Trauma care | Some key considerations
/by Dr. Kausthub Desikachar
Trauma is an experience or situation that is often both emotionally painful and distressing, and leaves an enduring impression on the person experiencing it. We all experience painful and distressing events in life. But what makes one experience a trauma, and another not is dependent on a wide variety of parameters.
One of the most important ones include the way that experience was handled. Most trauma victims often did not have the necessary support system to handle and heal the painful experience, be it in a conscious manner or a subconscious manner. So when a difficult experience is encountered by a person, who has a support system that holds him/her through this experience, chances that this will become a trauma are lesser, when compared to another person who does not have such a possibility. In this context, it is also important to understand that its not just the mere presence of a family or friend circle that is critical, but more that there is a container of care that holds the person through this experience.
Another significant contributing factor is also the genetic construct of the person, which can influence a person to be predisposed to trauma. These include genetic and hereditary parameters, as well as the experiences that one may encounter during the time of conception, gestation and the birthing experience itself.
Also in consideration is whether there is any older trauma that was unresolved from earlier generations. According to the Yoga school, often one impression (vasana-s) builds over the foundation of an already existing one. This means a challenging experience for one person can end up being a traumatic one. While for another person who does not have this impression already, it may not. However, there is every chance that if this experience repeats itself in this person, the succeeding times it could build on top of the earlier experiences.
Sometimes trauma can also be a result of other medical procedures such as surgery, overuse of antibiotics, or other interventions to critical parts of the body such as the spine, through procedures such as epidural, spinal tap or lumbar puncture. Trauma also can be a result of other illnesses that a patient can suffer from, especially those affecting the brain or the spinal cord. Emotional illnesses can also cause a disconnect from oneself, and result in traumatic symptoms.
So the mysterious phenomenon of trauma is a complex one, and one that holds many unknown variables that have to be dealt with. Here are five important considerations to be acquainted with when dealing with trauma.
1) Trauma does not discriminate | Trauma affects a wide variety of people. It is not affecting only a specific target group of subjects, but rather it can be experienced by anyone in this world. Men suffer from Trauma. Women suffer from Trauma. And even Transgenders suffer from it. Be it the rich or the poor, trauma does not discriminate. Be it a believer or an agnostic, it does not matter. Be it a healthy person or one with illness or disability, trauma does not differentiate.
This is because there are a wide variety of opportunities that makes one vulnerable to this disease. For example trauma can occur from the birthing process itself. Trauma can come from social status, oppression, racism, religion, hostile or violent environments, work place, place of treatment (such as hospital, therapy etc.) learning environments (school, university learning centers, etc.), loss (of a loved one or job or social status etc.), and a wide variety of other such circumstances or parameters.
2) Trauma is not just emotional | Trauma also presents itself through a host of different symptoms that can manifest in many dimensions of the body. It can manifest in the physical dimension as chronic pain, fatigue, elevated heartbeat, muscle tension etc. Mental symptoms could include nervousness, irritability, inability to focus, forgetfulness, loss of memory, selective remembrance, distraction and attention deficit among others. Emotional symptoms include, but are not restricted to, depression, denial, anger, sadness and emotional outbursts. Spiritual symptoms could include a disconnect from oneself (the feeling of lost soul), spiritual obsession, spiritual bypassing, or atheism. And owing to the inter-connectivity of our structures, often one set of symptoms exaggerate another set.
3) Trauma has short term and long term effects | All effects of trauma can take place either over a short period of time or over the course of weeks or even years. Any experience of trauma should be addressed immediately to prevent a permanent effect. The sooner a trauma is addressed, the better chance a victim has of recovering successfully and fully. However, in most cases trauma victims are so often caught up in the ‘victim’ role, and become so strongly identified with it over time. This converts the effect of trauma from being just short-term, to one of long-term.
Short-term and long-term effects of trauma can be similar, but long-term effects are generally more severe. Short-term mood changes are fairly normal after trauma, but if the shifts in mood last for longer than a few weeks, a long-term effect can occur. And this makes it harder to heal. Also trauma when experienced chronically, has a cumulative impact that can be fundamentally life-altering, often times in a negative manner.
4) The Anger of Trauma | Often times victim of trauma suffer from deep seated anger. One reason is mainly because of the ‘why-me’ question that repeatedly comes forward to their mind. Another reason for anger could be the fact that they did not get the necessary care that was needed, when it was needed. Hence there is a deep seated resentments even towards the loved ones around, as usually this is the first line of support one looks forward to receiving care from.
An additional factor is that, when the trauma includes shame and guilt, and this is reinforced again and again, eventually the patient starts to hate oneself, and this can lead to deep seated anger as well. Another possible reason for such intense anger includes the distorted interpretation of admitting the moment of helplessness faced, as not having had the strength to counter the threat or stand up for themselves during the experience of trauma.
No matter the cause, anger, particularly when not dealt with immediately, translates into a long-term systemic symptom. Hence it is not uncommon that such trauma victims redirect the overwhelming emotions they experience toward other sources, such as friends or family members or anyone else. This is one of the reasons why trauma is so difficult for loved ones as well.
Long term anger also often blinds them to such an extent, that they themselves become abusive to others. They also seek out friends and social networks that also exhibit similar anger, and constantly vent our their frustrated feelings of resentment and hatred, and get caught in a web of negativity. Trapped in this web, often their energies are directed in a negative manner, rather than actually embarking on a positive journey of self-healing. Constantly blaming the perceived source of trauma, and directing energy and attention there, is not a healthy strategy to deal with its healing.
This is precisely the reason why its so hard to treat trauma, as it takes quite an effort for the patients to break free from the cycle of negativity and to embrace the nurturing care of healing.
5) That lonely feeling | Trauma patients often feel lonely. One important reason may be because they were not cared for when they needed to be, which could precisely be the reason why a challenging experience may have become a traumatic one. So they don’t have the habit of seeking help, as they feel it won’t be available to them even when sought. Strong memories of abandonment or lack of care could enhance this feeling. Another reason for the loneliness could be depression. Depression is a common symptom of trauma patients, and it definitely makes one aloof from social structures, especially meaningful social structures. This depression itself could be the result of social alienation, shame, guilt or other such reasons. Getting caught in this cycle also makes one feel lonely, and hence also more difficult for one to seek help.
These and many other factors make the journey of a trauma patient really difficult and challenging. It is also the reason why a uni-dimensional approach does not work well to assist them in the healing process. Care and compassion is necessary to deal with them in a step by step manner that requires individual attention, case sensitive treatment and perhaps a collaborative effort between different paradigms of treatment.
Yoga Therapy is one such paradigm that can provide deep insights into trauma and offer supportive and meaningful practices that can assist in the process of healing. Yoga understands trauma from a multi-dimensional point of view and also offers holistic tools that can be helpful to the patient.