A few days ago I picked up Trauma and Recovery by Judith Herman a book that has been recommended by various people I’ve met in the field of trauma. Herman uses a feminist narrative to understand the history of trauma, responses to trauma, and recovery. Right now I’m entrenched into the gory details of human suffering. As I read the descriptives of what people have suffered in concentration camps, through rape, kidnapping, and child abuse I begin to feel that I cannot bear taking in any more stories of such pain. It is at these moments that I feel the weight of working in the profession that I do.
In reading this book and hearing the reams of horrible nightmare-like events that people survive I’m drawn back to Job. How in the world did he manage to cling to his faith in God during that time? Herman in her book claims that only the smallest minority can survive intense war/kidnapping/abuse without experiencing symptoms of trauma. She develops a hypothesis that for all there is a breaking point although that is different for some than others.
I was speaking to a colleague today and I challenged her to find a client with a significant persistent mental health issue who has not suffered family neglect/abuse or some sort of trauma inflicted by others.
It is interesting that the line of treatment for mental health issues is cognitive behavioral therapy something which is aimed at understanding and restructuring thoughts and negative core beliefs, but does not centre on pain and suffering as a central part of its framework. However, for the severely traumatized/mentally ill most clinicians likely agree that this is rarely adequate or enough. Many cases we file away as hopeless, at least within the bounds of a brief therapy/managed care setting.
I tend to hope that even a short-term therapy interaction that can provide a person a sense of safety, a holding place to process their emotions and begin to understand their thoughts and feelings could be helpful. I believe this because I have faith that most of the change in people’s life happens outside of the therapy session, through the community, extended family, and social engagement. However this change may not be initiated or engaged when a person continues to be captive to the negative and false beliefs about themselves that were necessitated by an oppressor (especially one who they loved). How can we give the fit of beginning on the path to change and healing without falling off that path all together?
For many we do not do enough and some will leave the opposite feeling disappointed and abandonned again, by us as mental health professionals.
Some, however, I hope (with God’s grace and care) are carried onward by a significant experience of care and understanding in therapy. For this these individual are able to begin to acknowledge their pain, sit with it, process it, and then through re-imagine the world based on new experiences and then regain a realistic trust in the world and see themselves as worthy and lovable human beings.