Instinct, Defense, and the Development of Complex Trauma
Not All PTSD Is Created Equal
Pierre Janet (1859-1947) once wrote, “Traumas produce their disintegrating effects in proportion to their intensity, duration and repetition.” (1909) He was the first in a long line of clinician theorists who have attempted to explain what happens to the human condition as a result of enduring repeated, ongoing neglect and all manner of abuse. And though contemporary understandings have made PTSD a commonly recognized acronym, a majority of mental health professionals grapple with efficiently treating the complexity that PTSD often involves. Why? The simple answer is that not all PTSD is created equal. Here’s an illustration: Surviving the fallout from a fiery car crash (having previously enjoyed a trauma-free upbringing) is quite different from surviving the latest trauma of a fiery car crash given the backdrop of an abusive, neglectful and chaotic upbringing.
The roots of psychological disintegration that Pierre Janet so elegantly outlined for us come from an instinctual, desperate attempt to survive perceived threat. Humans (at any age) will do whatever is necessary to survive when escape from perceived threat is impossible. Infants cry instinctually in an attempt to get attention, so their physical survival is maximized. And when aggressors are much larger, the primacy of the fight instinct is abandoned for fleeing as the best way to cope. And when fleeing is not an option, what’s left is to submit and comply with the powerful other’s demands; submittal with analgesia (the body goes limp and internal endorphins are released) is the last survival strategy by instinct. These automatic survival processes are designed by nature to segregate traumatic experiences, especially severe and chronic ones. This process helps the survivor to most efficiently focus on daily life despite their trail of traumatic experiences.
The success of survival from chronic, perceived threat comes at the price of a disintegrated psyche via traumatic learning.
Traumatic learning is very difficult to undo because it holds strong survival value. Here’s an example: A child learns to wall off the realization that the parent who molests her late nights is the same parent smiling and making small talk at the breakfast table the next morning. This child cannot escape the molestations and must carry on a “normal” relationship with that parent. This girl who submits to and experiences the molestations may be remotely aware (or even unaware) of the one who makes small talk with her molester-parent at the breakfast table. This is but one possible effect of traumatic learning processes that are born out of an instinctually defensive purpose to survive.
How Do We Begin To Help Our Clients?
So where do we start as clinicians with treating such complex trauma? We start with gentle kindness, with friendly curiosity. We hold space for our clients’ confusion, their knowing and not knowing about what their past experience holds. And when the time is right, we reaffirm whatever the client had to do in order to survive was alright. That’s where we begin, and that’s where we stay as long as is necessary.
When we, as clinicians, understand these instinctually defensive roots of traumatic response, we can help our traumatized clients begin to stabilize their daily living and to build customized skill sets that address what is needed to eventually confront the realization of their traumas. Out of this process, our clients will eventually make sense of their trauma in terms of who they intend to become—not only as survivors, but also as thrivers.
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Photo by Camila Quintero Franco on Unsplash