Report on Symposium on Post Traumatic Stress Disorder

Irish Association of Humanistic and Integrative Psychotherapy

Saturday 5 March, 1994

By Mavis Arnold

Like all the speakers, Barbara Fitzgerald from Eckhart House, emphasised the importance of the therapeutic relationship in the healing process. From a psycho-synthesis perspective she stressed the importance of an internal movement in the client leading to deeper dialogue and presence to self. We must look at what happens in consciousness when the energetic flow is cut off in moments of terror (which leads to powerlessness), and what is the pathway back.

The therapist, she said must empower survivors. Due to trauma, transfer­ence reactions are often brought into the relationship and the therapist must be careful not to act as rescuer. The therapist’s aspirations must be to heal all, know all, love all. If he or she is completely trustworthy, then everything can be worked through.

Shirley Ward, from the Amethyst Centre, spoke about the trauma result­ing from pre and peri-natal experience which can often manifest itself in illness. We can develop immune systems for our minds as well as our bodies and many symptoms of PTSD are treated with a medical model. She stressed the importance of the mother’s feelings during pregnancy and birth. If trauma occurs in the first trimester the foetus may be ‘marinated’ into that trauma. The foetus may be stuck in the womb, unable to struggle free. This trauma may be locked into the subconscious and can surface during or after a crisis in a person’s life. She posed the controversial question of whether cancer is manifesting as post traumatic stress, with its origins in utero.

Deirdre Walsh, from the Avalon Therapy Centre, emphasised the need for therapists, when dealing with PTSD, to remain non-judgemental and informative. She said that its effects can result in the development of charac­ter symptoms outside the range of the client’s experience. These can include:

reduced involvement, psychic numbing and detachment, anxiety, guilt, panic attacks and weeping. Reaction may occur up to 20 years after trauma! Clients may also experience difficulties in relationships.”They may have a tendency to dissociate which re-occurs frequently throughout life. Their story can be confused and disjointed and there may be massive denial – forgetting, repressing. They may also suffer re victimisation experiences: abused as a child, raped as an adult or may themselves sexually abuse.

In therapy she said, re-experiencing every detail of original abuse is important. This can be both a curative and a cathartic experience. There can be huge damage to sense of self which tends to be deeper if the trauma has been caused by sexual abuse.

It is important to look at the context of abuse. Children become empathic for appropriate and inappropriate behaviour. Incest leads to disconformation which allows the child to follow rules of secrecy. This can alter their own effective responses. Parents are ‘good’ parents and the children inter­nalise rage. The therapist must work with the presenting problem. They need to change the meaning of abuse. The belief held by so many who have been abused: “I am responsible, this is pleasurable”, leads to terrible con­fusion, to a disordered and fragmented sense of self, to numbness and emptiness. The therapeutic relationship is primary and the goal for clients is to take back that part of themselves which has become estranged.

In his introduction, Dr. Jim O’Donoghue, of the Dublin Counselling and Therapy Centre, reminded his audience that in the 1980 edition of DSM III, Post Traumatic Stress, known intuitively and as a lived experience from time immemorial, became an official psychiatric illness. The meaningful, signifi­cant personal consequences of human suffering were then labelled as Neur­osis. If they were really severe enough so as to create spontaneous deeper states of consciousness they were now to be labelled as Psychosis. This formal recognition in psychiatric nomenclature negatised a valuable aspect of the human journey towards wholeness and offered us instead a diagnosable illness with a differential symptomatology.

In Jim O’Donoghue’s view PTSD is not a disorder at all. It is an attempt of the human organism – our embodied spirit – to heal self and to maintain self in a state of growthful equilibrium. The very struggle, the chaos that is experienced, is in itself an aspect of the journey towards healing. It is the natural inner, embodied response to threatening circumstances that have not been assimilated into consciousness and integrated into a person’s way of being in the world. This understanding has important implications for the psychotherapeutic process.

When working with unassimilated trauma from the past it is generally agreed that the trauma in its original form must be experienced fully, worked through, re-appraised and integrated into the living process of daily experience, if genuine healing is to take place.

It would seem, from action based research, that when a person is sub­jected to a serious traumatic experience that is too much to assimilate, an immediate, non-conscious, biological mechanism is invoked which helps suspend the experience, either partly or completely, blocking further processing and integration into long term memory. Such experience may be an early life situation or event, a pre/peri natal happening, a transpersonal or phylogenetic impingement on personality or a later event such as illness, accident, imprisonment, or incarceration in a psychiatric hospital. Such trauma can have serious physical, psychological, spiritual and social consequences. To be effective, therapy must work with the whole person, taking all these aspects into account.

Quoting Shubow he said that the most vital factor in effective outcome is not the accurate application of techniques but the fact that the unique con­sciousness of a particular therapist is interacting in unique ways at unique moments of spacetime with unique individuals whose symptoms, though superficially similar, may stem from highly variable roots in the psyche/soma.

He ended on an optimistic note emphasising that there is a cyclic nature to the therapeutic process, with successive phases. Healing traumatic stress is a journey back to the place where the journey really began. But that place is now changed. Viewed from a new perspective what initially may have been thought to be illness will now be regarded gratefully as opportunity.