Podcast: #12 – What does recovery from trauma look like?

 
 
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Recovery from trauma is a journey, an orientation, a direction, not a specific location. Just head north – where you’re at is less important than which direction you’re headed in. In this podcast, Carolyn discusses why we can feel that recovery is impossible, how recovery perhaps doesn’t look as we imagine it to, and how society needs to help with ‘public transport’ to help us on our way.


Transcript

Hello friends, Carolyn Spring here – and welcome to my podcast: ‘What does recovery from trauma look like?’

So I get asked a lot about recovery – probably because I’m always banging on about it myself. Can we recover from trauma, even extreme trauma, complex trauma, chronic childhood trauma? How do we recover? What does that recovery look like?

And I talk about it a lot because of two things: firstly, quite simply because that’s been my journey – and oh what a journey it has been! In the last fifteen years I’ve gone from regularly trying to kill myself, having full-blown dissociative identity disorder, not being able to manage my emotions at all, not really knowing where I was and what I was doing or even who I was, in horrific distress all day and all night – and this went on for several years, with flashbacks, with nightmares, with just excruciating psychological, emotional, mental and even physical pain … I went from that, completely dysfunctional and in deep distress, to now living a life that’s certainly not perfect, but it is undeniably good. I love my life now – I’m so grateful for it.

So of course I believe in recovery – how could I not, when I’ve experienced it? But there are a lot of people who say – a lot of you who are listening may want to say – “Well, that’s great for you, but that’s not my experience. I’ve been in therapy for ten, twenty, thirty years and I still haven’t experienced anything like what you’re talking about. Life is still a terrible, terrible thing and I suffer daily, and I don’t know if I can keep going. How can you talk to me about recovery? I haven’t experienced it.”

And so it can seem really insensitive of me to keep going on about recovery if it’s something that, despite your best efforts, is eluding you. And I get that – I totally get that – and the last thing I want to do is to add to your pain, your suffering, in any way. So in this podcast I’m going to talk about what recovery looks like, what I mean by it – which might not be what you mean by it – and why I think it’s so so important.

Because – here’s the thing – your suffering matters. Pain matters. There’s this cry on the inside of us, isn’t there, this huge, unbearable, soul-splitting pain, because of the things that happened to us – trauma, abuse, abandonment, betrayal, grief, loss, torture, humiliation, rejection. The ancient Hebrew word for that pain is sa’aq. It’s an onomatopoeic word, a word that sounds like its meaning – the sa’aq  – the ouch, cry. Something that is so big and so painful that we cannot put it into words, which is why I prefer to refer to the sa’aq rather than ‘cry’ because ‘cry’ just doesn’t do it justice. I mean, how on earth do you put that pain into words? You can’t! I wanted to kill myself to get away from that sa’aq, because I just didn’t know what else to do. It’s deep, ineffable distress. And it matters. Oh my word, it matters.

It matters so so much – that’s why I bang on about recovery. Because what I’m really talking about is easing that pain, relieving that suffering, finding a solution to the sa’aq that erupts from our guts. I’m not talking about ‘recovering from a mental health condition’ – that just sounds so clinical, so emotively empty, as if there’s just a couple of switches that have been flicked into the wrong position in our head and all we have to do is to locate them and flip them back again.

No – that’s not at all what I’m referring to when I talk about recovering from trauma. I’m talking about relieving this indescribable awful ‘ouch’ on the inside of us that is so unbearable that we can’t bear to be ourselves – that’s my real-life description of dissociative identity disorder. DID is when it is too painful to be ourselves and we have to become other versions of us just to cope with the pain of being alive. And I don’t even really like the term ‘dissociative identity disorder’ – it feels like a way of distracting attention from our sa’aq, by putting it in medical terms. I understand that the NHS uses diagnoses and labels in order to decide on treatment approaches and availability, but I really really don’t want to talk in those impersonal, soulless terms. I want to talk in terms of human suffering that needs a solution.

So when I talk about recovery from trauma, I’m talking about hearing and responding to that cry, that sa’aq in our soul: something very primal, very real, and unbearably painful. Not something with a technical description that’s responded to with a checklist.

And it’s one of the things I probably get asked more than anything. The question is asked with different words, but underlying it all is this heartfelt, painful painful question around recovery which is basically, “Will life get better? Or will I always be in this much pain?”

And that’s what I’m responding to when I talk about recovery. I’m saying, with every ounce of my being and all that I am, “Yes, we can recover. Yes, it gets better. And it has to – it really, really has to, because it’s unacceptable for you or me or anyone else to be in that much suffering for the rest of your life.” So please hear everything I’m going to say with the compassion, with the empathy, that is motivating it. Recovery matters to me, because human suffering matters to me.

So people ask me a lot about recovery and whether it’s possible. Whether they will always be affected by their trauma. Whether it’s possible to ever be able to talk about what happened without being triggered or switching or getting distressed. Whether recovery is complete and final, or whether you can sort of revert, or go backwards and end up at square one again. Whether you can ever stop having such awful memories, and nightmares, and flashbacks of the abuse. Whether you can get to the point of not feeling so unbelievably ashamed all the time of what happened. Whether you can get to a place of feeling that your identity isn’t in your trauma.

These are heartfelt, meaningful and indeed complex questions. But the answer to them in our soundbite culture is often simplistic and binary.

The first response is basically: no. You’ll never recover from trauma. You can only learn to manage it a bit. Everything else is unrealistic. And this is the standpoint of many people who have been trying valiantly for years to recover, and it’s true to their experience. They’ve tried so so hard to recover; it’s not happened, so of course they believe now that it’s not possible – because that’s what they know in their own lives. Totally understandable.

And then the other response is yes – of course! And it tends to a bit of a ‘ra ra’ response. ‘Yes, you can recover! You can do anything! All things are possible! Just think positive, be positive, and stick positive quotes from Facebook up all around your house! Ra ra!’ … and preferably drink some kind of disgusting green smoothie while you’re doing it!

Now, perhaps unsurprisingly, I don’t think it’s either. I think both are a caricature of the truth.

When we talk about recovery, often we focus solely on the role and responsibility of the individual. We think in terms of whether this person is capable of recovering. We think about what they’re doing to recover. We think about their motivation, their resources, their mentality. But the problem with that is that we can end up implicitly blaming them for not having recovered. And that’s not right. The blame for being traumatised, and even for ‘failing’ to recover, is only and always with the person or people who traumatised them. If we hadn’t been traumatised in the first place, we wouldn’t be ‘failing’ in some way to recover from trauma now! – so our baseline has got to be: no fault, no blame, no criticism, no anything. Just lots of love and support and empathy and a sense of coming alongside and saying, “I’m so sorry this crap has happened to you. It’s not right. It’s not right that you have to deal with the after-effects of it.”

And anyway, if we’re talking about someone having recovered or not recovered, we’ve got to be really careful that we’re not thinking in terms of yes or no – you have or you haven’t – – when obviously it’s a spectrum. It’s a journey. And also we need to be really careful that we’re not imposing arbitrary timescales either – the sense that it’s okay to be traumatised for a while, but not a ‘long’ while. And it’s so random how long we think ‘long’ should be: this is why I object to the concept of ‘Persistent Complex Bereavement Disorder’ in the DSM-5. It basically says you can feel loss and grief and distress for 6 months after a significant bereavement. But six months and one day and there’s something wrong with you – you are mentally unwell. How ridiculous is that! – medicalising misery. How dare anyone suggest such an arbitrary timescale – in fact any timescale at all! You grieve for however long you want to grieve for!

Also, I’d say that how recovered we are is relative to where we started. Because recovery is about movement, about a direction that we’re headed in, not a particular location. Recovery is like saying that we’re in London at the moment (the evil city! – that’s a joke) and we want to be in Scotland (the best place on earth – not a joke!) And so the point is that we’re heading north. Maybe we’ll go slowly, maybe we’ll go quickly. Maybe we’ll go with a whole load of detours, like via Wales. That’s irrelevant. The point is that we’re heading north, even if for a while we double back on ourselves because we need to find a petrol station, or avoid a roadblock. Someone else heading north to Scotland might go at a completely different pace along a completely different route. That doesn’t matter. It’s irrelevant to us: our journey is our journey, no-one else’s. And it’s not a race.

If we stop for a while in Watford, or Nottingham, or York en route, then that’s okay too. Sometimes we need to stop and refuel. Sometimes the car breaks down and we need to wait for a replacement. Some parts of the journey we do by train, some by car, some we hitch-hike, and some we walk. And yes, some of them we crawl forwards almost imperceptibly on our hands and knees.

That’s very much what my recovery looked like. At any given point you could have looked at me and said, “Are you sure you’re heading north? Really?” Because actually I was on the M23 heading south towards Brighton. There were lots of detours, lots of going the wrong way, lots of pulling over to the hard shoulder and staring in despair at Google Maps to try to figure out where I was. But I got there in the end. That’s the point.

And even more importantly for me, I decided where I wanted to go. Nobody told me, “You have to go to Scotland. And when we say Scotland, we mean Perth.” I decided what I wanted recovery to look like, and I decided how to get there. And in metaphorical as well as literal terms, I’m now doing a grand tour of Scotland – recovery is ongoing: it’s a lifelong journey.

So it’s very easy to criticise people on the journey and heap blame on them, to say, “Well this person doesn’t seem to be making progress in recovery. They’re not travelling very fast.” Well, no, they’re not, because they’re walking on their own two feet. And they could really do with a lift. They could do with a ride in a taxi, on a bus, on a train – they could do with some support. That’s what ideally should be provided by our statutory services. So of course people aren’t making as much progress as they’d like to – because it’s a long way to walk, or even crawl on hands and knees, from London to Scotland. It’s a difficult journey to recover from trauma without adequate therapeutic support.

And so of course people who have heavy rucksacks tied on their backs, who are crawling through mud, don’t feel like it’s possible to get all the way to Scotland. Of course! And it makes sense that they then end up saying, “You know what, I’m not even going to try. It’s too painful, it’s too difficult. I’m going to pitch a tent here in this field and just learn to manage.” And that’s not just sensible – that’s adaptive, given their circumstances.

But living in a tent in a field in winter snow, with no sanitation, with no water, with no heat – that’s not a life. That’s a tough, tough gig. So of course I want to encourage them to keep going. And I want to campaign for us all as a society, in the guise of social services or the NHS or the voluntary sector, to send them an Uber, to get them a train ticket, to speed forth their journey, to help them. Of course I do. I spent plenty of time in a pitched tent in a muddy field myself, thinking it was never going to get better, not even knowing which way to go to head north. So I know what it’s like.

But I want to encourage everyone who’s stuck there right now, not to feel ashamed of that, or feel judged or criticised by anyone for that, but to realise that a lot of it is our failure as a society to adequately provide public transport to enable people to head north. And if we could just coordinate ourselves as a society to fund trauma treatment properly, and we could send out some Ubers to pick these folk up, suddenly they’d find themselves crossing the border into Scotland and they’d realise their journey speed wasn’t all down to them.

I think another issue, as well, is that we often think that recovery is impossible because we have an unrealistic view of what recovery looks like. One of the things that has really struck me over the last ten years or so is that if I ask many survivors what recovery looks like, they actually have no idea. They’ve not really thought about it. They’ve not been able to formulate it in their mind. It’s abstract and vague. It’s like they might have heard someone say, ‘Head towards Scotland’ but they’ve never been to Scotland before, they don’t know where it is, and they don’t know what it looks like. Or all they’ve ever experienced of it is watching a New Year’s Eve programme of ‘Fireworks from Edinburgh’ and so they think that the whole of Scotland is like that – they think it’s all castles and sparkly bangs in the sky, so if they find themselves on the edge of a loch in the Highlands, they think they’re in the wrong place.

And it’s not surprising that people think that recovery from trauma is impossible if they think that means that we’ll live as if the trauma hadn’t happened in the first place, as if recovery means that our childhood is somehow magically restored – that someone waves a magic wand and the past is changed so that all that stuff didn’t happen – and as if life recovered means that there’s no more pain or struggle or suffering ever. But that’s not reality. Recovery from trauma isn’t about a sanitised life free from suffering and struggle, with our childhood magically restored as if nothing bad ever happened. Recovery from trauma isn’t fairy tale. That’s not possible. So because we know – obviously we know – that that’s not possible, we therefore draw the conclusion that recovery isn’t possible. We’ve got the wrong end of the stick about what recovery is.

But I’m talking about real, realistic, real-life recovery, not magic. And not an alternative, sliding-doors-type reality.

When I talk about recovery, I’m talking about resolving our trauma, not pretending it didn’t happen. I’m talking about resolving the effects of trauma on our lives, not erasing traumatic events from our history. I’m talking about a life where we’re able to experience increasing moments of joy even in amongst the pain. I’m talking about living by default, the majority of the time – not the whole time, but more often than not – in the green zone, where we feel safe, where we’re able to (in technical terms) neurocept safety, and our nervous system is therefore calm and relaxed and we’re able to relate well to others, with our social engagement system switched on. I’m talking about living mostly in daily life mode, not danger mode. I’m talking about us living not in the hyperarousal of the amber zone or the hypoarousal of the red zone, but in the alert, calm, relaxed, creative, balanced, window of tolerance of the green zone. I’m talking about us being in control of our bodies and our nervous systems, rather than being hijacked by them or disconnected from them.

I’m talking about living a life where we can remember the trauma as ‘something that happened to us’ but without reliving it when we do. So it becomes an explicit, narrative memory, but without the reactions in our nervous systems of unprocessed, raw, implicit memory. And where we can choose to remember it, but even more importantly we can choose not to remember it – we can think, ‘No thanks, not now’ and turn away from the memory of any aspect of it when it arises. Because it will – that’s the nature of memory. You hear a song on Spotify and you’re reminded of being in a shop where you heard it once before. You drive past a signpost and you’re reminded of the argument you were having with someone ten years ago in that place. But with processed memories, we can let them go when they come – we just turn our attention onto something else. And the same even for trauma memories with recovery. I get reminded every single day of some aspect of the abuse I suffered. But it’s fleeting. It comes, it goes, I don’t dwell on it and my body doesn’t react to it – totally different to previously. So it is possible.

With recovery too, there’s peace and calm in our heads. It’s not a constant shouting match, a constant stream of self-criticism, a constant clamouring, or a constant sa’aq emanating from our guts. It’s quiet and calm – busy maybe, but quiet. And with recovery we’re able to manage stress. It’s not that we don’t get stressed – of course we do: this is life. Sometimes we even get overwhelmed by stress, just like other people do. But on the whole we’re able to manage it. When it does get too much, we know what to do – probably even better than lots of other people do, because we had years of learning how to – so we have a tonne of strategies that we can implement.

This is what recovery is like for me, and again it might be different for other people, but this is my particular version or area, if you like, of Scotland. Recovery is when we’re comfortable with ourselves. I’m comfortable being me, being in my body, knowing that I’m not perfect, but accepting of myself. Self-compassionate. Kind to myself. My own best friend. My own biggest advocate. And I’m able to make decisions most of the time out of my front brain, to make choices, to be in charge of my responses and reactions, rather than being held hostage by my back brain and reacting all the time out of a sense of terror and dread and shame and fear and that sa’aq of trauma.

So that’s a lot of what recovery looks like for me. Does this mean though that I don’t live with the consequences of trauma? Of course not. The stuff that happened to me happened to me. However recovered I am or I become doesn’t change that. And it shouldn’t change that. Recovery doesn’t mean living a lie and pretending that the trauma didn’t happen. Recovery just means that trauma doesn’t dominate our life any more. But it still has its consequences – of course it does.

For example, I’ve not been able to have children, almost certainly because of the abuse I suffered as a child. That is a very direct, very physical consequence. ‘Recovery’ hasn’t meant some kind of miraculous healing of fertility for me. It’s a harsh and a painful reality and sense of loss. There’s a huge well of sadness there. And so there are knock-on effects for the rest of my life – no kids, no family, no grandchildren – and that’s going to be a real, undeniable consequence in my life until the day I die. It’s reality, and I’ve had to come to terms with it and grieve it.

Grieving is painful. Accepting is painful. Feeling the feelings of it doesn’t change the reality of it. It’s just better, healthier, more adaptive, than denying those feelings and denying that reality. And what I’ve learned to do instead is to build good things in the gaps. There will always be a ground zero in my life where I wanted children and family to be. But I’ve at least built something else there. It’s never going to be the same, but I can hold both simultaneously: the lack, the loss of children and motherhood and family, and the things that I’ve built in their place, the things I have freedom to do. The gain doesn’t cancel out the loss, but neither does the loss cancel out the gain. They’re just separate things. But what I’ve refused to do with my life is to be so bitter about what I’ve lost, that I’ve refused to build any joy into it. I can hold joy and grief at the same time.

So with the childlessness thing, I’ve learned to manage the pain of that so that I can live, bearably, with it. At times it flares up – of course it does. But most of the time I live happy and free. I don’t resent other people for having kids – I take great delight in them. And I’ve always worked hard to steer clear of an attitude of entitlement. Being a mother, being a parent, is a gift and a privilege. I was never entitled to it in the first place. It’s a privilege and a responsibility, and it’s something that just didn’t fall on my shoulders, however much I desperately wanted it to. But I have other privileges and other responsibilities – I get to help reverse adversity in people’s lives for one thing – and my focus is on my life, the life I have, not the life I don’t have. That’s been really freeing for me. I am deeply, deeply grateful for all the good things I do have in my life.

And gratitude again is something that there’s a lot of confusion and mixed-up-ness over. Gratitude doesn’t negate the grief. Often it feels like we’re told, when we’re suffering, to be grateful for the good things we have, and often it feels like we’re just being told to shut up, to squash our pain and our grief down, and put on a brave face. But that’s not what real gratitude is about. You don’t have to choose between gratitude and grief. You can have – you must have – both simultaneously. The gratitude in many ways, actually, makes the grief worse. It makes the pain deeper. But then the grief makes the gratitude deeper too.

When our pain is so deep – this sa’aq that arises from the very depths of our being – what often feels so offensive is when we’re given simplistic solutions. And that’s often how gratitude and positivity are offered – ‘Oh, just count your blessings, just be positive’. But life is complex. Trauma is complex. Our pain is complex. We live in complexity, our feelings are complex – nothing more so than this intertwining of gratitude and grief at the same time. Personally I’ve found that gratitude without grief is simplistic twaddle – it’s numbing, it’s dissociative, it’s just plain stupid.

But gratitude with all the depth and complexity of pain and grief, being really real about it – that’s powerful. For me gratitude has become a powerful tool for directing my focus onto joy, and joy itself has been the best antidote to pain that I’ve found. I think especially in our culture we’re used to ideas of numbing pain – medicating it away, dissociating it away. But there’s an experience I’ve found of joy that is all the richer because it is laced with grief. It’s a real gratitude that I can enjoy this sunset, or sunrise, or beach, or mountain, or my dog – that I’m so so grateful for the pleasure I feel in that moment, exactly because I’m conscious of the pain of trauma, of things that happened to me.

So recovery isn’t numbing or pretending, but nor is it just unmitigated pain, day in, day out. Not at all. I’ve found in my life, in recovery from trauma, that the joy has expanded to fill the empty spaces. It’s taken a long time, and I’ve had to work really really hard, to consciously, deliberately expose myself to experiences that will bring my joy – and I’ve written about that elsewhere – but over time, oh my goodness what a difference it has made. I live a life now that is largely joyful and even more so because I’m conscious of my pain.

So yes I do believe that recovery is possible, and I’m very aware that even this podcast has probably provoked more questions than it has answered, because I haven’t delved at all into the ‘how’ we recover. But I just think it’s so important that we ask the question first of ‘Can we recover?’ and we look at the reasons why we might resist it even as a possibility. And what I’ve seen time and again is that trauma survivors can become quite militantly opposed to the positivity inherent in a recovery narrative because they feel that they’re being asked to pretend – to pretend that their trauma didn’t happen, that the sa’aq doesn’t hurt. Or they’re being judged and criticised and shamed for pitching their tent in a muddy field or only inching forwards on their hands or feet, rather than speeding on a train towards the border.

So I wanted to put that recovery narrative into a wider context. Head north – that’s all you have to do. Head north even if it means for a while you head south, if that’s what you need to do. Head north even if you don’t know what the north looks like, even if you can’t imagine it. Because your suffering matters too much for you to stay as you are. I will work with all my energy to campaign for you to get more help, for you to be sent a bus or train or taxi or even a light aircraft! But hear my heart, which I know is echoed in the heart of the many many professionals I’ve met over the last ten years who have come on my training days – a heart for your wellbeing and recovery, for your suffering to be relieved, for things to get better for you. Don’t give up. Just head north.