Reflections About Those He Loves

I need a better theology of trauma. What I mean is, I am learning more about the psychological and physical aspects of trauma, but the spiritual aspects regarding how our faith life relates to the impact of a life-threatening event are less clear to me.

Let me first say that many of my traumatized clients do not understand their psychological injuries very well. They think that they are mental cases because they have "become paranoid," for instance, about going out of their houses, about sexual involvements, about others acting maliciously, or about traumatic events happening again. They avoid the world, and they want to withdraw socially. They do not know why. They also start believing that they are "going crazy" because of the way that they have changed emotionally. They observe that they have developed an "I don't care" attitude in which they are highly irritable and they readily "let everyone have it," yet at the same time feel emotionally numb and indifferent.

Furthermore, their sense of self is shaken, that is, they report feeling like they are not the same persons. "This is not me!" When the trauma results in an inability to work and to conduct the usual daily routines, then this threat to self is further intensified. It is almost like a personal identity crisis because some kind of inner disintegration is occurring. The integrity of self is disrupted. Likewise, their basic sense of trust and of the world being safe is taken away from them. That which previously did not upset them emotionally now becomes an object to fear. Dormant memories of upsetting events from long ago become energized again and haunt them.

People going through these experiences find it helpful when I explain that their "symptoms" are the product of an emotional injury consisting of a posttraumatic response. I further explain that the trauma involves a disinhibition of emotional energy resulting in a loss of the ability to regulate emotions, though I usually state it in less technical language. Although such explanations do not take away the symptoms, they at least help traumatized people stabilize and acquire a less anxious reaction to these symptoms. It means a lot to them to feel understood and that someone can help them understand better.

Sometimes these traumatized patients do not understand their physical injuries very well either, for the longer their physical pain persists and the more they are sent for tests that are unable to detect any structural problems, the more they wonder if it is "all in their heads" or somehow imagined by them. However, I explain that in addition to any structural damage they might have received due to the accident, this matter of being nearly scared to death affects them physically in the form of abnormal physiology including disrupted brain processes. For instance, all of the emotional/mental disturbances tjat they are experiencing are from a physical point of view physiological disturbances.

I further explain that people who have been nearly scared to death are of course shaken and shocked at a fundamental core of their being, that is, deep within themselves, which of course includes their physical nature. Not surprising to me, this shock is followed by aches and pains including headaches, by mental confusion due to "mental fog," and by lack of energy, malaise, and feeling depressed. Sometimes when I first meet a patient, their body language suggests that the trauma occurred recently. Further inquiry, however, reveals that the original trauma occurred weeks if not months ago. Somehow this traumatic event is still live for the person and has entered their being.  Possible retraumatization in one form or other needs to be explored.

I try to communicate to these patients that the more the original event was traumatic and the more additional traumas also occur, the more likely their "symptoms" will persist and become deeply entrenched.  I raise the possibility that a more serious condition has developed such as when their psychobehavioural presentation fits with posttraumatic fibromyalgia.

Even a brief discussion of possible methods to "treat" these posttraumatic "symptoms" requires more space than this short essay provides. Let me say, however, a few words about a counterproductive thing that most patients do, especially those who before they were injured took charge, stayed in control, organized themselves and others, and tackled problems head on. Many patients fight their psychophysical symptoms, saying they "should" not have them, and thus try to control, bully, or stamp them out.  They cannot stand being weak and dependent. This does not help.

What I encourage these patients to do instead is, in essence, to forgive themselves for having their psychophysical wounds. This requires a kind of acceptance, of course not one in which they conclude that it is okay to have their injuries but one in which they admit that they are injured and that therefore they must change their self expectations during a perhaps extended period of recovery.

The treatment of trauma requires a holistic perspective in which the trauma is primarily viewed as an injury to a psychophysical self. To see only the injuries that may have been sustained by body structures is to miss what has occurred physiologically as well as psychologically, the result being that the medical profession blames the patient for not getting better on time. To see only the injuries that occurred psychologically is to forget that psychological life has its bodily correlates and social context. Then the mental health professional unfortunately approaches the problem irrespective of correlates and context. For instance, I am becoming more convinced that it is nearly impossible for someone to recover from traumatic experience if they lack support from family and friends, if they have become financially stressed, and if they are not eating and drinking properly and not involved in some sort of physical rehabilitation.

So what is missed when the spiritual dimension of their traumatic experiences are disregarded? Furthermore, what might be a Christ-inspired way to understand the spiritual dimensions of their trauma? These questions of course can be answered in many different ways. Among other things, what makes sense to me so far is the Christian concept of suffering, in which the psychophysical wounds resulting from life threatening trauma are somehow a blessing. How can this perplexing if not offensive assertion be true? Its reality, I believe, is reflected in the Beatitudes that start with "Blessed are those who are poor in spirit for they shall see God." Paraphrased it reads, blessed are those who have the breath/spirit [knocked] out of them and are hence dispirited and disheartened, for they shall have a sense of God's presence. How can this be for those whose emotional lives are entirely disrupted to the extent that they can feel irritable and numb and the same time?

Entering into this reality requires an acceptance of our status as creatures, acknowledging that we are nothing in ourselves. God is the giving agent and we are the receiving patient. That "patience" of Job has its origins in an Aristotelian/Medieval concept that points to the way that finally he accepted his role as patient despite the fact that he had been irritable, angry, disconsolate, and grief struck, in sum, entirely not patient. Spiritually speaking, he came to see his own arrogance before God and in the process submitted to the creaturely status of patient. When traumatized persons are able to accept their injuries spiritually, then they are able to transcend the haunting question, "Why me?" Once they have experienced their own "nothingness," then recovery becomes more possible. This healing from trauma includes a rebuilding of basic trust, not only in regards to people around them, but also with respect to their God.