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
- Fear
- Ignorance of healthy choices
- Lack of access to helpful resources
- Secondary gain
Physical Aspects
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.
Fear
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.
Ignorance
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.
Secondary Gain
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.
A
Challenge
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
