Trauma
Trauma looks different for each person, depending on their situation and background. Still, it involves up to four internal symptoms: hyperarousal, re-experiencing, disassociation (internal and external/social), and emotional numbing. These symptoms, illustrated respectively below, signal dysregulation of the nervous system. Do any of these statements reflect your lived experience?
1.) "I feel constantly on edge. I can't relax around certain people, sometimes everyone! I don't know what to expect or expect the worst."
2.) "I re-live the scenario all the time. I can't seem to stop."
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3.) "Sometimes, I'm not really "there," especially when stressed. I know what's happening, but I go somewhere else in my mind. I want to stay present."
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4.) "I don't feel much of anything anymore. Negative situations don't bother me, but I don't react to positive ones either."
Those are some intense states of mind! While they are intense, it's crucial to emphasize as a starting point that, as far as how I work with them, they are much more effectively thought of as normal responses to abnormal situations rather than abnormal responses to "normal" situations, however maladaptive the client feels they are in the present.
It's also crucial to point out both the regularity of trauma responses among ordinary people as well as the simplicity (though not ease) with which they are treated. In his book "The Trauma of Everyday Life," Mark Epstein uses the Buddha, Siddhartha Gautama (generally considered a psychologically healthy guy!), as a case study of the trauma responses and their transformation. Reading Epstein's book and reflecting on my own experiences, I was left viewing trauma responses as a spectrum, which we all express a bit of as people with sensitive nervous systems (as anyone who's been in a tense political debate with a significant other, or been around a mob, can attest). The spectrum consists of overstimulation of the normal well-known sympathetic nervous system responses of "fight," "flight," "freeze," "flop," and "(be)friend." Hence, the trauma responses are normal responses to abnormal situations.
Another powerful book I read as part of my Masters Degree that outlines the simplicity and difficulty of trauma recovery is the eloquent "Trauma and Recovery" by Judith Hermann, in which she divides recovery into three loose and broad stages (of indeterminate length): safety, remembrance and mourning, and reconnection. Each of these stages requires courage to undertake from the client and steady support from the counsellor.
When working with trauma from a person-centred foundation, I prioritize curiosity (sometimes called the antidote to anxiety, which drives dysregulation of the nervous system), and I am more closely attuned to how the client receives my empathy. This serves the project of establishing safety as well as remembering and mourning the experience. Perhaps I hit the mark in exposing the meaning of what the client said when they described the abuse they suffered. Whether I hit it too hard is a question of carefully pacing the conversation, checking in if potentially unsettling topics are okay to discuss, and gently addressing any signs of dysregulation in the client to see if they need a breather.
I find that solution-focused therapy (SFT) and Bowen Family Systems Theory, the other general approaches I use, suit the work of reconnection but can also provide helpful perspectives for remembering and mourning. Solution-focused therapy examines the narratives the client uses to conceptualize their experience and solve problems to support finding solutions. Since reconnection is a practical goal, clear steps (unique to each client) to achieve it can be devised. At the same time, SFT can illuminate the things the client is already doing or highlight the things they did do to help survive their experience and upon which they might build.
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Finally, when using Bowen Family Systems Theory to work with trauma, I look at how the client's pattern of sympathetic nervous system response reflects the patterns of their family and its other members. Whether the trauma happened in the family or not, the family was there in the conditioning imprinted in the client's nervous system. Often, the conditioning is unconscious, but by drawing attention to it and the patterns that led to its creation, the client can consciously choose to override it if they feel it is appropriate.​
Regardless of the scenario and client, my primary goal is to support the client's recovery in a way aligned with their goals and values, ensuring a healthy and effective therapeutic relationship and empowering the client.
If you're curious to know more about my counselling approaches, you can find more information here.