Newtown/Everlasting Arms

Newtown/Everlasting Arms

By  Gary Reece, Ph.D

It has been a week since a lighting bolt struck with unprecedented, unimaginable, catastrophic violence in a small town in Connecticut.  It was an act of terror committed by a young man who lived amongst us, not some foreign Jihadist.  His wanton act hit Newtown with shattering, traumatic force.  It shattered the security, serenity, safety, beliefs, hopes, and dreams which form the secure base that is the foundations of all communal life.

These attachments form the very essence of what it is to be human and are the vital force which make life together possible.  It is through attachment that infants are made to feel valued, safe, secure, and trusting.  It is through attachment that infants develop a working view of the world.  It is through attachment that we learn love, empathy, compassion, and the ability to intimately connect with an other.  It is our attachments which give us a sense of meaning, purpose and significance.  It is through attachment that we learn to be self reliant, regulate our emotions, and govern our impulses. And it is attachment that binds us to our family friends, community and our country.

Last Friday’s travesty followed an all too familiar macabre tableau.  A gunman enters a public building, armed to the teeth with multiple weapons and hundreds of rounds of ammuntion: ready to make war.  He begins randomly shooting, an alarm goes out, first responders appear on the scene and begin to deal with the bedlam and chaos of multiple gunshot victims.  Shortly there after the media arrive in droves.  Reporters frantically search for a story begin  thrusting  their microphones and cameras into the faces of shocked children and parents:  searching for the “epic” shot that will capture the essence of horror in the faces of the victims.  They want to display the moment on national TV.  The story goes viral. The parade of interviews of victims; talking heads telling us how horrible, shocking, and unprecedented this unfolding story will be.  “Breaking News, more at 11.”  As the memorials pile up, the President addresses a shocked nation.  He expresses sorrow and indignation:  “this is enough, this can not happen again, we must do something!”  And then the funerals begin.  The coverage continues and the media look for “Heroes.”  There is nothing like hero stories to capture an audience.  And then in all probability the media moves on to the next tragedy of the day.

Also predictably families, and the community respond with normal reactions of shock, terror, and horror to an extremely abnormal situation.  Because of the terror unleashed by such a random, horrific act of violence we all feel vulnerable and helpless.  There is a terrible fear of recurrence.  We are made to feel vulnerable and helpless, so fragile and terribly mortal.  Everyone becomes hyper vigilant and rushes about frantically trying to find a way to reestablish some vestige of control.  This is very understandable, we have experienced the worst kind of trauma:  a sudden, random, act of overwhelming violence by a member of our community.  This is the worst kind of betrayal.  It is a terrorist act perpetrated on the innocent, the undeserving, our children, neighbors and friends without apparent motive. We are defenseless.  People asking the unanswerable:  Why? Why?  Why?  It is senseless!  There is no logic; there is no answer, even so we struggle to find a coherent survival strategy in order to make sense of it all.

As a result we get responses that are driven by fear and panic.  One artifact of these attempts to regain control is very concerning to me:  gun sales went off the charts and established one day sales records.  Another proposal got publicity.  “We need to arm our teachers,” gun proponents advocated, if more people had guns these things would be prevented.”  From the NRA, “we should put armed personnel at every school.”  Not recognizing that we are having to lay teachers off because of lack of funding. It is too ignorant and frightening to seriously consider turning our schools and public places into fortresses.  Another proposal came in the true spirit of American Capitalism:  body armor for children.  For only $150 you can protect your child.  All of these are responses to the terror,  and the fear of losing more children to violence.

As a parent I know what it is to lose a child, and as a psychologist I have spent my entire career working with victims of trauma.  As part of the concentric circle of victimization this event opens wounds of all who have experienced similar wowrld changing events.  Parents, teachers, pastors, first responders, no one is exempt from such shock, terror, horror and grief.

I remember standing  with my wife and  our two children by the grave site of my daughter and looking into the grave, it was like looking into the abyss.  The little white coffin was so small.  We were surrouded by friends while a friend delivered a few words of support and comfort.  All I remember from that moment was the feeling of utter numbness and unreality.  My friend said, “you feel like you have fallen off a cliff and there is no bottom, but you must trust that you will fall into the “everlasting arms.”  It took me a long time to understand the import of his words.

In Newtown, one parent said it well as she spoke to a reporter:  “What we need is for all of you to leave so we can start to heal.”  Scott Peck once wrote, “It is only through Community that the world will be saved.”  I believe he had it right.  Newtown and its citizens will hopefully discover the power of covenantal community.  I have found that we do not heal alone.  Grief is best born by the everlasting arms of people who love and support each other.  Yes the night is dark, life feels devoid of meaning, the grief is fierce, the losses seem unbearable and the road to recovery seems only a distant possibility.

Recovery will come slowly as we do the work of community, binding up each other’s wounds with acts of kindness and sharing each other’s burdens. We discover ourselves in each other as we share our stories and create a common narrative. The nation is reaching out with cups of coffee, Penguins sent to comfort the children, and memorials spring up spontaneously.  Rituals are performed, funerals attended, and condolences offered, all are important first steps. Arms reach out from around the world to touch with acts of Kindness.

Gradually the shock will wear off and be replaced by the acute,  aching pain of grief, sadness and endless tears, only to progress on to the deep valley of despair and suffering as the moments are relived, rooms are found empty, and school lunches no longer need to be packed. And then a deep anger at the senselessness of our loss sets in. Somewhere in this bereavement process we must find faith and hope that we can rebuild as we search for meaning and purpose.  We must rebuild our shattered lives through community and a commitment to find loving ways to build a new safe base, and create secure and firm new attachments which will keep our children safe and restore our wounded souls.  Guns will not heal.

A line from an author I have been reading frames it this way:  “A fundamental and permeating strength of humankind is the capacity to form and maintain relationships-the capacity to belong.  It is in the context of our clan, community and culture that we are born and raised. . . .We each feel a need to be connected to the people of our past, and without being able to draw on this connection-the narrative-it is almost impossible to envision hopes and dreams for a connected safe future.”  Richard Rose

We must also learn from this tragedy:  it is the children who do not feel this inclusion, who have been marginalized and have become fragmented and damaged and do not feel this affirmation of community who grow up full of rage and strike back because of their wounds.  It is the failure to love them that is the source of such terrible, rageful violence.  And it is a careless, neglectful nation that allows  weapons of war to be so easily acquired by these wayward, wounded children.

Tragedy and loss is a universal human experience and in that way Newtown is every town.

Trauma and Addiction

Trauma and Addiction
By Gary W. Reece, Ph.D.


There are many consequences that follow an experience of trauma.  One of the more common reactions often goes unrecognized because it takes a while to develop and as a result people fail to make the connection.  Following a traumatic experience there is a relatively high probability that a person will develop one or more addictions.

It has particularly been noticed in certain high risk professions such as first responders, police, fire fighters and soldiers.  In one study done after the Oklahoma City bombing, they noted a higher than usual number of  individuals who developed addiction, there were also a high number of suicides, divorces and related symptoms of post traumatic stress disorder.  There were other high risk behaviors also noted such as thrill seeking, gambling, and other self-destructive behaviors.

There are many reasons for the development of an addiction.  Some individuals  are more risk prone because of such factors as a family history of addiction, hence you would be at greater risk.  Or being in a high risk profession where individuals are exposed daily to danger. There are also personality types who are more vulnerable, particularly those that are considered Macho so that a person is thought to be weak if he exhibits any kind of weakness such as an open display of emotion.  Men are more prone to this because we are expected to be strong, and that means we do not show weakness, feelings,  neediness, or vulnerability.

The dynamics of trauma make us particularly vulnerable to addiction because the experience itself subjects us to “an overwhelming event which exposes us to violence, harm, or death and renders us helpless in response to it."  Furthermore, during that experience we are hit with a shock, a surge of emotions which are too great to handle.  It is this shock wave of overwhelming terror, fear, or horror which immobilizes our psychological defenses so that in the initial stage we experience a state of numbness, shock and helplessness.  This is a natural psychological reaction to shut down when too many painful feelings come all at once.

What most people do not realize is that we are at the highest risk psychologically right after the traumatic event.  What we do to cope is critical.  The people most vulnerable are those who are isolated:  do not have a good social support group and have difficulty experiencing painful feelings.   This is particularly true in single event traumas.  In the case of the military or law enforcement, these individuals experience a different kind of stress.  They are exposed daily to a variety of stressful experiences, many of them do not rise to the level of trauma but fall into the category of multiple, chronic stressors.  High stress over a long period can lead to addiction as the individual begins to gradually use substances to help deal with the tension, fear, frustration or helplessness attendant to the profession.

The dynamics of addiction are relatively simple to understand.  It is a simple law of learning.  If a person experiences a high level of  emotional or physical discomfort and then by chance does something to cope and experiences immediate relief, this associative connection gets linked.  Pain=relief=positive reinforcement=reliance on whatever “worked”.

In my particular case, for example, I was in a prolonged state of shock and emotional deadness after the sudden death of my daughter and discovered that by going back to work and working long hours I felt better.  I felt the reward of being in control, I could work, be successful and be rewarded by making money.  Hence I became addicted to work.  This helped me feel back in control, powerful, and socially validated.  So, in essence, whatever we do immediately following a traumatic event can potentially be addictive.  If we have poor coping skills then we are more vulnerable.

My poor coping skills were an inability to feel or express strong emotion, difficulty trusting others by exposing my felt fear, vulnerability, weakness, neediness , and helplessness.  I felt so much rage and disillusionment and did not know what to do with it.  So I found great relief in avoiding it all together.

Instead, I found great relief and real magic in buying new Jaguars and Porsches.  About one a year.  The sales men were so glad to see me, I felt so powerful driving off the showroom floor with my new Red XKE roadster.  It felt so good to show off and feel the excitement of driving it.  But the high lasted only about a year and then I had to get a new fix.

There are all kinds of addictions: shopping, sex, alcohol, drugs, affairs, the list is potentially endless.  It is whatever helps us feel better.  Trauma shatters self-esteem, our sense of control, our beliefs, and overwhelms us with painful feelings.  Whatever helps us cope has the power to be potentially addicting.  If it helps us to feel like somebody again, restores our damaged self-esteem, helps us feel less isolated, lonely, afraid, and empty:  in short a shattered lonely nobody, then we have found indeed the magic elixir.  As they say in the addiction community, it is a short term solution which becomes a long term problem.

Addiction, then is a failed attempt to restore the shattered harmony of our lives.  It is a symptom of failed mourning.  I have told many who came to me for therapy that you cannot grieve and practice your addiction.  Overcoming addiction is doubly painful.  First, there is the problem of abstinence-withdrawal, very painful and uncomfortable, requiring a great deal of courage to give it up.  And then there may also be repairing whatever damage we have done to our lives by the addiction.  It took me years to overcome the financial disaster of buying new cars every year.

There was also the matter of a divorce as the cost of my self-indulgences. That was also emotionally and financially catastrophic.  Secondly, in giving up the addiction we then open ourselves up to feeling the grief we have been avoiding.

But the good news is that once I began facing my demons, I was able to begin cring again,  feel the feelings, feel more alive, and that led to being more authentic which enabled me  to genuinely respect myself.  In healing I had to give up my addictions, feel my pain, restore my shattered life, and find authentic ways to feel good about myself.  This route may initially be the harder path, but the rewards are infinitely greater because of the joy and peace that is found in facing the darkest moments of one’s life.  I also found that healing cannot be done alone.  And I might add, it took many years to create a life of meaning and significance with family and friends at the center.

Mourning and Attachment

Mourning And Attachment
The injured self
by Gary Reece, Ph.D.

For the past many years I have been working on a book focusing on the effects of trauma on children.  In the course of my research I have learned a lot about the concept of attachment.  This is the reason for this blog.  Human development from its very beginning is transactional and dialectical. What does that mean?  That from the very beginning of our lives we are developing in an environment of relationships.  Attachment is the process by which we develop into human beings.  Even the structure and workings of our brain is influenced by the quality of our original attachment bond with whoever is the primary caretaker.  It is a biologically based survival mechanism.  All species survive because of the skill, care and nurture of  adults.

Through attachment we develop our essential sense of self.  Our identity is the sum total of all of our attachments.  Through attachment we learn a “working model of the world.”  We form a template of how to relate to others.  Through attachment we learn to regulate our feelings as well as how to soothe and comfort ourselves.  We also learn how to deal with separation and failures of attunement or relationship breaches through the dialectic dance of intimacy and separation.  Hopefully we also learned how to repair disruptions of attachment and separation.

If we had loving, consistent, stable, secure attachments as children, then it is said we will have a secure attachment style and have probably created an adult world where we feel at home and have a “secure base.”  If we had difficult or traumatic attachments in infancy, then we may as adults have attachment problems:  be insecurely attached or ambivalent in our attachments.  In severe cases we may not be able to sustain relationships and intimacy will be difficult for us.  In extreme cases of abuse, disrupted attachment, or trauma we see the origination of violent, abusive, character disordered individuals with no capacity for empathy.

We carry all of this, in fact we embody all of those very early attachment experiences into adulthood.  The child is the parent of the adult.  So how does all of this relate to grief and mourning?  Very simply.  Any loss is an injury to our sense of self.  The greater the loss, then the greater will be the injury. This is why we react with pain, anxiety, depression, and anger when we  have a blow to our attachments.  If we learned how to deal with early separation, abandonment, and frustration due to loss then we will be better prepared to grieve our loss, heal our wounds and regain our equilibrium.

Through mourning we go through the very process of sustaining the original blow and losses to our attachments.  Those which are the foundation of our personhood and the world we have created for ourselves.  In my experience loss opens old wounds, and we find ourselves grieving every loss.  Losses in life all tend to be connected in our emotional memory banks:  they plunge us back into the experience of feeling alone, vulnerable, fragile and helpless:  like an abandoned child.

The severity and type of loss and our attachment history determines how long it will take us to heal.  By the active process of mourning we must to deal with powerful emotions, deep wounds, lost attachments, and the disorganization which comes when our world gets shaken at its very base.

Mourning is a dynamic process of healing in which we are dealing with the emotions of loss, working through whatever issues are raised by the loss, trying to make sense of it, dealing with the practical aspects of keeping  life going while all this is happening, and finally being able to create new attachments that will give us meaning, purpose, joy and hope.  Attachment is the ability to care, to experience intimacy, to trust, and engage with others: it is what makes us human and is the defining experience of life.  The reason I say it is transactional and dialectical is because  life is a struggle: it is a test of our ability to sustain love and faith in spite of what happens. We are always existing in a state of trying to maintain our equilibrium and dealing with things which threaten our identity. Mourning is an essential skill for the well lived life.

Good Grief!

Good Grief!

By Gary Reece, Ph.D.

To live is to experience loss.  Yet so few people understand the grief and loss process, in particular the process of mourning.  There are  many myths and so much misunderstanding about how to deal with loss.  It is very understandable that none of us likes to experience pain and so therefore avoid it at all cost.  In fact most people view pain as something that indicates that something is wrong.  In the case of grief and mourning it is an indication that something is right.  It is normal to experience pain over a loss.  Yet most people tend to want to “put it behind them, to move on” because they see grief as a pathological state. And because of this attitude  people in mourning are often stigmatized and avoided.

So in this blog I would like to explore some of our attitudes toward grief and mourning and put forth the position that Grief IS Good:  that it is a normal reaction to loss and when done properly leads to healing, and when it is avoided it can lead to a condition called Complicated Mourning which I have written about previously:  Unhealed Wounds.

There are many reasons why grief is seen as something to be avoided.  First, because it is painful, but more importantly because it is seen as a sign of weakness and finally, because others are very uncomfortable around people who have experienced a loss.  These attitudes and ignorance about the very necessity of grief and mourning add to the probability that a person will not complete the mourning process.   In fact, I believe that  ignorance and common myths may contribute to increasing the pain of the whole loss experience.  This is important to understand because there are over two million deaths a year in which 8-10 family members are affected.  And this only relates to death, and death is only one kind of loss experience.  There are many other kinds of losses which affect us and also require us to deal with them.  Such as divorce, losing a job, foreclosure of a home, and dealing with normal life passages.

I would like to explore some of the myths about grief and mourning.  But first let me define some terms so we will be on the same page, so to speak.  Bereavement is the actual state of having suffered a loss.  It implies that something has been taken from us, in this definition is an implication that someone who is bereaved has become a victim, an unwilling participant.  Something has been taken unjustly and it has injured us.  Grief refers to the process of experiencing the loss:  the actual psychological, social, behavioral and physical reactions to whatever was lost.  Grief is a natural, expected reaction to loss, all kinds of loss, not just death.  What determines the amount of grief we experience depends upon what was lost, and it is our perception of what was lost that determines our reaction.  Others may not see the loss as significant.  For example, I spoke at a convention held for families who had experienced the loss of a child through miscarriage.  What stood out at that convention is that many have the attitude that a miscarriage is not a significant loss. The common response these families reported was that people told them, “you can always have another child.”  In other words, the loss was not seen as significant.  These kinds of losses are called “disenfranchised bereavement.”  Where what was lost was not seen as significant, or that the experience itself was not viewed as worthy of a grief reaction.  “What’s the matter with you, you have to put that behind you.”  “Haven’t you gotten over that yet?”

Mourning is the actual experience and the active working through process.  The ultimate goal is to react to the loss and then experience the pain of the loss, and then actively work through the feelings, reconcile and make sense of the loss and then to rebuild your life around new and healthy attachments.  Mourning is a very active process, it requires work to come to grips with what was lost, to make adaptations to the reality of the new life imposed by grief, and then achieve a state of acceptance--resolution.  Grief is only the first step in mourning.  Grief helps the individual recognize the loss and prepare for mourning.  Mourning is the active process of coming to terms with the loss.

Here are some of the most common myths about grief and mourning.  1)  Grief steadily declines with time:  time heals all wounds.  2)  Mourning should be over in one year.  3)  Mourning merely involves catharsis, you just need a good cry.  4)  The intensity of your reaction testifies to your love of the individual.  5)  Mourning only has to do with death.  5)  Recovery means putting the experience behind you as quickly as you can.  6)  Loss is the same whether it is anticipated or not.

These myths about mourning often make them worse and more difficult for the mourner.  Being around individuals who care, understand and are comfortable with feelings is very important to healing. And secondly, misguided attempts to help by offering clichés often send messages that hinder grief:  "Don’t feel, your feelings make me uncomfortable and I don’t know what to say.  Get on with your life.   Stop being a victim."  All of these reactions may create secondary reactions and make it difficult for us to grieve.  Remember, grief is good.  It is normal, there are many losses in life, and they are all linked like a chain.  That is why grief can be so difficult because if we have unresolved losses from the past they are frequently triggered  by and compound the present loss.

Therese Rando wrote in her classic work on bereavement:  “In other words, the destabilization occasioned by major loss often puts one in touch with past pain and previous times of chaos, stress and transition, and can summon unfinished business from the past all of which can add to current distress.”  Good Grief, no wonder we don’t like to grieve.

I will write more about the process of mourning in my next blog.  My goal is to create understanding and appreciation for one of life’s most common but most misunderstood experience.  To live is to mourn.  Yet few know how to go about it.

Heroics

Heroics
By Gary Reece

Watching the 2012 Olympics from London inundated all of us with the epic drama
of individuals performing amazing fetes of  athleticism, and countries celebrating the achievement of their athletes represented by their number of medals.  It is easy to get caught up and  identify with the “ecstasy of victory and the agony of defeat.” To strive for something with a single mindedness all of your life and then put it on the line with the whole world watching:is truly engaging.  It all comes together, supreme focus of heart, mind, body, and spirit in one performance.  We saw a plethora of gold medals, and heard national anthems; for a two week period we vicariously participated in the pageantry and theater of heroics.  It was all  heightened by the slickness of the telecasts and the production of events to fit into prime time.  There was a compelling narrative telling the stories of athletes like Oscar the double amputee competing with able bodied runners, or a lone woman from a Muslim country competing for the first time.  Or barefoot Kenyans running in the Marathon.  It appealed to our emotions and kept us tuned in to the next impossible scene.  And then it was over.  Television became kind of flat and ordinary agaln, back to real life.

This contrast got me thinking about the whole idea of heroics and how we worship the spectacular, and celebrate extraordinary individuals doing amazing, unusual things.  Things we can never do.  We raise them to levels of adulation and heap huge amounts of money upon them. The term Hero is used  so casually and we are quick to anoint someone as the hero de jur.

This is  the point  I wish to make, there is a level of heroism that is seldom seen or  acknowledged  of individuals doing things not on camera.  Oh we see a story occasionally about another soldier coming home with devastating injuries and we on the anniversary of 911 parade our heroes.  But, I wondered if perhaps we have been seduced by the glitz and glamour of high production values and TV ratings.

Is it possible, I wondered that there is a theater of heroics all around us, but we just are not aware of it, that heroism can be found in the way ordinary people face extraordinary circumstances?   That in fact, perhaps our central calling, is to raise our own  lives a level of heroism, where we make decisions, find something worth living for and elevate our lives to a level of significance which brings occasional joy.  I wondered how many of us are doing things to earn the feeling of heroism?  The kind of heroism, I envision takes place on the boundary, on the edge of life where there are no gold medals but instead what is at stake is our mortality.  The way we face up to challenges and trauma certainly calls for courage.  This, for me, has a greater resonance and ring of authenticity.  For example.

One of the most common but overlooked traumatic events which affects literally thousands of Americans everyday takes place behind closed doors and is given in muted tones.  What?  A trauma that literally affects thousands of families every day and the perpetrators are getting away with it?  And it’s legal?  What is this scourge?  Call Eye Witness News, breaking news!   It is the conversation that begins in soft and measured tones.  It happens daily, a family is told their child has Leukemia, or your child has a rare, unpronounceable heart disorder.  In my case it was a conversation I had with my doctor, “Gary, we found something, its going to have to come out.”  The pronouncement had the impact of a sledge hammer.  Stunned, too overwhelmed to even think rationally, to formulate a question, I let him talk as the whirlwind spun my mind into dark, catastrophic scenarios.  I hear words like surgery, tests, x rays, CT scans, blood tests, all the indignities of being dehumanized and processed through encounters with cool, professional medical technicians who have seen it all before.

When I got home, my mind cleared and a quote came to me, from Ernest Becker, “The prospect of death wonderfully concentrates the mind.  The fear of death haunts the human  animal.”  It certainly does!  It changes everything in a moment, we are not always aware of our having to die,  in fact most of us see it as a theoretical possibility, an abstraction, but when the realization breaks through in the boundary experiences we are thrust into, “we see the world differently.”

The psychological impact of these sorts of encounters leave people feeling stripped of their humanity, vulnerable, shocked, terrified, confused, lost and so very alone: singled out from the herd.  First protest, “its not fair! Why me?“ Then denial, then terror and feelings of helplessness  followed by despair. The dawning dread often blooms into shock  when we are given an unfavorable diagnosis by our physician.

When it sinks in, it is the realization of our not being able to preserve our lives, a sense of our helplessness and futility of our fate which exposes us to naked anxiety and despair. Alone, feeling unsafe and betrayed by my body, I stoically accepted what must be done and submitted to the procedures.

When my doctor told me I had to have surgery because I had stage one  Colon Cancer, I felt like I had been jerked out of the safety of my little boat that I had been paddling around in so sublimely unaware of the dangers lurking within, taking for granted so many of life’s pleasant offerings,  like we all do.  

These existential moments of crisis which threaten our very lives, make us acutely aware of our fragility, our mortality, vulnerability, and dependency.  Seeking to regain control and manage my terror, I engaged in a flurry of activity, got things done, got my Will in order, talked with my children, and did what the doctor ordered.  This was 5 years ago, and I  to my amazement, survived and got on with my life.

I was lucky, the surgery was successful, and I am now cancer free, but in the meantime I had another conversation two years later. This time it was about a bone infection in  my foot due to diabetes.  This conversation was a “to be or not to be talk.”  I could have my left foot amputated or die of slow blood poisoning. I put the decision off for two days.  Three years later, after months in a wheel chair, walker, and being fitted for a prosthesis, I am back to normal.  (Well, some would argue that I have never been normal.)

What have I learned?  Life is precious, I am fragile, I have good friends, and my family is there for me.  I decided I was working myself to death, and so I retired.  I made many lifestyle changes.  I exercise daily, lost 50 pounds eat well and started doing some things I’ve always wanted to do, like writing.  I stopped working myself to death and retired.  I spend my days going to the gym and last year traveled with my son to Yellowstone and took lots of pictures.  I have also gone to Sedona, and camped with my grandkids at Big Sur.  I take great joy in my hobby of Bonsai and created a Japanese meditation garden for myself.

I now see the theater of heroics differently.  I don’t give much thought to the spectacular, celebrity driven, entertainment created heroes.  I see these as contrived  and view them as failed heroics.  My hero theater is everyday life.  This is where I see the human spirit ennobled by small acts of love and nameless acts of transcendence.  There is a man at the gym who every day brings his son in a wheel chair--he has cerebral palsy.  He patiently helps him get on an exercise machine, helps him move the weights, and then goes on to the next machine.  There is a man who comes everyday in a walker and gets on and off the machines by himself.  He has ALS.  Look around, every person is a story, some may be walking right by their opportunity for heroism, they are just not aware, their lives pass before their very eyes without  them ever seeing the significance of their hero drama.

This, for me is the heroics of everyday life.  It is people saying yes to life, to their circumstances and confronting their mortality, facing it and finding a way to live in spite of it.  These people redefined heroics for me.  I would not have gotten through my ordeal without my good friend Jack carrying my wheel chair up and down the stairs, loading me into his  car, having me over for dinner on Christmas Eve and taking me to the movies.  Or my son and daughter stopping their lives to come and be with me.

And now the next conversation has already taken place.  My daughter Michele has been talking with her doctors and will be having surgery in September. She is already discovering the miracle of friends lining up to help.   This blog is for her.

Life on the edge is terrifying, we are so very mortal.  It can happen so suddenly and capriciously, to get jerked out of our comfortable boat, oblivious to the dangers all about us.  This is the theater of heroics.  Its not about gold or celebrity, these are distractions, they seek to entertain, distract and keep our eyes diverted from what is going on all around us just below the level of our consciousness.  The skull is always present at the banquet, so says William James, and I say all we can do is look it in the eye and smile.

The Legacy of Trauma: Unhealed wounds

The Legacy of Trauma:  Unhealed Wounds
By Gary Reece, Ph.D.

We have witnessed another large scale traumatic event which in its concentric circles of victimization will traumatize not only individuals, but an entire community.  Aurora Colorado gets added to the list of unbelievably tragic events:  Columbine, Oklahoma City, Virginia Tech, 911, Tsunami, all are recognizable by just a word or letters.  What is not understood is that those who were the first responders also are impacted because they are “tough, highly trained professionals just doing their jobs.”  First responders after all of the events cited above have higher levels of addiction, depression, suicide, and failed marriages than ordinary citizens.  Why?  Because of the seldom recognized  and little known reason that they are terribly affected by what they do.

They are more vulnerable to trauma effects than the other victims because they are exposed to a high level of blood, horror, and devastating wounds they are expected to cope with.  We call them heroes, and they are, but that appellation does not immunized them from what they experience in the trauma scene.  They will be haunted by what they saw, smelled, touched, and waded through in their initial response.  They as well as all other victims are endanger of ending up with unhealed wounds.  The legacy of incomprehensible terrorizing, horrifying violent attacks against our humanity, communities and collective psyches is the very real danger of lasting and crippling wounds.  The first responders I have worked with are also in danger because of a culture of machismo which leads them to believe they should be “strong and invincible” unaffected by the events because to feel and be hurt by what they have participated in would leave them feeling like the rest of us: vulnerable and fragile, so they say they are “fine” and function right through the pain and horror.  It is only later that they are not fine.

The risk of these horrific, violent kinds of trauma, is that all affected become stuck, or frozen in time. An unhealed wound is by definition a failure or distortion of  the tasks of mourning and healing of psychic wounds due to trauma.  This failure to grieve a loss, this failed resolution can happen at any stage in the recovery process.  Another risk is secondary trauma, which can be attributed to insensitive media members violating the privacy of victims in their race to cover the event.

Recovery involves essentially 4 phases.  The first stage is Recognition.  The primary symptom of being stuck in this stage is either numbness or a total absence of feeling.  This is the residual of shock with feelings of unreality:  victims often remark that it felt “surreal, as if it wasn’t happening.” This is because the event is too overwhelming:  our psychological defenses cannot process that level of feelings all at once.Trauma by definition is an overwhelming experience that renders us shocked and helpless.

If healing is to take place it must be Recognized and the victim must find a way to work through denial and numbing.  This cannot be done all at once or merely a superficial, Yeah, it happened and I moved on.  This is still denial.  The worse the trauma the longer it will take to begin to feel and process what happened.  The risk at this stage is to our ability to feel anything, to  remain in a state of emotional deadness.  At one event I participated in, I did a critical incident debriefing  with a team of first responders to a plane crash at an airport.  One of the responders recounted that he couldn’t get the smell of the burned bodies off his skin and found himself taking a dozen showers.  Others reported similar experiences and found it helpful to talk about it together.

It should be stated that all of our reactions to unspeakably  high levels of violence are normal reactions  to abnormal situations.  This leads us to the second stage of mourning:  Recall, remembering.  This is when the very appropriate feelings of sadness, rage, emptiness, horror, confusion, regret, guilt, and failure begin to surface.  It is not uncommon for individuals to get stuck at this stage.  I have talked to individuals who walked around for years after the event stuck in rage.  They just can’t get past it.  Others become perpetually sad, their grief is worn like a second garment.  It becomes a part of their every waking moment.

Remembering and recall are critical to recovery because without them their can be no healing.  In order to heal we must be able to remember what happened, but not only remember but to recall and experience the feelings associated with the traumatic losses and residual effects.  This is what it means to grieve.  To permit ourselves to acknowledge the loss in its stark reality and work through all the difficult feelings.

This sets the stage for the next step.  Reconciliation.  What I mean by this is to actively work through the entire event and make sense of it by dealing with all the conflicting feelings and ways in which the event shatters our  beliefs and assumptions.  These events are horrific and shatter our view that life is orderly, just, safe, and meaningful.  When an insane person walks into a theater and begins shooting, this violates all of our assumptions about life and shakes our foundations.  We don’t feel safe, we fear for other acts of violence, we realize our vulnerability and go into a frenzy of trying to make ourselves and communities safe from random acts of violence and realize that we can’t because it keeps happening.

There is no timetable for mourning.  The myth that time heals all wounds is just that, a myth.  We all deal with loss in our own individual ways and each person experienced the event uniquely.  And because of this the task of rebuilding and reattaching is done at an individual’s own pace depending on how they were affected, what was lost, and their own resilience and community resources.  And it must be said that recovery depends in large part on the quality of the recovery environment.

In a community wide event, the entire community must come together and mourn collectively and be aware of the risks of mass tragedies.  Because we exist in community and our attachments to that community are what make us human it is critical that community leaders recognize the power of community in healing and that individuals not try to heal alone.  It is always inspiring to me to see the impromptu memorials which sprout up as if by magic at the site of the tragedy.  Rituals can be powerful ways to collectively mourn.

There are many signs of unhealed wounds.  Some things to watch out for are:

1)  A tendency to be hyper sensitive or to over react to anything having to do with the event.

2)  Restlessness or inability to relax and the need to be compulsively busy.

3)  Fear of recurrence and feelings of vulnerability.

4)  The tendency to over idealize the dead and enshrine them, remember they were human just lie us.

5)  Rigid, compulsive, ritualistic behavior that takes over your life.

6)  Persistent thoughts and preoccupation with elements of the loss.

7)  Blocked emotions,  Inability to feel or a constricted range of emotion.

8)  Inability to talk about anything related to the loss/avoidance.

9)  Relationships marked by fear of intimacy and fear of future disappointment.

10)  A pattern of self-destructive behavior or risk taking.

11)  Development of reliance on substances or abuse of medication.

12)  Chronic experience of numbness, alienation and isolation.

13)  Chronic anger, depression, irritability, intolerance.

14)  Total absence of mourning.  Acting as if nothing happened.

15)  There is a very long list of bodily symptoms:  insomnia, weight loss,
        anxiety,  and stress related illnesses.

The question I am most frequently asked is, “but why do we have to dwell on it?”   “Why don’t we just put it behind us and move on?”

Answer:  Avoidance leads to further complications and unhealed wounds.  Grieving is hard work, but necessary to restore our broken relationships, shattered communities, and wounded minds and souls.  We heal through the process of courageously facing, exploring, feeling, and talking with others.  We make sense of what has happened, face the insanity and meaninglessness of horrific violence and embrace our humanity.  In so doing we affirm the power of love and healing in our relationships with each other.

Trauma: Hidden Epidemic

Trauma:  Hidden Epidemic
By Gary Reece, Ph.D.

     Loss, disappointment, failure and grief are normal and natural accompaniments to the human experience.   Bereavement, the response we have to grief and loss is also familiar to most of us. However common loss is, few of us have learned how to deal with it well. There are many types of loss. There are losses that occur due to normal passages in life, changing jobs, losing jobs, divorces, children leaving home, aging etc.  These also leave scars and contribute to the cumulative effect of life stress.  With each primary loss there are also secondary losses.
      Some losses are the unavoidable results of the human life cycle.  To live is to experience loss.  Most losses are survivable and individuals move through them and restore balance to their lives.  It is estimated by one expert that there are approximately 2 million deaths a year in which 8 to 10 people are affected.  This means that there are as many as 16-20 million new mourners every year.  This expert also notes that at least 1/3 of these individuals will suffer the consequences of complicated mourning, or in other words fail to fully recover from the loss.
      There is another class of loss, however, which presents even greater risks and challenges: Traumatic Loss. In the past decade we have experienced an amazing number  of catastrophes. These catastrophic events have left survivors by the millions with traumatic effects from which they might never recover.  Several come to mind.  We can start with 911, then in random order others spring to mind, Oklahoma City, Colombine, Katrina Hurricane, Joplin Missouri tornado, the Japanese earthquake and tsunami and Haiti earthquake.  Then add wars and civil unrest to the discussion:  the Mid East events: Libya, Syria, Egypt, Iraq, Pakistan, Afghanistan, the genocide in Africa and global terrorism.
This is what I believe constitutes the hidden epidemic, with the epidemic comes its hidden victims.   I think it is because perhaps we don’t think of these as traumatizing events because they are so ordinary, frequent,  and on such a massive scale.  But think of the definition of Trauma.  DSM IV “The person develops characteristic symptoms following exposure to an extreme traumatic stressor  involving direct personal experience of an event that involves actual or threatened death or serious injury or other threats to one’s physical integrity or witnessing an event that involves death, injury or a threat to another person or one’s family or close associates. And the person’s response must involve intense fear, helplessness or horror.  To put it more succinctly,  it is an overwhelming event producing helplessness and terror.  These events are now serial and complex which compounds the effect.
     Clearly all of these events fit the definition, and then add to the list all of the children living in refugee camps, and all of our returning veterans who have experienced events way beyond the definition of trauma and we have an epidemic of unprecedented proportions.  We are in danger of having a whole generation of  victims of severe trauma.
     This is the new age, the new reality affecting our consciousness and perhaps blunting our sensitivities. Can it be possible that through the process of unconscious accommodation that we have become desensitized?   Is this the new normal?
     While the actual experiences of trauma and mourning and its inherent demands have not changed over time, what has changed is the context in which they now occur.  This changed environment is charged with the potential for complicated grief and mourning: unhealed wounds.  The reason for this is quite simple; conditions creating complicated mourning have become more prevalent and wide spread.  Unnatural and violent death is now occurring with less of a social context in which it can be integrated.  The social conditions under which we exist are characterized by increased violence, accidents, terrorism, disaster, holocausts, plane crashes and natural disasters.   The result is victims living side by side, unaware of their wounds. We live in anonymous neighborhoods. Our whole social milieu and dynamic has changed.  Indifference to violence and increased homicide rates in all of our urban areas might reflect this new malaise.        The fort Hood rampage is symptomatic of this unseen trauma effect.
     The loss of the extended family, single parent families, anonymous neighborhoods, and urbanization result in the loss of the experience of community.  Add to this the loss of mental health resources, and the result is more wounded people with fewer resources and opportunities to successfully transition life’s many challenges.
     Lack of resources, lack of awareness, lack of community, and a lack of knowledge regarding the potential harm of living with unhealed wounds leaves many people accommodating to their wounds and living with addictions, depression, fractured personalities, failed relationships, physical health problems, self-destructive behavior, suicide, violence, child abuse and unfulfilled potential.
     I have devoted my entire career as a psychologist to studying and treating trauma and bereavement.  I have experienced many different forms of traumatic loss and participated in many workshops and community disaster responses.  I have also worked with hundreds of victims of trauma.  What I am left with is the awareness of the challenge of raising community awareness, educating individuals to their condition and trying to create opportunities for addressing their wounds.
     One thing I have discovered  in my career is the certainty that it is the quality of the recovery environment which in the long term determines the outcome of recovery. If it embodies the necessary conditions for healing then the outcome is much more favorable.  These conditions are found in the best forms of human community.  Communities bound together by compassion, empathy, intimacy, and trust: and they must also be intentional and bound together by commitment to common values.
     One recent experience led me to understand and appreciate the role a Covenantal Community can play in the healing of persons.  I was called by the Rector of local Church to see if there was anything I could do to help them deal with the sudden loss of two of their most loved members due to sudden death.  I consulted with the Rector and we planned an experience to help the entire community deal with their loss. We gathered in the fellowship hall; shared a meal, and I talked about loss and bereavement and I encouraged them to talk about what they were experiencing.  It was a good time of feelings being expressed, stories told, and sharing of wounds.  Following this experience we went into the sanctuary and took communion.  After the experience, the Rector and I reviewed our experience together.  She stated, “This was the most seamless expression I have ever had of what the original church must have been like.”  That and other experiences like it left me with the conviction that these kinds of shared experience present a wonderful opportunity by the very nature of their structure, values, and founding purpose to be an intentional healing community. At times like this I am  reminded of a quote by Scott Peck:  “It is only in and through community that the world will be saved.”
I will write more about complicated bereavement and PTSD in my next blog.  For those interested you can contact me through my e mail:  gwrphd@verizon.net.  My book:  Trauma  Loss and Bereavement is available by contacting me.