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“To thine own self, be true.”  William Shakespeare.

I remember in undergraduate school….a professor told me ‘you have to specialize in something.”  I didn’t want to do that, because I wanted to learn as much as I could about everything in psychology.  He also told me that it was impossible to have a successful practice in a town of less than 20000 people.  I knew better on both counts.  I know he felt conflicted about my attitude and was only ‘trying to be helpful.’  But frankly, he didn’t have a clue. 

Most of my patients drive more than 30 miles to see me.  It probably averages about 45 miles.  That’s fairly humbling…  The thing about private practice is, people pay you their hard-earned money in the hopes that you can help.  That’s a fair amount of pressure to be actually and truly helpful.  Truth is, I’d be ‘a lost ball in high weeds’ (as my father liked to say) without all of the teaching of my mentor who has been in practice for 30+ years.  If you truly want to learn, learn from someone who is doing the exact same thing that you are.

If I had to consider myself an expert, it would probably be in trauma and psychological testing.  I’ve worked with numerous combat veterans and people who have experienced a variety of traumas. 

In the field of psychology, it seems everything is now considered a trauma.  But the reality is trauma is a very personal to the individual.  It involves a feeling of complete helplessness, hopelessness, terror, or feeling horrified.  At times, it is more subtle….a complete betrayal (such as being sexually used) without some of those overt feelings I mentioned previously.  I might call it intense confusion of boundaries. 

Traumas early in life shape the whole formation of the personality structure.  They are much more difficult to treat than the trauma that occurs in adulthood.  However, some adult traumas are so horrific that they shift the entire functioning of the personality.  Traumas interact with each other.  Early traumas make one more susceptible to suffering later traumas.  The effect seems to be cumulative.  It adds up with each successive trauma. 

Now very often, and understandably so, there is a social component to the expression of the effects of trauma.  Posttraumatic symptoms rarely occur in the absence of some external factor (such as possible compensation or relationship problems).  That doesn’t mean that the symptoms are faked, because they are not in most cases.  These external situations are activating factors for the traumatic experience.  In fact, I’ve only seen posttraumatic symptoms in the absence of possible compensation or relationship problems in one instance.  This is somewhat different for early traumas that have a shaping effect on the entire personality and often on an unconscious level. These problems express themselves without the frequent context of possible compensation or relationship problems. Those factors may be there, but they are not there nearly as consistently as with traumas that occur in adulthood.

Common effects of trauma are reexperiencing the traumatic event (in thoughts, unconsciously repeating similar actions, extreme reactions to reminders (which are sometimes conscious and other times unconscious).  Avoidance behaviors….avoiding reminders, conversations, or situations that are in some ways related to the trauma.  And hyperarousal….anger, feeling on edge or hyperalert, sleep, and concentration problems. 

At the personality level, trauma often results in relationship problems….extreme emotions, making bad choices in relationships (that often result in further trauma), self-defeating patterns, problems forming close relationships, anger, anxiety, and depression.  Again, the earlier the trauma, the more pervasive effects on the personality.  I have explained it to patients by use of an analogy.  If you injure a tree as a sapling, it’s entire growth pattern is affected.  The same with people…  If you injure a fully grown tree, it might have a pretty good gouge in its trunk, or missing limbs, but the basic structure of the tree is intact.  Successful treatments of earlier traumas are more difficult and take more time, but they can, and do happen.  Is any kind of treatment easy….NEVER.  The easiest kind of treatment is medication, but the benefits are often quite meager.

As with anything else in life, the things that yield the greatest benefit, are the things that require the most effort.  For some patients, treatment with me is the hardest thing they have ever done in their lives.  But as I’ve said before, great challenges result in wisdom and knowledge about the self on a deeper level than can be achieved by any other method. 

Most folks who have experienced a traumatic event ‘wouldn’t take it back.’  In other words, they credit the traumatic experience with shaping who they are as a person.  It’s rare that there are not positive effects that also come from trauma.  These are rarely discussed.  But I have not seen one case in which an individual did not gain knowledge or understanding from their traumatic experience that could not have been gained in any other way.  In treatment, I try to increase that positive knowledge, wisdom, and understanding from those traumatic events.  Viktor Frankl, a psychiatrist who survived a Nazi death camp, found that the most important thing for people in their lives was having a “why.”   A reason for being..   A purpose…   A reason for going on and striving.  When people in the concentration camp lost this….they died.  I try to help folks find that deep meaning in their lives.  To REALLY live and want to live life.  Deep down on an unconscious level, we REALLY want to live.  But life circumstances often interfere. 

Maybe you have something that deep down feeling of what you’ve always wanted to do.  Or you have given up on things that brought you great joy.  I tell you ‘go for it,’ and really live.  You’ll ward off diseases such as cancer by doing so.  See, You can fight for your life.  But not just cancer…you’ll experience better emotional and mental health by being true to yourself and finding that way that you can truly live.  It might be as simple as truly enjoying yourself in the way that you most desire (music, fishing, quilting, riding motorcyles, writing, making music, and so forth).  But the reality is, that by doing these things, you reduce the significance of any past traumas.  You ’shrink it’ so to speak.  That’s why I call myself a ’shrink.’  Anything good you can add to your life….do so!!

You’ll find these books of interest:

 You Can Fight for Your Life: Emotional Factors in the Treatment of Cancer

Trauma and Recovery

 Man’s Search for Meaning-Viktor Frankl