So you have old trauma and it's making life hard--it's important to get the right kind of help
  1. Right now, everybody I see in therapy who has pre-existing trauma is in a state. Newspapers, TV, and the Internet are bombarding us with stories and images of horrific trauma.
    Whether it is a school shooter or a terrorist attack, the images trigger our most primal fears. If in your past, you already have experienced terror or if you have been neglected and unprotected, your reactions can be quite unbearable.
  2. The thing about early trauma and neglect is that they have an indelible effect on the nervous system.
    People who have experienced early trauma tend to alternate between feeling flooded, overwhelmed, and unable to escape their emotions--They then flip into a state of disconnection, emotional constriction, and avoidance. They are either dissociated or they are out of control with depression and anxiety.
  3. Oftentimes people who suffered too much neglect and abandonment in childhood have difficulties activating themselves or feeling anything at all.
    These people will frequently alternate between acting out in order to feel: by cutting, fighting, overeating, compulsively exercising, or some other stimulating experience--or they are in a disconnected, dissociative, empty place.
  4. So maybe you deal with one or both of these experiences, and maybe right now life is hard. You have to cope in an adult world when most of you feels like a neglected or abused little kid. What do you do??
  5. Certainly the usual three, the three things I always recommend in every list:
    Great therapy, appropriate meds and excellent social support. Yada yada yada--The same three things I always recommend, but what beyond that??? What else helps when you're feeling traumatized, overwhelmed, and unable to cope???
  6. Minimize your triggers:
    If you have been traumatized and abused, you do not need to spend hours on the Internet reading new stories about planes blowing up, terrorist attacks, or random shootings. be the good parent you never had. Expose yourself to positive images. This is not sticking your head in the sand this is titrating and diluting exposure to triggers.
  7. Remember that you have overcome adversity in the past.
    See your present feelings as a breakthrough of old implicit memories of a time when you were helpless and afraid. Remember that you are no longer a helpless child and that you have resources now that you never had then.
  8. Check in with yourself and observe what is happening: are you anxious, depressed, dissociative, or falling into avoidance? Be your own good parent and take steps to combat these feelings appropriately. Make efforts to keep to your usual routines:
    Do you usually go to the gym? Meet friends for coffee? Are you usually present and engaged at work, but now not so much? If necessary, make yourself do old familiar comforting and positive activities. Don't let yourself avoid life.
  9. Find ways to have a sense of control in your life. Remember that the nature of terrorist attacks is to create fear and uncertainty and a sense of having no control over events that might destroy you.
    The odds of actually being a victim of an attack like this are very very small, the problem is that when you have previously been abused or neglected, rationality and statistics are meaningless. Your nervous system knows what it is to be traumatized and expects it to happen again. You have to actively combat this.
  10. The bottom line is be a good parent to yourself, maybe the parent you never had.
    Don't let the internal child reexperience the horrors of once upon a time, no matter how much our crazy current reality seems to trigger those old feelings of helplessness and horror. Odds are, you really are safe now.
  11. So yeah: here's the mantra, good therapy, Meds if necessary, good social support, avoid triggers, work on self soothing capacities, observe your usual routines.
    Be very very very loving and kind with yourself. You don't deserve to feel this scared and alone. You never did. Be the force of love and care for yourself that you never had.
  12. Love, Doc P