her body. Experiences which one has had when young, perhaps of which she has no memory, can have made her suspicious of being fully relaxed in the presence of another person. Her eyes are closed and she is in a semi-recumbent position with her legs and arms uncrossed. She is deliberately trying to let go of muscles that are ordinarily kept tight. She has discovered a long time ago that when she holds herself tightly, she feels more alert, more ready for the scary thing that has happened and could happen again. So when someone tells her to relax and let go, she will move toward those things that she doesn’t want to feel and there will be a reaction. This may take the form of tensions in her legs: those legs want to be ready for running – to get out away. Or she may be aware of the tensions in her neck and shoulders. She keeps herself tight in her upper body with energy concentrated in her head – keeping alert and ready. Her eyes may twitch as she struggles to comply with the therapist’s directive to keep them closed. Her body’s reaction is to keep “the other” in view.

Letting go deeply enough to gradually connect with the feelings of terror that underlie her body’s tensions is a slow process that requires patience and a great deal of trust. It is the gradual evolution of this trust that over time can operate on many levels within the therapeutic relationship to allow an easing of the fear that she has carried and the development of strategies that allow new forays into a world once boundaried by threat.