I always thought that putting myself together, lining things in order, being OCD and fastidious about little things, feeling a sense of “control” if I touched the doorknob a certain amount of times or lined things up a certain way, being an overachiever in everything that I tried and was instructed to do, and always being/seeming confident, happy, secure, and optimistic….. (phew that is a lot!) would soak like a sponge into my mind and body and evaporate off all of the inner struggles, pains, and trauma that defied this outward sense of control, optimism, security, safety, and confidence.
It does, and it has. I recently realized that no matter how much I ignore my triggers through avoiding my body’s reactions to triggers (long ago I realized that there is no avoidance of triggers, but just an avoidance to the connection between mind and body), there is a takeover in my body and in my sense to fight and protect that cannot always be ignored and reigned in. At times, my fierce protectiveness and fight for what is fair, equitable, as well as fight for who is underprivileged, forgotten, alone, and being or in a traumatic situation, becomes to overwhelming, like a strong storm flowing over the levies that have been rebuilt again and again, stronger each time to handle fiercer storms, but yet might not always hold up.
I have a service dog, Mindi. She nudges me and licks me when I’m appearing to be zoned out, have anxious symptoms such as biting nails (getting my nails manicured has helped this somewhat, but then it just goes to biting my cuticles – all of us know that can be a painful habit!), shaking my leg, unable to sit still, and being wound up. She senses the stiffness in muscles, the fidgeting, any tension as well as helps me to be aware of any threats in my sight or in my area. She is very protective. She also senses slight movements, gestures, and energy in my body that are not remotely evitable in interactions these days over zoom, email, text, or other modes of “anti-social” interactions during the pandemic and in this generation. So, in theory, she should be my armor and I should be able to let down my guard, somewhat. Mindi has made my levy extremely high, a strong fortress, but my trauma and my sense of needing to protect, fight for myself, and defend others who cannot defend themselves is still there.
I always like to think that trauma has not affected me. I’ve been through childhood sexual trauma, teenage sexual trauma, adult sexual trauma, an inordinate amount of physical/obstetrical trauma as well as the trauma and grief of tremendous loss. I have faced too many times that sweaty, clammy, pale, whiteness, fuzziness feeling that signifies I’m coming too close to death. I have recovered, or so I used to be able to continue telling myself, and can continue to act, behave, and do things as if nothing has ever happened to me.
The hard truth:
No matter how hard I try or work to not be scarred, to not hold those traumas, to ignore the triggers and the bodily emotions that come through if my mind is numb, there is always a level of functioning and a position that I’m put in that corners me, forcing me to “act” traumatized, fiercely protective, incensed at the injustices in our world and society and the people that reinforce them.
No matter how many times I try to brush off fears that my kids will experience what I did, or that one of the adorable children playing outside of the local elementary school is going through trauma and in an unsafe environment right now, I cannot get away of that nagging fear. This is definitely why from a young age I wanted to help those individuals who could not advocate for themselves. I had started by working with young children with autism. Children who could not speak. They could only behave in ways that were “not normal” to most children. Years I continued working with these children and became attached to the idea of being a child/adolescent psychiatrist in order to help children with psychiatric disorders that developed from genetics, predisposition fueled by environment, solely the environment, etc. I worked. I worked through my own circumstances at times and ignored my own traumas. By ignoring my own issues, I had control over my outcome and what I would become, my traumas did not control me.
Time flew by in my overachieving world until I landed in my second year of residency in psychiatry. The levy broke. The triggers from the patients, the environment, the topics, built up into a huge wave that crashed through the levy. It wasn’t just a leak; it was a full hurricane. The damages from this hurricane and the breakdown of my fortress landed me in a position where my behavior and feelings were “not normal.” No, I was not ready to let it all out, to expose the traumas, vulnerability, and secrets of the inner pains of my body that were manifesting in erratic, irritable, and extremely depressed behaviors. It was safer to be diagnosed with bipolar disorder, blaming it on some chemical makeup that was not a manifestation of what I had been through and did not require me to “talk” about anything. Well, as you can imagine, this avoidance of true help, did not help J Medication trials did not really work all that well, some did as they helped with anxiety, but they did not take away or “normalize” me. My levies could not be rebuilt, and I was fragile and wide open to the elements that came my way.
After some period of time, I started to talk. As many of us know who have dealt with chronic childhood trauma, there is no “incident” that you think of over and over, there are fragments of senses, smells, triggers, tastes, etc. There are some single memories, but we all question how accurate these memories are or are they just “formed” because it helps our mind to put together some cohesive story that makes sense and gives us a harsh reality, but still reclaims some control, because we KNOW that reality. When childhood trauma happens and is then reinforced again and again by multiple more, but unrelated traumas, the idea that there really is something inherently wrong with me and that I am permanently damaged or that I deserve this, perfectly makes sense. Just so you know, I still have a very hard time countering and arguing with myself about my imagined inadequacies. Others get self-compassion and can heal, but not me. For me, the scars from surgeries, from losses, from assaults – they are real, they are not transformable. The emptiness in my abdomen from my hysterectomy is very real and a result of multiple traumatic experiences. There is no “taking back.” (Which brings me to the slight side note how I hate the expression “take back the night” – that’s a crock of shit). We can’t take back anything, what we can do is to fiercely protect, defend, and empower ourselves and those around us who are not able to advocate for themselves. We also need to remember that pains, injuries, trauma is not something that is necessarily apparent on the façade, many times it is not and it is a disservice to believe that “what you see is clearly what you get.”
This past week, I was faced with a near levy break. I was cornered and forced to defend something that was not fair, not equitable, and not in my control. I had no control. My accomplishments, the person who I am, how I present, none of this seemed relevant. Faced with real threat (in my mind, it wasn’t actually), I fight. I advocate for individuals who are not able to advocate for themselves against much more powerful communities, institutions, and individuals. I have been doing this for some time. I love to do this and I rarely feel defeated, but this past week was eye opening, exhausting, and saddening. Safe havens and supports did not feel like supports. I began to feel claustrophobic in my own environment, suffocating in an already hard to breath mask because of COVID, unable to relax and let down the argument. I was once again reminded that I did and do have a history of trauma, that I could not ignore it, that it had changed me and has changed me and it lives in there, sometimes behind levies and Mindi, but it’s there.
TAKE AWAY AND WHY I WILL NOT STOP ADVOCATING AND TRYING TO HELP SUPPORT COMMUNITIES AND INDIVIDUALS WHO ARE VULNERABLE, CAN BE RENDERED POWERLESS, AND CAN BE FORGOTTEN:
Mental health in our community and in many communities across the country and the world is in serious danger of becoming (if not already) the new pandemic. We have insufficient resources for the onslaught of this mental health pandemic, particularly when addressing young children who require child specialists. We need to address just how widespread trauma is within our communities. In the words of a local educator, "we no longer have to address the couple of students in our class with a history of trauma, we need to address all of the students, because they all are living and have lived through trauma since the COVID pandemic." Social/emotional support, role models, mentors, and individualized attention can be instrumental in helping young students (any students!) through challenging and difficult circumstances. Role models/mentors can help to demonstrate how to channel anger, frustration, grief, sadness into productive and effective activity and expressions. I look at how college students embrace helping underprivileged younger students and want to just be with them; they want to be in their company and to teach them "cool" things and that it's "cool to learn and to go to college and to love science," I see the admiration and care on both sides.
The college student and the younger student equally admire and respect each other. These relationships and supports, while not solving the problem of widespread trauma and circumstances that lead up to this such as loss, poverty, physical and sexual abuse, witness to domestic violence, neglect, and verbal abuse, help students (college and younger students) to develop a voice and a safe space to begin to learn, share, and talk. Right now, all our youth, is dealing with uncertainty. College students, high school and middle school students, elementary students, preschoolers; all are constantly faced with the disappointment of things changing, being canceled, being alone, and much more that is because of COVID. The one thing that individuals can do in uncertainty is control their interactions (whether it's remote or in-person - this we cannot control) and mentor/mentee relationship. Supports that the college gives to the surrounding community and that the community provides for the college are sustainable and can be permanent. Finding some permanence within an unstable, fragile system will help to cope with the traumas that we cannot always control. This is a step in helping to reclaim mental health and we all can be part of it.
When powerful institutions continue to challenge the permanence of such programs, they reinforce and prey on the vulnerabilities of the less privileged. They reinforce and underscore the discrepancies between communities that have many supports and permanent programs and those that don't. They underscore and further divide those that "have" from those that "do not have." It's painful to witness and must change.
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