EXPLORING THE IMPORTANCE OF CONNECTION AND MEANING IN THE HEALING OF COMPLEX TRAUMA Elsa Voak (OHS) What does terror do to a person? ‘Complex’ trauma is broadly defined as ‘a type of trauma that occurs repeatedly and cumulatively, usually over a period of time and within specific relationships and contexts’ (Courtois) and includes, but is not limited to: child abuse, domestic abuse and multiple military deployments in dangerous locales. Fundamentally, when trying to understand the multifaceted effects of complex trauma on an individual, we need to have a basic understanding of the concept of attachment. Bowlby (1988) saw attachment as the secure base from which a child moves out into the world; for most of us we carry a secure attachment - the emotional and physical synchrony we develop with our primary caregivers from the age of about 2-7 months (Schaffer and Emerson 1964) and then onwards throughout our development initiates a sense of pleasure and safety, which helps create the foundation for all future social behaviour. Bessel van der Kolk (2015) states ‘Our attachment bonds are our greatest protection against threat’. In situations of terror, people seek their first source of comfort and protection. Children are programmed to be loyal to their caretakers, even if they are abused by them : the terror inflicted on them increases the need for attachment which results in ‘disorganized attachment’; ‘fright without solution’. Vulnerable adults in situations of domestic abuse or traumatic military combat feel utterly abandoned and isolated, as no one
comes to their aid and protection during their repeated, intense, unbearable distress - the vital connection and meaning fostered through attachment has been broken. Both children and adults thereafter commonly feel a sense of total alienation and isolation; indeed, many struggle with ‘alexithymia’ (Ancient Greek for not having words for feelings). They are compulsively and constantly pulled back into the past; their imagination and mental flexibility - the qualities that allow us to lead meaningful lives - fail. Van der Kolk comments ‘without imagination there is no hope, no chance to envision a better future, no place to go, no goal to reach’. Survivors may go into denial - their bodies sensing the threat, but their conscious minds refusing to accept it. Stress hormones send signals to the muscles to tense for ‘fight or flight’ or immobilize for ‘freeze’, and numerous unexplained medical symptoms such as autoimmune disorders and chronic pain arise. They may experience a sense of ‘dissociation’, where the world is full of triggers that create a life where the fragmented memory of the trauma is constantly present. Often, they cannot tolerate knowing what they have experienced or feeling what they feel - not talking, staying silent, acting and dealing with feelings through rage against others and the self, shutting down, becoming excessively compliant or defiant. Medications, drugs and alcohol may serve as a temporary sedative to these unbearable sensations and feelings; however, connection with others, belief in divine authority and sense of self all crumble. This state of ‘hyperarousal’ means that survivors are often not able to take in deeply what is going on around them: they cannot be fully alive in the present so they are trapped eternally in the past. Joy, creativity, meaning, connection, recovery: Disempowerment and disconnection are the markers of psychological trauma. Recovery, therefore, includes a return to self-determinism, self-confidence, intensely supportive and loving relationships, and finally playfulness, creativity and meaning. Complex traumas are, by their very name, complicated syndromes, requiring complex, comprehensive treatment and involving every aspect of human functioning from the biological to the social. In this piece I have decided to focus on solely the fundamentals of the later stages of recovery once a diagnosis by a professional has been initiated and the safety of the individual established. In addition, the second stage known as ‘remembrance and mourning’ (Herman 1992) which involves slowly reassembling an organised, detailed and verbal account of the trauma from the previously fragmented components of frozen imagery and sensation remembered, has commenced. The cutoff elements of the trauma are gradually integrated into the ongoing narrative of life. As with any psychiatric condition, the connection between patient and therapist (the ‘therapeutic
