Over time as most people fail the survivor's exacting test of trustworthiness, she tends to withdraw from relationships. The isolation of the survivor thus persists even after she is free.
But on Kwajalein, the guards sought to deprive them of something that had sustained them even as all else had been lost: dignity. This self-respect and sense of self-worth, the innermost armament of the soul, lies at the heart of humanness; to be deprived of it is to be dehumanized, to be cleaved from, and cast below, mankind.
I was not descending in a plane, coming Home. I was watching an alien world as it ascended towards me - and one that I could never begin the process of readjusting to, because I knew that I would just as soon be returning to another world, whose normality was as alien to this home as I now was.
Traumatic events destroy the sustaining bonds between individual and community. Those who have survived learn that their sense of self, of worth, of humanity, depends upon a feeling of connection with others. The solidarity of a group provides the strongest protection against terror and despair, and the strongest antidote to traumatic experience. Trauma isolates; the group re-creates a sense of belonging. Trauma shames and stigmatizes; the group bears witness and affirms. Trauma degrades the victim; the group exalts her. Trauma dehumanizes the victim; the group restores her humanity.Repeatedly in the testimony of survivors there comes a moment when a sense of connection is restored by another person’s unaffected display of generosity. Something in herself that the victim believes to be irretrievably destroyed---faith, decency, courage---is reawakened by an example of common altruism. Mirrored in the actions of others, the survivor recognizes and reclaims a lost part of herself. At that moment, the survivor begins to rejoin the human commonality...
In response to threat and injury, animals, including humans, execute biologically based, non-conscious action patterns that prepare them to meet the threat and defend themselves. The very structure of trauma, including activation, dissociation and freezing are based on the evolution of survival behaviors. When threatened or injured, all animals draw from a "library" of possible responses. We orient, dodge, duck, stiffen, brace, retract, fight, flee, freeze, collapse, etc. All of these coordinated responses are somatically based- they are things that the body does to protect and defend itself. It is when these orienting and defending responses are overwhelmed that we see trauma.The bodies of traumatized people portray "snapshots" of their unsuccessful attempts to defend themselves in the face of threat and injury. Trauma is a highly activated incomplete biological response to threat, frozen in time. For example, when we prepare to fight or to flee, muscles throughout our entire body are tensed in specific patterns of high energy readiness. When we are unable to complete the appropriate actions, we fail to discharge the tremendous energy generated by our survival preparations. This energy becomes fixed in specific patterns of neuromuscular readiness. The person then stays in a state of acute and then chronic arousal and dysfunction in the central nervous system. Traumatized people are not suffering from a disease in the normal sense of the word- they have become stuck in an aroused state. It is difficult if not impossible to function normally under these circumstances.
So, what role does memory play in the understanding and treatment of trauma? There is a form of implicit memory that is profoundly unconscious and forms the basis for the imprint trauma leaves on the body/mind. The type of memory utilized in learning most physical activities (walking, riding a bike, skiing, etc.) is a form of implicit memory called procedural memory. Procedural or "body memories" are learned sequences of coordinated "motor acts" chained together into meaningful actions. You may not remember explicitly how and when you learned them, but, at the appropriate moment, they are (implicitly) "recalled" and mobilized (acted out) simultaneously. These memories (action patterns) are formed and orchestrated largely by involuntary structures in the cerebellum and basal ganglia.When a person is exposed to overwhelming stress, threat or injury, they develop a procedural memory. Trauma occurs when these implicit procedures are not neutralized. The failure to restore homeostasis is at the basis for the maladaptive and debilitating symptoms of trauma.
One of the paradoxical and transformative aspects of implicit traumatic memory is that once it is accessed in a resourced way (through the felt sense), it, by its very nature, changes. Out of the shattered fragments of her deeply injured psyche, Jody discovered and nurtured a nascent, emergent self. From the ashes of the frantically activated, hypervigilant, frozen, traumatized girl of twenty-five years ago, Jody began to reorient to a new, less threatening world. Gradually she shaped into a more fluid, resilient, woman, coming to terms with the felt capacity to fiercely defend herself when necessary, and to surrender in quiet ecstasy.
Escape from reality. In some instances, dissociation induces people to imagine that they have some kind of mastery over intractable environmental difficulties. Dissociation is often implicated in magical thinking or self-induced trance states. This aspect of dissociation is frequently found in abuse survivors. It is not uncommon for abused children to engage in magical thinking to retain an illusion of control over the situation (e.g., believing that they "cause" the perpetrator to act out).
Early relational trauma results from the fact that we are often given more to experience in this life than we can bear to experience consciously. This problem has been around since the beginning of time, but it is especially acute in early childhood where, because of the immaturity of the psyche and/or brain, we are ill-equipped to metabolize our experience. An infant or young child who is abused, violated or seriously neglected by a caretaking adult is overwhelmed by intolerable affects that are impossible for it to metabolize, much less understand or even think about.
Traumatic events, by definition, overwhelm our ability to cope. When the mind becomes flooded with emotion, a circuit breaker is thrown that allows us to survive the experience fairly intact, that is, without becoming psychotic or frying out one of the brain centers. The cost of this blown circuit is emotion frozen within the body. In other words, we often unconsciously stop feeling our trauma partway into it, like a movie that is still going after the sound has been turned off. We cannot heal until we move fully through that trauma, including all the feelings of the event.
If your body is screaming in pain, whether the pain is muscular contractions, anxiety, depression, asthma or arthritis, a first step in releasing the pain may be making the connection between your body pain and the cause. “Beliefs are physical. A thought held long enough and repeated enough becomes a belief. The belief then becomes biology.
...repeated trauma in childhood forms and deforms the personality. The child trapped in an abusive environment is faced with formidable tasks of adaptation. She must find a way to preserve a sense of trust in people who are untrustworthy, safety in a situation that is unsafe, control in a situation that is terrifyingly unpredictable, power in a situation of helplessness. Unable to care for or protect herself, she must compensate for the failures of adult care and protection with the only means at her disposal, an immature system of psychological defenses.
The traumatic moment becomes encoded in an abnormal form of memory, which breaks spontaneously into consciouness, both as flashbacks during waking states and as traumatic nightmares during sleep. Small, seemingly insignificant reminders can also evoke these memories, which often return with all the vividness and emotional force of the original event. Thus, even normally safe environments may come to feel dangerous, for the survivor can never be assured that she will not encounter some reminder of the trauma.
Attitude Is EverythingWe live in a culture that is blind to betrayal and intolerant of emotional pain. In New Age crowds here on the West Coast, where your attitude is considered the sole determinant of the impact an event has on you, it gets even worse.In these New Thought circles, no matter what happens to you, it is assumed that you have created your own reality. Not only have you chosen the event, no matter how horrible, for your personal growth. You also chose how you interpret what happened—as if there are no interpersonal facts, only interpretations.The upshot of this perspective is that your suffering would vanish if only you adopted a more evolved perspective and stopped feeling aggrieved. I was often kindly reminded (and believed it myself), “there are no victims.” How can you be a victim when you are responsible for your circumstances?When you most need validation and support to get through the worst pain of your life, to be confronted with the well-meaning, but quasi-religious fervor of these insidious half-truths can be deeply demoralizing. This kind of advice feeds guilt and shame, inhibits grieving, encourages grandiosity and can drive you to be alone to shield your vulnerability.
While in principle groups for survivors are a good idea, in practice it soon becomes apparent that to organize a successful group is no simple matter. Groups that start out with hope and promise can dissolve acrimoniously, causing pain and disappointment to all involved. The destructive potential of groups is equal to their therapeutic promise. The role of the group leader carries with it a risk of the irresponsible exercise of authority.Conflicts that erupt among group members can all too easily re-create the dynamics of the traumatic event, with group members assuming the roles of perpetrator, accomplice, bystander, victim, and rescuer. Such conflicts can be hurtful to individual participants and can lead to the group’s demise. In order to be successful, a group must have a clear and focused understanding of its therapeutic task and a structure that protects all participants adequately against the dangers of traumatic reenactment. Though groups may vary widely in composition and structure, these basic conditions must be fulfilled without exception.Commonality with other people carries with it all the meanings of the word common. It means belonging to a society, having a public role, being part of that which is universal. It means having a feeling of familiarity, of being known, of communion. It means taking part in the customary, the commonplace, the ordinary, and the everyday. It also carries with it a feeling of smallness, or insignificance, a sense that one’s own troubles are ‘as a drop of rain in the sea.’ The survivor who has achieved commonality with others can rest from her labors. Her recovery is accomplished; all that remains before her is her life.
She's terrified that all these sensations and images are coming out of her — but I think she's even more terrified to find out why." Carla's description was typical of survivors of chronic childhood abuse. Almost always, they deny or minimize the abusive memories. They have to: it's too painful to believe that their parents would do such a thing.
Carla's description was typical of survivors of chronic childhood abuse. Almost always, they deny or minimize the abusive memories. They have to: it's too painful to believe that their parents would do such a thing. So they fragment the memories into hundreds of shards, leaving only acceptable traces in their conscious minds. Rationalizations like "my childhood was rough," "he only did it to me once or twice," and "it wasn't so bad" are common, masking the fact that the abuse was devastating and chronic. But while the knowledge, body sensations, and feelings are shattered, they are not forgotten. They intrude in unexpected ways: through panic attacks and insomnia, through dreams and artwork, through seemingly inexplicable compulsions, and through the shadowy dread of the abusive parent. They live just outside of consciousness like noisy neighbors who bang on the pipes and occasionally show up at the door.
I'm not crazy, I was abused. I'm not shy, I'm protecting myself. I'm not bitter, I'm speaking the truth. I'm not hanging onto the past, I've been damaged. I'm not delusional, I lived a nightmare. I'm not weak, I was trusting. I'm not giving up, I'm healing. I'm not incapable of love, I'm giving. I'm not alone. I see you all here. I'm fighting this.
Traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from their selves.” (p.97)
Generally the rational brain can override the emotional brain, as long as our fears don’t hijack us. (For example, your fear at being flagged down by the police can turn instantly to gratitude when the cop warns you that there’s an accident ahead.) But the moment we feel trapped, enraged, or rejected, we are vulnerable to activating old maps and to follow their directions. Change begins when we learn to "own" our emotional brains. That means learning to observe and tolerate the heartbreaking and gut-wrenching sensations that register misery and humiliation. Only after learning to bear what is going on inside can we start to befriend, rather than obliterate, the emotions that keep our maps fixed and immutable.
The victims of PTSD often feel morally tainted by their experiences, unable to recover confidence in their own goodness, trapped in a sort of spiritual solitary confinement, looking back at the rest of the world from beyond the barrier of what happened. They find themselves unable to communicate their condition to those who remained at home, resenting civilians for their blind innocence.The Moral Injury, New York Times. Feb 17, 2015
Blame is a Defense Against PowerlessnessBetrayal trauma changes you. You have endured a life-altering shock, and are likely living with PTSD symptoms— hypervigilance, flashbacks and bewilderment—with broken trust, with the inability to cope with many situations, and with the complete shut down of parts of your mind, including your ability to focus and regulate your emotions.Nevertheless, if you are unable to recognize the higher purpose in your pain, to forgive and forget and move on, you clearly have chosen to be addicted to your pain and must enjoy playing the victim.And the worst is, we are only too ready to agree with this assessment! Trauma victims commonly blame themselves. Blaming oneself for the shame of being a victim is recognized by trauma specialists as a defense against the extreme powerlessness we feel in the wake of a traumatic event. Self-blame continues the illusion of control shock destroys, but prevents us from the necessary working through of the traumatic feelings and memories to heal and recover.
When you have a persistent sense of heartbreak and gutwrench, the physical sensations become intolerable and we will do anything to make those feelings disappear. And that is really the origin of what happens in human pathology. People take drugs to make it disappear, and they cut themselves to make it disappear, and they starve themselves to make it disappear, and they have sex with anyone who comes along to make it disappear and once you have these horrible sensations in your body, you’ll do anything to make it go away.
Fear and anxiety affect decision making in the direction of more caution and risk aversion... Traumatized individuals pay more attention to cues of threat than other experiences, and they interpret ambiguous stimuli and situations as threatening (Eyesenck, 1992), leading to more fear-driven decisions. In people with a dissociative disorder, certain parts are compelled to focus on the perception of danger. Living in trauma-time, these dissociative parts immediately perceive the present as being "just like" the past and "emergency" emotions such as fear, rage, or terror are immediately evoked, which compel impulsive decisions to engage in defensive behaviors (freeze, flight, fight, or collapse). When parts of you are triggered, more rational and grounded parts may be overwhelmed and unable to make effective decisions.
Patients with complex trauma may at times develop extreme reactions to something the therapist has said or not said, done or not done. It is wise to anticipate this in advance, and perhaps to note this anticipation in initial communications with the patient. For example, one may say something like, "It is likely in our work together, there will be a time or times when you will feel angry with me, disappointed with me, or that I have failed you. We should except this and not be surprised if and when it happens, which it probably will." It is also vital to emphasize to the patient that despite the diagnosis and experience of dividedness, the whole person is responsible and will be held responsible for the acts of any part. p174
As long as you keep secrets and suppress information, you are fundamentally at war with yourself…The critical issue is allowing yourself to know what you know. That takes an enormous amount of courage.
Several researchers demonstrate the ways people fail to label trauma as such or underreport traumatic experiences. In a sample of 1,526 university students, Rausch and Knutson (1991) found that although participants reported receiving punitive treatment similar to that of their siblings, they were more than twice as likely to identify their siblings’ experiences as abusive as they were to label their own in this way. The authors reported that participants were likely to interpret parental treatment toward themselves but not parental treatment toward their siblings as deserved and therefore not abusive. Other studies similarly indicate that those reporting abuse experiences often do not demonstrate a metaconsciousness of having been abused (Goldsmith & Freyd, in press; Koss, 1998; Varia & Abidin, 1999; Weinbach & Curtiss, 1986)." KNOWING AND NOT KNOWING ABOUT TRAUMA: IMPLICATIONS FOR THERAPY (2004)
Psychological trauma is an affliction of the powerless. At the moment of trauma, the victim is rendered helpless by overwhelming force. When the force is that of nature, we speak of disasters. When the force is that of other human beings, we speak of atrocities. Traumatic events overwhelm the ordinary systems of care that give people a sense of control, connection, and meaning.… Traumatic events are extraordinary, not because they occur rarely, but rather because they overwhelm the ordinary human adaptations to life.… They confront human beings with the extremities of helplessness and terror, and evoke the responses of catastrophe.
It is a rare person who can cut himself off from mediate and immediate relations with others for long spaces of time without undergoing a deterioration in personality.
There needs to be a nationwide awareness programme for all NHS staff, to educate them about dissociative disorders. Diagnoses need to be more obtainable within the NHS; people's lives should be placed ahead of funding restraints and bureaucratic red tape. We need minimum standards of care and treatment agreed and implemented within the NHS to end the current nightmare of the postcode lottery—not just guidelines that can be ignored but actual regulations.
Dissociative identity disorder is conceptualized as a childhood onset, posttraumatic developmental disorder in which the child is unable to consolidate a unified sense of self. Detachment from emotional and physical pain during trauma can result in alterations in memory encoding and storage. In turn, this leads to fragmentation and compartmentalization of memory and impairments in retrieving memory.2,4,19 Exposure to early, usually repeated trauma results in the creation of discrete behavioral states that can persist and, over later development, become elaborated, ultimately developing into the alternate identities of dissociative identity disorder.
When preparing for Book One, I talked to a couple of psychiatrists about psychosomatic phenomena, neuroses and dissociative conditions, for example the so—called hysterical blindness suffered by many who saw the Killing Fields in Pol Pot’s Cambodia: their eyes objectively see, but they are not aware of it and are blind because they believe they can’t see. One specialist told me that among modern Western people, ’metaphorical’ symptoms such as Fredy or those Cambodians evince are much rarer now than earlier in the twentieth century or before. Nowadays most people are better equipped by education to verbalise their neuroses, and have lots of jargon in which to do so. For most of the dissociative dimension, I could draw on things I knew from within myself.
Trauma destroys the fabric of time. In normal time you move from one moment to the next, sunrise to sunset, birth to death. After trauma, you may move in circles, find yourself being sucked backwards into an eddy or bouncing like a rubber ball from now to then to back again. ... In the traumatic universe the basic laws of matter are suspended: ceiling fans can be helicopters, car exhaust can be mustard gas.
However, if you do not believe your clients, they may sense your doubt and never fully trust you. As Bruce Goderez (1986), director of a PTSD inpatient unit says, "It is important for the clinician and counselor to be willing to be made a fool." In other words, it is better that you believe a client who is lying or distorting the truth than to disbelieve a hurting trauma survivor who may never seek help again if your attitude is one of disbelief or disdain. Even if that client were to continue in therapy, they would never fully trust you.
Victims”, by definition, are those that have just experienced a trauma of some sort. They are going through an entire array of emotions and circumstances that are happening to them internally and/or externally. They are trying to wrap their mind around what just happened to them. They are trying to regain some sort of balance in their mind. They feel violated, cheated, confused, scared, insecure, ashamed, guilty, impotent and at a loss for words/actions/thoughts. Many times, they even feel numb and in shock. Their mind is in a state of crisis and chaos. They are in the “victim stage”. They are truly a “victim” by definition.
You are no longer human, with all those depths and highs and nuances of emotion that define you as a person.There is no feeling any more, because to feel any emotion would also be to beckon the overwhelming blackness from you. My mind has now locked all this down. And without any control of this self-defence mechanism my subconscious has operated. I do not feel any more.
Too often the survivor is seen by [himself or] herself and others as "nuts," "crazy," or "weird." Unless her responses are understood within the context of trauma. A traumatic stress reaction consists of *natural* emotions and behaviors in response to a catastrophe, its immediate aftermath, or memories of it. These reactions can occur anytime after the trauma, even decades later. The coping strategies that victims use can be understood only within the context of the abuse of a child. The importance of context was made very clear many years ago when I was visiting the home of a Holocaust survivor. The woman's home was within the city limits of a large metropolitan area. Every time a police or ambulance siren sounded, she became terrified and ran and hid in a closet or under the bed. To put yourself in a closet at the sound of a far-off siren is strange behavior indeed—outside of the context of possibly being sent to a death camp. Within that context, it makes perfect sense. Unless we as therapists have a good grasp of the context of trauma, we run the risk of misunderstanding the symptoms our clients present and, hence, responding inappropriately or in damaging ways.
Without trauma-informed treatment, traumatized clients may not respond optimally and they may even be re-traumatized by the mental health system if they are labeled as “treatment resistant” because the treatment does not address the core issue of trauma; some may be misunderstood as fabricating or exaggerating their trauma history or symptoms.
In the culture people talk about trauma as an event that happened a long time ago. But what trauma is, is the imprints that event has left on your mind and in your sensations... the discomfort you feel and the agitation you feel and the rage and the helplessness you feel right now.
In this paper I propose the existence of two distinct presentations of DID, a Stable and an Active one. While people with Stable DID struggle with their traumatic past, with triggers that re-evoke that past and with the problems of daily functioning with severe dissociation, people with Active DID are, in addition, also engaged in a life of current, on-going involvement in abusive relationships, and do not respond to treatment in the same way as other DID patients. The paper observes these two proposed DID presentations in the context of other trauma-based disorders, through the lens of their attachment relationship. It proposes that the type, intensity and frequency of relational trauma shape—and can thus predict—the resulting mental disorder. - Through the lens of attachment relationship: Stable DID, Active DID and other trauma-based mental disorders
Much, much later. when I am back home and being treated for Post Traumatic Stress Disorder (PTSD). I will be enabled to see what was going on in my mind immediately after 11 August.I am still capable of operating mechanically as a soldier in these following days. But operating mechanically as a soldier is now all I am capable of.Martin says he is worried about me. He says I have the thousand-yard stare'.Of course, I cannot see this stare. But by now we both have more than an idea what it means.So, among all the soldiers here, this is nothing to be ashamed of. But as it really does just go with the territory we find ourselves in. it is just as equally not a badge of h
Dr. Peter Levine, who has worked with trauma survivors for twenty-five years, says the single most important factor he has learned in uncovering the mystery of human trauma is what happens during and after the freezing response. He describes an impala being chased by a cheetah. The second the cheetah pounces on the young impala, the animal goes limp. The impala isn’t playing dead, she has “instinctively entered an altered state of consciousness, shared by all mammals when death appears imminent.” (Levine and Frederick, Waking the Tiger, p. 16) The impala becomes instantly immobile. However, if the impala escapes, what she does immediately thereafter is vitally important. She shakes and quivers every part of her body, clearing the traumatic energy she has accumulated.
In 1973, Jan Erik Olsson walked into a small bank in Stockholm, Sweden, brandishing a gun, wounding a police officer, and taking three women and one man hostage. During negotiations, Olsson demanded money, a getaway vehicle, and that his friend Clark Olofsson, a man with a long criminal history, be brought to the bank. The police allowed Olofsson to join his friend and together they held the four hostages captive in a bank vault for six days. During their captivity, the hostages at times were attached to snare traps around their necks, likely to kill them in the event that the police attempted to storm the bank. The hostages grew increasingly afraid and hostile toward the authorities trying to win their release and even actively resisted various rescue attempts. Afterward they refused to testify against their captors, and several continued to stay in contact with the hostage takers, who were sent to prison. Their resistance to outside help and their loyalty toward their captors was puzzling, and psychologists began to study the phenomenon in this and other hostage situations. The expression of positive feelings toward the captor and negative feelings toward those on the outside trying to win their release became known as Stockholm syndrome.
When experiences or emotions become too overwhlming, the mind clevely encapsulates the material and stores it for safe-keeping. Many people respond this way in the face of trauma, but the additional step that occurs in this process, in the case of DID, is the formation of distinct ego states that carry the experience.
One of Coin's men lays a hand on my arm. Its not an aggressive move, really, but after the arena's I react defensively to any unfamiliar touch. I jerk my arm free and take off running down the halls. My mind does a quick inventory of my odd little hiding places and i wind up in the supply closet, curled up against a crate of chalk.
July 15, 1991Nita: My mother was a paragon of our neighborhood, People always come up to us with hugs, saying "You have the most wonderful mother." l'd think. “Don't you see what's going on in this house?” To this day, if somehow even in jest raises their hand to me, I will do this (raises hands to protect face and cowers) I cringe. Then they look at me like, what's your probem? You don't get that from a great childhood.
Complexly traumatized children need to be helped to engage their attention in pursuits that do not remind them of trauma-related triggers and that give them a sense of pleasure and mastery. Safety, predictability, and "fun" are essential for the establishment of the capacity to observe what is going on, put it into a larger context, and initiate physiological and motoric self-regulation.
TRAUMA STEALS YOUR VOICE People get so tired of asking you what's wrong and you've run out of nothings to tell them. You've tried and they've tried, but the words just turn to ashes every time they try to leave your mouth. They start as fire in the pit of your stomach, but come out in a puff of smoke. You are not you anymore. And you don't know how to fix this. The worst part is...you don't even know how to try.
The culture and heritage should stay intact and be maintained as it provides the individuals with some degree of resiliency. The effects of the trauma is what should be focused on and treated. Improving the quality of life for survivors is the focus of treatment. It is not to erase the past.
In 2006, there is no army of recovered memory therapists, and Dr McNally’s assumptions about patients with PTSD and those working in this field are troubling. Owing to past debates, those working in the PTSD field are perhaps more knowledgeable than others about malingered, factitious, and iatrogenic variants.Why, then, does Dr McNally attack PTSD as a valid diagnosis, demean those working in the field, and suggest that sufferers are mostly malingered or iatrogenic, while giving little or no consideration is given to such variants of other psychiatric conditions? Perhaps the trauma field has been “so often embroiled in serious controversy” (4, p 816) for the same reason Dr McNally and others have trouble imagining the traumatization of a Vietnam War cook or clerk. One theory suggests that there is a conscious decision on the part of some individuals to deny trauma and its impact. Another suggests that some individuals may use dissociation or repression to block from consciousness what is quite obvious to those who listen to real-life patients."Cameron, C., & Heber, A. (2006). Re: Troubles in Traumatology, and Debunking Myths about Trauma and Memory/Reply: Troubles in Traumatology and Debunking Myths about Trauma and Memory. Canadian journal of psychiatry, 51(6), 402.
Yolanda Gampel utilizes an expanded concept of the "uncanny" to outline the results of violence: Those who experience such traumas are faced with an unbelievable and unreal reality that is incompatible with anything they knew previously. As a result, they can no longer fully believe what they see with their own eyes; they have difficulty distinguishing between the unreal reality they have survived and the fears that spring from their own imagination.
A refusal on the part of psychiatrists and therapists to validate the horrors of their patients' tortured past implies a refusal to take seriously the unconscious psychological mechanisms that individuals need to use to protect themselves from the unspeakable. Such a denial is, however, no longer ethical, for it is in the human capacity to dissociate that lies part of the secret of both childhood abuse and the horrors of the Nazi genocide, both forms of human violence so often carried out by 'respectable' men and women.
Eighty two percent of the traumatized children seen in the National Child Traumatic Stress Network do not meet diagnostic criteria for PTSD.15 Because they often are shut down, suspicious, or aggressive they now receive pseudoscientific diagnoses such as “oppositional defiant disorder,” meaning “This kid hates my guts and won’t do anything I tell him to do,” or “disruptive mood dysregulation disorder,” meaning he has temper tantrums. Having as many problems as they do, these kids accumulate numerous diagnoses over time. Before they reach their twenties, many patients have been given four, five, six, or more of these impressive but meaningless labels. If they receive treatment at all, they get whatever is being promulgated as the method of management du jour: medications, behavioral modification, or exposure therapy. These rarely work and often cause more damage.