Trauma turns the world upside down and inside out, disrupting our ability to process feelings and meaning. In psychology, the word “affect” is used to mean emotions or feelings. A big part of trauma-informed psychotherapy is about working to process trauma-linked emotions and regaining—or learning—affect regulation and affect tolerance.
Donald Kalsched, author of The Inner World of Trauma, offers us his useful definition of trauma: “Trauma is about the fact that we are all given more to experience in this life than we can bear to experience consciously.” (This quote is from a lecture Dr. Kalsched gave by the title “Glimpses Through the Veil: Encounters With the Numen of Clinical Work,” which can be viewed on YouTube.)
Kalsched emphasized Dr. Paul Russell’s quote that “trauma is primarily an injury to the capacity to feel.” The work of the psychotherapist is to create an empathic field in which the trauma survivor can learn to recognize and bear feelings linked to the trauma that were previously experienced as overwhelming to the point they had to be dissociated due to the threat posed to the essential integrity of the self. We call this clinical work developing affect tolerance, or the ability to bear painful and threatening emotions that have been pushed down or away from conscious awareness during the experience of trauma.
One of the side effects of this dissociation of trauma-related emotions is a loss of vitality—the feeling of being fully alive. In this state, the survivor often experiences feelings of deadness or emotional numbness. This leads to feeling stagnated, detached, and estranged from others.
Once these feelings that have been buried alive have been freed to the light of consciousness, emotional life and connection can resume. Kalsched reminds us that the goal of meaningful clinical work is to help the survivor fall in love with the life they are living. But this means letting go of the life that was lived prior to the trauma. Trauma changes us. There is self before the trauma, and self after the trauma. This change can be difficult to accept. There are feelings of loss and grief that must be addressed.
I think of devastating trauma as being like a forest fire that engulfs all life in its path, leaving only burned ash in its wake. With the support of effective psychotherapy, a richness of unsurpassed life can replace the smoldering ash-covered land. Being able to recover the capacity to imagine and feel are central to this recovery.
One of the great tools in this work are trauma-related dream images and flashbacks that contain the story of what was too overwhelming to consciously experience in its totality. These images, while often horrific, can serve as the psychotherapeutic entrance to processing the trauma which will ultimately allow the trauma survivor to reclaim the life they were meant to live and the sense of their right to be fully alive in this world.
Psychotherapy is necessary because we cannot be aware of that which we have split off in the traumatogenic process. This splitting-off results in what Winnicott (1960a) termed the "False Self." This creation of a second self serves as a defense against ejected aspects of the overwhelming trauma experience which threatened the core of selfhood. Because it is ejected, dissociated, and disowned, it becomes free to take on a life of its own. This false, defensive, inner center can direct self-destructive behavior patterns, i.e., aggression towards self. Alcohol, drug abuse, or other addictive patterns can develop out of this defensive, self-defeating drive.
Effective psychotherapy creates the safe vessel in which these split off, unconsciously exiled fragments can be claimed and a life-sustaining meaning forged that is true to the "True Self." A life can then be lived that is authentic and allows for full actualization of one’s potential.
The horrific images of trauma are actually miraculous gifts the mind produces that can facilitate healing. They are artifacts of what on the outside overwhelmed us, and what we need to process in order to move on and not remain stuck in the inner world of trauma.
Kalsched, Donald (1996). The Inner World of Trauma. Archetypal Defenses of the Personal Spirit. New York: Routledge.
Winnicott, D.W. (1960). The Maturational Processes and the Facilitating Environment. London: Hogarth