Tuesday, January 31, 2012

The Compulsion to Reenact Trauma as a Component of PTSD for the Christian as well as the Hephzibah House Survivor

Fairly early in the book, Love is a Choice, it talks about how when there are two people with significant shame and pain left over from their childhood which affect their behavior as adults, if you put those two people in a crowded room full of people, they will find one another. They are most likely the worst people in the room for one another to get to know, but they respond to the familiarity of the dysfunction that they recognize in themselves and from their families of origin. Likewise, abused people tend to be attracted to abusers, and predatory abusers know well how to target a new mark. Even if the relationship is undesirable, the draw of the familiar overrides one's sensibilities. The dysfunctional person's instinct and radar will always draw them to the most unhealthy people, as they too will tend to play out aspects of their childhood in their adult relationships because it was a type of trauma.

In Post Traumatic Stress Disorder (PTSD), just as those unhealed wounds from childhood tend to call out for attention through bad relationship patterns, those who are unaffected by such wounds also experience a compulsion to repeat trauma until they have resolved it, desensitizing to and reprocessing the experience. This pattern was among the earliest observations made in the study of human behavior, in fact. War veterans will often choose high risk helping professions when they return from combat, and they may also seek out very high risk recreation, something that is seen as a replaying and attempt to process their unhealed traumas. Children who are abused often grow up to marry an abuser, or they may divorce an abuser or an addict, merely to remarry another one, somehow unaware of the warning signs in their second spouse. The repetitive aspect of trauma gives the individual a false sense of control and comfort as they return to the familiar, even if those experiences are painful or dangerous for them. Some theorists suggest that this represents an “addiction to trauma” because it is the only way that the traumatized person feels alive and experiences life.

We also know that there is some link between early trauma and repeated trauma. People who suffer trauma early in their lives tend to go on to live through other types of trauma in ways that other people who have never experienced trauma do not. It is speculated that traumatized children fail to learn how to self-soothe and then make decisions from a place of pessimism and mistrust which may predispose them to new trauma as they venture through life. The traumatized person's compulsion to seek out the familiarity of unhealthy relationships suffered in their family or origin or with their abuser may also play a role in the repetition of trauma. There may be no direct cause and effect relationships explaining this tendency and common finding, but it does warrant consideration because of it's significance. For example, women who were sexually abused as children have significantly greater rates of sexual assault as adults (68% vs 38% in general population in a Van der Kolk study). Similar trends exist concerning physical abuse, marital rape, unwanted sexual advances, and other types of abuse.

What Purpose Could Trauma Reenactment Serve?

Essentially, it is believed that this compulsion serves a few different purposes which are all aimed at coping with trauma, however ineffectively. The traumatized person operates under the umanagable tension to both deny and hide from the experience of pain that produced the PTSD, but at the same time, they also seek to purge the trauma, stress, and shame associated with the event. While the mind becomes incredibly creative in its efforts to suppress the memory of the event, those memories also emerge and invade the person's consciousness and physical function because of hypervigilence (that sensation of waiting for the next shoe to drop).

On a very ineffective and very subconscious level, the individual very ineffectively attempts to work through the trauma because of three specific unrealized objectives:
  1. Understanding of the experience
  2. Mastery of the experience
  3. (Distraction) To manage mood with a stimulating but less threatening type of similar but controlled trauma

Remember that the structures in the brain that govern the survival response have nothing to do with rational though, and because of the physical response in the brain when PTSD occurs, the emotions become almost alienated from reason, having lost their ability to inform one another to help a person find meaning in their experience and transcend it. The experience is not rational but takes place in the background, so to speak, governed by the deeply emotional structures that control a person's survival response. The separate structures of the brain's system continue to fail to work together, and all of them, in terms of moving past the experience of PSTD, prove to be ineffective on their own. The conscious mind tries to heal but cannot understand, and the emotions create deep and powerful motivations which the conscious mind cannot understand. Considered as separate structures that have lost their synchronization, PTSD makes a great deal of sense.

Understanding and Mastery

People then seek out new trauma, because a part of them on a deeply emotional level and a behavioral level that is non-rational is trying to purge the shame of the first trauma and perhaps seeks a type of replay so that they can “get it right this time.” In a way, by succeeding under similar circumstances under similar conditions, on some unconscious level, the person is tries to vindicate themselves, or at least atone in some way for what they seem to sense as a prior mistake. They couldn't get it right the first time, but they can make sure to get it right on the second, third, fourth fifth, etc. attempt. However, this does noting to remove the source of the compulsion, and it never seems to effectively reduce it.

For the Christian, this becomes terribly frustrating, because they can have perfect understanding of doctrine, ethics, and behavior, all while the overactive survival system rages on, trying to connect with the rest of the mind and body in order to process events and return to healthy function. If their thought life is good, and if they are in right standing with God, they may still continue to feel the irrational compulsions and shame associated with the interrupted or ineffective survival response which has kicked into overdrive. They are healed in one sense, but a part of them feels quite tortured, even though such feelings should really not exist.

These types of people suffering from PTSD also seem to demonstrate an array of contradictory behaviors and traits. They may be very competent in one area of life, then abysmally incompetent in another in a way that seems to make no sense. They may be very good at impossible tasks but may fail to keep up with routine and simple tasks. They both crave certain types of excitement, but paradoxically, they will avoid other activities that seem rather benign to people on the outside of their lives, looking in. They seek stimulation, but the also seem over stimulated and easily overwhelmed. This also creates difficulties for the Christian who believes that they should be well adjusted because they have a very rational grasp of things through their faith. The contradictions and difficulties modulating behavior and experience don't make any sense. They definitely don't make sense in terms of Christianity which teaches balance, moderation, and highly values self-control.

All of these factors tend to be shame-producing. If a person does understand, why can they not feel well again? If a person values responsibility and can be responsible, why do they have problems with modulating feelings and behavior? Why does the compulsion remain? (Some counseling traditions that take the nouthetic approach misinterpret these symptoms as an indication of deserved, appropriate and underlying guilt which can only be sin based.)

Regulation of Mood

People who experience PTSD contend with very difficult and disturbing symptoms of mood and behavior. They become anxious quite easily (a sense of generalized fear that is not associated with a particular threat, whereas fear results from a particular stimulus), in addition to hypervigilence. They cope with feelings of numbness and the opposite extreme of feeling overwhelmed and overstimulated. They struggle with emotions that range from and vacillate between shame and grief to hostility. They may cope by becoming impulsive or driven to succeed. Overstimulation or avoidance can offer some distraction from these variations in mood, and trauma repetition may also provide some distraction from these difficult experiences.

Self-Injury.  In addition to self-destructive impulsiveness that can accompany PTSD, the person struggling to regulate their mood can resort to willful physical injury or self-mutilation, one type of addictive behavior that is used as an ineffective coping mechanism. There are multiple reasons offered by experts and victims for this behavior which is associated with certain types of trauma (particularly in Borderline complex trauma, childhood trauma, and childhood sexual abuse).

  1. Expression pain or aggression that cannot be verbalized. Self-injury becomes a non-verbal testimony which expresses that something very terrible has occurred. The suffering person may have no other way or permission to express what has happened to them.
  2. Conversion of emotional pain to physical pain. Physical pain makes emotional pain tangible, and it can be expressed, released and resolved when the individual feels as though their emotional pain is locked away.
  3. Alleviation of pain. Self injury is thought to stimulate natural pain killers that the brain generates in response to pain in order to self-soothe.
  4. Breaking or creation of states of dissociation. When the experience of numbness and dissociation leaves an individual feeling nothing, self-injurers report that pain returns them to the present and grounds them, taking them out of the feelings of deadness. It reminds them that they remain alive. Self injury may also be used as a way of escaping or distracting oneself from a greater threat or trigger when the self injury activity creates a state of dissociation. When a traumatized individual uses self injury to break through numbness, they are essentially using dissociation to attempt to break out of a different state of dissociation.
  5. Creation of an illusion of control. During their initial trauma, the victim has no control, but by recreating a situation wherein the are in control of the injury, it renders them with some sense of the control.
  6. Creation of a sense of mastery. As previously mentioned, self injury can be viewed as a type of laboratory for creating a traumatic event that gives the traumatized person the sense that they are able to work through their pain using self injury as an alternate method.
  7. Purging of feelings of self-recrimination directed inward toward self. Self injury can be a way of expressing emotions that should be directed toward the abuser by turning them in on the self. Rather than seeking justice by retaliating against the aggressor, the traumatized person turns this impulse on themselves. It may also be an expression of lack of self-value and self-image as well as the pervasive pessimism and nihilism experienced in chronic trauma.
  8. Protection against further abuse by making the self unattractive. This behavior and motivation often seems to be a defense against continued sexual abuse. (This is also true of weight management.
  9. Creates a need for self-care. When a person suffers a lack of ability or restraint of self-care, self injury creates a demand for self care, learning to associate self-injury with self love, care and pleasant feelings associated with the aftercare rituals that tend to follow the process.
  10. Direct repetition of abusive behavior and a related means of bonding with the abuser. Children tend to develop behaviors as a type of imitation of the abuse they've suffered. In addition to pure repetition, the victim may be attempting to bond with the abuser through shared behavior.
  11. Creation of a sense nostalgia through familiar and predictable experience. As discussed, human beings tend to seek out the familiar, even when the familiar presents threat of harm or pain.
  12. Triggering of response from others. Self injury may be a way of expressing trauma to others in an effort to manipulate them into responding, triggering nurture from a significant other or caregiver.
  13. Etc.

Consideration for the Survivor of Hephzibah House

As previously discussed in several posts, survivors of Hephzibah House suffered many different varieties of abject abuse and torture, and their environment was highly sexually charged. Girls report that Ron Williams behaved inappropriately with them, seeming to flirt with them at times, all while he objectified (treating them as little more than objects because they were women and were viewed as impure as well). Many were sent to Hephzibah House because they had been sexually assaulted, and parents neither knew how to cope with these situations nor had resources to minister to their children. They had no idea that they were sending their children into a highly sexualized environment.

In the previous post, we examined freezing behavior in response to threat, a response that is often associated with sexual assault. I would like to add the consideration of the compulsion to reenact trauma and to experience repeated trauma after suffering early trauma in childhood as perhaps another factor in explaining why young women who were incarcerated at Hephzibah House would suffer sexual assault after their release from the facility. It also provides a reasonable explanation for behavior of ineffective coping including erratic, impulsive, or even self-destructive behavior following release from the facility. As repeated in earlier posts on this subject, the experience of Hephzibah House is one of trauma and one of the after effects of torture.

Deep-seated disturbances in identity, self-concept, and security in the world can also render individuals vulnerable to being enticed by others who resonate with and counter these ego deficits. Because of early trauma, person can feel helpless, fragile, and out of control. In turn the person may be extremely susceptible to anyone who can take control, who can gratify dependency needs, and who can elegantly counter the individual's extreme sense of powerlessness, insecurity, and vulnerability. In this regard, Kluft has discussed incest survivors who became sexually victimized by their therapists.
For those who have struggled with any of these after effects, I've presented this information for your consideration to urge you towards self acceptance, self compassion and healing. Guilt and shame comprise part of the core experience of those who suffer with PTSD. It is my prayer that all who endured at Hephzibah House find healing, and I believe that an essential part of that healing will come through knowledge about the experience of trauma. We are all flawed and imperfect human beings, and we need to find meaning in our lives in a way that helps us deal with our limitations. We all sin. But not all suffering, guilt, shame, or difficulty results from failure. The aftermath of symptoms, difficulty and sometimes tragedy experienced by the former Hephzibah Girls results directly from the various types of trauma and abuse endured there.

May you be free and healed of it all.


   Alderman T. The Scarred Soul: Understanding and Ending Self-Inflicted Violence. Oakland, New Harbinger, 1997.
   Herman JL. Trauma and Recovery. New York, Basic Books, 1992
   Levy MS. A Helpful Way to Conceptualize and Understand Reenactments. J Psychother Pract Res 7:227-235, July 1998
   Miller A: Thou Shalt Not Be Aware. New York, Meridian, 1984
   Van der Kolk BA. The Compulsion to Repeat the Trauma. Psychiatric Clinics of North America, 12(2), 389-411, June 1989.
   Van der Kolk BA: The psychological consequences of overwhelming life experiences, in Psychological Trauma, Van der Kolk (editor), Washington, DC, American Psychiatric Press, 1987, 1–30.