“The Body keeps remembering what has happened to it and it has changes in order to cope with the original trauma”. “These post traumatic reactions feels incomprehensible and overwhelming. Feeling out of control, survivors of trauma often fear that they are damaged to the core and beyond redemption” Dr. Bessel Van Der Kolk: The Body Keeps the Score. 2014
A CASE STUDY
Imagine a young girl (we’ll call her Sally) who one day was told by her mother, that she was going to visit her uncle and aunt in the city. Her mother took her to visit her uncle, but then left her behind and returned home without her, with the only explanation that she will come and visit her soon. She was only three years old.
Life with her uncle and aunt was good - they adored Sally. Then one day, her life changed forever when a bomb was dropped on the city where she lived in Europe and her aunt and uncle were sent away to a concentration camp. She had vivid memories of the explosions and the heat of the fire. At age five, she was put on a train all by herself, to go back to her family. Life became foggy in a battle to survive. Back home she felt like an outcast as her siblings did not welcome her back. Her father was off to war and she had to work from early morning till night, to help her mother to make ends meet. The only income for her mother was to brew beer for the soldiers. Sally recalls drinking the beer before bed at night as she was so hungry all day. Eventually she ended up in an orphanage and was shipped out to Canada for a “better life”.
As a young woman, Sally explored her talent in dancing as a young woman, but her anxiety, insomnia, hypervigilance and her inability to trust anybody, destroyed many promising work opportunities, relationships, friendships and marriages. She recalled how she would go out into nature to try and calm herself down or find a fleeting moment of peace in her mind.
Her anxiety, flashbacks and hyperarousal was constantly triggered by nightmares, sirens from the firetrucks or police, the smell of smoke, the smell of alcohol, bright lights and crowded places. She started to withdraw herself from friends, community and tried to avoid people. Her emotions and thoughts became very negative, with fear, guilt, sadness, shame, confusion and self-loathing. She became very irritable with angry outbursts that included verbal and physical aggression. She tried to quiet her mind with alcohol. She had severe problems with concentration and she became depressed and suicidal. This cycle of trauma held Sally captive for 50 years of her life. These are all the debilitating symptoms of Post-Traumatic Stress Disorder (PTSD).
Sally originally came to me for treatment for anxiety and panic attacks at work. Unable to function, she was on sick leave and taking medication. Working with her I noticed that her “anxiety and panic attacks” was really a window into a much more complex history of PTSD. She was very ashamed and believed that she was inherently “bad” or “cursed” and that she did not deserve to be happy. She was paranoid about psychotherapy as he did not trust the psychiatric diagnostic way of treatment, of which she had multiple traumatic experiences. After connecting with me, she became very intrigued by the process of psychotherapy and understanding her trauma.
When we started psychotherapy, she was a single mother with a low income. She was fighting an alcohol addiction, although had been sober for 5 years. By creating a safe therapeutic relational field with empathy, attunement, unconditional acceptance and containment in our therapy sessions, she was able to process her pain, helplessness, debilitating fear and anger, related to the abandonment of her mother and family. She shared memories of overwhelming suffering and abuse during her childhood years. Gradually she worked through the layers of attachment and trauma memories that haunted her throughout the years, preventing her from experiencing meaning and fulfilment in her work and relationships.
Through therapy she came to understand and reclaim her mental and physical health. She was relieved to hear that she was not totally “crazy”, but that her brain and body nervous system just responded to the traumatic environment and managed to keep her safe. She was also relieved to hear that her sensitive fight-flight-freeze nervous system response can be renegotiated by psychotherapeutic interventions.
In therapy, I worked on repairing trust, giving voice to her anger towards her parents who abandoned her and the perpetrators who violated her. We explored and utilized all the caring protectors that she did have in her life “installing a Competent Protector,” represented by her uncle and aunt and various supportive therapists throughout her life. In emphasizing their caring behaviors, a container and resource for secure, supportive attachment could be developed, strengthened by the safety of the therapeutic relationship. She also had to grieve the loss of her carefree, protected childhood which was robbed from her by poverty, violence and war.
Once she and I established trust, she was able to reprocess her traumatic past. She learned strategies to self-regulate her response to anxiety and the flashbacks. She was also able to become more tolerant of triggers and accepting of other people’s vulnerabilities. With her new found skills and a calmer nervous system she returned to work and she became trusting of people again – even finding love in her life once more. She is now more aware of her feelings and is no longer hijacked by them. She is more attuned and present in every moment. She is more tolerant of physical touch. When she does get triggered by a body memory, she is able to remind herself that some parts of her body are holding experiences and she can acknowledge and validate the memories, breathe her nervous system to calmness, and then let it go.
Sally is now a loving grandmother, enthusiastic member of her community and church group and is an active volunteer supporting others who have experienced trauma.
Sophia Van Vuuren, M.A. Clinical Psychology | Registered Psychologist#1659