Trauma and Therapists
Following the attacks of September 11, 2001, there was a tremendous amount of literature written about the impact of having a shared trauma in clinical dyads (Coates, Rosenthal, & Schechter, 2003; Pierce, 2006; Tosone, Minami, Bettmann, & Jasperson, 2010). It was an amazing clinical moment, because the shared vulnerability of the therapist and client, alike, was crystal clear. It also became totally acceptable for the therapist to not be more evolved in negotiating trauma than the client. For a moment, we were all admittedly in the confusion, rage, fear, and sadness together.
What feels so stunning about the passing of that moment is that we, clinically, have lost sight of the very real fact that 9/11 was one of many shared traumas that clinicians and clients co-occupy. It was an acceptable issue, at the time, to discuss, because it was so obvious and so huge and there was no shame in being affected by it.
I think it is fair to say that we have receded back into the fantastical recesses of believing that our clients are traumatized, while we, their therapists, are not. The power of this false dichotomy pervades our work as we learn about the trauma of our clients, as if we are not talking about ourselves the whole time. Most of the time, our clients have some sort of trauma histories. But the hard truth is that so do we. We, of course, are supposed to be on the side of either not having been traumatized or on the side of having worked through our trauma enough that we are not at risk for feeling triggered or unhinged by our own pasts.
For starters, let me offer a definition of trauma that will help us all to know what I am talking about. The definition of trauma is clearly debatable and complex. To combat that, I am going to use the Webster’s definition of it, to simplify that part of the discussion. The dictionary defines trauma:
1. an injury (as a wound) to living tissue caused by an extrinsic agent
2. a disordered psychic or behavioral state resulting from severe mental or emotional stress or physical injury
3. an emotional upset
The broadness of the definition of trauma is useful here, because I am trying to acknowledge the far-reaching impact of trauma. To add to the definition, I will say (in my own words) that trauma usually includes an attack on an attachment, a feeling of being out of control, and a loss of internal and external sites for safety.
We don’t know how many people are traumatized. It would be impossible to calculate, not only because of underreporting, but because we don’t all fully agree on the definition of it. We do know (at the least) that 1 in 4 college women report having been sexually assaulted in their lifetimes. That number has remained constant since the 1980s. And that is just sexual assault. Given that statistic alone, it makes sense to finally acknowledge that clinicians are often trauma survivors, and we bring this to our treatment.
I write this as a trauma survivor, myself. In a way, I feel inhibited saying that and at the same time, of course, there shouldn’t be any surprise there. There are many of us who are trauma survivors, and oftentimes the only thing that separates one trauma survivor from another is the willingness to identify as such.
Okay, so what about all of this? What does it mean if we ourselves are traumatized? Can we still be good at our jobs? How evolved beyond our trauma do we have to be?
I operate with these questions in mind all the time. I think about them as a professor, a therapist, and a supervisor. I know my students, when I am teaching about trauma, are trying to learn more about their clients, but are also listening for information to better understand themselves. I see them taking dutiful notes, while I see them internalizing the information to deepen their own understandings of themselves. I know they are hiding this, and I also want them to know that it is okay.
I want you all to know that it is okay that you have been traumatized. I want you to know that it is okay that sometimes you feel triggered and scared and ashamed. I know that you wonder if you can be good at this work when you have been through your own histories, and I know that this question is terrifying.
It is amazing, because in the field of substance abuse, there is shame when the clinician has not been through some sort of addiction and come out the other side. Clinicians who are not sober often wonder if they can help their addicted clients. Why is the opposite true for trauma? Why are we often made to feel that if have been traumatized, we can’t help people because we are too messed up? Perhaps the answer has something to do with gender, but I don’t think it is that simple. And I am not exactly sure that the answer matters. What does matter is that the shame transforms into something else, something powerful.
This is what I have come to believe: I am not sure that we can do this work well unless we have gone through some sort of a trauma.
There is something quite magical and painful about the traumatized mind.
The traumatized mind is one that is highly sensitive, attuned, and capable of understanding nuance and complexity. It is sensitive because traumatized folks typically had to study their abusers to try and survive their trauma. This study of psychology was initiated by something horrible, but it was initiated early and has left many of us as experts in our field. It is attuned because those who have been traumatized have typically learned how to tune into the needs of others in order to keep themselves safe. This is a complex phenomenon and typically the byproduct of two things. First, for many who have been traumatized, the pain of being in one’s own mind can be unbearable, and we have vacated our own mind to be in the mind of another for relief. Second, because we know the pain of trauma so well, we can carefully pick up on it in others. Some say that those who have survived trauma have antennae. I think this is true. Trauma survivors are capable of understanding complexity and nuance, because many of us know our abusers and simultaneously love and hate them. We know that many emotions can be held at one time, because we have done it ourselves. Ambiguity is something we are well versed in.