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At some time during our lives, all of us will experience upsetting and distressing life events. Sadly, we all lose people we love through death, divorce, or the ending of relationships. Some of us may lose our jobs or have to deal with serious ill health in our loved ones or ourselves. In the world of psychology these are known as major life events.
Others of us will find our lives touched by traumatic life events. Trauma is the emotional shock we feel following an extremely stressful or traumatic event. Events such as traffic accidents and other accidents or acts of violence are known as traumatic life events. They are often unexpected, unpredictable, overwhelming, and highly life threatening (to us or other people), and they can be extremely difficult to come to terms with. One of the things that makes these traumatic events different from other, often anticipated, major life events (such as divorce or job loss) is the magnitude and unexpectedness of the emotional shock that we experience—feelings of intense fear, helplessness, and even horror. The intensity of our feelings can often overwhelm us and can seriously disrupt our lives, as these feelings can continue long after the trauma actually happened. Added to this, we are often plagued with thoughts that we did something to deserve the bad things that happened to us and that our suffering is our own fault and of our own doing, and these thoughts can lead to additional feelings of shame. Some examples of traumatic events are listed in the box below. As you will see, some traumas are very personal and are caused by the unpleasant and malevolent behavior of other people, while other traumas are caused by more impersonal events such as train crashes and work accidents.
Traffic accidents
Train accidents, other transportation accidents, and work accidents
Natural disasters such as tsunamis and earthquakes
Mass disasters such as terrorist attacks
Combat and the stress reactions arising from it
Diagnosis of life-threatening illness Childhood sexual, physical, or emotional abuse
Attempted murder
Torture
Kidnapping
Physical assault such as stabbing or mugging
Sexual assaults
Rape
Domestic violence
Bullying
This is by no means an exhaustive list, but it gives you an idea of the sorts of events that we are talking about in this book. These are the more severe types of trauma, of course, but the fact is that we can all experience smaller events that can really have an impact on us and we can struggle to come to terms with them. For example, going through an acrimonious divorce can be experienced as traumatic. Even major nightmares for some people leave a residue of trauma-like anxiety and flashbacks.
Therefore, learning some of the skills we will outline in this book can be helpful for many types of life-event difficulty that you may be struggling with. If what you have suffered is not on this list, this does not mean that you have not suffered a trauma, or that the event was not traumatic for you. What all these things have in common is that they are physically, mentally, and emotionally shocking and threaten our survival, well-being, sense of self, or hopes for the future. Those of us who have been seriously hurt by others or had our lives threatened may also have had our ability to trust or be intimate with people damaged. We may have experienced some of these things firsthand, or they may have happened to someone we know and love and we are having difficulty coping with the aftermath.
This book is all about how we can develop and use self-compassion to explore the effects of traumatic experiences on our lives in terms of our thoughts, emotions, motives, and behaviors; it also explores some helpful ways to cope. Now, before you think this is soft or easy or that you don’t deserve compassion (not as uncommon as you might think), the truth is that being compassionate can be a tough approach to adopt because you have to be willing to face the things that are upsetting and distressing you. Compassion helps to do this and may feel challenging, but not overwhelming.
The basic approach we will be taking here is from a therapy called compassion-focused therapy (CFT), which was developed by Professor Paul Gilbert. My traumatic stress clinic in Berkshire, UK, is at the forefront of using compassion-focused therapy for people who have been traumatized. Through this work I have received enormous insights and feedback, which has helped me to develop this approach as a self-help guide.
We know traumatic events have the ability to affect us profoundly because they make us feel that our lives are unpredictable and that we are not in control of our own world; we may find it difficult to feel safe or to trust others, and we can also lose trust in ourselves and our judgments. This issue of safeness is something we will explore throughout this book because it is essential that we find a way to trust in human nature again and reclaim our lives after a trauma. Often we are deeply disturbed by traumatic events because they feel unfair, unjust, inhumane, and cruel. “Why me?” we ask. “Why now?” They can make us question our views and feelings about ourselves, the world that we live in, and the people who may have caused us such harm and emotional pain. We can even lose the comfort of our spiritual belief system in the face of what we perceive as cruelty. This is additional loss, as it results in a feeling of disconnection. It is not just in the face of great human atrocities that people can lose their faith; it can also be when we feel the world is cruel to us and the people we love.
Traumatic events have the ability to shatter our lives, leaving us with the seemingly enormous task of picking up the pieces, putting our lives back together, and finding a way to live and trust in life again. Most of the people we have worked with who have experienced trauma describe being overwhelmed by a toxic cocktail of intense emotions. Some of them also feel bad about themselves; indeed, it is common for people to describe themselves as feeling grief stricken, frightened, alone, ashamed, angry, and guilty.
Blaming yourself
These distressing emotions, described above, are often accompanied by thoughts of self-blame and self-loathing, and feeling responsible for causing the events. Traumatized people can talk as if they were responsible for the events and will say things like “It’s all my fault,” “I deserved this,” or “I should have behaved differently.” Self-blame is often at the heart of people’s distress. Some of you may know what it’s like to blame yourself for what has happened to you; there are countless reasons many people blame themselves for their traumas. Sometimes it’s because they desperately want to hang on to a view that they did have, or could have had, control; sometimes it’s because they want to make sense of and find meaning in the event amidst what is sometimes simply arbitrary chaos; sometimes they come from backgrounds where parents impressed on them that when bad things happened it was the child’s own fault; and sometimes it’s because it’s easier to blame oneself than to deal with rage at the world or God. Our explanation for negative events happening to us can be crucial to how we deal with them, as we can see in Sally’s and Tom’s stories below:
Sally’s story
Sally had a spontaneous miscarriage at 14 weeks and thought that this was God’s punishment for a teenage abortion. She was very depressed as a result of her loss and was fearful of God’s further punishment. This is a situation where, because Sally felt bad about the earlier abortion, she assumed others (including God) would want to punish her.
So you can see how sometimes we jump to very harsh conclusions about what others (including God) might think of us and begin to blame ourselves for the sad things that happen in our lives.
Tom’s story
Tom was walking home from the train station after work one evening when his briefcase was stolen from him. Tom wanted to blame himself for being mugged. Although this was a swift attack, in which a youth grabbed Tom’s briefcase out of his hand unexpectedly as he walked, it had a major impact on Tom’s well-being. He could not stop thinking about how stupid he had been to let go of his briefcase. He reproached himself for not fighting off the youth. He just could not let it go in his mind and he would spend hours thinking about the event and what he should or could have done differently. He felt humiliated and angry and was embarrassed to tell people about the mugging in case they also thought he was a wimp. As I got to know Tom, it turned out that blaming and criticizing himself was a long-standing habit. Through therapy we discovered that during his childhood he had developed the habit of blaming himself for things that went wrong rather than looking for other explanations. Essentially he always looked to himself to explain why bad things happened.
I have found in my clinical practice and research that people who are very critical of themselves and blame themselves for things that happen in their lives not only seem to suffer from intensely painful feelings of shame, but also tend to struggle more with the aftereffects of their traumatic experience. Their self-criticism and self-blame keep them in a state of shame, which makes it difficult for them to cope with their trauma in a way that might help them to work through it. People who are very self-critical tend to want to avoid their shame-filled memories—for good reason—because these memories cause them so much pain and distress. Sadly, the unintended consequence of this avoidance is that the trauma is not dealt with and the shame is not resolved.
Are you naturally inclined to blame yourself?
There are some important reasons we self-blame, or blame ourselves. In compassion-focused therapy, we look at our natural tendency to blame ourselves when we are confronted by powerful “others” whom we fear or upon whom we may be dependent. For example, over a thousand years ago, ancient cultures would have been subjected to a range of life-threatening events such as famines, diseases, and war. It was widely believed at that time that various powerful gods controlled these occurrences and that the people needed the gods on their side to protect them and to avoid being punished. This allowed people to gain some feeling of control over the life-threatening events in their lives. In a number of cultures, this feeling of control was often achieved by making human sacrifices to a named god, such as the Egyptian sun god Ra, in the belief that this demonstrated loyalty, obedience, and love toward the higher being. They saw their gods as potential helpers and saviors, but also as potential punishers who could cause horrible things to happen.
We know from history that despite such sacrifices being made, life-threatening events continued to happen. How do you think the people explained why the diseases still came and why their children still died of malnutrition? Typically, people blamed themselves and thought that they had done something wrong to upset their gods. So the solution was that the following year they made even more sacrifices to appease the angry gods. We can therefore see a process of self-monitoring taking place in which we question ourselves (What did we do wrong?) and then blame ourselves (We didn’t get our sacrifice right). This example demonstrates our innate and natural human tendency to self-blame when confronted by those we both fear and/or upon whom we are dependent.
Once we understand how this can occur, we can appreciate how easily it happens in child/parent relationships. Children need the love and attention of their parents but can also be frightened of them. Children can learn to monitor their own behavior so as not to anger or upset the parent and to blame themselves if their parents become angry—“Mommy is only upset because I made her cross. I shouldn’t have acted that way. It is my fault that she is angry.” You see, just like the people who worshipped the sun god, the fear of blaming those who are more powerful than us is bigger than the fear of blaming ourselves. And so over the years we learn to monitor ourselves and our behavior, and when things go wrong, particularly in relationships, we blame ourselves rather than another person because that is one way to try to retain some sort of control.
Just as the ancient cultures would not find it easy to blame their gods or even consider that such gods didn’t exist, so it is with us. We can find it extremely difficult to find fault with our parents or to blame them for their behavior even if it has caused us harm, such was their position of power in our early lives. To think in such a way can make us feel that we are betraying those who we believe could have acted only in our best interests. It can therefore often be easier to blame ourselves rather than blame other people. We may not be consciously aware that we are doing this or be aware that there are people in our lives who have such power over us. We may say about the trauma we’ve experienced at the hands of others, “Well, even if I think I’m not to blame, when I start to blame other people it makes me feel very bad.” And, of course, when we shift from blaming ourselves to blaming someone else, additional and very powerful emotions can be ignited, for example, rage, which in itself can feel terrifying. Even if we are able not to blame ourselves it does not necessarily mean we feel any better because we still have to face and cope with the fact that others have caused us such pain. This is why it may feel easier to continue to blame ourselves rather than someone else, even if we recognize the event was not our fault. We will explore this situation in more detail in chapter 4.
Another reason we blame ourselves is because we want to see the world as meaningful and to believe that there must be a reason for the bad things that happen in life. For instance, it is difficult for us to look at the recent tsunami in Japan—a tragic natural disaster—and comprehend that it was the result of a shift of tectonic plates on the seabed, which is a process that’s been going on for millions of years. How can so much suffering have so little meaning? Difficult to accept, isn’t it? Yet this act of nature is the only reason for this tragic natural disaster, and it’s hard to cope with its meaninglessness. The way we engage compassionately with this level of suffering is very important in how we cope with it, both when it affects our lives and when it affects the lives of others.
You may have noticed that we often compare ourselves to others. It is a way in which we take a measure of our lives, and such comparisons don’t stop if we become traumatized. Many of us are concerned that our trauma is not as bad when compared to other peoples’ trauma, or it is not serious enough, or that others have suffered “greater, more serious” traumatic events, or that they are coping with things better. Of course, this can make us feel that we must be weak and flawed in character, which is not the case. Such comparisons are not helpful to our recovery. There are very good and understandable reasons we are struggling in our lives, regardless of the extent of our traumatic experiences.
Our previous life experiences and how we coped before we were traumatized help us to understand how we are managing our current distress. There are many things that influence how we are able to work through and deal with traumatic experiences. While some of us may be able to come to terms with our traumatic experience in time without any help, others of us will struggle with our reactions and may even develop symptoms of what is called post-traumatic stress disorder (PTSD). These symptoms may present immediately or may develop over the weeks and months after the event and can then last for further months or even years.
If you are struggling to come to terms with the aftermath of a traumatic experience, it is not a sign of weakness or of an inability to cope with your life. It is just the way it is for you, and there may be a host of other important influences in your life that will help you to understand yourself and the difficulties that you are currently struggling with.
Our personal histories are a key part in understanding how we feel about, react to, and respond to what is happening in our lives. Our childhood experiences are one such important influence. For example, consider what it would be like if we had been bullied at school. The experience may have undermined our self-confidence, affected our ability to trust in other people, and left us with a legacy of feeling bad about ourselves or believing that we are not as good as other people. This is a hard and painful set of beliefs to carry around in our minds throughout our lives, and you can perhaps imagine how easy it then becomes to blame ourselves for other things that “go wrong” later in our lives.
We also know that having loving and supportive friendships can help us deal with difficult life events. There is lots of evidence from research to suggest that good-quality social support can buffer us from stress because friendships provide emotional support, encourage caregiving, and create a sense of being connected to others. A good social support network (in other words, close friends and family) can protect us from developing, or reduce the extent of, problems we incur from traumatic experiences. However, the very experience of trauma can itself lead us to feel disconnected from our loved ones and emotionally numb, and leave us with a sense that no one understands what we are going through. This makes us feel more alone and stops our talking to our friends and family, which is the very thing that could help us through our difficulties.
Other factors that are important to take into account when thinking about our reactions to traumatic events are things like our age and life stage when we were traumatized. For instance, children who experience traumatic events such as abuse tend to blame themselves. This is often because they are told by the adults involved that they are bad and deserve to be punished. The adults will often say things like “You made me do this to you, so you only have yourself to blame.” If the child does not tell anybody about what is happening, and perhaps does not have a caring adult to reassure him or her that he or she was not to blame, then it is easy to see how such a child grows up into an adult who believes that the bad things that happened in his or her childhood were his or her own fault. Of course, adults who abuse children also create a web of secrets and lies and will emotionally manipulate and blackmail children into not telling other people about the abuse. Consequently, these children are often denied access to the adults who are most able to protect them and who could tell them that what is being done to them is wrong. Where the trauma is caused by a parent or other caregiver, this will be such a breach of the child’s trust that it can badly affect how the child is able to develop relationships throughout his or her subsequent adult life.
Sometimes after traumatic events people develop PTSD. You may have already heard about this condition and wondered whether you have it. PTSD is a recognized diagnosis, which, put simply, means that you are suffering from known symptoms from which it can be deduced that you are suffering from PTSD. (This is just the same as saying that there are known symptoms such as an aching body and a sore head from which you can be diagnosed as suffering from flu.) The symptoms associated with PTSD fall into three categories, which are outlined below:
Those of us working in the compassion-focused therapy field have observed that there are varying degrees and dimensions of responses to experiences of trauma. People experience some, most, or all of the symptoms, most or all of the time. On the other hand, difficulties may ebb and flow over time.
The purpose of this book is to help you if you are having difficulties. When reading this you may try to diagnose yourself, but rather than trying to figure out whether you have PTSD or not, it may be more helpful to focus on the difficulties you are having and think about ways this book can help you overcome them. If, as you read through this book, you are concerned that you are having serious difficulties arising from your trauma, then visit your GP, or seek out a counselor with experience with trauma.
Below are outlined the main symptoms or signs that can point to the existence of PTSD or trauma.
What are the main symptoms of PTSD?
Flashbacks
Avoidance
Being “on guard”
Other common emotional reactions to trauma
Now let’s look at Alex’s experience of trauma and what symptoms she developed in the aftermath of the event. This is an example of someone who suffered from a serious sexual attack and who attended the trauma clinic to be helped with recovering from her trauma.
Alex’s story
Alex was walking down the street one evening after having dinner with some friends when she was attacked by a couple of men at knifepoint. Earlier that evening a friend had tried to persuade Alex to take a taxi home but she had insisted that it would be fine to walk. As the men approached, Alex tried to run away but they caught up with her, sexually assaulted her, and then robbed her. During this attack, Alex was convinced that the men would kill her.
After the attack, Alex was troubled by feelings of shame and self-blame and did not want to tell anyone what had happened to her. She was very concerned that people would think she was stupid to have walked home alone at night and then blame her for the attack. Alex started to feel panicky and very jumpy whenever she was walking alone on the streets when it was dark. Memories of the attack haunted her several times a day, during which time she felt as if she were reliving the events. This made her feel scared and full of dread. She kept playing the attack over and over in her mind, in a desperate attempt to work out why this had happened to her. Over time Alex started to avoid going out at all because she felt safe only in her own house. Whenever something reminded her of the attack, like seeing a knife, she felt her heart pounding, as if the attack were happening all over again.
When Alex came to the clinic for help, it was apparent that she was suffering from feelings of shame and self-blame as well as the symptoms of PTSD. Her symptoms included:
The symptoms that Alex suffered in the aftermath of this distressing and life-threatening traumatic event are characteristic of someone who is not only suffering from PTSD but is also struggling with overwhelming feelings of shame and self-blame. You may have noticed that her feelings were self-focused rather than externally focused on her attackers; there was no sense of vengeance or rage. Try to consider why she was self-blaming.
When something traumatic happens in our lives we may experience some or all of the symptoms set out in the exercise earlier in this chapter. Not all of us who experience a trauma will have PTSD, though, or be diagnosed with PTSD. If you think you have these symptoms, please be reassured that you are not alone, and consider visiting your physician to discuss your current difficulties and ways of accessing more formal support if you feel you would benefit.
A special word on flashbacks and nightmares
Flashbacks and nightmares deserve a special mention in this chapter, not only because they are a key symptom of trauma but also because they can be frightening and make us feel as if we are losing our minds. Flashbacks are often referred to as the hallmark symptom of PTSD: most of us who have been traumatized will experience them. They are the most common and most distressing symptom for those of us who have lived with trauma, making us feel that we are reliving the traumatic event over and over. To help learn to deal with flashbacks it may be helpful to first explain what a flashback is and why it occurs so that we can understand what is happening in our minds. Understanding what flashbacks are may help us to begin to feel in control of them, and it is for this reason that I have devoted the whole of the next chapter to helping you understand your trauma memories and flashbacks.
Traumatic experiences affect our lives in many ways other than the symptoms described above. This can be particularly true if we have had to endure repeated experiences of being traumatized or harmed by other people over long periods of time. These sorts of experiences may have happened in our childhood (sexual, physical, or emotional abuse) or in adulthood (domestic violence, torture).
That said, keep in mind that a key to trauma can be the degree to which a sense of intense fear is activated in our minds. So, for example, parents may create feelings of intense fear in their child even if they are not physically abusive. Enduring intense, repeated, and prolonged periods of fear (without any physical or sexual harm) can also have a profound impact on the way we think about ourselves and other people. This might help some of you understand why you feel a certain way about yourself even though you don’t have a big “skeleton in the closet.”
Some ways trauma can leave a legacy on your life follow:
Have you ever had the experience of driving home and finding yourself outside your house before suddenly realizing you can’t really remember the journey because your mind was thinking about other things? This is a mild form of what we call dissociation, where our bodies are acting automatically and our minds are distracted. The ability of the mind to do this is well known: it is a type of daydreaming. Dissociation literally means “difficulties integrating information” from the different parts of the mind. Generally, dissociation is a defense mechanism that everyone uses every day. There are varying degrees of this state and it can certainly occur when the mind is traumatized. Strange as it may seem, our minds and brains will try to protect us from trauma and its effects as best they can.
Sometimes the way our brains do this is to try to switch off certain systems to avoid things becoming overwhelming. When this happens we can have all kinds of experiences of disconnection, such as going numb at certain points, zoning out, or feeling that our emotions aren’t real or even that we aren’t real. Some people who have been traumatized describe themselves as being on automatic pilot, as if they are on the outside looking in (an out-of-body experience) and things around them feel surreal.
Dissociation occurs when our minds can’t integrate information and so they shut down instead. It is a crucial survival mechanism that protects us during a crisis and afterward. The first person to recognize and note how dissociation works was the French therapist Pierre Janet (1859–1947). Later, Sigmund Freud (1856–1939) argued that dissociation could be a way of defending against painful memories or emotions.
Although dissociation can be very troublesome and unhelpful, it is best thought of as a natural protection mechanism, not some sort of terrible illness or something wrong or bad about us. However, sometimes we do need to learn to override this protective system in order to start to integrate and heal some of our traumatic experiences.
If you experience an event as unreal or dreamlike, or things seem to go in slow motion, or it feels as though you are watching life unfold as if it were part of a film without your actually being there, then you may be experiencing dissociation. This can occur because things have become so scary or stressful that the mind automatically cuts out in order to protect us. It means we are still able to function without fully experiencing the emotional impact of an event. In this way, dissociation is an understandable thing to have happen. Flashbacks, nightmares, and highly stressful situations can trigger bouts of dissociation. You may also experience these feelings if you have been taking drugs.
When dissociation happens frequently or is very intense, it can be a distressing problem.
Signs of dissociation
There are varying levels of dissociation. Everyday dissociation, which we all experience, encompasses daydreaming and spacing out. Traumatic dissociation can also include feeling numb, having deadened emotions, and experiencing the sensation that you are leaving your body. If these symptoms continue after the traumatic event, they can cause problems. For example, difficulties can arise in relationships because there may be times when you are just “not there.” It can also be a safety risk if you are unaware of what you are doing or where you are going when you are driving or operating dangerous machinery. These feelings may be frightening in themselves, although this is not always the case. There is no reason to panic and they are not an indication that you are going mad.
Do you recognize yourself in this list of difficulties mentioned above? Very often if you are experiencing these sorts of fears and problems you will feel unable to overcome them, which is understandable given the enormity of what you have endured, but this book should be able to help.
We began this chapter by highlighting the idea that coming to terms with painful and traumatic life events is a common difficulty. Indeed, it seems that many of us can have difficulties with certain traumatic events that involve flashbacks, intrusive images, and painful memories that are hard to deal with. When this situation becomes severe and when the emotional shock and trauma are also major, people are sometimes diagnosed with PTSD. Studies of how we process emotional shock and trauma have revealed some very important information about how our brains actually work and why we suffer from the symptoms that we do. We will look at this issue in more depth in chapter 2.
The traumatic events we experience range from being mild in nature to very serious, as does the emotional shock or trauma that results from them. We may experience some of the milder symptoms described earlier in this chapter, or we may experience most or all of the serious symptoms of PTSD. The thing we have in common is that we have all been affected in some way and we all want to improve our well-being and get on with our lives.
Those of us suffering as the result of a traumatic or life-threatening event will know what a powerful effect it can have on our quality of life. Very often the spectrum of negative emotions can make us feel miserable and as if our lives have been ruined. The most powerful and affecting experience of PTSD is the occurrence of flashbacks. These nightmarish relivings of the traumatic event are triggered without conscious control and can often feel entirely unmanageable. That said, please bear in mind that you don’t have to have PTSD to suffer from flashbacks. Most people who are traumatized to a greater or lesser degree will suffer from flashbacks and intrusive memories.
Most of the people who attend the trauma clinic blame themselves for what happened to themselves. They talk to and about themselves in a critical and derogatory way and are desperately trying to cope with overwhelming feelings of shame and self-loathing.
Some of us may be struggling to trust people and form relationships, especially if we’ve been hurt by others. It naturally feels too risky. There are those of us who may have been struggling with these difficulties since childhood who think that this is just the way our lives are, and that we will never be able to have trusting and safe relationships.
For some, our efforts to deal with painful memories and emotions will lead us to dark places in our minds, and we may engage in all sorts of unhelpful behaviors aimed at ending our pain. We may cut ourselves, drink too much, take drugs, starve ourselves, push people away before they hurt us, or even have suicidal thoughts. It is important that we compassionately remind ourselves that the ways we have found to cope with our feelings, memories, and fears are our best efforts to deal with things. However, in the end, they may serve to become part of our problems, as they have all sorts of unintended consequences in our lives.
Whatever we are going through and however bad the extent of our suffering, it is important to appreciate the reality that our difficulties are natural and understandable reactions to what we have experienced. It’s no wonder that we may struggle, especially if we have not been taught how to cope with either the trauma or the traumatic memories. We need to remind ourselves that dealing with traumatic events is not part of our everyday lives. The skills that equip us to cope with “normal life” are not always sufficient to help us manage trauma, which is why the memories of the event are so troublesome and distressing.