In a nutshell, there are a few primary reasons why a person might resist recovery from trauma, though this list certainly isn't exhaustive. I believe that the list itself attests to the need for the love and support of others who have your best interests at heart. They can give you information, feedback, and a broader perspective when you need them most.
None of these reasons should be seen as “bad,” for they are a part of what we encounter. As human beings, we face these challenges, and we do so in predictable ways. There can be comfort in that idea, though we likely don't want to admit that we are so predictable.
- The far reaching effects of the physical aspects of trauma
- Ignorance of healthy choices
- Lack of access to helpful resources
- Secondary gain
The physiologic state of a person in PTSD makes it very difficult for them to heal. The physical changes in the brain cause heightened negative emotions, pessimism, diminished critical thinking, as well as a sense of detachment. This detachment which causes a pervasive feeling of isolation from others also alters the physical connection with one's own body through felt sense. A part of the self is not fully present. (This is part of the reason why physical exercise can be so helpful because it reestablishes the ability to feel – for the body carries the trauma physically as much as the mind carries trauma memory. When people are encouraged, another response kicks in, and instead of feeling comfort, a sense of aggression often activates – another aspect of the survival response.
Sometimes, the devil you know seems much better than what might turn out to be the devil you don't. And recovery can feel like that. We don't like to feel pain, and recovery involves looking into the darkness of who we are as we grieve what we lost or wanted but can never have. I like the expression of “finding courage,” because in the midst of the pain, courage seems fleeting if not completely absent.
Another element of fear is the avoidance of what can be very bleak possibilities. I recently read that Philip Zimbardo was hospitalized with a difficult respiratory infection when he was a young child. Every day, fellow children who were also sick would disappear, and others would ask about where they were. The nurses told them that the children went home, and everyone would be happy for them. He explains that those kids really knew that the children had died because of how sick they were, but they chose not to think about what going home really meant. They needed to hang on to optimism so that they could live and recover. They made a somewhat conscious but willful choice to ask no further questions, knowing that more specific answers would add to their suffering.
I think that after a bad trauma, we do much of the same thing. We don't want to look into the darkness of our own deficiencies and weaknesses or the consequences of all of the things we did or didn't do that resulted in some bad outcome. Yet we know that the damage that we suffer in spiritually abusive environments has profound effects on almost everything – especially if we grew up in a group and that is all we ever knew.
Particularly for second generation adults who grew up in isolated communities or were kept from much knowledge of the world outside of their religious bubble, the idea that a better way of doing things may have never occurred to them. This is an element of bounded choice, for from the outside of the system, it appears that all choices are available and limitless. But how does someone blind from birth come to understand color if they've never experienced it. Were it not for others telling them about it, they wouldn't know that there was such a sensation and that they lacked it. This lack of knowledge robs them of possibilities.
Reaching out for effective help for trauma may also be something vilified by their group and their families, so fear of getting mental health counseling may be unthinkable for them. They may not know anything about the real process and goals of healing.
Lack of Resources
For some with great needs, limited funds, no available time due to other responsibilities like work and family, or those who live in remote areas might not have what they need to achieve wellness. Luckily, today we have many books on the subject of recovery and self-help. The internet is also full of good information, too.
Also not a negative thing but a powerful trauma trap, secondary gain describes the benefits that people get by making no effort to overcome their problems. It is often the reason why people stay “stuck” in an unhealthy place and resist the work of healing. People who benefit from secondary gain usually have no conscious idea that the comfort of those benefits interferes with their motivation to achieve health.
People who get stuck because of secondary gain aren't deliberately manipulative, but the benefits are self-reinforcing. They're rewarded for stasis, and growth seems costly and painful. Their impairment is very real, but the gains create a pocket where the person can hide and resist change. It doesn't mean that anything about their limitations is pleasant but just offers some kind of benefit that becomes a subtle reward that renders some comfort. Any comfort when you are in pain can be very powerful.
Sadly, secondary gain puts a stress and burden not only on those who are traumatized but also on the people around them. They can find convenient excuses to avoid responsibilities or even to further isolate themselves from others. I had a friend who was a former alcoholic, and he used to tell me that “isolation was his drug.” His constriction kept him from taking risks, and his isolation kept him safe from the possibility of rejection and other pains we all experience in relationships. Isolation gave him the benefit of freedom from relationship pain, but it also kept him out of the flow of living a meaningful life and narrowed his perspective.
Pursing healing threatens the disabling of those systems that render secondary gain, but before venturing into the territory of healing, this can seem like a terrible potential loss. It is often hard for people to understand that it is the maladaptive mechanisms of coping that provide for secondary gain and not a character issue for the person. It's just a trap of trauma that we human beings can easily fall into when life takes a heavy toll on us.
If you've suffered from PTSD and don't believe that you're moving forward, or if you tend to be more like the biker gang member than a war veteran who goes to counseling at the VA, ask yourself if you might be held back by some benefit.
In social media, I've read comments from others who protest the idea that there is a healthy way of adapting and healing. These others contend that there is no such thing as maladaptive coping and that all forms of self-expression are good and right.
If you might be one of those people who believes that there is no truly unhealthy way to heal after trauma, play devil's advocate and see if you can come up with reasons why you find the idea of maladaptive coping distressing. Ask yourself if secondary gain might possibly be holding you back in that vortex of pain in that left upper quadrant of the maze in our model.
For further reading until the next post:
- Judith Herman's Trauma and Recovery
- Peter Levine's Waking the Tiger: Healing Trauma
- Bessel Van der Kolk's The Body Keeps Score