Trauma Management Has Not Been Given the Necessary Attention.
The mention of trauma does not seems to draw so much attention and it has not been given significance as a crisis in society despite of the ‘epidemic’ that it really is. Covid19 was declared an epidemic and disrupted every aspect of life but it has been dealt with accordingly, because it was given the necessary attention, not so with trauma which has largely been downplayed as a normal and manageable problem. Bessel Van De Kolk is a Medical doctor, practicing Psychiatrist, Professor of Psychiatry in Boston University and a leader in cutting-edge psychotherapy continuing education, he is also the bestselling trauma researcher author. He spends time studying how children and adults adapt to traumatic experiences, and has translated research findings from neuroscience and attachment research to develop and study a range of treatments for traumatic stress in children and adults. In his book The Body Keeps the Score, Van de Kolk helps in the understanding of traumatic stress, showing how it literally rearranges the brain’s wiring in the specific areas dedicated to pleasure, engagement, control, and trust.[1] While trauma has conventionally been treated with drugs and through talk therapy, Van de Kolk, shows through his own research and other leading specialists, how these areas can be reactivated through alternative innovative treatments including neurofeedback, mindfulness techniques, play, yoga, and other therapies, to reclaim lives. Van de Kolk posits that the key to resolving trauma is helping people repair the connection between their mind and body instead of self-numbing or dissociating. He specializes in working with people in addressing their bodily sensations in order to better process trauma.
Van der Kolk’s central message is that America is experiencing an ongoing and pervasive “hidden epidemic” of trauma and trauma-related problems. This seems an overblown claim that at first glance, especially given that America has been at ‘peace’ and is by all means the place that anyone across the world dreams of living in. Van der Kolk’s evidence-based and compassion-driven approach however reveals the gravity of the crisis which is worth taking seriously, and I believe that the same would apply to many other societies. From the ground-breaking research in the original study on Adverse Childhood Experiences (ACEs), by Kaiser Permanente and the CDC in the 1990s where, they administered questionnaires to more than 17,000 participants, to search for links between ACEs and subsequent health problems in Kaiser patients, the findings are mind boggling and calls for special attention. The main findings of this study can be summarized as:
“They had stumbled upon the greatest and most costly public health issue in the United States: child abuse. He [[Robert Anda of the CDC]] had calculated that its overall costs exceeded those of cancer or heart disease and that eradicating child abuse in America would reduce the overall rate of depression by more than half, alcoholism by two-thirds, and suicide, IV drug use, and domestic violence by three-quarters. It would also have a dramatic effect on workplace performance and vastly decrease the need for incarceration.”[2]
The last part of The Body Keeps the Score identifies the alternative, innovative cutting-edge modalities that represent the way practitioners approach and treat trauma in modern medicine and psychotherapy. Dr. van der Kolk gives the most focus to Eye Movement Desensitization Reprocessing (EMDR), yoga and other forms of bodywork, Internal Family Systems, Pesso Boyden System Psychomotor (PBSP), Neurofeedback, and theater-based approaches. These practices may differ dramatically in their theories and methods but they all attempt to defuse the power of traumatic memories by creating a novel pathway for healthy reintegration with a client’s normal memories and autobiographical self. Van der Kolk is not in favor of the medical model of mental illness, he shies away from psychotropic medications as a primary method of treatment for trauma, generally characterizing them as ways of numbing or suppressing symptoms rather than tools for fixing root causes. He also points to the limitations of talk therapy, which though useful in many circumstances, is ineffective for people in the early stages of recovery from serious trauma:
“Even years later traumatized people often have enormous difficulty telling other people what has happened to them. Their bodies reexperience terror, rage, and helplessness, as well as the impulse to fight or flee, but these feelings are almost impossible to articulate. Trauma by nature drives us to the edge of comprehension, cutting us off from language based on common experience or an imaginable past.”[3]
These therapies that involve little or no speaking will bring improvements in a client’s relationship with their own body-mind. The clients learn to self-sooth and autonomously disengage from states of hyperarousal, talk therapy often becomes a viable route to healing:
“The essence of a therapeutic relationship: finding words where words were absent before and, as a result, being able to share your deepest pain and deepest feelings with another human being. This is one of the most profound experiences we can have, and such resonance, in which hitherto unspoken words can be discovered, uttered, and received, is fundamental to healing the isolation of trauma––especially if other people in our lives have ignored or silenced us. Communicating fully is the opposite of being traumatized.”[4]
Every human being is a social animal and is part of a structured social entity that is the community in which he or she should thrive but trauma limits the victims. Van der Kolk understands and honors the structural and social nature of trauma in a way I haven’t yet encountered from other authors writing on this topic. In his own words:
“Humans are social animals, and mental problems involve not being able to get along with other people, not fitting in, not belonging, and in general not being able to get on the same wavelength. Everything about us––our brains, our minds, and our bodies––is geared toward collaboration in social systems. This is our most powerful survival strategy, the key to our success as a species, and it is precisely this that breaks down in most forms of mental suffering…The neural connections in brain and body are vitally important for understanding human suffering, but it is important not to ignore the foundations of our humanity: relationships and interactions that shape our minds and brains when we are young and that give substance and meaning to our entire lives.” [5]
Dealing with this issue will require so much more than inventing or applying the “correct” therapeutic treatment in any given case. It will require dedicated dismantling of the underlying causes of trauma: poverty, underfunded schools, racism, frivolous wars, and restricted access to healthcare, to name just a few. “Trauma is now our most urgent public health issue,” van der Kolk writes, “and we have the knowledge necessary to respond effectively. The choice is ours to act on what we know.”[6] The underlying causes are the same issues that have featured prominently in society and should draw the attention of the church in response to our missional obligation to alleviate suffering in society. This especially draws my attention in my research for the case for holistic ministry, where the church is a transformation agent in society in line with carrying out the great commission and the great commandment.
[1] Bressel Van Der Kolk. The Body Keeps The Score: Brain, Mind, and Body in the Healing of Trauma. (New York, USA. Viking, 2014).
[2] Van Der Kolk. The Body Keeps The Score. Page 150
[3] Van Der Kolk. The Body Keeps the Score. Page 43.
[4] Ibid,… Page 237
[5] Van der Kolk. The Body Keeps the Score. page 168.
[6] Ibid,…page 358.
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