As you may know, many people who experience traumatic events do not subsequently develop post-traumatic stress disorder (PTSD).Â One of the determining factors seems to be the feeling of extreme helplessness at the time the trauma occurred:Â people who don’t feel helpless are able to process the experience in their usual way.Â In language I’ve used elsewhere on this site, they are better able to “contain” their experience.Â When someone is overtaken unaware by a traumatic event, however, they can’t rely on their usual resources to process or contain the flood of fear, anxiety, pain, etc. aroused by the event.Â To protect itself from this overwhelming experience, the mind erects a barrier against the memory, segregating it from other memories and emotions in a process of defense against it.Â The defense fails as the memory can’t be entirely excluded but continues to exert an extremely powerful effect.Â The paradoxical result of this effort to ward off an overwhelming experience is to give it a lasting power to cause pain.
It was Sigmund Freud and Josef Breuer, of course, who first theorized about the power of unintegrated traumatic memories.Â In their Studies on Hysteria (1895), the authors presented a theory that women who exhibited conversion (hysterical) symptoms suffered from “reminiscences” or memories — and in particular, memories of childhood sexual abuse.Â They believed that these memories retained a lasting effect because, at the time the trauma occurred, these children were helpless and unable to protect themselves from the assault or react to it in a normal fashion.Â As a result, the memory of that traumatic experience becomes walled off, segregated from other experiences and memories; it “acts like a foreign body” in the mind because it hasn’t been subjected to normal mental processing like other experiences (p. 6).
In the normal course of experience, a memory would be “abreacted” — brought into the “great complex of associations … alongside other experiences” where it “is subjected to rectification by other ideas” (p.9)Â A “normal person” would be able to dissipate any disturbing feelings through this “process of association” with other thoughts, ideas and memories.Â The treatment for hysteria which the authors recommended was to help their patients abreact the traumatic memories by doing just that — encouraging them gradually to revisit the painful emotions stirred up by the trauma and to reintegrate their memories of their experience into normal consciousness.Â To my mind, this seems very much in keeping with the goal ofÂ modern-day treatments for ptsd symptoms, whether it be through psychodynamic psychotherapy or graded explosure techniques used in cognitive-behavioral therapy.
Freud began his career as a neurologist and Studies in Hysteria explains these foreign-body-like memories on the level of neurons:Â normal mental processing involves many interconnections between the neurons in the brain, while traumatic memories are deprived of such interconnections.Â This was the beginning of his theory of psychological defenses; he believed that the overwhelming power of emotional trauma, coupled with the physical and psychological condition of helplessness, led the mind to protect itself from a sudden influx of extreme stimulus by diverting the neurological current of such stimulus and sidelining it, away from from the normal flow of thought and feeling.Â My background in physiology is
limited, but this theory still makes a great deal of sense to me.Â In an earlier post, I described how our psychological defenses are like well-worn ruts in the neurological road; traumatic memories are like little cul-de-sacs or dead-end roads that don’t connect to major thoroughfares or highways.
If this process of psychological self-defense occurs dramatically and suddenly in post traumatic stress disorder, leading to the eventual onset of ptsd symptoms, an analogous process occurs slowly over time and through repetition in the development of other types of defense.Â In both cases, helplessness is the crux of the matter.Â Let me explain by giving an example.Â We need to envision the state of dependency and helplessness that characterizes infancy; try to imagine what it feels like to be a baby who understands virtually nothing about its experience.Â Because everything is new, nothing is expected, at least at first.Â All sorts of scary feelings and sensations come up with no advance idea that they will occur and and no understanding of what they mean.Â Under “good enough” conditions, the parents protect their baby from too much stimulus and respond promptly to its needs; thus, those “impingements” don’t overwhelm the baby.
What happens when the parents are not “good enough”?Â Say they lack the skills and empathy necessary to respond in the way their baby needs and therefore repeatedly expose it to excessive pain or frustration — more than it can bear but without any single moment rising to the level of ptsd-type trauma.Â In this case, the infant finds its own neediness unbearable and develops defenses against the awareness of it.Â Instead of isolating one traumatic experience from normal mental processes as in post traumatic stress disorder, it segregates an entire aspect of its emotional experience — that of being needy and depending upon other people.Â Instead of displaying ptsd symptoms, it may develop a particular set of defenses that evolve into a character type. He or she may grow up to be an extremely self-reliant person who has a hard time sustaining intimate relationships.
In psychotherapy, the goal would be to make that person aware — again and again — of how he or she avoids the experience of neediness through the use of characteristic defenses.Â IÂ might show him how he typically elicits desire in other people and then rejects them; or how she keeps herself so busy with her high-profile profession (and all those people depending upon her!) that she never has time to date.Â Â Within the context of the psychotherapy relationship, I would expect such a client to have a hard time letting me help.Â He or she might continually bring up reasons to quit, or try to develop a collegial relationship with me instead of turning to me for help.
Just as the traumatic memory in post-traumatic stress disorder must gradually be revisited and re-integrated, so must the disavowed needy self be brought back into the light and absorbed.Â Think of it as forging new neurological links, re-connecting the isolated aspects to the rest of the brain.Â That’s how Freud thought about it, well over a hundred years ago as he began to develop his psychoanalytic model of the mind.Â It still seems valid today … at least to me.
Finding Your Own Way:
The other night, I was lying in bed, trying (not for the first time) to imagine myself into the experience of an infant.Â I think this is almost impossible, but give it a try.Â Most important would be to deprive yourself of words:Â don’t describe the experience to yourself but instead try to feel your way into it.Â Try the moment of birth if you want a challenge.Â Imagine you’re in this very warm, relatively stable environment where nourishment is delivered to your body before you ever become aware that you need it.Â Almost nothing “happens”; the realm of your experience feels bounded and safe.
Then the birth process begins and you’re squeezed through a space far to0 small for you (this has to be painful and scary).Â Â You finally emerge and feel cold for the very first time.Â In the bad old days, somebody would then have slapped your behind and you would have experienced intense pain, most likely for the very first time.Â Nowadays, they shove something up your nose and suck out the mucous so you’ll begin to breathe.Â Soon enough, they wrap you in something soft (but nowhere as comforting as warm water), arms enfold you and maybe you feel safe again.Â Then your body exhausts its pre-birth fuel and you feel hunger pangs for the very first time.
If you want to get closer to that particular experience, try fasting for half a day or so.Â See how long you can bear those hunger pangs before you simply have to eat.Â Now imagine if you were a hungry baby, unable to feed itself, feeling such pangs … and nobody came to feed you.Â What could you do but try to get rid of your awareness of the experience. Â That’s the beginning of projection and if it becomes habitual due to repeated and excessive frustration, it lays the groundwork for various types of mental illness.