Is recovery possible?
That’s the question that everyone is asking, even when they’re not asking it. After a breakdown, perhaps after years in the mental health system, do we have to simply accept that we’re broken and that we’ll always be broken, or is it possible to live a life where we’re back in control again, where we’re living as we want to live, where life has purpose and meaning? And what about revenge? What about that indelible desire for retribution and justice that is etched on each of our souls? Does recovery imply that what happened didn’t really matter, that our abusers can get away with it scot-free, that we should just ‘forgive and forget’ and ‘move on’, as so many people exhort us to do?
When I brought out my first book last year, I thought long and hard about a title. In the end I settled on Recovery is my Best Revenge because implicit within those words are two concepts that I hold very dear. Firstly, the belief that recovery is possible – it really is possible – and I know because I have experienced a significant measure of it: I am here, I have survived. Trauma is neither a life sentence nor a death sentence. It can be processed, and we can recover. And the second concept is the self-evident truth that it’s not okay that I was abused and traumatised the way I was. Recovery does not make up for what I experienced. It does not erase the past. What happened to me was wrong, and the desire for revenge is, I believe, a wholly righteous one. It’s the part of us that stands up in the midst of evil and says, That ain’t right!
But my revenge has been found not in becoming an abuser myself, but in becoming the best human being that I can be: the kind of human being that my abusers definitely were not, and the kind of human being that they didn’t want me to be either. I want to live as a human being, not an inhuman being. And I want to live the kind of life that helps other people to live as human beings too.
But to live with recovery as your best revenge, you have to believe that there is hope for recovery from trauma. If recovery is not possible, then it is so much easier just to slide into the lazy evil of abusing others as your way of coming to terms with what happened to you. But I believe that recovery is possible and that we can in fact choose compassion, both for ourselves and others, rather than abuse.
But I do believe that trauma leaves indelible scars, and in order to recover we need to understand what it has done to us. Because trauma is not just a bad thing or even a series of bad things that happened to me in a vacuum, one cloudy day in August 1976. Trauma is something that shaped my brain just as it was developing. It impacted directly on my growing neural circuitry. It made my amygdala, my brain’s ‘smoke alarm’, more sensitive to incoming threat. It limited the connections between my thinking front brain and my survival-based back brain, making me more reactive to that threat. It affected the internal working models I was building of the world I lived in. It destroyed my sense of self, and my sense that I had a right to be alive.
Trauma breaks down the normal integration, the normal joining-up of thoughts, memories, feelings, behaviours, perceptions and sensations. Our memories are disjointed and held as somatosensory fragments. Our feelings don’t integrate with our memories. Our thoughts don’t integrate with our behaviours. And trauma has a profound effect on our autobiographical sense of self, as we see in my own experience of dissociative identity disorder (DID). I grew up without an integrated sense of self: all the different aspects of my experience and my self-identity did not join up together into a coherent whole. So I developed with what is vividly but inaccurately described as ‘multiple personalities’. Walt Whitman, the American poet, expressed it well – he said, ‘I am large; I contain multitudes.’
Trauma is not just a ‘bad experience’ that I haven’t been able to get over. Chronic trauma in childhood is a way of life and a way of learning. It defines the way that our brains organise and understand information. Recovery is a slow, hard process, and it cannot be achieved in six sessions or even six months. Because trauma by its very nature is disintegrative, disconnecting and disempowering.
Trauma is also disconnecting. At a profound level, trauma impacts our relationships. It teaches us that even the people who should have nurtured us and cared for us – even they can use us and abuse us. The trauma of abuse teaches us that we exist to manage the feelings of others, and that our own feelings must be blocked out of awareness to cope with that. It teaches us that to go on living with ‘good mummy’ who irons our clothes for school, we must shut out the consciousness of ‘bad mummy’. So we grow up with a very one-sided view of people, as either angel or demon, as either good or bad, but not as a complex mix of both. We carry a profound mistrust of people into relationships for the rest of our lives: the expectation that what you see is not what you get: the expectation that someone’s comfort, or affection, or praise, is a prelude to abuse. And so in our therapeutic relationships, your smile or greeting, or expression of delight, feels like a form of grooming – it feels like the prelude to abuse, and we square up to you with fight, or run from you with flight, because unwittingly you have triggered deep within us a vision of our abuser.
Trauma disconnects us not only from other people but also from ourselves, and these are the conflicts that can tear us apart on the inside – in my case, with DID, where the parts of my personality are pitched against each other: the parts of me that want to carry on with daily life and are apparently normal, who cope with the trauma by avoiding it and denying that it ever really happened, and the traumatised, emotional parts of my self who are stuck in the trauma, raw as a knife edge, because the trauma has never been brought into consciousness and processed and experienced as being over.
Trauma is also profoundly disempowering. I believe that the very essence of trauma is powerlessness. It is that unavoidable, inescapable overwhelm of suffering that we can do nothing about. Some of us learn that it’s best never to struggle, to just accept the freeze response and lie still until the danger passes. Perhaps by freezing, perhaps by submitting, it will be over with more quickly and we will be hurt less in the process. Lie still until the danger passes … But then, in our minds, the danger never passes, and so we live our lives inhibited by an eternal learned helplessness. We feel inept and incapable and stupid and weak, because when it really mattered, when our lives were at risk, we couldn’t even move a muscle. So we feel terribly disempowered by that, as if it means that in the rest of life we will be incapable too. And we think: ‘What’s the point?! What’s the point in trying to recover when I’m too helpless and powerless and stupid and weak to be able to do it?’
Breaking out of that mindset has been my journey over the last decade. I have had to work hard at breaking out of that learned powerlessness. I have had to work hard at overcoming my fundamental mistrust of other people. I have had to work hard at learning to live in a joined-up way where I’m in touch with all of me: where I can stretch backwards to the me-that-was, whilst also stretching forwards into the me-that-can-be. That’s been a battle – a deep, deep struggle. But I can say with all honesty that there is a point to it all, because there is recovery from trauma and I’m living it. I’m doing things now that I never thought would be possible, even just a few years ago.
But – and there is a big ‘but’ – for there to be recovery, we need other people. It was ‘other people’ who caused the damage in the first place, and I believe that we need other ‘other people’ to help repair it now. And that’s where therapists come in. Because therapy can help to provide the ‘someone’ that is needed to move a trauma survivor like me along in life, out of the realm of flashbacks and body memories and nightmares and freeze, and into a place where we can both think and feel: a place where we are not just plagued with intrusive thoughts and images and memories that we cannot face alone, but where we can start to mentalise and think about the trauma rather than just reliving it. Therapy can provide the place for us to begin to feel the feelings that were frozen at the time, rather than those feelings coming out in somatic symptoms alone.
Because one of the unacknowledged realities of trauma is that it carries with it a devastating retinue of physical impacts, everything from heart disease to cancer, to diabetes to rheumatoid arthritis, to ME and fibromyalgia. This is one of my biggest areas of ongoing struggle. In my life, physical ill health has been as much a problem as mental ill health has been. But it’s an area, again, where therapy has made a difference more than drugs have. Because so much physical ill health has its seeds in the trauma that we suffered as children, and as I’ve faced that and dealt with it, so my physical health has improved as well. There is no mindbody split – that’s a false dichotomy, and in reality we live as integrated wholes, whatever Descartes had to say about it.
I’ve had in therapy a ‘safe enough’ place, a ‘secure enough base’ to begin to explore who I really am. Trauma told me that I am a victim, but through therapy I’ve become to see myself as a resilient survivor. I survived horror without support as a child. And now as an adult I can transform that suffering into compassion both for myself and for others.
Therapy has been life-changing for me. But when I walked into my therapist’s office in May 2006, she was just a trainee with very little experience of counselling let alone dissociative disorders and organised and extreme abuse. If we go by some of the textbooks, she shouldn’t even have started seeing me. Of course I didn’t present in that first session with ‘multiple personalities’. I did my best to ‘act normal’ so that I didn’t drive her away, because after a year of floundering around in the midst of a breakdown that hit me out of nowhere, towards the end of that first session, she looked me in the eye and said with a fierce but kindly determination, ‘I can help you’.
Those four words transformed my life. Because for the first time, I’d found someone who didn’t run away from me, who didn’t disbelieve me, who didn’t tell me that I just needed to pull myself together. She said, ‘I can help you’. And she was just a normal human being, without much training, without much experience. And yet she has had a significant impact on my life.
For many of us, the experience of trauma has been such a lonely one, so isolating, that the biggest shift for us is when someone is just present, and promises to remain present, while we work things through. The presence of another human being is transformative. This therapist has listened to me, and heard me speak of things that I thought were unspeakable. And through that, she has helped me to realise that I am just a human being, just like her. I am not a label, I am not a mental health patient, I am not a victim. I am just a human being, just like her, but one who has had some extreme experiences of suffering which have not yet had the opportunity to heal.
And it can be easy to talk about ‘suffering’ and ‘trauma’ as if it’s some ethereal, nebulous pseudo-event. But really we’re talking about real things happening to real people. I tried to dissociate from the trauma I experienced, to say that it didn’t happen, and it didn’t happen to me. But it did, and recovery has come through accepting those experiences as my own, rather than pushing them away.
Of course this therapist didn’t have much experience of dissociative disorders and ritualised and organised abuse. But in many ways, all the reasons why she shouldn’t have started work with me are the reasons why she’s been so successful in working with me – because she’s been humble, and open, and curious, and willing to learn: all the things I’ve needed to be to rediscover who I am, too, and heal from this suffering. She wasn’t such an ‘expert’ that she could afford not to listen to me. She wasn’t such an ‘expert’ that she tried to do anything more at first than just be a safe person, a witness, a reassuring presence. She was open-minded, and despite her lack of direct experience, she was actually incredibly wise. And she had a great deal of integrity – she was solid, and grounded, and right from the start, she treated me with a dignity and a respect that had been rare in my life.
I was manifesting very strange behaviours, but she didn’t treat me as if I were strange. And yet of course it is very strange when someone switches to another part of their personality for the first time, when they start talking with a completely different tone of voice, with different facial expressions and a different way of holding their body. But she saw through my symptoms and my behaviours and she saw me as a person. And in over 8 years now, she has never for one moment treated me as anything less than an equal human being who deserves to be listened to and respected.
What she seemed to instinctively grasp was that all my symptoms, and all my behaviours, were communications. They were me trying to tell my story, trying to speak when I had been forbidden ever to tell. They were my dissociative unconscious desperately forcing itself into consciousness. They weren’t a sign of my madness – they were a sign of my sanity, because my mind wanted to heal. She understood, and I began to understand, that DID is a sane response to some very insane things that happened to me in childhood. After all, how is a child to survive those kinds of experiences, except by chopping them up into more manageable little chunks, and hiding them away in boxes in our mind that we try never to open? What better way to cope with uncopeable realities than by saying that they’re not real, by saying that they didn’t happen – or at the very least that they didn’t happen to me? And she has coaxed that communication out of me, and given me a place to speak.
Many, many other people in my life ran away from me during this time. I think, deep down, they were afraid of my suffering, and they didn’t know how to handle it. I’m so grateful that my therapist didn’t run away. She has never rescued me, and nor has she ever abandoned me. At times, the pressure to run was huge. She was hearing me not just retell but many times relive some of the most horrendous, atrocious forms of abuse. When I have been unable to face my trauma, and I’ve escaped in my head and I’ve dissociated, she’s had to face it down all by herself. She hasn’t had the luxury of dissociation. She hasn’t had the luxury of overdosing or getting drunk or self-harm or overwork. She’s just had to be able to sit with the unbearable suffering of another human being and feel it – every last ounce of unbearability and pain. She’s had to draw on all her own internal grounding strategies, her self-soothing strategies, her mentalising capacity, to be able to deal with what she’s heard. She’s had to hold onto her faith in the universe and her faith in humanity and her faith in the process of therapy that this stuff can heal.
And by doing so, she has shown me that there is another way to deal with trauma other than by dissociating from it. She has shown me that there are things that we can do to manage our emotions when they threaten to overwhelm us: there is breathing and mindfulness, there is nature and birdwatching and sunsets and stargazing, there is comedy and friendship and holidays and sleep. She has shown me that I can stand back from what happened to me, rather than being sucked into endlessly reexperiencing it. She has shown me that I can hold it in my mind as an event that happened to me, that I can think about it and I can feel the feelings I have about it. I can hold it in mind rather than pushing it out of mind with dissociation. She has shown me that I can feel its feelings rather than avoiding them through numbing or minimising or self-medication or self-harm.
She taught me that feelings are meant to be felt and thoughts are meant to be thought and that dissociation doesn’t achieve either. She has shown me that if I can both think and feel at the same time, then my hippocampus – my memory system’s ‘context stamp’ – can tag the memory as ‘over’, that it has happened, that it’s in the past. She has shown me that it’s okay to have feelings – even strong feelings – about the things that happened to me. She has shown me that it’s okay for me to express those feelings, and that I can choose good ways, rather than destructive ways, to express those feelings.
And she has done all of these things, not through some application of heavy textbook theory and a thousand CPD hours, but through the quality of who she is as a human being. Of course I believe that textbooks and theory are important, and that CPD is important – after all I spend a lot of my time delivering CPD and studying textbooks! But I believe the fundamental difference that therapists can make to people like me is in who you intrinsically are. It’s your character, ultimately, that counts. The theory, the textbooks, the CPD – they are incredibly useful tools. But it’s you as a person that counts, and therefore how you use those tools. I believe that ‘good enough’ therapy requires a ‘good enough’ therapist who is a ‘good enough’ human being.
Are therapists peddling a technique? Or are they fundamentally restoring someone’s sense of dignity and respect as a valuable and precious human being? Suzette Boon says:
‘The therapeutic relationship is the most important vehicle in the treatment of patients with complex dissociative disorders. Patients heal from their early interpersonal trauma in a safe therapeutic relationship that respects healthy boundaries.’
The good news there is that patients – clients – do heal. And we achieve that through at least three things. Firstly, you can help our brains to see that the trauma is over. It won’t work if you don’t believe that this is so. If you can’t see that the trauma is something that happened to us but that it is not us; if you are intimidated or entranced by our labels, and you forget that we are just a traumatised human being – no more, no less – then you won’t help us see that trauma is something that happened to us, but that it doesn’t need to define us. What we’re experiencing is just a flashback, it’s just a feeling, it’s just a body memory. Don’t let trauma intimidate you. The trauma is past; we just need our brains to realise it. So the first step is that your brains realise it too.
Secondly, you can help us to develop ‘earned secure’ attachment. We have missed out on the ability to mentalise, to think about our thoughts, to stand back from ourselves and our experience and notice it rather than being in it. Peter Fonagy says that mentalising is being able to see ourselves from the outside and other people from the inside. Many of us as trauma survivors struggle to do that, because there was never an ‘other’ to see from the inside; there was never an ‘other’ who could help us to see ourselves from another perspective. Therapy provides that opportunity – to think about our thoughts, and to begin to see the filter through which we see the world and ourselves – what Bowlby termed our ‘internal working model’.
I have had to change my view of myself: from someone who was chronically overwhelmed and disempowered, to someone who survived – a survivor in the very best sense of the word. I went through the worst, as a child, on my own: I survived that. So I can surely survive this, now, as an adult, with support. I am resilient – because I didn’t give up, I haven’t given up, I keep going. The post-post traumatic worldview accepts the reality of what happened, but it also accepts the reality that we survived what happened, that we are amazing, that our lives have value, and that we are precious, resourceful, courageous human beings.
And we have also missed out on the ability to ‘affect regulate’, to manage our emotions and feelings. Dissociation is what you do when you don’t have any other affect regulating mechanism to deal with this overwhelm of feelings from trauma, but then dissociation becomes the only tool we have to manage our feelings, so we need to build up other means of regulating our emotions. This happens, as Allan Schore puts it, in right brain to right brain attunement. It’s bad enough that we have experienced such awful suffering in the first place, but that suffering is compounded by our inability to be soothed in our distress. When we feel that there is no soothing, then we will continue to dissociate and the trauma will never be processed and healed. But if we can learn to manage our distress, if we can ‘regulate’ our ‘affect’, if we can learn to receive comfort from others and to self-soothe in ways that do not block out the pain, if we can learn to sit with the pain until it passes … then we can overcome our suffering.
And thirdly, you can help us to make meaning of our lives and our experiences that is ‘post-post-traumatic’. Living in a post-traumatic worldview, we believe that everything is dangerous and that we have no tomorrow. But it’s not enough to try to develop a sanitised worldview, one that pretends that the trauma wasn’t there or that it didn’t happen. I live with the reality of my scars, without a family, whether I like it or not. Much better is to develop a post-post-traumatic worldview – one that can integrate the safe and the unsafe and say: ‘Bad things happened, but I also overcame them and if they happen again, I can overcome them again.’
Bad stuff happens and it can drive us crazy. But we can also survive the bad stuff, and we can overcome its scars. We are not ‘mad people’ with labels, we are just traumatised human beings. You as therapists don’t need to be experts. You need to be compassionate human beings who are safe, and who will treat us with dignity and respect as equal human beings who are able to recover from our experiences, because we have already survived them. You just need to come alongside us. You need to provide good enough therapy as good enough therapists who are good enough human beings. You need to be able to sit with us in our unbearable suffering and neither rescue us nor abandon us. You need to be able to step back from our trauma and recognise that it is our trauma, not yours, and that it has happened but that it is no longer happening. You need to see our trauma as something that happened to us, not as something that defines who we are. And you need to believe that there is recovery from trauma, because there really really is: recovery can be our best revenge.