Trauma Articles

Superstitions: Coping with Uncertainty

Tuesday, May 27th, 2014

black catAre you superstitious? Do you knock on wood? Wear a lucky jersey when your favorite team plays? Believe deaths occur in three’s or use your horoscope as a life guide?

If so, you are not alone. It may surprise you to know that according to a 2012 CBS News poll, 51% of Americans endorse “knocking on wood” to insure good luck or ward off adversity, and 17% of Americans believe in the power of sports superstitions, like fans wearing lucky hats, to determine the outcome of a game!


The Ohio Kidnapping Case:The Moral Injury of Witnessing Atrocity

Thursday, May 16th, 2013

oldcoupleonbenchIn the past two weeks it has been difficult to be anywhere without reading or hearing about the Ohio Kidnapping, 10 year captivity, sexual abuse, torture and beatings causing miscarriages to three young woman and one daughter, locked in a neighborhood house by one man.

Both in and outside of my office people have commented and questioned:

  • How does something like this happen?
  • I can’t watch the news anymore.
  • How could the neighbors not know?
  • Why is there such evil in the world?
  • I could never have survived. 
  • Can these women ever be the same?

Judith Herman tells us that a traumatic event is one that has the capacity to provoke fear, helplessness, or horror in response to the threat of injury or death, or witnessing that in another.

When the trauma is that of nature, we speak of disaster.

When the trauma is man-made, we speak of atrocities.

It is worth considering that in face of this Ohio atrocity, whether we live in that neighborhood or witness the horror in the virtual community of viewers, we cannot easily shake this inhumanity because it is not only traumatizing— it evokes moral injury.

According to psychologist Brett Litz, moral injury is the (social, psychological, spiritual, behavioral) impact of perpetrating, failing to prevent or bearing witness to acts that transgress our deeply held moral beliefs and expectations.

Much like the impact of bearing witness to the horror of the Holocaust, the Genocide in Rwanda, or the modern slavery of human sex trafficking, the Ohio kidnapping transgresses our moral code.

  • We are compelled to talk about it, read about it, rage and despair in face of it because it assaults our beliefs and implicates our humanity.
  • We not only identify with the fear and terror of victims, we fear that we could resonate with the guilt and shame of perpetrators.
  • It disturbs us on many levels.
  • As humans it is beyond us to accept that one of us could do this to another.
  • Yael Danieli suggests that in face of moral horror, we suffer the “Guilt of the Just.”

How Do We Deal …


Surviving and Succeeding in Face of Uncertainty: Six Strategies

Tuesday, April 30th, 2013

uncertaintyEvents like the Boston Marathon Bombing, Hurricane Sandy’s Devastation, The Newtown CT School Shooting and the many traumatic events they echo, assault us with the uncertainties of life.

Leaving death and destruction in their path, such events undermine our necessary denial that life is predictable, that children can be safe and that we can be in control.

For a time, we are left wounded, shaken, vulnerable and afraid. Caught in the traumatic moment, we fill in the future unknowns with expectations of more of the same trauma so that next time we will be ready.

Eventually, despite the memory, the extreme loss, the bodily injuries and even the fear, we want our lives back, we want our children to play, and we want to smile…

We need to find a way to survive and at times even succeed with life’s uncertainties.

Here are six strategies that may begin to answer that need. Some you may already use. Some you may want to consider.

Validation of True Self

  • Often recognition of who we are and what we need in life out-trumps the fear of uncertainty. In her personal description of running the Boston Marathon, runner and blogger, Chrissy Horan describes that although finishing as the first bomb went off, she has struggled with grief and sadness for those killed and injured, with “what if” she had walked through the last water stops, with tears and with questions of safety. Notwithstanding the uncertainty, however, she like many throughout the country put her sneakers back on to run. As she says, “ It is just what I do.”
  • Not dissimilar are Long Islanders now six months after Hurricane Sandy, who report that faced with extreme weather patterns, altered and destroyed shore lines, partial renovations, houses raised and more hurricanes coming–they are afraid. Many have for the first time considered leaving. Most will wait and see. They report a “magnetic draw” to the water. As one man who feels that his family could not survive another Hurricane Sandy said, “We don’t have very long memories . . . We live on an island and this is …

When Injury Disrupts Exercise: Five Ways to Reduce Stress

Thursday, March 21st, 2013

sneakersThere is considerable evidence that exercise benefits our mental health. Research suggests that in addition to improving memory, lifting mood, moderating depression, and reducing attention fatigue, exercise is a significant stress reducer.

Whether you are a varsity player, a daily walker, a gym rat or an avid golfer, it is likely that the exercise you do helps you psychologically as well as physically. What happens when you get injured?

In most cases physical injury happens in the two minutes we never see coming.  It is physically and psychologically disruptive because it not only involves physical pain and concern about intervention and recovery; it reminds us of the unpredictability of life, and the reality of our vulnerability. For athletes, as well as those determined to exercise, it is a loss that insults our sense of self as well as our sense of mastery.

 “ I can’t be injured, we are in the semi-finals. I have to play!”

 “ I just got the motivation and the routine going and now I break my ankle?”

 “ What will I do if I can’t golf?”

  • If you have ever been taken off the court or out of your usual routine by injury, it is likely you have felt the constraints of a Catch 22.
  • At a time when you are feeling more pain and stress than usual, the one thing you can’t do is use your usual stress reducer–Exercise will make matters worse!

How Do You Proceed?

No matter what anyone says in the first hours, days or week of an injury, it won’t feel right.

“ So You Won’t Run Anymore- You will Do Something Else!” 

“ Don’t Worry—You will be back.”

It is difficult to suddenly adjust to the loss of something that has added value to your life and it is also difficult to suddenly believe you will be ok, when you don’t feel ok. But it does get better…

What seems impossible starts to become possible when you realize there are many ways to reduce stress if you are able to focus on healing, open options, risk possibilities, and draw upon your resiliencies.

Five Ways To Reduce Stress

Become …


The Family Story of Trauma: Ways to Change the Legacy

Sunday, February 17th, 2013

family story of traumaWhether in the past or the present, a traumatic event experienced by one or all members of a family, impacts the entire family system. Be it the violent loss of a child, the devastation from natural disaster, the injury of a combat vet or the suicide of a family member, trauma assaults the lives of all family members and the legacy they share.

How Does a Family Cope?

One of the most important things a family can do in the aftermath of a traumatic event is to find a way over the days, months and even years “to speak about what happened.”

All families engage in story telling. Around the dinner table, in car pools, at holidays, in the middle of the night, family members share the day-to-day experiences of big and small events in their lives. Through the stories they tell, families create the fabric of their life and their legacy.

Why is it Difficult for Families to Speak About Trauma?

  • Families have a difficult time speaking about traumatic events because traumatic events assault the fabric of family life.
  • They are unexpected events that threaten, injure, and take the life that was known and the people that were loved.
  • They leave family members overwhelmed, frightened, angry, haunted with images, self-blaming, and bereft.
  • They are beyond what family members can physically and emotionally comprehend.
  •  Traumatic events feel “beyond words”.

Family Protection Through Silence and Avoidance

Given this impact of trauma, the inclination of many family members is to protect each other by not speaking about the trauma.In an effort to spare others from more pain, prevent the stirring of feelings, avoid contaminating with traumatic memories, or burdening the family with grief, both adults and children disavow history, deny feelings and often avoid connection. The myth is that “if we don’t talk about it we can live beyond it.”

Historically we know that the opposite is true. As  trauma expert, Cathy Caruth says, trauma “will out” in one way or another in spite of being silenced or denied. What can’t be said must be carried and acted out.


Tattoos After Trauma-Do They Have Healing Potential?

Monday, December 31st, 2012

Whether you have many tattoos or would never consider getting one, you may be surprised to learn that 40% of Americans between the ages 26-40 and 36% between ages 18-25 have at least one tattoo.

Once associated with marginalized, oppressed, victimized or transient groups in the population, tattoos are increasingly part of mainstream culture.

Americans spend $1.65 billion dollars annually on tattoos.

While the reasons for tattoos are as varied as the people who choose to get them, certain trends have been identified. One is the choice of a tattoo in the aftermath of trauma.

  • Across generations and wars, those in the military have used tattoos as tributes to fallen comrades.
  • In the aftermath of 9/11, civilians and firefighters throughout the world choose tattoos as an indelible reminder of the  terrorist assault, the courage of First Responders and the loss of so many.
  • Sociologists, Glen Gentry and Derek Alderman estimate that there are thousands of Katrina and New Orleans-related tattoos reflecting both horrific images of crumbling buildings and gushing floodwater, as well as signs and symbols of a beloved city.
  • In the wake of the unprecedented destruction from Hurricane Sandy, tattoos and tattoo fundraisers have emerged. The message of one seems particularly meaningful- “ Hold Steadfast.”

Do These Tattoos Have Healing Potential?

A close consideration suggests that both the reasons and the choice of tattoos reflect many of the factors associated with recovery after trauma.

Healing From the Body Out

  • Whether a traumatic event involves a car accident, escape from freezing floodwaters or the loss of a child, it is registered in our body in terms of the survival reflexes of fight, flight and freeze.
  • Encoded under these conditions, our memory of the traumatic event is not registered as narrative, but as fragments of highly charged visual images, bodily feelings, tactile sensations or sensory reactivity to reminders of the event.
  • As such, trauma experts encourage us to work from the body out in the course of recovery and healing—to attend to the sensations, senses, and images that carry the imprint of trauma.

The tattoo’s use of the body to register a …


Coping with the Holidays: Family Bonds and Family Binds

Friday, December 21st, 2012

While many may aspire to a Hallmark Holiday Season, the reality is that the holiday season involves real people in real families doing the best that they can do.

Most families are a group of related people of different ages with a mix of personalities, needs, feelings and expectations. They may be a nuclear family, an extended family, a reconstituted family or a blended family. In any case, they share an identity as family and, as such, consciously and unconsciously have an impact upon each other.

Their lives can be touched by the joy shared by one family member, the excitement of another and the heartache and loss of still another –sometimes all on the same day.

Most would agree that at times of pain and joy, families are the greatest source of support and the greatest source of applause. They can also be the greatest source of stress.

Holidays seem to turn the volume up on all possibilities.


You Needed Last Night’s Dream: Research and Re-thinking

Monday, October 22nd, 2012

Whereas there is increasing recognition of the importance of sleep, there is less awareness that one of the reasons we need to sleep is that we need to dream.

Even though you may not remember them, you dream several times a night.  In a typical lifetime, we spend about six years dreaming.

Throughout time and across cultures man has ascribed importance to dreams. Recognized for his seminal contribution of The Interpretation of Dreams, Freud considered dreams as the royal road to the unconscious. According to him, dreams represented instinctual aggressive and sexual drives pressing for discharge. Disguised by the primary process of symbols, displacements and condensations, the dream was believed to represent hidden instinctual wish fulfillment.

While dreamers still make important use of the metaphors and symbolic representations in their dreams, the royal road has been expanded and repaved.

Evolving psychological theory and research from Brain Science reveal that well beyond wish fulfillment, we need and use dreams in the organization of data, the consolidation of memory, the integration of skills and the regulation of psychological functioning.

Matt Wilson of the Massachusetts Institute of Technology tells us “ Dreaming is a process, and not only is it useful, it may be essential for making sense of the world.”

Important in understanding the function of dreams are the new findings on sleep cycles:

  • Early dream studies had found that at those times when sleepers were deeply asleep with muscle tone at zero, they were exhibiting rapid eye movement (REM). When awakened, they reported dreaming. This was termed REM Sleep.
  • We now understand that most people sleep in 90 minute cycles in which they descend from light sleep, stage 1, without rapid eye movements (non-REM) to deep non-REM sleep (stages 3 and 4, also known as “slow-wave sleep”), then begin a return journey; but don’t quite make it. Just before waking, we enter REM sleep after which we repeat the cycle four or five times a night.
  • Lab studies reveal that we have dreams in both phases of sleep and that non-REM dreams and REM dreams actually serve different functions.

The …


Finding New Meaning In Life After Trauma:Three Guidelines

Tuesday, September 11th, 2012

This weekend the Wounded Warrior Project came to our town. Many had the opportunity to run the 4-mile race next to veterans and their families. The t-shirt of the young man in front of me read “ New Year’s Eve 5K, Afghanistan. ” Many were wearing shirts that read, “ If you Like Freedom- Thank a Vet.”  The father of a vet wore a shirt that read, “ We’ve got them back-Now Welcome Them Home.”

As of August 12, 2012 there are 49,251 wounded service members, 320,000 suffering with Traumatic Brain Injury and 400,000 with PTSD. We have lost 6,549 of our men and women to war.

On the 11th Anniversary of 9/11, thousands remembered an unprecedented terrorist attack on this country that took the lives of close to 3,000 worldwide and plunged us into war. It was an event shared publically by the world and suffered privately by too many.

How Do We Go On In The Aftermath Of Pain And Traumatic Loss?

The answer offered by well-known author and Holocaust survivor, Victor Frankel is consistent with positive psychology, definitions of posttraumatic growth and the nature of the human spirit to hope.

  • He suggests that we find new meaning in life, something that he recognizes as difficult in face of the tragic aspects of life –pain, guilt and death.
  • Frankl suggests that it is not a search for happiness, but for a reason to be happy despite suffering.

Here are three possible guidelines for finding your way to new meaning in life after trauma:

Meaning by the Hour

In his wisdom, Frankl clarified that finding a new meaning in life does not mean arriving at a single goal that will direct the rest of your life, or make sense of evil. Rather finding new meaning in life should be translated to finding a reason to go on, to having a purpose, to feeling valuable in the hour, the day, the week.

A 14-year-old adolescent girl, who lost her Dad on 9/11, has struggled for these 11 years with shyness, loss of two grandfathers, few friends and the …


Recognizing and Understanding Depression After Trauma

Thursday, August 9th, 2012

depression after traumaDisaster and trauma studies often focus on identifying the incidence of PTSD as the sequel to traumatic events.

Early interventions with those affected after a disaster or traumatic event increasingly utilize psycho-education to clarify and normalize common post-traumatic stress reactions and coping strategies.

While mentioned as a possible response, the high incidence of depression after trauma is less delineated and often goes unrecognized by those suffering.

Depression Occurs after Trauma:

  • A Rand corporation study reports that nearly 20 percent of military service members who have returned from Iraq and Afghanistan – 300,000 in all – report symptoms of Post-Traumatic Stress Disorder or major depression.
  • In the first long-term study of the health impacts of the World Trade Center (WTC) collapse on September 11, 2001, findings indicate that seven percent of police officers were diagnosed with depression, nine percent with PTSD and eight percent with panic disorder. Twenty eight percent of other rescue and recovery workers had symptoms of depression.
  • A survey of survivors from the Oklahoma City bombing showed that 23% had depression after the bombing.
  • Depression affects approximately 15 percent to 25 percent of cancer patients.
  • After a myocardial infarction, the incidence of major depression is from 15 percent to 20 percent, and an additional 27 percent of patients develop minor depression.

Both major depression and Post-Traumatic Stress Disorder (PTSD) occur frequently following traumatic exposure, both as separate disorders and concurrently.

Depression is the most common disorder suffered in conjunction with Post-Traumatic Stress Disorder.

Depression is nearly three to five times more likely in those with PTSD than those without PTSD.


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Suzanne Phillips, Psy.D., ABPP & Dianne Kane, DSW are the authors of Healing Together: A Couple's Guide to Coping with Trauma and Post-Traumatic Stress. Pick up the book today!

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