Tell Me Why It Hurts
August 2, 2023 3:21 PM Subscribe
"Call it what you want, but the core idea is always shaped like trauma. Once, we were whole, but now we’re not; now we suffer from a sickness we struggle to grasp or name. Yet this wound provides our new identity, at once the thing that gives us the right to speak and the only thing we have left to say when we do. Underwritten by its literalism, our trauma is the guarantor of what we believe we are owed."
How Bessel van der Kolk’s once controversial theory of trauma became the dominant way we make sense of our lives. (NYMag)
I'm on a VERY long waiting list for my local library's digital copy of The Body Keeps the Score, primarily because I see his book recommended so. so. often. (Secondarily 'cause chronic PTSD comes up in discussions about ADHD fairly regularly)
It's surprising (in a "oh wow I had no idea" kind of way) to learn HOW controversial his ideas have been.
Regardless, not a fan of "winsomely thatched behind rimless glasses" as a description
posted by Baethan at 4:20 PM on August 2, 2023 [4 favorites]
It's surprising (in a "oh wow I had no idea" kind of way) to learn HOW controversial his ideas have been.
Regardless, not a fan of "winsomely thatched behind rimless glasses" as a description
posted by Baethan at 4:20 PM on August 2, 2023 [4 favorites]
Sounds like his workshops replicate what Werner Erhard's EST, Scientology, and many cults perfected long ago:
Over the course of six days, in small groups, in evening exercises, over lunch, many people described their pain. One night, we stood in a circle as everyone took turns stepping into the center; then the group would say their name “with delight at their existence.” It was supposed to replicate the feeling of being a child basking in their parents’ love. People cried. I cried.
That type of environment will elicit deep emotions just as consistently as a strenuous round of weightlfiting produces DOMS. Whether it does anything more than that is unclear.
posted by mono blanco at 5:40 PM on August 2, 2023 [19 favorites]
Over the course of six days, in small groups, in evening exercises, over lunch, many people described their pain. One night, we stood in a circle as everyone took turns stepping into the center; then the group would say their name “with delight at their existence.” It was supposed to replicate the feeling of being a child basking in their parents’ love. People cried. I cried.
That type of environment will elicit deep emotions just as consistently as a strenuous round of weightlfiting produces DOMS. Whether it does anything more than that is unclear.
posted by mono blanco at 5:40 PM on August 2, 2023 [19 favorites]
I had therapy very near this circle about ten years ago. It was there I heard that van der Kolk was a rough customer, although the therapist did recommend his book
posted by Countess Elena at 5:44 PM on August 2, 2023
posted by Countess Elena at 5:44 PM on August 2, 2023
I have read the book and I know many people who have embraced its thesis; I also know a lot of people who tell me they have trauma from childhood experiences. I also knew about the allegations of bullying and his senior staff member harassing people. My problem is that it seems to be one of those popular theories that is applied to everything under the sun. “ a ubiquity of trauma that seems to leave hardly anyone in the “non-traumatized” category” as the article puts it. This is one of those theories that is self referential; that is, it justifies itself by reference to the rules it creates and purports to explain everything. Freudianism was like that until people started realizing that its explanatory power wasn’t supported by much except its own assertions.
I guess I worry that too many of us are more and more wedded to some experience of damage.
Mind you, a core part of my identity is that I stopped drinking a long time ago, but I’m more defined now by the things I’ve been able to do since then than in what started me drinking.
posted by Peach at 6:07 PM on August 2, 2023 [29 favorites]
I guess I worry that too many of us are more and more wedded to some experience of damage.
Mind you, a core part of my identity is that I stopped drinking a long time ago, but I’m more defined now by the things I’ve been able to do since then than in what started me drinking.
posted by Peach at 6:07 PM on August 2, 2023 [29 favorites]
Peach, you could conduct seminars where attendees re-live the best moments in their lives. Here, take my money!
posted by mono blanco at 6:48 PM on August 2, 2023 [7 favorites]
posted by mono blanco at 6:48 PM on August 2, 2023 [7 favorites]
Bessel Van der Kolk is a person who has written some books and holds workshops based in his own understanding of the societal manifestations of trauma. Dr Vincent Felitti did the original studies that established a relationship between trauma and adult health manifestations. Having worked with clients for years and seen impressive outcomes based on treating them with what is widely known and accepted as "trauma informed care", as well as getting treatment myself and experiencing great improvement, it concerns me deeply to see any of the vast research into the effects of childhood trauma dismissed because someone who wrote a book about it is a difficult personality. This stuff really doesn't have that much to do with Van der Kolk at all.
This stuff is real, and there is considerable evidence that shows it.
posted by cybrcamper at 6:55 PM on August 2, 2023 [36 favorites]
This stuff is real, and there is considerable evidence that shows it.
posted by cybrcamper at 6:55 PM on August 2, 2023 [36 favorites]
I guess I worry that too many of us are more and more wedded to some experience of damage.
There's a lot of discomfort with having to recognize how widespread experience of abuse (by which I mean, regular recognizable abuse, whether by an individual or by the system, not Satanic child orgies) is in society. I don't think that's a reason to reject the theory in itself, though some of the caveats raised in this article are reasonable concerns. Particularly, I'm not sure it's clear that making trauma the organizing narrative of one's life benefits everyone. I'm in the middle of reading Strangers to Ourselves, and one of the main implicit arguments seems to be that an ill-fitting model of mental illness can cause nearly as much distress as the illness itself. But...these are the kinds of things we are going to have to sort out now that we are slowly waking up to how much damage traditional childrearing practices can cause and how intimately most people with a marginalized identity have suffered at the hands of our systems.
posted by praemunire at 7:07 PM on August 2, 2023 [32 favorites]
There's a lot of discomfort with having to recognize how widespread experience of abuse (by which I mean, regular recognizable abuse, whether by an individual or by the system, not Satanic child orgies) is in society. I don't think that's a reason to reject the theory in itself, though some of the caveats raised in this article are reasonable concerns. Particularly, I'm not sure it's clear that making trauma the organizing narrative of one's life benefits everyone. I'm in the middle of reading Strangers to Ourselves, and one of the main implicit arguments seems to be that an ill-fitting model of mental illness can cause nearly as much distress as the illness itself. But...these are the kinds of things we are going to have to sort out now that we are slowly waking up to how much damage traditional childrearing practices can cause and how intimately most people with a marginalized identity have suffered at the hands of our systems.
posted by praemunire at 7:07 PM on August 2, 2023 [32 favorites]
I, for one, am only pleased to see some popular backlash against pervasive ideas from psychology that are taken as fact when they are often backed up by evidence that in any other field of science or medicine would be considered unreliable at best and based on theories that are culturally appealing but not necessarily grounded in fact.
Maybe it would do us well to accept how little we understand the human mind and proceed accordingly.
posted by ssg at 7:25 PM on August 2, 2023 [13 favorites]
Maybe it would do us well to accept how little we understand the human mind and proceed accordingly.
posted by ssg at 7:25 PM on August 2, 2023 [13 favorites]
I read it last year and almost posted an Ask looking for debunkings because there was far more woo than I expected and it seemed more "sciencey" than science. I've had that issue with a couple of other pop science books I've read recently--I find myself muttering replication crisis as I turn the pages.
posted by betweenthebars at 8:17 PM on August 2, 2023 [19 favorites]
posted by betweenthebars at 8:17 PM on August 2, 2023 [19 favorites]
What even is trauma? Are we all talking about different things?
I feel like trauma, and this article, cover too many things to broadly embrace or dismiss either of them.
posted by Baethan at 9:46 PM on August 2, 2023 [1 favorite]
I feel like trauma, and this article, cover too many things to broadly embrace or dismiss either of them.
posted by Baethan at 9:46 PM on August 2, 2023 [1 favorite]
One man thanked his activity partner, whom he’d hugged at the end, for a healing experience. When his partner took the mic, she said she had felt coerced into the hug, then burst into tears. It was like something else had happened to her, she said.
Well, that was enough of an ending for me.
posted by BlueHorse at 10:05 PM on August 2, 2023 [3 favorites]
Well, that was enough of an ending for me.
posted by BlueHorse at 10:05 PM on August 2, 2023 [3 favorites]
I think PTSD as a phenomenon is very real, and recently I unexpectedly ran into what I consider to be pretty convincing anecdotal evidence for its existence as a distinct entity rather than as the extreme end of a smooth continuum of levels of response to difficult experiences in a person's past: the reaction of some people with PTSD as they come out of surgical anesthesia.
As detailed in this video put up by an anesthesiologist on his Medical Secrets channel.
I recommend watching it on YouTube instead of in the Metafilter window for the sake of its comments, which include many further examples of similar reactions from people who were surgical patients, as well as a comment from a veterinary surgeon who says that about 1 in 5 of the dogs he operates on show the same reaction.
Just the other day in an AskMe thread about Alzheimer's disease, eirias pointed out that in AD the brain begins to shrink "most notably first in the hippocampus" which is preeminently the part of the brain necessary for the formation and retrieval of memory, which I’d read before in a number of sources, and which caused me to wonder again whether PTSD and Alzheimer’s might be connected, as apparently they are:
posted by jamjam at 10:15 PM on August 2, 2023 [2 favorites]
As detailed in this video put up by an anesthesiologist on his Medical Secrets channel.
I recommend watching it on YouTube instead of in the Metafilter window for the sake of its comments, which include many further examples of similar reactions from people who were surgical patients, as well as a comment from a veterinary surgeon who says that about 1 in 5 of the dogs he operates on show the same reaction.
Just the other day in an AskMe thread about Alzheimer's disease, eirias pointed out that in AD the brain begins to shrink "most notably first in the hippocampus" which is preeminently the part of the brain necessary for the formation and retrieval of memory, which I’d read before in a number of sources, and which caused me to wonder again whether PTSD and Alzheimer’s might be connected, as apparently they are:
Studies have shown a link between childhood post-traumatic stress disorder (PTSD) and an increased risk of Alzheimer’s disease later in life. Until now, the studies have suggested a link between the two conditions, but a new study from the University Medical Center of Goettingen in Germany recently discovered a molecular link between the disease and PTSD.Which suggests to me that one function of the protein which misfolds, accumulates, and ultimately causes Alzheimer’s might be getting rid of PTSD memories.
posted by jamjam at 10:15 PM on August 2, 2023 [2 favorites]
Here's an ungated version in case your subscription to New York Magazine has run out.
posted by chavenet at 12:19 AM on August 3, 2023 [2 favorites]
posted by chavenet at 12:19 AM on August 3, 2023 [2 favorites]
Man this kind of smarmy article tires me. I admit I had to start skimming. There’s good stuff in here but the tone…
I hope we all know, Freud is kind of famous for having worked with women who reported being abused, decided that couldn’t be possible, and came up with a whole theory to explain it away. This is kind of the history of abuse and oppression. It can’t really have been that bad.
It’s also a bit like the way there are people who have biopsies for celiac disease and then there are people who are anti-gluten wheat belly people. People who avoid gluten for annoying woo reasons are no skin off anyone’s nose, even if they are also inconsistent at times and snub their family’s Thanksgiving. Celiacs still can’t have even tiny amounts of gluten.
As someone with PTSD who is multiple and who knows other people the same, here’s the thing. I’m sure of my abuse because my abuser, unusually, both admitted it in front of my parents and wrote me a lengthy letter confirming things. Also, 20+ years later I had an MRI for peripheral neuropathy and my neurologist was like “oh, you didn’t mention PTSD on your forms?” (Which I hadn’t because I assumed if I did I wouldn’t be believed about the neuropathy) and I said oh yeah sorry…and then realized he was inferring that from a scan of my brain. I also had a clearly traumatic event as an adult so if I feel like it, which I almost never do, I can now talk about PTSD without having to eat the shit of people deciding they know better about my childhood.
I have gone to considerable lengths in my life to be the perhaps second or third last person you would diagnose as either from the outside. (I realize that’s hard to believe from my posting history but that’s a choice about being open in this environment.) Up until Covid I almost never took a sick day. I worked up to the top digital editor in a women’s magazine company which is a hyper-normative environment. Etc. And all that has both challenged me to grow fiercely into strength, and which has also cost me in a lot of ways.
One of my OG multiple support group…I hesitate to call them friends, they were closer for a decade although we grew apart…died last month. Their sister organized the memorial. It occurred to me that I didn’t know if they ever told their sister about being multiple, or even about the extent of the abuse they suffered. I have watched their friends and professional colleagues leaving thoughts on the Legacy.com page, referencing their sense of humour, ability to connect with others, and professional and educational accomplishments. All of which is absolutely true. I also have zero doubt about their trauma and their multiplicity. But it really brought home to me that as much as they would not have wanted “abuse victim” on their headstone…it’s also sad that it’s taboo to celebrate also publicly the years of effort and the zillion hours of pain and they way we both used to stay up until 2 crying for each others’ stories and nightmares and inability to sleep, hyper-vigilant, and then go to work and text each other jokes about staying awake in boring town halls being harder.
Both of us shared the same capacity to be utter wrecks by normative standards and a built-in capacity to dissociate enough that even as kids…you couldn’t tell.
So….here we come back to the tone of this article. If everyone has trauma then…so fucking what? Is it annoying to me if people go on about something relatively minor, or treat liking anime as if it’s equivalent to the fractured experience of my youth? As a gut reaction at times, sure…but no, not really. There’s no trauma Olympics gold medal. Those people may, I suppose, lead other people to believe I’m faking but really…that’s on the other people. It costs me nothing — out of a lifetime of paying the costs for having been used as a child — to simply believe them. And like gluten-free stuff is now on shelves for the celiac and the woo-laden alike, trauma-informed care is now available to me too. (Although it’s still mostly shit, gotta say.)
Is it frustrating that right-wing people call trauma on things? I dunno. If “calling it trauma” is responsible for better child welfare laws, less abuse, better treatment of women, and a better examination of the results of racism and colonialism then that’s great. Of course there a backlash. I’ve been in that backlash all my adult life, including right here on Metafilter. Stupidity and skepticism both prevent people from listening to others.
I have been on Zoom with 20 martial arts guys “but what if-ing” the whole men in the bathroom (!!!) thing regarding trans rights and it was actually really easy to say “hey, you guys get a lot of adults taking martial arts because of trauma due to assault, and face it, you also have known guys who were capable of it, do you think the non-binary kid in your studio is the problem?” And trust me, they *shut up* and in at least 3 cases, reported back they were welcoming trans students (not a great ratio but you fight another day). You really can both believe in trauma and be principled.
It’s ok if people say they’re “addicted” to Succession. It’s ok if people say something hard was traumatic. Neither person probably would use those words if they were also addicted to heroin or had fought in Iraq.
It’s less ok that there have been a parade of people, more therapists than multiples I will point out — the OG fame-seeking people were not the traumatized people but the fucking rock-star “professionals” including Michelle’s god awful therapist — blowing stuff up on Oprah. But just because Dr. Oz is a shit, doesn’t mean there aren’t celiacs or that deficiencies in vitamin C or D or whatever can cause rickets.
You know what traumatizes me? The scent of Old Spice.* No one has to ban it. We can agree on people’s right to wear it.
It’s also ok to recognize that van der Kolk’s work has helped people. I thought it was a bit sciency and annoying. It helped me anyway - definitely more than the true science has. As much as I hate it, doing yoga and martial arts has given me the ability to smell Old Spice, breathe, and not get a migraine. I’m fine with people calling that out.
But you don’t have to write it like parts of this piece. I wish I could have edited it with a trauma-informed lens.
* This is a trigger, not a trauma. But the language is fuzzy for a lot of people because that’s the physical experience, that you feel the same feelings.
posted by warriorqueen at 4:04 AM on August 3, 2023 [63 favorites]
I hope we all know, Freud is kind of famous for having worked with women who reported being abused, decided that couldn’t be possible, and came up with a whole theory to explain it away. This is kind of the history of abuse and oppression. It can’t really have been that bad.
It’s also a bit like the way there are people who have biopsies for celiac disease and then there are people who are anti-gluten wheat belly people. People who avoid gluten for annoying woo reasons are no skin off anyone’s nose, even if they are also inconsistent at times and snub their family’s Thanksgiving. Celiacs still can’t have even tiny amounts of gluten.
As someone with PTSD who is multiple and who knows other people the same, here’s the thing. I’m sure of my abuse because my abuser, unusually, both admitted it in front of my parents and wrote me a lengthy letter confirming things. Also, 20+ years later I had an MRI for peripheral neuropathy and my neurologist was like “oh, you didn’t mention PTSD on your forms?” (Which I hadn’t because I assumed if I did I wouldn’t be believed about the neuropathy) and I said oh yeah sorry…and then realized he was inferring that from a scan of my brain. I also had a clearly traumatic event as an adult so if I feel like it, which I almost never do, I can now talk about PTSD without having to eat the shit of people deciding they know better about my childhood.
I have gone to considerable lengths in my life to be the perhaps second or third last person you would diagnose as either from the outside. (I realize that’s hard to believe from my posting history but that’s a choice about being open in this environment.) Up until Covid I almost never took a sick day. I worked up to the top digital editor in a women’s magazine company which is a hyper-normative environment. Etc. And all that has both challenged me to grow fiercely into strength, and which has also cost me in a lot of ways.
One of my OG multiple support group…I hesitate to call them friends, they were closer for a decade although we grew apart…died last month. Their sister organized the memorial. It occurred to me that I didn’t know if they ever told their sister about being multiple, or even about the extent of the abuse they suffered. I have watched their friends and professional colleagues leaving thoughts on the Legacy.com page, referencing their sense of humour, ability to connect with others, and professional and educational accomplishments. All of which is absolutely true. I also have zero doubt about their trauma and their multiplicity. But it really brought home to me that as much as they would not have wanted “abuse victim” on their headstone…it’s also sad that it’s taboo to celebrate also publicly the years of effort and the zillion hours of pain and they way we both used to stay up until 2 crying for each others’ stories and nightmares and inability to sleep, hyper-vigilant, and then go to work and text each other jokes about staying awake in boring town halls being harder.
Both of us shared the same capacity to be utter wrecks by normative standards and a built-in capacity to dissociate enough that even as kids…you couldn’t tell.
So….here we come back to the tone of this article. If everyone has trauma then…so fucking what? Is it annoying to me if people go on about something relatively minor, or treat liking anime as if it’s equivalent to the fractured experience of my youth? As a gut reaction at times, sure…but no, not really. There’s no trauma Olympics gold medal. Those people may, I suppose, lead other people to believe I’m faking but really…that’s on the other people. It costs me nothing — out of a lifetime of paying the costs for having been used as a child — to simply believe them. And like gluten-free stuff is now on shelves for the celiac and the woo-laden alike, trauma-informed care is now available to me too. (Although it’s still mostly shit, gotta say.)
Is it frustrating that right-wing people call trauma on things? I dunno. If “calling it trauma” is responsible for better child welfare laws, less abuse, better treatment of women, and a better examination of the results of racism and colonialism then that’s great. Of course there a backlash. I’ve been in that backlash all my adult life, including right here on Metafilter. Stupidity and skepticism both prevent people from listening to others.
I have been on Zoom with 20 martial arts guys “but what if-ing” the whole men in the bathroom (!!!) thing regarding trans rights and it was actually really easy to say “hey, you guys get a lot of adults taking martial arts because of trauma due to assault, and face it, you also have known guys who were capable of it, do you think the non-binary kid in your studio is the problem?” And trust me, they *shut up* and in at least 3 cases, reported back they were welcoming trans students (not a great ratio but you fight another day). You really can both believe in trauma and be principled.
It’s ok if people say they’re “addicted” to Succession. It’s ok if people say something hard was traumatic. Neither person probably would use those words if they were also addicted to heroin or had fought in Iraq.
It’s less ok that there have been a parade of people, more therapists than multiples I will point out — the OG fame-seeking people were not the traumatized people but the fucking rock-star “professionals” including Michelle’s god awful therapist — blowing stuff up on Oprah. But just because Dr. Oz is a shit, doesn’t mean there aren’t celiacs or that deficiencies in vitamin C or D or whatever can cause rickets.
You know what traumatizes me? The scent of Old Spice.* No one has to ban it. We can agree on people’s right to wear it.
It’s also ok to recognize that van der Kolk’s work has helped people. I thought it was a bit sciency and annoying. It helped me anyway - definitely more than the true science has. As much as I hate it, doing yoga and martial arts has given me the ability to smell Old Spice, breathe, and not get a migraine. I’m fine with people calling that out.
But you don’t have to write it like parts of this piece. I wish I could have edited it with a trauma-informed lens.
* This is a trigger, not a trauma. But the language is fuzzy for a lot of people because that’s the physical experience, that you feel the same feelings.
posted by warriorqueen at 4:04 AM on August 3, 2023 [63 favorites]
My problem is that it seems to be one of those popular theories that is applied to everything under the sun. “ a ubiquity of trauma that seems to leave hardly anyone in the “non-traumatized” category” as the article puts it. This is one of those theories that is self referential; that is, it justifies itself by reference to the rules it creates and purports to explain everything.
No, it doesn't. I've only read the book and haven't dived deeply into this work, but a firm line is drawn between "trauma" and "stress," and attention is given to the unhelpful temptation to label all of the former as the latter.
I imagine that an outpouring of critique is called for when any idea takes its place in popular consciousness, but this trauma-centric stuff does seem to have a lot of supportive evidence. If it's not relevant to you personally, you can smooth your feathers and know that you're not alone while still making room for that evidence to do its thing.
posted by late afternoon dreaming hotel at 5:15 AM on August 3, 2023 [8 favorites]
No, it doesn't. I've only read the book and haven't dived deeply into this work, but a firm line is drawn between "trauma" and "stress," and attention is given to the unhelpful temptation to label all of the former as the latter.
I imagine that an outpouring of critique is called for when any idea takes its place in popular consciousness, but this trauma-centric stuff does seem to have a lot of supportive evidence. If it's not relevant to you personally, you can smooth your feathers and know that you're not alone while still making room for that evidence to do its thing.
posted by late afternoon dreaming hotel at 5:15 AM on August 3, 2023 [8 favorites]
A week after my dad died I tried an online support group for young people who had lost parents. That group was one of the most traumatizing aspects of that entire awful period of my life. I sat there listening to person after person - who were clearly all regulars and clearly knew each other quite well - talk about how they were three years, five years, ten years out from their loss and still feeling so so horrible and I thought, this is my life now, this is my life, I’m permanently broken, my life is over, I am never never going to feel ok ever again. After a couple hours of this (they hadn’t, apparently, noted that I was new and hadn’t yet been given time to speak) someone mistakenly started ringing my doorbell over and and over and over, and I just sat there with mounting anxiety and frustration and rage and fear listening to the outpouring of trauma and the ringing ringing ringing and wound up slamming the door open so hard I broke the wall and screaming in this guy’s face like a maniac. Truly out of my mind. When I ultimately got to speak in the group I broke down sobbing and told them all this and they apologized.
I am now two years out from the death. I never went back to that group, did join a different one with better moderation that only lasted two months by design, got my own therapist, did some work, and I am fine. I miss him so much and will love and grieve him forever but I absolutely CANNOT IMAGINE going to that original group now - and while of course I know that everyone is different, I cannot imagine that group is helping people more than it hurts them.
Trauma is real. But making trauma an identity and making a trauma group your social group precludes the possibility of recovering from trauma. It stops being about healing and becomes something else.
posted by showbiz_liz at 5:16 AM on August 3, 2023 [24 favorites]
I am now two years out from the death. I never went back to that group, did join a different one with better moderation that only lasted two months by design, got my own therapist, did some work, and I am fine. I miss him so much and will love and grieve him forever but I absolutely CANNOT IMAGINE going to that original group now - and while of course I know that everyone is different, I cannot imagine that group is helping people more than it hurts them.
Trauma is real. But making trauma an identity and making a trauma group your social group precludes the possibility of recovering from trauma. It stops being about healing and becomes something else.
posted by showbiz_liz at 5:16 AM on August 3, 2023 [24 favorites]
One of the reasons psychology is more science-y than science is that it needs to be like that to work. We’ve come to think of science as experiments replicable in large populations, and while that’s usually fine for appendixes (human appendixes are pretty similar), it’s not fine for human brains. There are a lot of differences between our brains. It’s currently illegal to replicate a human brain to do a double-blind study on it. Can we stop pretending that the knowledge gathered through the scientific method is the best way to do everything? It’s useful and important, but it also left me suicidally depressed for almost 20 years, while adding memory loss and significant weight gain for my troubles. Plus, we have, for a variety of reasons (mostly sexism-related), a lot more information on men’s bodies on the whole than on women’s, and women are less likely to receive adequate medical care. (And that’s not even touching on trans people, who have their own history of medical exclusion.) Woo is a direct response to the failures of the medical establishment, and if we want to solve the problems that emerge from its dominance, we have to ensure the medical establishment takes people’s suffering seriously. If the trauma model is helping a significant enough number of people live healthy and fulfilled lives, it doesn’t matter if it’s “science”; there are major differences in fields in terms of the ease of gathering replicable evidence. It matters that it’s working for people. And the trauma paradigm pretty clearly is.
posted by vim876 at 5:22 AM on August 3, 2023 [12 favorites]
posted by vim876 at 5:22 AM on August 3, 2023 [12 favorites]
" Those people may, I suppose, lead other people to believe I’m faking but really…that’s on the other people."
Thank you warriorqueen. That's an attitude we need a lot more of.
posted by Zumbador at 6:11 AM on August 3, 2023 [3 favorites]
Thank you warriorqueen. That's an attitude we need a lot more of.
posted by Zumbador at 6:11 AM on August 3, 2023 [3 favorites]
Man this kind of smarmy article tires me. I admit I had to start skimming. There’s good stuff in here but the tone…
Yeah, the author seemed to have an axe to grind. It sounds like Van der Kolk really is a jerk, and having worked in academia I am not surprised. But the article ended with an eye roll at the (inferred) messianic goals of the... what, exactly, the trauma movement? The trauma cabal? The poor deluded trauma survivors?
I can say that trauma informed therapy has made a difference for me. Cognitive behavioral helped to stabilize me somewhat, but it did nothing to address the childhood experiences that were actually causing me to wreck my life. I was unable to actually remember 95% of those experiences, even though I knew with perfect clarity that one of my caregivers had been an alcoholic rage monster and the other had used me as an emotional support animal to deal with the rage monster. It is unbelievably frustrating to recognize the silhouette of the thing that upended your life and is still infecting your mind with misery, but to be unable to look directly at the thing, talk to anyone about it, or actually feel the feelings associated with it. This is the difficulty with trauma: it is a great silencer. Even when the survivor is acting out in the wildest ways, the core of the experience, the memory of the experience, the feeling of the experience are all just out of reach and cannot be communicated to anyone else through the normal means. I am trying somatic therapy now, trying to locate feelings in my body, because my mind is so thoroughly trained to anesthetize and drown every emotion that I can't identify what I'm actually feeling most of the time. Good luck talking that out with cognitive behavioral therapy!
Because trauma is a great silencer, it means a lot to me to have language and therapeutic modalities that help me name what's wrong and slowly, slowly heal it. It was a great relief to know that this huge, smothering silhouette that lurks in my own mind has a name and has been encountered many times before, and that other people have actually gotten better. So I admit that I get annoyed, even angry, when people say things like "I went through a really traumatic breakup" when what I assume they mean is that they went through a difficult, painful, grief-laden breakup. I know, I know.... it's not for me to say what is or isn't trauma. But the trauma I experienced forced me into silence for most of my life, made me unable to communicate what had happened except through acts of self-destruction. Trauma didn't just impose silence between me and other people, it imposed silence in my own mind and soul - an inability to communicate with myself, to understand what was going on in my own mind and body. To this day, I am still unable to feel my feelings the way the average person apparently does. It's been such a hard fight finding a name for the thing that was wrong inside me that I really do wish the word trauma were used more carefully.
In that light, I think it's interesting that the very concept of being traumatized has changed from being a shameful, hidden thing to being almost a badge of honor. It's like I'm supposed to believe that the hardship that I've endured makes me special, or something. It doesn't make me special. It just makes me hurt and I want it to be gone.
posted by cubeb at 6:26 AM on August 3, 2023 [22 favorites]
Yeah, the author seemed to have an axe to grind. It sounds like Van der Kolk really is a jerk, and having worked in academia I am not surprised. But the article ended with an eye roll at the (inferred) messianic goals of the... what, exactly, the trauma movement? The trauma cabal? The poor deluded trauma survivors?
I can say that trauma informed therapy has made a difference for me. Cognitive behavioral helped to stabilize me somewhat, but it did nothing to address the childhood experiences that were actually causing me to wreck my life. I was unable to actually remember 95% of those experiences, even though I knew with perfect clarity that one of my caregivers had been an alcoholic rage monster and the other had used me as an emotional support animal to deal with the rage monster. It is unbelievably frustrating to recognize the silhouette of the thing that upended your life and is still infecting your mind with misery, but to be unable to look directly at the thing, talk to anyone about it, or actually feel the feelings associated with it. This is the difficulty with trauma: it is a great silencer. Even when the survivor is acting out in the wildest ways, the core of the experience, the memory of the experience, the feeling of the experience are all just out of reach and cannot be communicated to anyone else through the normal means. I am trying somatic therapy now, trying to locate feelings in my body, because my mind is so thoroughly trained to anesthetize and drown every emotion that I can't identify what I'm actually feeling most of the time. Good luck talking that out with cognitive behavioral therapy!
Because trauma is a great silencer, it means a lot to me to have language and therapeutic modalities that help me name what's wrong and slowly, slowly heal it. It was a great relief to know that this huge, smothering silhouette that lurks in my own mind has a name and has been encountered many times before, and that other people have actually gotten better. So I admit that I get annoyed, even angry, when people say things like "I went through a really traumatic breakup" when what I assume they mean is that they went through a difficult, painful, grief-laden breakup. I know, I know.... it's not for me to say what is or isn't trauma. But the trauma I experienced forced me into silence for most of my life, made me unable to communicate what had happened except through acts of self-destruction. Trauma didn't just impose silence between me and other people, it imposed silence in my own mind and soul - an inability to communicate with myself, to understand what was going on in my own mind and body. To this day, I am still unable to feel my feelings the way the average person apparently does. It's been such a hard fight finding a name for the thing that was wrong inside me that I really do wish the word trauma were used more carefully.
In that light, I think it's interesting that the very concept of being traumatized has changed from being a shameful, hidden thing to being almost a badge of honor. It's like I'm supposed to believe that the hardship that I've endured makes me special, or something. It doesn't make me special. It just makes me hurt and I want it to be gone.
posted by cubeb at 6:26 AM on August 3, 2023 [22 favorites]
Trauma is real. But making trauma an identity and making a trauma group your social group precludes the possibility of recovering from trauma. It stops being about healing and becomes something else.
I’ve left therapists and lost friends over this. I appreciate that we’re all different and have different needs when processing trauma or grief, but at some point if I cannot find a ladder out, I will stop swimming. It doesn’t matter how many people find comfort or validation in the pool. I know myself. I will feel trapped. I will drown
posted by thivaia at 6:31 AM on August 3, 2023 [12 favorites]
I’ve left therapists and lost friends over this. I appreciate that we’re all different and have different needs when processing trauma or grief, but at some point if I cannot find a ladder out, I will stop swimming. It doesn’t matter how many people find comfort or validation in the pool. I know myself. I will feel trapped. I will drown
posted by thivaia at 6:31 AM on August 3, 2023 [12 favorites]
Is there any evidence base for group therapy? Or is it just cheaper than individual therapy?
I read van der Kolk's book a few years ago. I got some useful stuff from it, but later when I found out he was a dickhead I wasn't really surprised. Just something about the way he writes as though he's talking directly to traumatised people, but also is happy to give detailed descriptions of other peoples' trauma to his audience like they'll enjoy it.
posted by harriet vane at 7:15 AM on August 3, 2023 [2 favorites]
I read van der Kolk's book a few years ago. I got some useful stuff from it, but later when I found out he was a dickhead I wasn't really surprised. Just something about the way he writes as though he's talking directly to traumatised people, but also is happy to give detailed descriptions of other peoples' trauma to his audience like they'll enjoy it.
posted by harriet vane at 7:15 AM on August 3, 2023 [2 favorites]
This article is as difficult to read as I found the book to be, and I haven't finished either. My alternate recommendation remains Complex PTSD: From Surviving to Thriving.
I am 100% Team Let's Talk More About Trauma As An Unavoidable Human Experience. We all have traumatic experiences, many of which we process without any significant intervention (or could have processed much less messily with fairly basic help) and they resolve into Life Experiences - they may even leave triggers behind (where trigger means a noticeable stress/adrenaline response), but not to the point of interfering with activities of daily life. But however overinvolved some people get in trauma as an identity, there's far more people walking around hurting and not understanding why or thinking they are just broken or that there's nothing they can do about it.
I guess I do subscribe to the overarching construct that trauma is a neuro-bio mechanism as a result of some experiential force, which is why I get uncomfortable when people who experienced complex ongoing trauma as a result of, say, childhood abuse take issue sharing their word with someone who was shot or had cancer/treatment or experienced abuse as an adult for a shorter period of time or from a non-parental source. Part of the science process has been defining more specific categories - like Adverse Childhood Experiences - so that we can talk about (without competing, ideally) the source versus the neuro-bio consequences versus the not-so-specifically-neuro-wired consequences which are ALSO really important to treatment and sometimes overlooked.
It currently looks like treatments of the physical medical symptoms of post-traumatic disorder might be more or less the same whether you had longterm ACEs or witnessed a terrible accident, but the actual "toolbox" psychological treatment is of course going to be wildly different because the cause is wildly different. van der Kolk's work didn't NOT contribute to getting to that place of understanding better what the body does under intense pressure, but I think the credit goes far more to the relatively obscure doctors and researchers continuing to do rigorous study and not the dude throwing luxury trauma camps in the woods.
posted by Lyn Never at 7:23 AM on August 3, 2023 [12 favorites]
I am 100% Team Let's Talk More About Trauma As An Unavoidable Human Experience. We all have traumatic experiences, many of which we process without any significant intervention (or could have processed much less messily with fairly basic help) and they resolve into Life Experiences - they may even leave triggers behind (where trigger means a noticeable stress/adrenaline response), but not to the point of interfering with activities of daily life. But however overinvolved some people get in trauma as an identity, there's far more people walking around hurting and not understanding why or thinking they are just broken or that there's nothing they can do about it.
I guess I do subscribe to the overarching construct that trauma is a neuro-bio mechanism as a result of some experiential force, which is why I get uncomfortable when people who experienced complex ongoing trauma as a result of, say, childhood abuse take issue sharing their word with someone who was shot or had cancer/treatment or experienced abuse as an adult for a shorter period of time or from a non-parental source. Part of the science process has been defining more specific categories - like Adverse Childhood Experiences - so that we can talk about (without competing, ideally) the source versus the neuro-bio consequences versus the not-so-specifically-neuro-wired consequences which are ALSO really important to treatment and sometimes overlooked.
It currently looks like treatments of the physical medical symptoms of post-traumatic disorder might be more or less the same whether you had longterm ACEs or witnessed a terrible accident, but the actual "toolbox" psychological treatment is of course going to be wildly different because the cause is wildly different. van der Kolk's work didn't NOT contribute to getting to that place of understanding better what the body does under intense pressure, but I think the credit goes far more to the relatively obscure doctors and researchers continuing to do rigorous study and not the dude throwing luxury trauma camps in the woods.
posted by Lyn Never at 7:23 AM on August 3, 2023 [12 favorites]
I own a paperback copy of The Body Keeps the Score and have made several unsuccessful attempts to read it. Something about the author's tone and writing style has been off-putting to me. I'm glad to read this thread and see that my reaction wasn't unusual.
posted by fuse theorem at 7:40 AM on August 3, 2023 [6 favorites]
posted by fuse theorem at 7:40 AM on August 3, 2023 [6 favorites]
I honestly hit the bit where the article claimed that The Body Keeps the Score is "a technically dense overview of a theory of traumatic stress that once spurred 20 years of scientific controversy" and bounced off in confusion. Uh. I mean, I guess I can call myself a neuroendocrinologist with a straight face these days, toxic stress and the effects of long term experience on decision-making remain strong interests of mine, and I've found a number of things in that book useful, but... That is not my memory of that book. Technical and dense it is not. I will have to skim it again and find out if I'm misremembering or something. I remember it being actually quite light and "fluffy".
The suspicion about trauma-induced memories being different from memories of a grocery list is also baffling. We have lots of types of memory, all of which have widely varying levels of fidelity to reality. Emotional salience can distort or strengthen memories. This is not controversial, and it's something I learned first as an undergrad working in an animal cognition lab in... oh, 2009 or so? I spent some time knocking around memory workers, is my point, and it's an understanding that is not remotely specific to trauma researchers or even to researchers working primarily on humans.
It's an accessible book aimed at a popular audience, just like Bruce Perry's The Boy Who Was Raised As a Dog, another book often recommended in the same vein by a prominent trauma researcher. It seems weird to frame it as something that's dense and academic.
posted by sciatrix at 8:10 AM on August 3, 2023 [11 favorites]
The suspicion about trauma-induced memories being different from memories of a grocery list is also baffling. We have lots of types of memory, all of which have widely varying levels of fidelity to reality. Emotional salience can distort or strengthen memories. This is not controversial, and it's something I learned first as an undergrad working in an animal cognition lab in... oh, 2009 or so? I spent some time knocking around memory workers, is my point, and it's an understanding that is not remotely specific to trauma researchers or even to researchers working primarily on humans.
It's an accessible book aimed at a popular audience, just like Bruce Perry's The Boy Who Was Raised As a Dog, another book often recommended in the same vein by a prominent trauma researcher. It seems weird to frame it as something that's dense and academic.
posted by sciatrix at 8:10 AM on August 3, 2023 [11 favorites]
It kind of reveals the limits of that person's capability to handle truly dense academic material, doesn't it?
posted by I-Write-Essays at 8:27 AM on August 3, 2023 [3 favorites]
posted by I-Write-Essays at 8:27 AM on August 3, 2023 [3 favorites]
I appreciate this discussion (and the article). I have experienced the powerful impact of exploring in therapy how early experiences of overwhelming stress have had a lifelong set of impacts on me. How sense-making assumptions established in childhood have seemed to lead to behavioral and thought patterns that persist in me as a middle aged person today. I've benefited from therapists who help me explore the way my response patterns could be rooted in fears, associations, impressions, and conceptions established early, and reinforced and rebuilt over decades.
I'm an ambivalent convert to using the term 'trauma' so widely, but if we want to call the broad range of high-stress (and often objectively harmful) experiences that seem to lead to ongoing behaviors and well-documented physical impacts, "Trauma", then, OK, I can make peace with that. So basically, I'm on team: yes, Trauma is very real - it is almost ubiquitous although unevenly distributed, and and there is good research establishing it's impacts on our physical health and emotional well being for decades.
But I do think there's a huge value in unpacking the social impact of this trauma framing, and contextualizing it historically. Given how values and ideas change over time, we are unlikely to maintain forever our focus on trauma as the locus or explanation of so much of human behavior. These ideas and framings shift as the culture shifts. And the way we call so much 'trauma' right now, while in some ways useful, is also flattening. The article author rightfully notes that Prince Harry & the majority of the world's most suffering people may both have had painful childhood experiences that impact them over time, but like, who cares how Prince Harry feels when he's one of the richest people on earth and millions of others live lives of incredible suffering and their possibilities of escape are deeply constrained?
The age of the trauma framing that we are living through now, is also the age of NOT seeing the world through other lenses. Does childhood trauma have a bigger impact on society than income inequality or climate change? I agree with the article author's (Danielle Carr) skepticism of the potential impact of 'trauma work' as a meaningful intervention in 'the war in Ukraine, global warming, the refugee crisis, famine, guerrilla violence'.
I am a daily practitioner of 'trauma informed care' in my case management work with mostly homeless patients, and I find I can build more trust in my patients who have gone through what are most certainly repeated traumas by asking permission, aiming to follow through on my promises, working collaboratively, and attempting to have curiosity and humility. I would love to connect all my patients with skilled therapists who could support them to explore the impact of their traumas on their lives. But I don't think I can change the conditions that caused my patient's trauma through these actions. That takes generating enough power to actually change the political and economic rules that govern our lives. Trauma is a useful, but in my mind not sufficient framing to understand human suffering. And it's current ascendancy reveals what is missing in our collective response.
posted by latkes at 8:36 AM on August 3, 2023 [21 favorites]
I'm an ambivalent convert to using the term 'trauma' so widely, but if we want to call the broad range of high-stress (and often objectively harmful) experiences that seem to lead to ongoing behaviors and well-documented physical impacts, "Trauma", then, OK, I can make peace with that. So basically, I'm on team: yes, Trauma is very real - it is almost ubiquitous although unevenly distributed, and and there is good research establishing it's impacts on our physical health and emotional well being for decades.
But I do think there's a huge value in unpacking the social impact of this trauma framing, and contextualizing it historically. Given how values and ideas change over time, we are unlikely to maintain forever our focus on trauma as the locus or explanation of so much of human behavior. These ideas and framings shift as the culture shifts. And the way we call so much 'trauma' right now, while in some ways useful, is also flattening. The article author rightfully notes that Prince Harry & the majority of the world's most suffering people may both have had painful childhood experiences that impact them over time, but like, who cares how Prince Harry feels when he's one of the richest people on earth and millions of others live lives of incredible suffering and their possibilities of escape are deeply constrained?
The age of the trauma framing that we are living through now, is also the age of NOT seeing the world through other lenses. Does childhood trauma have a bigger impact on society than income inequality or climate change? I agree with the article author's (Danielle Carr) skepticism of the potential impact of 'trauma work' as a meaningful intervention in 'the war in Ukraine, global warming, the refugee crisis, famine, guerrilla violence'.
I am a daily practitioner of 'trauma informed care' in my case management work with mostly homeless patients, and I find I can build more trust in my patients who have gone through what are most certainly repeated traumas by asking permission, aiming to follow through on my promises, working collaboratively, and attempting to have curiosity and humility. I would love to connect all my patients with skilled therapists who could support them to explore the impact of their traumas on their lives. But I don't think I can change the conditions that caused my patient's trauma through these actions. That takes generating enough power to actually change the political and economic rules that govern our lives. Trauma is a useful, but in my mind not sufficient framing to understand human suffering. And it's current ascendancy reveals what is missing in our collective response.
posted by latkes at 8:36 AM on August 3, 2023 [21 favorites]
I love this discussion.
I speak here with a history only of ordinary traumas, in the modern parlance, not extraordinary ones, so please pardon me if I'm speaking out of turn. Is there room in the "trauma-informed" framework for the meaning-making that one might do to tame a traumatic event, to incorporate it into a world that seems manageable again? Or for the idea that our biggest struggles sometimes turn out to be enduring sources of pride?
Perhaps latkes' point about addressing root causes is key here. My own drive, when someone in my life falls down a metaphorical well, is to cover over all the wells. I'm sure this isn't universal, but I think it's a widely shared impulse. Changing the conditions that caused a trauma is a huge ask when it is something like climate change (because I don't think your question there is either/or, latkes, I think climate change will be the root cause of trauma, is already the root cause). But such an effort can, under some circumstances, give meaning to life.
posted by eirias at 9:36 AM on August 3, 2023
I speak here with a history only of ordinary traumas, in the modern parlance, not extraordinary ones, so please pardon me if I'm speaking out of turn. Is there room in the "trauma-informed" framework for the meaning-making that one might do to tame a traumatic event, to incorporate it into a world that seems manageable again? Or for the idea that our biggest struggles sometimes turn out to be enduring sources of pride?
Perhaps latkes' point about addressing root causes is key here. My own drive, when someone in my life falls down a metaphorical well, is to cover over all the wells. I'm sure this isn't universal, but I think it's a widely shared impulse. Changing the conditions that caused a trauma is a huge ask when it is something like climate change (because I don't think your question there is either/or, latkes, I think climate change will be the root cause of trauma, is already the root cause). But such an effort can, under some circumstances, give meaning to life.
posted by eirias at 9:36 AM on August 3, 2023
I think trauma is pretty much the basic human condition. Everyone you know and love is going to die. And so are you!
And it has always been this way throughout humanity's existence. Realizing that this is an over-arching trauma, and not specific horrible shit that has happened to someone, you would think we would have gotten a better handle on it, rather than just religion/promise of an afterlife.
posted by Windopaene at 9:43 AM on August 3, 2023 [1 favorite]
And it has always been this way throughout humanity's existence. Realizing that this is an over-arching trauma, and not specific horrible shit that has happened to someone, you would think we would have gotten a better handle on it, rather than just religion/promise of an afterlife.
posted by Windopaene at 9:43 AM on August 3, 2023 [1 favorite]
Okay, I've had a chance to sit with this for a while.
I guess I'm coming at this not from a childhood trauma position, I'm sure I have that, but I'm currently basically out of commission because of trauma from a job where I just kept going in and doing this thing that was burning bad paths into my brain. Because of my Presbyterian background and not wanting to appear a weak little gay guy, I just shoved all my emotions and stuff down, kept doing the thing for YEARS after I should have stopped, and now it's ALL living in my body. I end up having what are basically full-on panic attacks except for zero emotional involvement, it's just my body living out its trauma.
I'm living in a health care professional desert, with nobody taking on new patients who will deal with someone like me. Marriage counseling I could get five appointments for, but PTSD/trauma/weird brain stuff? Yeah, the waiting lists are huge, and the entire "will this person take my insurance" nightmare defeated me twice when I thought I found a match. I was in EMDR therapy for a while, and had a couple of very interesting moments with that which I want to explore further. I bought some buzzers that don't do the thing right, so maybe when I have some more bucks I will get one of the pro models.
So, yeah, I fully believe trauma lives in your body. I'm living through it. I'm better now than I was a year ago, but I'm still just not functional a lot of days, even with all the possible things I can do to detangle the knots in my brain paths. I was on EMDR therapy for a while, and had a couple of very interesting moments with that which I want to explore further. I bought some buzzers that don't do the thing right, so maybe when I have some more bucks I will get one of the pro models.
posted by hippybear at 10:26 AM on August 3, 2023 [13 favorites]
I guess I'm coming at this not from a childhood trauma position, I'm sure I have that, but I'm currently basically out of commission because of trauma from a job where I just kept going in and doing this thing that was burning bad paths into my brain. Because of my Presbyterian background and not wanting to appear a weak little gay guy, I just shoved all my emotions and stuff down, kept doing the thing for YEARS after I should have stopped, and now it's ALL living in my body. I end up having what are basically full-on panic attacks except for zero emotional involvement, it's just my body living out its trauma.
I'm living in a health care professional desert, with nobody taking on new patients who will deal with someone like me. Marriage counseling I could get five appointments for, but PTSD/trauma/weird brain stuff? Yeah, the waiting lists are huge, and the entire "will this person take my insurance" nightmare defeated me twice when I thought I found a match. I was in EMDR therapy for a while, and had a couple of very interesting moments with that which I want to explore further. I bought some buzzers that don't do the thing right, so maybe when I have some more bucks I will get one of the pro models.
So, yeah, I fully believe trauma lives in your body. I'm living through it. I'm better now than I was a year ago, but I'm still just not functional a lot of days, even with all the possible things I can do to detangle the knots in my brain paths. I was on EMDR therapy for a while, and had a couple of very interesting moments with that which I want to explore further. I bought some buzzers that don't do the thing right, so maybe when I have some more bucks I will get one of the pro models.
posted by hippybear at 10:26 AM on August 3, 2023 [13 favorites]
I find it interesting that psychedelic therapy hasn't been mentioned in the article or this thread. It looks so promising.
posted by bink at 11:06 AM on August 3, 2023 [3 favorites]
posted by bink at 11:06 AM on August 3, 2023 [3 favorites]
Can you please point to the specific difference between acknowledging you trauma, getting treatment, and doing the things you need to do to work towards healing, and 'letting your trauma define you'?
Because it seems really, really difficult for non-professionals to evaluate a traumatized individual and determine what the appropriate response to their trauma actually is. And professionals generally don't diagnose and recommend treatment without getting to know a patient and their needs pretty thoroughly.
So if you're capable of judging who is and who isn't letting their trauma 'define them' in the wild, you're either on a whole new level above what modern psychiatric medicine is capable of, or you're being kind of judgmental and victim-blamy.
posted by MrVisible at 11:25 AM on August 3, 2023 [8 favorites]
Because it seems really, really difficult for non-professionals to evaluate a traumatized individual and determine what the appropriate response to their trauma actually is. And professionals generally don't diagnose and recommend treatment without getting to know a patient and their needs pretty thoroughly.
So if you're capable of judging who is and who isn't letting their trauma 'define them' in the wild, you're either on a whole new level above what modern psychiatric medicine is capable of, or you're being kind of judgmental and victim-blamy.
posted by MrVisible at 11:25 AM on August 3, 2023 [8 favorites]
If trauma "shouldn't" define people, then what does that mean for the people who do feel defined by their trauma? Are they not trying hard enough? A lot of things "shouldn't" be true, but they are, regardless.
posted by cultanthropologist at 11:29 AM on August 3, 2023 [5 favorites]
posted by cultanthropologist at 11:29 AM on August 3, 2023 [5 favorites]
So, yeah, I fully believe trauma lives in your body. I'm living through it. I'm better now than I was a year ago, but
I have been waiting for you to say something like this, hippybear, because your prose style has improved markedly. I first started noticing it ~8 months ago, and I suspected it might reflect a positive development in basic brain health.
I find it interesting that psychedelic therapy hasn't been mentioned in the article or this thread. It looks so promising.
The anesthesiologist whose channel I linked to in my previous comment apparently owns a string of Ketamine clinics, though he hasn’t talked about them in the dozen+ videos I’ve watched, and he is not pushing Ketamine therapy at all as far as I can tell.
posted by jamjam at 11:36 AM on August 3, 2023
I have been waiting for you to say something like this, hippybear, because your prose style has improved markedly. I first started noticing it ~8 months ago, and I suspected it might reflect a positive development in basic brain health.
I find it interesting that psychedelic therapy hasn't been mentioned in the article or this thread. It looks so promising.
The anesthesiologist whose channel I linked to in my previous comment apparently owns a string of Ketamine clinics, though he hasn’t talked about them in the dozen+ videos I’ve watched, and he is not pushing Ketamine therapy at all as far as I can tell.
posted by jamjam at 11:36 AM on August 3, 2023
Trauma is real. But making trauma an identity and making a trauma group your social group precludes the possibility of recovering from trauma. It stops being about healing and becomes something else.
This is a small part of this overall discussion, but in The Body van der Kolk talks specifically about this, about how early on in his career he led a group of WWII vets in a group he hoped would be healing, but it ended up being a lot of folks stuck in their trauma and finding ways collectively to make that okay.
posted by wemayfreeze at 11:40 AM on August 3, 2023 [3 favorites]
This is a small part of this overall discussion, but in The Body van der Kolk talks specifically about this, about how early on in his career he led a group of WWII vets in a group he hoped would be healing, but it ended up being a lot of folks stuck in their trauma and finding ways collectively to make that okay.
posted by wemayfreeze at 11:40 AM on August 3, 2023 [3 favorites]
professionals generally don't diagnose and recommend treatment without getting to know a patient and their needs pretty thoroughly.
The problem is that the standards for both the diagnosis itself and the treatment are fluid and contested. So when we're speaking broadly, deference to presumed professional expertise is not in itself sufficient. (Also, to be blunt, there's lots of folks with subclinical-to-clinical problems who self-diagnose and self-treat, for all kinds of reasons, and there's no expertise check there.)
You might find it interesting to read the book I mentioned above, Strangers to Ourselves, where some patients find themselves "stuck" in a diagnosis and treatment modality that they don't necessarily find helpful but aren't sure what a suitable replacement for would be. It's not an anti-psych or anti-psych med book (at least not so far; I haven't finished it), but it does illuminate the difficulty of constructing diagnoses and prescribing treatments for partially non-physical pathologies.
posted by praemunire at 12:25 PM on August 3, 2023 [3 favorites]
The problem is that the standards for both the diagnosis itself and the treatment are fluid and contested. So when we're speaking broadly, deference to presumed professional expertise is not in itself sufficient. (Also, to be blunt, there's lots of folks with subclinical-to-clinical problems who self-diagnose and self-treat, for all kinds of reasons, and there's no expertise check there.)
You might find it interesting to read the book I mentioned above, Strangers to Ourselves, where some patients find themselves "stuck" in a diagnosis and treatment modality that they don't necessarily find helpful but aren't sure what a suitable replacement for would be. It's not an anti-psych or anti-psych med book (at least not so far; I haven't finished it), but it does illuminate the difficulty of constructing diagnoses and prescribing treatments for partially non-physical pathologies.
posted by praemunire at 12:25 PM on August 3, 2023 [3 favorites]
Avgi Saketopoulou's very new book Sexuality Beyond Consent: Risk, Race, Traumatophilia offers a viable alternative model for reconciling with trauma. She talks about it on one of the best podcast episodes I have ever heard.
Trauma doesn't heal per se. You don't get to go back to being un-traumatized. At best you learn how to live harmoniously with it.
posted by tovarisch at 12:32 PM on August 3, 2023 [6 favorites]
Trauma doesn't heal per se. You don't get to go back to being un-traumatized. At best you learn how to live harmoniously with it.
posted by tovarisch at 12:32 PM on August 3, 2023 [6 favorites]
Trauma doesn't heal per se. You don't get to go back to being un-traumatized. At best you learn how to live harmoniously with it.
This is what psychedelic therapy, whether it's ketamine, psilocybin, or MDMA, is beginning to challenge. It appears there can be a restoration of plasticity using these substances that can significantly, for lack of a better metaphor, rewire the pathways away from trauma entirely.
I got some muscinol gummies a while back to try microdosing for a bit. They might be doing a thing, they might not be. They recommend taking a break after a month and so I will let it go after I'm done with this batch I bought. Of course, amanita muscara are not psilocybin so I don't know what I was expecting.
posted by hippybear at 12:37 PM on August 3, 2023 [3 favorites]
This is what psychedelic therapy, whether it's ketamine, psilocybin, or MDMA, is beginning to challenge. It appears there can be a restoration of plasticity using these substances that can significantly, for lack of a better metaphor, rewire the pathways away from trauma entirely.
I got some muscinol gummies a while back to try microdosing for a bit. They might be doing a thing, they might not be. They recommend taking a break after a month and so I will let it go after I'm done with this batch I bought. Of course, amanita muscara are not psilocybin so I don't know what I was expecting.
posted by hippybear at 12:37 PM on August 3, 2023 [3 favorites]
a ubiquity of trauma that seems to leave hardly anyone in the “non-traumatized” category” as the article puts it.
I wonder when someone will make the connection that the reason it seems like everyone has trauma is because our society is designed to treat people like shit. I have difficulties dealing with anger because my father was taught by his father that sometimes you just need to hit things/people/animals to get them to understand. I have longstanding difficulties managing my own emotions because I grew up hearing that crying was for babies and weaklings.
When you grow up in an environment that believes in tough love, violence as a valid solution, and bad shit happens to you because you deserve it, how the hell can you reach adulthood without some form of trauma? They say broken people break people but where the hell are the unbroken people?
I know people are doing better with how they raise their kids but it seems like a long and slow process to create a society where the ideal something that you have to be broken to get.
posted by teleri025 at 12:51 PM on August 3, 2023 [9 favorites]
I wonder when someone will make the connection that the reason it seems like everyone has trauma is because our society is designed to treat people like shit. I have difficulties dealing with anger because my father was taught by his father that sometimes you just need to hit things/people/animals to get them to understand. I have longstanding difficulties managing my own emotions because I grew up hearing that crying was for babies and weaklings.
When you grow up in an environment that believes in tough love, violence as a valid solution, and bad shit happens to you because you deserve it, how the hell can you reach adulthood without some form of trauma? They say broken people break people but where the hell are the unbroken people?
I know people are doing better with how they raise their kids but it seems like a long and slow process to create a society where the ideal something that you have to be broken to get.
posted by teleri025 at 12:51 PM on August 3, 2023 [9 favorites]
Seeing this pop up was interesting because I just was about to read this: WaPo gift link
‘The Body Keeps the Score’ offers uncertain science in the name of self-help. It’s not alone.
Some best-selling books express great confidence in theories of the brain that are still in their unproven infancy
posted by PussKillian at 12:52 PM on August 3, 2023 [2 favorites]
‘The Body Keeps the Score’ offers uncertain science in the name of self-help. It’s not alone.
Some best-selling books express great confidence in theories of the brain that are still in their unproven infancy
posted by PussKillian at 12:52 PM on August 3, 2023 [2 favorites]
Maybe right, hippybear. I still think that even if you resolve your trauma, you're fundamentally changed by it, and I think it might not help more serious mental illnesses (that are also trauma responses), but it's exciting to see psychedelic therapy help people.
I have heard that microdosing isn't currently used in clinical settings. My experiment with it was a wash, but I'd never discourage a friend from trying it out. Meanwhile I have a bunch of psilocybin chocolates in the fridge, but I'm wary of trying them at the clinical doses even with supervision. Maybe one day soon.
posted by tovarisch at 1:08 PM on August 3, 2023 [1 favorite]
I have heard that microdosing isn't currently used in clinical settings. My experiment with it was a wash, but I'd never discourage a friend from trying it out. Meanwhile I have a bunch of psilocybin chocolates in the fridge, but I'm wary of trying them at the clinical doses even with supervision. Maybe one day soon.
posted by tovarisch at 1:08 PM on August 3, 2023 [1 favorite]
I am convinced that trauma can heal, and that such healing is one of the primary functions of dreams — when it comes to the question of effectiveness in treating trauma, the resemblance between the state of mind induced by psychedelics and dreaming is NOT a coincidence.
And neither is the resemblance between EMDR and the eye movements of REM sleep.
posted by jamjam at 1:56 PM on August 3, 2023 [3 favorites]
And neither is the resemblance between EMDR and the eye movements of REM sleep.
posted by jamjam at 1:56 PM on August 3, 2023 [3 favorites]
I think trauma is pretty much the basic human condition.
You might want to give ACT therapy a look. The premise is that examining and resisting negative thoughts may only be entrenching them. Here the goal of therapy is abandoning the battlefield, not winning the war.
posted by justsomebodythatyouusedtoknow at 1:58 PM on August 3, 2023 [2 favorites]
You might want to give ACT therapy a look. The premise is that examining and resisting negative thoughts may only be entrenching them. Here the goal of therapy is abandoning the battlefield, not winning the war.
posted by justsomebodythatyouusedtoknow at 1:58 PM on August 3, 2023 [2 favorites]
And neither is the resemblance between EMDR and the eye movements of REM sleep.
The couple of moments I had with EMDR were when the buzzers, I was using buzzers and not an eye tracker, somehow lined up within something inside me and I could FEEL things untangling for me. It's difficult to quantify because I didn't really have enough time to get into it before the temp program I was on ran out of payments for me, but during those two sessions I could tell, if I could get all these things lined up, I might be able to really accomplish something deep for myself within that kind of therapy.
posted by hippybear at 2:00 PM on August 3, 2023 [5 favorites]
The couple of moments I had with EMDR were when the buzzers, I was using buzzers and not an eye tracker, somehow lined up within something inside me and I could FEEL things untangling for me. It's difficult to quantify because I didn't really have enough time to get into it before the temp program I was on ran out of payments for me, but during those two sessions I could tell, if I could get all these things lined up, I might be able to really accomplish something deep for myself within that kind of therapy.
posted by hippybear at 2:00 PM on August 3, 2023 [5 favorites]
I own a paperback copy of The Body Keeps the Score and have made several unsuccessful attempts to read it. Something about the author's tone and writing style has been off-putting to me. I'm glad to read this thread and see that my reaction wasn't unusual.
For me it was the bit at the beginning, where he talks in detail about the Vietnam veteran and self-admitted war criminal, ignoring the political and moral context of the traumatic event experienced by the veteran, and glossing over the traumas inflicted by the veteran.
Recall the anecdote: the guy volunteered to take part in a brutal aggressive war, his buddies were killed. By his own admission, the guy responded to his trauma by committing horrible atrocities. And van der Kolk finds it unproblematic to focus on humanising the veteran, talking about his anger and family life and motorcycle rides, almost entirely ignoring the numerous moral angles but, more surprisingly, almost entirely ignoring the suffering and trauma inflicted by the guy in his revenge-war-crimes binge. van der Kolk's account of the incident and authorial choices are definitely gratuitously racist and pretty deep into some sort of imperialist apologia/genocide denial as far as I am concerned.
I would have thought someone who spent a career studying trauma would have thought through that sort of thing more carefully. Throughout the rest of the book, there are many other things that had me attacking the margins with an angry pencil. Basically the author displays selective and limited empathy, and adopts a smugly (kind of...Protestantly?) judgemental stance frequently enough that one is (if ignorant of the science and inclined to take it at face value, like me) kind of shocked that he'd have pursued an explicitly helping/caring profession when he obviously has so little regard for so many people.
There's plenty that's valuable in the book, and it's worth reading the whole thing, but the guy's personal insufferable-ness and blind spots and prejudices are palpable throughout. It's totally possible for a body of theory and practice to have good evidentiary support and explanatory power and therapeutic utility and whatever, while being presented in a package of ideological and moral trash by an obvious dingus, and I sort of thought TBKTS was that (and evidently had a strong reaction 'cause look at this rant).
posted by busted_crayons at 2:28 PM on August 3, 2023 [7 favorites]
For me it was the bit at the beginning, where he talks in detail about the Vietnam veteran and self-admitted war criminal, ignoring the political and moral context of the traumatic event experienced by the veteran, and glossing over the traumas inflicted by the veteran.
Recall the anecdote: the guy volunteered to take part in a brutal aggressive war, his buddies were killed. By his own admission, the guy responded to his trauma by committing horrible atrocities. And van der Kolk finds it unproblematic to focus on humanising the veteran, talking about his anger and family life and motorcycle rides, almost entirely ignoring the numerous moral angles but, more surprisingly, almost entirely ignoring the suffering and trauma inflicted by the guy in his revenge-war-crimes binge. van der Kolk's account of the incident and authorial choices are definitely gratuitously racist and pretty deep into some sort of imperialist apologia/genocide denial as far as I am concerned.
I would have thought someone who spent a career studying trauma would have thought through that sort of thing more carefully. Throughout the rest of the book, there are many other things that had me attacking the margins with an angry pencil. Basically the author displays selective and limited empathy, and adopts a smugly (kind of...Protestantly?) judgemental stance frequently enough that one is (if ignorant of the science and inclined to take it at face value, like me) kind of shocked that he'd have pursued an explicitly helping/caring profession when he obviously has so little regard for so many people.
There's plenty that's valuable in the book, and it's worth reading the whole thing, but the guy's personal insufferable-ness and blind spots and prejudices are palpable throughout. It's totally possible for a body of theory and practice to have good evidentiary support and explanatory power and therapeutic utility and whatever, while being presented in a package of ideological and moral trash by an obvious dingus, and I sort of thought TBKTS was that (and evidently had a strong reaction 'cause look at this rant).
posted by busted_crayons at 2:28 PM on August 3, 2023 [7 favorites]
Part of my thoughts on this I guess are why should the mind heal any better than skin does. You can get a cut and it can heal and you would never know it happened. Or you can get a cut that heals but leaves a scar. Scarred skin is not identical to unscarred skin but it can be just as functional especially after time and/or helpful treatment. Its not as easy to predict how a mind will heal or what helpful treatment would look like, but it doesn't have to be 'as if the trauma had never happened' to be functional and beautiful.
Significant bereavement is an example of an almost universal and completely normal trauma; after all, everyone does die eventually. It can cause wildly varying levels of ongoing difficulty for people sometimes related to how traumatic (in an informal sense) the bereavement was but sometime not. Pretty much everyone needs time to grieve, but after a year or so, only a minority of people need additional really good help in moving forwards.
posted by plonkee at 12:57 AM on August 4, 2023 [4 favorites]
Significant bereavement is an example of an almost universal and completely normal trauma; after all, everyone does die eventually. It can cause wildly varying levels of ongoing difficulty for people sometimes related to how traumatic (in an informal sense) the bereavement was but sometime not. Pretty much everyone needs time to grieve, but after a year or so, only a minority of people need additional really good help in moving forwards.
posted by plonkee at 12:57 AM on August 4, 2023 [4 favorites]
I mean, the prevailing perception in the corner of the field I read in is that yeah, trauma is so basically ubiquitous that relatively specific historical phenomena had to happen in order for us to realize it's not just the basic human condition, that we can actually do something about it in a useful way. That we can do things that make it better.
You know, the way it took us specific events and a lot of people working very hard to improve child mortality, which was also considered the basic human condition right up into the past hundred years or so. And solving that was widely considered hubristic in the same way by many people too.
Now think about the way that most humans would have experienced child death in their families, either in their own children or in siblings or among close family members or friends. We can all agree that child death is a traumatic incident, right? But it was such a normal part of life that it went largely unremarked for, again, nearly all of human history.
The reason we're aware of PTSD at all is because WWI (and later WWII) traumatized enormous swathes of entire nations at once and in a relatively uniform way while still allowing many of them to survive. That's actually an interesting story in its own right. Anyway my point here is that: yeah, of course this is common. That's the human condition. The goal is to find something like physical therapy, so you can regain the best range of function available to yourself without further damage. That doesn't necessarily mean reconciling yourself to being broken forever, and it certainly doesn't mean never focusing on anything else.
posted by sciatrix at 10:46 AM on August 4, 2023 [16 favorites]
You know, the way it took us specific events and a lot of people working very hard to improve child mortality, which was also considered the basic human condition right up into the past hundred years or so. And solving that was widely considered hubristic in the same way by many people too.
Now think about the way that most humans would have experienced child death in their families, either in their own children or in siblings or among close family members or friends. We can all agree that child death is a traumatic incident, right? But it was such a normal part of life that it went largely unremarked for, again, nearly all of human history.
The reason we're aware of PTSD at all is because WWI (and later WWII) traumatized enormous swathes of entire nations at once and in a relatively uniform way while still allowing many of them to survive. That's actually an interesting story in its own right. Anyway my point here is that: yeah, of course this is common. That's the human condition. The goal is to find something like physical therapy, so you can regain the best range of function available to yourself without further damage. That doesn't necessarily mean reconciling yourself to being broken forever, and it certainly doesn't mean never focusing on anything else.
posted by sciatrix at 10:46 AM on August 4, 2023 [16 favorites]
But making trauma an identity and making a trauma group your social group precludes the possibility of recovering from trauma.
Just pulling this out because that seems a common fear.
For the small percentage of people who do this, a group can be unhelpful (or the wrong therapist.) That bereavement support group sounds awful and I’m sorry that you went through that.
In my admittedly limited experience, there are people who seem from the outside to make trauma their identity for a time, and there are probably a few who do forever. I also think sometimes support groups have a lifecycle, unless they are professionally led.
if you’re taking about people with high ACE scores, I think there also is often a kind of evangelical period. And sure, it’s weird and annoying from the outside. Like holy shit, everything I thought was a normal reaction isn’t or might not be. It was overwhelming. For me I think that noisy period lasted a couple of years. Luckily I mostly whined online.
These are not in most cases symptoms of failure. They are part of a process that not everyone continues. Who continues can rest a lot on privilege. Easier for me than a residential school survivor.
I will also note identity is complex. People whose identities rest on single axes- former pageant queen, PTA mom, rational engineer, Christian, police officer, Cross Fit - can seem unbalanced.
I know when I was grieving I was very scared of getting stuck in Bereaved Mom. I now think that fear was actually my old trauma reactions — be normal, because you’re not, because something abnormal has happened but it must be your fault and if you can just be normal enough it won’t happen again.
Also in the case of trauma from childhood — there is an incredible pressure from families to get over it. Because then everyone can rest easy there was no lasting damage.
Then there are people who aren’t flamboyantly wounded but who are spending so much energy coping they are not able to realize their potential. And like…that’s ok. But I feel it. I finished my degree last year after I dropped out of two universities in my youth. That it took so long was not a tragedy. But I realized, this time when I got straight As and loved my classes — before, trauma made it so hard. I don’t think it’s stuck to say that.
Tl:dr - I think the fear that people get stuck because they are taking about trauma is overblown compared to the stuck of not addressing it. I really like the comparison to physical therapy.
posted by warriorqueen at 2:40 AM on August 5, 2023 [14 favorites]
Just pulling this out because that seems a common fear.
For the small percentage of people who do this, a group can be unhelpful (or the wrong therapist.) That bereavement support group sounds awful and I’m sorry that you went through that.
In my admittedly limited experience, there are people who seem from the outside to make trauma their identity for a time, and there are probably a few who do forever. I also think sometimes support groups have a lifecycle, unless they are professionally led.
if you’re taking about people with high ACE scores, I think there also is often a kind of evangelical period. And sure, it’s weird and annoying from the outside. Like holy shit, everything I thought was a normal reaction isn’t or might not be. It was overwhelming. For me I think that noisy period lasted a couple of years. Luckily I mostly whined online.
These are not in most cases symptoms of failure. They are part of a process that not everyone continues. Who continues can rest a lot on privilege. Easier for me than a residential school survivor.
I will also note identity is complex. People whose identities rest on single axes- former pageant queen, PTA mom, rational engineer, Christian, police officer, Cross Fit - can seem unbalanced.
I know when I was grieving I was very scared of getting stuck in Bereaved Mom. I now think that fear was actually my old trauma reactions — be normal, because you’re not, because something abnormal has happened but it must be your fault and if you can just be normal enough it won’t happen again.
Also in the case of trauma from childhood — there is an incredible pressure from families to get over it. Because then everyone can rest easy there was no lasting damage.
Then there are people who aren’t flamboyantly wounded but who are spending so much energy coping they are not able to realize their potential. And like…that’s ok. But I feel it. I finished my degree last year after I dropped out of two universities in my youth. That it took so long was not a tragedy. But I realized, this time when I got straight As and loved my classes — before, trauma made it so hard. I don’t think it’s stuck to say that.
Tl:dr - I think the fear that people get stuck because they are taking about trauma is overblown compared to the stuck of not addressing it. I really like the comparison to physical therapy.
posted by warriorqueen at 2:40 AM on August 5, 2023 [14 favorites]
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posted by hippybear at 3:40 PM on August 2, 2023 [1 favorite]