GUEST BLOG: Dr. Ted C. Bonar, PsyD
Without fail, a person seeking treatment for PTSD will come into my office and say something along the lines of, “Well, other people have had it worse. I should be over it by now.” This is the convincing trap of posttraumatic stress: I am weak. I shouldn’t be here. I should have done something differently. I shouldn’t need help. Other people have been through worse. Other people have gotten over it. The objective nature (if there is such a thing) of the traumatic incident itself, has little relevance here. The reaction…either to a horrific, brutal, violent sexual assault, or to the tortured memory of a middle-of-the-night hospital-worthy earache experienced as a child, remembered decades later by an elderly man…conjures the same thought. I am weak.
This is the layer that covers the lasting reaction to the original traumatic experience, which was a warranted, understandable reaction. Fear, the need to escape, to freeze, subsequent silence about the incident, and a forever-altered (auto)biography are all elemental reactions to a trauma. Add subsequent feelings of shame, guilt, embarrassment, isolation, and depression, and that’s a heavy burden for anyone to carry. The succession of valid, understandable reactions evolves into a syndrome of despair: Something is happening. I am in danger. I did not know what to do. The world is dangerous. I cannot cope. I am weak. Weakness is bad. People judge weakness. I judge myself. I am ashamed. Other people are not this weak. My life is forever changed. I will avoid everything. I will be alone but safe. There is no help for this. I am hopeless. I despair. This is me.
Most people untangle the thorny branches of trauma over time, in the course of their daily lives. I was on a bicycle and got hit by a car, and it was bad. Riding a bike was really, really hard for a while. Had to stop before I could start again. But I kept at it, and now I can ride again. Took a while, but it’s okay now. For others, however, the dangerous vines sometimes shut out the light, growing thicker and thornier. The purpose of evidence-based treatment for PTSD is to disentangle these dangerous, sharp, strangling vines one at a time. And the treatments work. Much (and yet not nearly enough) has been written about the effectiveness of treatment of PTSD via Prolonged Exposure therapy (PE) or Cognitive Processing Therapy (CPT). Dissemination and widespread use of these treatments must remain a professional priority among mental health providers, and overall awareness of their existence and efficacy must continue.
For the moment, however, let us return to the themes of the first paragraph of this post. What do we make of the day-to-day experience of the person having experienced trauma, and the subsequent message of…weakness? Sysiphus was doomed to push a boulder up a hill, only to have it roll down within a breath of the top, for eternity. The trauma survivor as Sysiphus is not hard to imagine: If only I was strong, I could make that last step and get this boulder to the other side. But I can’t. I am weak.
So how, then, do we understand the person having survived trauma who then walks a journey through the world and ultimately into a therapist’s office? This is where we debunk myths. Despair endured requires strength. A persistent, vigilant, unquitting quest for safety, integration, and an autobiography that can again be owned: these are the things we call heroic in others. To do this during a state of abject vulnerability, with constant, impinging reminders of physical or emotional trauma? This is the Sysiphean journey that belies the personal and cultural message of weakness.
But, Sir, this does not ring true. At all. I’m drinking. My relationship is in shambles. I trust no one. This has been going on for years, and nothing I can do will fix it. This is not strength. Sysiphus was doomed. Well, let’s look at that. Years feel eternal, and yet you strive. People tell you (or you tell yourself, or some combination) to “get over it,” and that feeling of despair doesn’t budge, but endurance is a marker. Therapy for ourselves can feel weak or fragile (these thoughts double back again and again), yet we admire the courage of the therapy patient when it’s an other. Fighting dragons isn’t easy. It’s a battle. It’s war itself. And it takes plenty of courage to go to war with a demon or a dragon or a relentless army bent on the destruction of your own autobiography.
The therapy room, and the use of treatments shown to work, is where the strength of the trauma survivor is revealed, displayed, and brought to life in full effect. The trauma experience captured in the safety of a therapy protocol with a compassionate, safe “other” (even if he/she does not right away “feel” safe) is the stuff of healing, hope, strength, and courage rediscovered, unhidden, having been present all along. The trauma experience then includes another chapter of the never-finished autobiography, now including the trajectory of strength, long forgotten but never gone.
Sisyphus…a myth…envies the trauma survivor. The trauma survivor carries the boulder a long, long way. Through branches and vines and rocks and boulders, the top of the hill is visible. The boulder is carried over without judgment. It vanishes. And there is life.
Ted C. Bonar, PsyD is an independent clinical psychologist, speaker, and trainer based in Columbus, OH. He is a recognized expert in PTSD and Prolonged Exposure therapy, suicide prevention, and closing the civilian-military divide.
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