Tags: Going to therapy means going on a shared journey with your therapist. For you, as the client, the focus is on finding relief, understanding, resolution, and perhaps, ultimately, change. For me, as the therapist, the focus is on providing you some guidelines, so you can stay on mentally healthy and productive pathways. But I do get a bonus, and that is the amazing things that I learn from you that help me understand others in your shoes, too.
One of my clients from whom I have learned the most was a 50-ish woman whom I will call Coral, with whom I shared a three-year journey into the world of PTSD (post-traumatic stress disorder). True, diagnosable PTSD is a condition that sometimes results from an intense psychological or physical shock, against which the psyche throws up all kinds of defenses and reactions, including even—surprisingly enough—re-traumatizing itself on an ongoing basis. Often there are flashbacks to the traumatic event, blunted feelings to dull the painful memories, and a fearful hyper-vigilance, as if to prepare oneself at any second for some random act of God to come out of the sky.
In Coral’s case, she had been sexually assaulted as a young girl on her way home from a music lesson one afternoon. No penetration took place, but the man shoved her into the bushes, pushed her down to the ground, jumped on her, and started tearing off her clothes. Coral fought back and eventually ran away. For decades following this event and its subsequent happenings (i.e., doctor visits, police reports, dealing with friends’ and neighbors’ stories, her parents’ inability to speak about it, and years in and out of therapy and support groups), Coral would spend years at a time exhibiting all the classic PTSD symptoms, rendering her life at times intolerable.
Having studied various approaches to PTSD treatment, I first worked with Coral to recover her ability to provide safety for herself and taught her mindfulness and other anxiety-reducing strategies. But she complained that people told her she should “just forget about it.” I was incredulous. How can you ever “forget” something like that? The most we can hope for, I told her, is to find some level of resolution that allows you to live with what happened and get on with your life. That event will want to be looked at again every few years—as is appropriate—but in the meantime, we find a way to function. And so Coral did.
But the memories and symptoms kept nagging at Coral, not at full strength, not incapacitating her, but enough to stand in the way of her ability to form relationships and trust others. It wasn’t until a year into our work that we found the roots of the ongoing traumatic symptoms—not the attack itself, but its aftermath. It seems that after the attack the perpetrator had indeed been caught and brought to trial (at which Coral testified)—but he was acquitted! What was truly traumatizing to Coral was not only the physical assault but, more insidiously, the failure of the justice system—the failure to be heard. It wasn’t that she didn’t think she could protect herself, that nagged at Coral, it was the evidence she had that the world would not back her. And what must that conclusion have done to a young person’s view of the world and of herself?
What Coral taught me as a therapist is that there is often trauma wrapped around trauma; that the big, glaring obvious causes of suffering can often be masking more haunting, more pervasive, more subtle damage. In Coral’s case this resulted in a slow chipping away of any belief that life could be made whole or that she deserved to get justice—or that people can be trusted. While Coral works on getting on with her life, on learning how to trust, we continue journeying together. Her PTSD is manageable, even forgotten for months at a time, but at least now she is prepared to look at it again, and knows that time will come. And I will forever be in her debt, as I hope other of my clients will be, too.
David Bowman LMFT is a licensed psychotherapist based in Los Angeles, California.
Photo credit: Kristopher Roller UNSPLASH