Trauma is difficult to define and talk about. A traumatic event is a specific incident, such as an accident or abuse, that can cause psychological harm. Trauma, is the lasting emotional response to a traumatic event or series of events, potentially impacting a person’s sense of safety, self, and ability to regulate emotions. Trauma has emerged as one of the great public health challenges of our time. Trauma is often caused by an abrupt, distressing, and unforeseeable event that affects an individual, family or community and triggers feelings of fear, helplessness and/or shame. It is often described as a bodily and psyche response to a real or perceived threat to one’s life, safety or bodily and/or psychological integrity. Often during a traumatic event one’s agency (and choice) is taken away. Causes of trauma include illness and accidents, and vary in intensity from complicated bereavement to war, torture, rape, and genocide. In situations of complex post-traumatic stress, the trauma often originates in the family system and is a result of chronic exposure over many childhood stages of development to events such as physical, emotional and/or sexual abuse. It may also originate in the attachment relationship due to poor attunement by caregivers to the child’s needs or in response to difficult events. This is referred to in family constellations as the ‘interrupted reaching out movement’.
Interrupted reaching out:
In a healthy parent-child relationship, the parents give, and the child takes. The parents are successful when life is fully passed onto the child. However, when a child’s connection to their parents (or primary caretaker), particularly with their mother, is disrupted by a physical or emotional separation, strong feelings of hurt, rejection, despair, hate, resignation, and grief can occur.
Ursula Franke-Bryson (2002) suggests two movements: a reaching out movement and a turning away movement. “A reaching-out movement can be understood as an interest in the world, turning towards life and openness as an unconscious or intentionally adopted attitude. A turning away movement can be understood as a kind of withdrawal, pulling back and closing up.” (pages 44-45). When young children can’t reach the person they love, they have a strong tendency to feel rejected, as if there were something wrong with them, and they stop practicing the movement. ” Hellinger, 1998, p278) The reactions and responses to our childhood distress impact the development of inner psychic structures.
Symptoms:
Symptoms that can indicate trauma include:
Physiological symptoms such as raised heart rate, shallow breathing, sweating and heart palpitations; changes in sleep, appetite and libido; hyper–vigilance; hypersensitivity to sound, lowering of the immune response; and somaticizing responses such as headaches, backache and stomach aches. Hyper-vigilance is a survival mechanism and a state of heightened awareness and alertness, to detect potential threats. This may include hyper sensitivity to sounds, certain visual triggers and a startle response. Somaticizing is when a person manifests (psychological states) through physical symptoms.
Intrusive symptoms such as nightmares, flashbacks and intrusive thoughts.
Emotional responses such as outbursts of anger; fear, depression and anxiety; self blame, survivor guilt, and shame.
Impact:
Trauma often results in parts of ourselves (often younger parts) becoming split off or suppressed and coping parts (manager parts) of ourselves taking control. The splitting off process is caused by what we call ‘dissociation’, an automatic reaction when our autonomic nervous system is overwhelmed and/or not adequately resourced by internal and external sources of love, connection and support. However, over time this may become restrictive to our growth even though at the time it was an important protective factor. This may lead to separation from one’s authentic self and loved ones.
How the world responds to the person after a traumatic event may further serve to impact the experience of trauma, either reinforcing shame and self-blame or supporting recovery and/or internal resilience. Therefore, the impact of a traumatic event depends on multiple factors. These include: closeness to the trauma (for example if you are personally involved or a very close loved one, and how physically close you were to the trauma), the number of adverse events faced, chronic exposure, access to resources such as loving family, attentive family or community members, as well as what happens and how people or environment responded. Trauma most often distorts the view of world and creates mistrust.
The nervous system.
The sympathetic nervous system (SNS) responds to trauma by activating the body’s “fight-or-flight” response, activating the amygdala and sending signals to the adrenal glands, leading to an increased heart rate, blood pressure, and respiration. This activation prepares the body to either confront or escape a perceived threat, releasing stress hormones like adrenaline and cortisol. However, if trauma is prolonged or repeated, the nervous system can become dysregulated, leading to chronic stress and hyperarousal and a lowered immune response.
If over activated the body-mind may move into “freeze” and paralysis in thought, numbness in emotions and slow body movements. Another possible response is “fawn” which includes meeting other people’s needs as a means of avoiding conflict. Therefore, when working with trauma we have to pay attention to the body’s nervous system and assist with rest, digestion, recovery, breathing and regulation of the nervous system to create an internal sense of safety. And so, in working with trauma we require a certain attitude, perspective, containment and skill (Porges, 2011).
Attitude:
Working with trauma requires a certain attitude. This needs to be both containing and attuned. Therefore, the facilitator must have some strength not to be wobbled by the feelings and story, to be a safe container; as well as being compassionate, and attuned to where someone is at, what their nervous system is doing, and what they are feeling and therefore to have knowledge but not an agenda. It requires encouraging agency in the client, where a previous experience has taken away agency. It requires being in uncertainty, attunement to another’s story, nervous system and process. It requires acknowledging what is and what has happened, acknowledging feelings and responses. Responsiveness is a primary movement, it opens, it connects, and it keeps the client in relationship. We need skills to regulate our own nervous system, while helping the client to regulate theirs. This is called ‘co-regulation’ (Porges, 2011). Co-regulation highights the idea that emotional and behavioural regulation is not solely an individual process but happens when two people help each other regulate their emotions. Co-regulation can occur automatically when we are centered and calm, and by simultaneously attuning to and drawing awareness to the client’s body, breathing and other nervous system reactions. Through presence, compassion and dual-awareness, the client begins to come into a regulated and centered place within themselves which enables their perspective to expand to see the bigger picture.
Resourcing:
Working with trauma should aim to offer resourcing, empowerment, and a wider perspective within which to ‘hold’ the trauma. We aim to develop the inner and communal resources to be able to “respond” and not react. Trauma often requires grieving losses, and in time accepting what is and finding steps forward (Ulsamer, 2023).
Insights:
I, the author, had the honour of facilitating a training module of working with trauma in constellations. Some of insights I gained from working with this group are reflected on below.
It is important to allow for working slowly and with titration. Titration allows the client and representatives to monitor their bodies and move closer to and further away from the trauma to regulate themselves. We do need to witness and integrate the trauma (where in the past the feelings may have been split off or suppressed because they were overwhelming), but now from a resourced, connected and therefore empowered place. This means we need to be careful to work from a place of empowerment, otherwise we might risk re-traumatising the client or just staying stuck in a shutdown state due to overwhelm and lack of resourcing. It is therefore to always check in with the client, their breath and body. The trauma must be witnessed and held in order to release the fight-flight or freeze response and allow for integration; but we need to always be careful that the client does not become overwhelmed.
When working with a client or group, it is also important to recognise systemic and environmental factors that influence the current interaction as well as the time of the trauma. These include recognition of race, gender, socioeconomic background and how one is perceived and perceives one’s belonging. If the facilitator is of a different race to the client, it is helpful to acknowledge the differences and invite the client to note if the facilitator is not quite attuned to the experience. It is helpful if we create spaces where there is a sense of moving towards each other but recognising we do not always get it quite ‘right’.
As a facilitator working with trauma we need to stay aware of the client, the witnesses, the representatives and ourselves as therapist. (Ulsamer, 2023). We do this by staying attuned, watching their breathing, and nervous system reactions.
The political is personal and the personal is political (carol Hanish’s 1969 essay).
The questions and unfolding stories were deeply personal and where influenced by larger social systems, such as war and apartheid. These systems and environments intimately affect the flow of love, the ability to love. For example, in one system a person moves from one community to another due to a trauma incident leaving her feeling unsafe for her family, yet moving means leaving a community of in which she feels belonging and moving into one predominantly of another racial group. South Africa has a history of geographical division based on race. In another, an interrupted reaching out movement of a child to a mother is influenced by the mother’s survival in an apartheid system. In another a father is emotionally absent because he is still grieving his own father lost in war, and not because he does not love. Our personal stories are integrally connected to the societal story.
Fear and isolation are at the core of trauma, and reshape the brain, body and behaviour. In constellations work, we are working directly with the trauma through embodiment and regulating emotions and bodily symptoms. Embodiment together with representative perception and embodiment enables us to witness what happened, and include what was excluded, such as perpetrators and emotions such as anger and outrage. It also provides the holding and presence that provides resourcing, containment and enables the system to move out of freeze, through fear, anger, hurt and grief, to rest and digest, changing a victim story into a survivor story. Constellations offer experiences that can directly counteract the helplessness and invisibility associated with trauma, enabling people to reclaim ownership of their bodies and their lives.
There is a connection between mind, body and spirit. The soul enfolds into the body. Every cell, every atom is infused with it. Every cell, every atom, is it. (Eisenstein, C.) when we work with trauma we are called to pay attention to the body, the nervous system, the psyche and the meaning of life and death.
Theoretical frameworks:
Some theoretical frames that can assist us:
Internal Family Systems (IFS) therapy by Richard Swarts (2021), suggests that the psyche is composed of many parts or sub-personalities, each with its own roles and perspectives.
IFS aims to help individuals create a relationship between, understand and integrate these parts, fostering harmony within the internal system. During a traumatic event, an inner part Swartz calls an ‘exile’ (or vulnerable child) may form. Exiles are parts that carry emotional burdens or trauma, often feeling vulnerable or wounded. To protect this vulnerable part, we may have what he calls ‘managers’ (parts that control and organize thoughts, feelings, and behaviours to prevent potential harm). ‘Firefighters’, are parts that react to intense emotions or painful experiences, to avoid pain, but often through impulsive, addictive or destructive behaviours. IFS therapy involves working with each part, understanding its role and intentions, and helping it to release its burdens. The process aims to integrate the parts, allowing the Self to lead and guide the internal system towards wholeness and healing. The term self is slightly different depending on one’s theoretical frame, but largely refers to a dynamic principle of wholeness, an organising principle of the psyche.
Schema therapy speaks of modes of functioning such as the ‘vulnerable child’, or the ‘angry child’ whose needs were not met by the parent, and a ‘punitive adult’ or a ‘healthy adult’ part that responds to this inner child part. It is recognized that internal modes develop from early attachment relationships.
Stephen Karpman (1968) introduced a Drama triangle – with rescuer, victim, and persecutor roles within a family system.
Franz Rupert (2007) also spoke of his understanding of the function of psychological splitting as a natural response and survival strategy to traumatic events. He recognizes traumatized parts, surviving parts and healthy parts. He describes how he uses constellations work as a means of achieving understanding and integration. Through representation, the inner parts are introduced to each other.
If a client moves into dissociation or panic, he helps them to step out, ground, breath and be present.
All these methods describe deep compassion for parts that have been split off or supressed or exiled in a bid for survival and how to bring healthy understanding and inclusion from the place and perspective of the adult self. Integrating a split of or exiled child part, takes place in relation to the client’s healthy adult part. They encourage resourcing and finding agency and a healing voice within. They require trust in the process and in the knowing field, remaining present and willing as a safe container that facilitates moving towards integration. I see this much like a potter centring clay on a wheel. The potter has to be centred in themselves, and in contact with their body as well as the clay. They work slowly and in tune with the clay. They open a container slowly and in relationship to the clay and the shape of the vessel.
I believe we are always working with some level of trauma. I also think it is essential that we are lifelong learners, and come from a stance of containment and strength, but also learning, and being with what is unfolding, therefore not assuming we know.
References:
Alessandra, L. & Levy, S. (2004). The impact of trauma on the psyche: internal and external processes (Ch.1). The Perversion of Loss: Psychoanalytic Perspectives on Trauma. (Eds). Whurr Publishers.
Bert Hellinger B, Weber, G and Beaumont, H (1998). Loves Hidden Symmetry: What Makes Love Work in Relationships, p 276
Franke. U. 2002. In My Mind’s Eye: Family Constellations in Individual Therapy and Counselling. Carl-Auer-Systeme. Verlag. Heidelberg
Karpman, S. (1968). The new drama traingles USATAA conference lecture. (PDF). karpmandramatriangle.com. Retrieved August 11, 2007.
Mate, G. (2003). When the Body Says No. Knopf, Canada, 2003 ; ISBN, 0676973116, 9780676973112
Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W W Norton & Co.
Ruppert, F. (2011). Splits in the soul: Integrating traumatic experiences. Green Balloon Publishing.
Schwartz, Richard C., and Alanis Morissette. No Bad Parts: Healing Trauma & Restoring Wholeness With the Internal Family Systems Model. Sounds True, 2021.
Ulsamer, B. (2023) Family constellations and trauma: How trauma therapy enriches systemic constellations, ISBN:9783949494192
van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.
https://www.pesi.co.uk/blogs/schema-therapy-for-trauma-1-5-what-is-schema-the/?srsltid=AfmBOor7AsFBIRjdNnX3IaroPQt_H-nULt0_KXBRcd9SK-fOARIAfHX8
Additional resources:
- Peter Levine
- Thomas Hübl.
Author: Angela Hough https://www.angelahough.com/
