Tuesday, July 29, 2008

Complex Trauma

Working in the trauma field for nearly three years has taught me the complexities of the human experience. Many clients who come into the clinic not only have experienced severe trauma, but they have identified with it, made it part of their personality and identity, been a direct contributor to the trauma thus being responsible for the trauma itself, or they stay in denial of the trauma to avoid guilt, shame, and responsibility. What makes the situation complex is that there are many layers to the trauma. There is the actual traumatic event(s), the person's interpretation of the events, the person's sense of identity with the trauma, the sense of responsibility, the guilt/shame involved with the trauma, the relationship with the trauma (i.e. if it was caused by a familiar person or situation). Therefore, there is no cookie cutter way to get to the trauma core and resolve everything all at once. There is too much to each individual to take into account every aspect to the trauma experience. The treatment then requires an eclectic and pragmatic approach. Many times, reality therapy is required in order to aid the client to come to grips with what truly happened and normalizing the effects. Some remain in consistent denial and avoid the truth or even lie to themselves or others. Some may even be directly involved with the trauma and responsible for it happened in one form or another. Such a situation is even more complex due to the underlying guilt and shame. If there are negative coping skills used to avoid the feelings of guilt and responsibility, that is just another layer that MUST be addressed and resolved before the trauma is resolved. One layer at a time.